i HOPE YOU ARE DOING OK MAN!!!! GL ON THIS SHIT!!!!

3/28/2008 6:52:58 PM

good news buddy, glad to hear the infection is [hopefully] behind you.

3/29/2008 1:14:19 PM

Quote :

"so has this ordeal scored you tons of play from lots of hot dames, at least?"

shit, i wish. it's a hell of a conversations starter and you might get some sympathy, but realistically it's hardly anything that's making them want to jump into bed. i'm mostly just similar to the woman with two heads booth at the fair. just a novelty, haha.

however, i will say that i have not "gone without" at any time during this, and even somehow got punked into a girlfriend a couple months ago. none of it really has much to do with the leg thing though.

Quote :

"Cadaver bone...creepy...are you seeing dead people yet? "

yeah, really. crazy stuff. modern technology has made it possible for people to live on through multiple generations in one form or another. wierd to think that some part of me could be used in a person 100 years from now.

Quote :

"I'm curious, did the leg bust from the landing or was that a result of the car slamming into you? I saw you said you landed on your back, so I guess it happened from the force of the car hitting you?"

it was a combination of things. the impact of the car as well as the bone shattering and coming through the skin. the impact broke the bones into several pieces, then they made the gaping incisions/holes as the leg moved around during flight and after landing.

3/30/2008 12:30:25 AM

well, i guess it's about that time for another update. i hate to get my hopes up too much with the history here, but things seems to be going really well for once. looks like the 15th surgery might have been the charm. i had x-rays taken last week, and the new bone graft is growing. i can start putting 50lbs. of pressure on it, and work up to full weight over the next 3-4 weeks. i'll do some more physical therapy at that time probably. main problems are getting strength and mobility back. also learning to control/compensate for the calf muscle that was relocated.

as best they can tell, the infection is still under control. if everything continues to go well, they may do biopsies in a few months. or, they might just leave well enough alone.

here's a few pics from after the last surgery i'm just now getting around to uploading. the last one is an x-ray where you can see the bone graft area, some of the hardware, etc.

6/7/2008 2:14:50 AM

just think, you get to go over tot he side at every metal detector for the rest of your life. Could be worse, my dad has a defib/pacemaker that does nto allow the use of even hand held metal detectors, sot hey have to pat him down every time. And seeing that we service the elevators in 3 prisons, several jails, and many of the courthouses in nc.....

6/8/2008 1:45:24 PM

bttt

10/9/2008 9:56:03 PM

So hoe did it go today Mr. GImp???

10/9/2008 9:58:58 PM

^pretty good i think, considering...

***warning, lots of words***

for anyone wondering, i had an "emergency" surgery this morning for a debridement. i guess this can serve as kind of an update of the current status of everything since i haven't updated in a while.

starting tuesday evening, a red blister looking spot became apparent along my shin about half way between the knee and ankle. by yesterday afternoon, it had grown to about the size of a quarter and was an obvious sign infection in some capacity attempting to work it's way to the surface. called the doctor, and they told me to come in immediately. he took one look at it, aspirated it with a needle to send a fluid sample to the lab, and scheduled surgery for first thing this morning.

upon opening the leg up, there was some obvious necrotic tissue and areas of infection. in addition, there was a bit coated onto some of the hardware. everything was cleaned and/or cut out as necessary. immediately after the procedure, massive amounts of antibiotics started being administered both orally (increased mg's of the three i currently take on a daily basis) in conjunction with several intravenous.

the positive news is that the bone and the graft material still appeared to be healthy and growth has still been progressing well. it's very nearly all completely fused together and solidified, just a few tiny fractures and little pinholes/pockets to fill which is by far the most progress that's occured thus far. the doctor seems optimistic that even with the infection lurking around that the bone and graft material can finish doing it's thing. at that point, any infection would still be some concern but it would no longer pose a thread to halting bone growth or killing off the living cells. furthermore, at that point removal of the hardware could be a possible option, or as least switching to something a little more resistant of playing host to the impenetrable "slime" pseudomonas forms on metal. simply put into tww garage terms, it's a race for the last little areas of bone to heal before the infection is allowed to linger much longer or spread.

so, now we're just waiting to see exactly what grows from the tissue and bone samples/cultures. after that, i'll know a better plan of action. it looks like it will probably just be an adjustment in the oral antibiotics or possibly another picc line for a few weeks of iv therapy. obviously, CLOSE monitoring of the external site, blood readings, and temp readings will be a must. worst case, the bone samples show something that wasn't visible to the naked eye, and a very small amount of the unhealed spots would need to be chiseled/cut back to fresh bone. even with that, there is still plenty of healed bone (at least ~75%) already in place.

i should know in the morning whether i get to go home or if he wants to go back in and poke around more. so far, it looks to be just a fairly minor setback though, and won't cause any real loss in time of healing in terms of the orthopedics. once that's complete, the infection can be much more aggressively attacked with some methods that would have otherwise had just as much of a negative affect on any bone and/or graft growth. i guess my body decided i need one more surgery (#16, lol) for good measure here just before the two year anniversary.

10/10/2008 1:23:29 AM

Consider eating more onions and garlic- although foul smelling, these foods are natural antiseptics due to their sulfur components. Maybe it helps with infections. I can only imagine the beating your liver is taking after so much antibiotics.

good luck man

10/10/2008 6:14:40 AM

i actually eat a fair amount of that stuff anyway, especially onions. i love them.

haven't really heard anything yet today, but they've pumped bags of vancomycin, tobramycin, and cepafime into me all night and today so far. that's in addition to my "regular" oral doses of ciproflaxen, flagyl, and doxycycline.

10/10/2008 1:20:15 PM

Wow. I bet your piss could kill the mold in my toilet.

10/10/2008 1:28:52 PM

Jesus god dude, that is some serious medicating. Do they have some opiates in you?

10/10/2008 1:33:32 PM

drugs are bad mkay

10/10/2008 1:34:27 PM

Quote :

"i actually eat a fair amount of that stuff anyway, especially onions. i love them. "

I personally have seen this guy feast on raw onions dipped in ranch dressing.

10/10/2008 1:39:26 PM

Quote :

"Wow. I bet your piss could kill the mold in my toilet."

I dont think he is pissing in any toilets yet

10/10/2008 1:40:55 PM

good luck Ivan!

10/10/2008 1:45:20 PM

^^^^^oh yeah. dilaudid pca dispensing 0.3mg every 8 minutes as needed. 4mg morphine shots every 4 hours as needed for breakthrough pain. that's a "light" regimen compared to some of the more involved procedures i've had.

outside of the hospital, i've been on a steady diet of percocet, oxycodone, and ultram the whole time. i finally gave in to going to a pain management clinic a few weeks ago, and they've switched me to opana which i'm happier with.

10/10/2008 3:06:38 PM

Oh wow, oxymorphone. Funky shit dude.

Yeah some of the most intense euphoria I've ever experienced came from a 4mg IV injection of hydromorphone (Dilaudid) in the hospital. I went from writhing around cussing to relaxed extreme contentment in about 5 seconds. You can feel it go through your veins, up through your neck and into the brain and then you feel the effects.

[Edited on October 10, 2008 at 3:18 PM. Reason : ]

10/10/2008 3:15:56 PM

I probably made batches of most the drugs you are taking, especially if you use Sandoz generics. Made doxy and cipro right in Wilson, NC

10/10/2008 9:52:14 PM

OH SNAP, Sandoz made LSD back in the day (Hell, maybe they still do for special purposes).

10/10/2008 10:09:02 PM

yes, swiss scientist working for sandoz

10/10/2008 10:53:41 PM

fuckin'-a, man. you can't catch a break, can you?

10/11/2008 6:53:50 AM

^haha, not hardly man. it could ALWAYS be worse though... just gotta keep that in mind. in the scheme of things, this isn't too big of a setback though. it appears the primary area of infection is just in the tissue and on one of the pieces of hardware. it hasn't really gotten into the bone yet as it has in the past, which wreaks havoc. the bone and graft material still seems to be okay, which is the main concern. the important thing is for that to keep on living/growing/healing. it's so close to being finished now, it'd be a real shame for it to have to be cut back out.

so, the plan is to put another picc line in and i'll be on cefepime for two weeks along with the "normal" oral anti biotics i've been on since day one. supposed to be discharged tomorrow evening or monday morning.

10/11/2008 2:21:55 PM

blow it out with an air hose, a little peroxide and a staple gun, good as new.

10/11/2008 2:38:46 PM

[Edited on October 11, 2008 at 6:41 PM. Reason : .]

10/11/2008 6:40:29 PM

ah well, at least if they get to take some hardware out you get more interesting keepsakes. Everyone can use a key chain that used to be a surgical pin

10/12/2008 3:07:28 PM

Dammit...oh well, what's another go and a few more weeks backwards at this point, when it looks like you're beating the odds after all, taken as a whole?

that still fucking sucks, though. i know you're ready to chalk up the "W" on this contest.

10/14/2008 4:42:30 PM

updates? thats why i got back on here cause the bastard never answers his phone, or doesn't recognize my new number

10/28/2008 8:04:03 AM

True. He is the no-phone-answeringest motherfucker I know.

10/28/2008 9:00:26 AM

you call him on the phone 3-4 times in an hour, never answers, pm him on tdub 5 min later, get a response in 30 seconds, weirdo

10/28/2008 10:39:22 AM

haha

10/28/2008 10:44:44 AM

good grief, you damn women. sorry i have not adopted the cell phone=leash philosophy yet.

nah, i'm just terrible about keeping up with the damn thing. i leave it everywhere, forget to charge it/turn it on, etc... out of sight, out of mind. if i didn't need it for work, i probably wouldn't have one at all.

oh, and yeah i don't have your new number keith. so, if you haven't left a message i don't know which one is you. i get work related calls from random ass area codes all the time.

10/29/2008 9:01:13 PM

your leg's history makes a petri dish look boring

10/29/2008 9:12:47 PM

you should do a thread of the overall progress w/pics all in one post when you're "done" with it all.. would be insane to see

10/29/2008 9:17:32 PM

its gonna turn out to be a superbionic limb and hes gonna be an NFL kicker or something, like that movie about the garbage man

10/30/2008 8:10:54 AM

lol

10/30/2008 2:50:46 PM

10/30/2008 4:28:50 PM

[no]

10/30/2008 6:03:42 PM

what's the latest, dude?

11/11/2008 9:16:52 AM

just finished up the IV antibiotic treatment last week and got the PICC line taken out. as far as they can tell from the physical looks of things and blood tests, the surgery combined with the antibiotics did it's job in knocking it back down.

so, now it's just back to the waiting game for the large area of graft to keep doing its thing. it's made substantial progress, and is really close to being healed. i'll go in for a CT scan the first week of december, which is good news because that means it's doing well enough that any remaining tiny fractures and/or voids are no longer detectable with a conventional x-ray.

even if things go perfect from here on out, i'm still looking at a 17th surgery sometime after the first of the year though. they've been kind of 50/50 on whether or not to leave all the hardware in, but have now decided that since the infection has been so persistent they want to remove as much of it as possible when things have healed. some of it will have to stay regardless, but one of the plates and two of the screws should be able to come out. anything remaining will be swapped out for fresh parts.

overall, still making positive progress even though it's mind numbingly slow. it's just one of those things where it's constantly been two steps forward and one step back (pun intended?).

on the chance things take a turn for the worse again, the procedures that have been done up to this point are no longer viable. however, i will have the option of undergoing a fairly radical procedure known as the ilizarov technique. it's not new technology, but it is rarely practiced for several reasons. i won't bother with a long explanation, but below are a couple of links that do a good job of explaining how it works if anyone is interested. amputation is/would become an option again as well, but for me personally it's still a last resort. i'll be damned if i've fought this for two years to throw in the towel now unless i absolutely have to.

simple overview of the process:
http://www.limblength.com/casestud/nonunion/case4/casestud.htm

wikipedia entry/defenition:
http://en.wikipedia.org/wiki/Ilizarov_apparatus

in depth explanations and accounts of specific case studies that are very similar to my situation (non union/mal union/osteomyelitis as a result of compound open fractures):
http://www.ejbjs.org/cgi/reprint/77/6/835.pdf

[Edited on November 12, 2008 at 12:44 PM. Reason : .]

11/12/2008 12:43:40 PM

i thought you already had to do that

11/13/2008 5:26:30 PM

nah. i had an external fixator before at one point, but it was only to stabilize everything for a while. they had removed an internal rod that ran the length of the tibia and inserted an antibiotic spacer before the last bone graft and current hardware was put in.

11/14/2008 5:44:45 PM

just tell em yopu want a 31 spline chromemoly shaft

11/14/2008 6:07:16 PM

haha. it really does surprise me that with all the advances in internal and external prosthetics that there isn't some option to have a completely synthetic bone. just completely chop out the natural one, and attach something man made in its place. i understand the issues with using metal, but i would think some sort of advanced plastic/polymer material might work. i mean, they've got completely manufactured hips, knees, etc. now.

[Edited on November 14, 2008 at 6:31 PM. Reason : like the nylabone dog bones or something, lol]

11/14/2008 6:30:52 PM

My dogs have a man made pork chop.

11/14/2008 6:36:20 PM

^^ I hear rejection, discomfort, irritation, etc can be an issue with hip, knee and other joint replacements too.

I've seen a number of presentations on them and my grandmother has had her knees replaced. They tend to have metal or ceramic components (The ceramic ones [surprise!] can crack) for the joint itself (Usually it's a simple ball and socket). I think the ball can be teflon coated but the parts that connect to the bone are metal from what I've seen.

11/14/2008 6:38:15 PM

they can use pig bone now

11/14/2008 6:47:06 PM

ok i'm guessing in like maybe another 5 years he will be cured enough to not have to go to the doc all the time

11/15/2008 12:16:26 AM

haha, at the rate it's been going you might be right.

11/15/2008 12:30:15 AM

damn dude, I've been reading this thread off and on for a lil while, hope your leg gets better, sounds like it really got fucked up.

hope you don't lose it, and your insurance is takin care of things right?

11/15/2008 6:08:21 AM