Saturday, July 31, 2010

The XT9 Prosthetic Knee

I did some more searching for amputee snowboarders. Their return to snowboarding was made possible by a prosthetic knee developed by SymBiotechs called the XT9. It is a knee prostheses that mimics the functions of the quadriceps in high activity sports.

Check out this video of a marine who lost his leg due to an IED in Iraq. This guy can shred.

Response To Your Comments

Gigantic thank you to everyone for your emails and comments. I read them all and appreciate each one. I wanted to take a moment to respond to everyone that left a comment earlier in the week.
illicit snowboarding said...
Wow. That's some really harsh news. Feel for you.


I'm worried that it really looks this is was caused by to too much pressure too early. Looks like there's been weight on the ankle before the bones had a chance to join up. Did they do a scan to check the healing process before you started weight bearing?
I had an X-Ray a few weeks before I was given permission to bear weight on my ankle and start physical therapy. From those images, Dr. Buchanan felt it was time to increase the pressure on the bones to strengthen them. There's an excellent chance this would have happened had I waited another month before bearing weight. Nothing ever really healed, so it would have fallen apart eventually. It makes you think, though. What can we do differently this next time around to avoid another catastrophe like this?
otter said...
Tony, you're still in all our prayers. We know you'll pull through this. If you need anything, don't hesitate to let us know.
Thanks, Matt. We really appreciate it. I need a beer.
luke said...
Man, that sucks. Sorry to hear it. Hope and pray some good treatment can be done. :(
Second time's the charm.
Lindsay said...
I'm really sorry to hear the news, Tony. You've worked so hard and showed so much patience with your healing and progress. Thinking about you and praying for better news with the blood tests and scans. Please let me know if there's anything I can do to help you and Brooke.
You can help us by taking care of Brooke. She's taking care of this guy and needs all the support she can get!
MA said...
Tony, That news more than sucks!!!! Your Dad called me this am and I talked with your Mom this afternoon. Is your Orthopedist Matthew M. Buchanan from Virginia? Just trying to find him on the web....Love, MA
Aunt Mary Ann, you are correct. My surgeon is Dr. Matthew Buchanan at the Orthopaedic Foot and Ankle Center in Arlington, VA. As soon as this situation gets fixed I think we owe you guys a bunch of visits.
Aubrey said...
Oh man, I'm so sorry, Tony! You know the news is bad when one of the funniest people I know (that's you) can't find a joke in there somewhere. We're thinking about you and praying for better news in the future. Hugs for you and weird European cheek kisses for Brooke. (Because that's NEVER awkward...) :)
Thanks, Team Pettyjohn! We hope Kate is doing okay! We don't do European cheek kissing here. This is America.
Jessie Case said...
Tony, I'm so sorry to hear this! I have been praying that you'd make a full recovery...and that will happen just not as fast as we'd all like. Please let us know if there is anything you need- there's always fedex- they ship cookies, right
?
Cookies are always welcome in this house. Keep in mind that I'm going to be on my butt for a very long time, so I have to watch my girlish figure.

I didn't upload this picture from Wednesday. There's really nothing going on here -- fairly boring. That giant thing hanging off of my first metatarsal is called a sesamoid bone. It's purpose is to look out of place in X-Rays.

Friday, July 30, 2010

Amputee Snowboarding

What a week! As one of my friends put it, at least this blog will start getting funny again after I get back on all of the pain medications. Something to look forward to.

I might as well be on staff at Dr. Buchanan's office. There are only 52 weeks in a year, and I stand a good chance at being in his office for over 20 of them. All I know is this guy is getting his picture on their wall of fame.

I have another scheduled visit with Dr. Buchanan on Friday, August 6th at 1100am, so there's a chance I could be in surgery on Monday, August 9th. Or it could be the week of August 16th. I won't know until next Friday.

My Dad passed along my latest x-rays to a radiologist with over 50 years of experience. He said there were some good things and some bad things.

What's good? The bottom pieces of my tibia are in a relatively good alignment with my talus bone and there are signs of bone growth in between my fibula and tibia. You can see the bone growth above just to the left of the tibia plate near the top.

What's bad? The three bottom screws in the fibula show tracking, a sign that the screws could be loose. You can see this in the dark halos surrounding the three screws. It also doesn't appear that the fibula has a great chance of union without some help, which is probably where my donor bone comes into play.

Bottom line -- the radiologist said this was fixable. That's the impression I got from Dr. Buchanan, just not in so many words.

So I'm not leaning towards amputation as much as I had been Wednesday and Thursday. I brought this up with my family doctor when I spoke with him over the phone yesterday. He was extremely opposed to the idea, and he hasn't even seen my ankle yet.

I ran across this awesome video on YouTube. They're speaking Italian, but you don't need to understand what they're saying to see the awesome.



I didn't realize it was possible, but it is! And not only is it possible, but you can do the same things with only one leg. This blows my mind.

Huge thank you to everyone for your continued support. This is a minor setback and only sweetens the deal for that first ride back on my board, now delayed until late 2011 or early 2012.

Wednesday, July 28, 2010

Bad News, Team

I've been trying to figure out a funny way to tell you about what happened today. Unfortunately, there's no sugar coating this, so I'll get right to it.

My fracture has not healed. None of the bone fragments "unioned." It looks like the lower fibula fragment is in more pieces now. The plate over my fibula has snapped in half. A screw from my tibia plate has snapped in half. My tibia looks like it's lost quite a bit of density.

How did I walk on this for so long? Scar tissue. My foot is still "dangling" like it was the day I hit the tree, it's just not as wobbly.

Here are the X-Rays.



Imagine my surprise when Dr. Buchanan told me the news. I thought at worst I'd hear I have arthritis. Never did I think this would happen.

What's next?

The first step is to figure out why the bones never healed. It could be due to infection, or it could be something else. The cause needs to be known before we move forward.

After we know why this happened, it's time for more surgery. I have a CT scan next Tuesday and a visit with my family physician on Wednesday to do some lab work. On August 11th, I'll see Dr. Buchanan again so he can review my results. I imagine I'll have surgery the following week. The surgery will require bone be removed from another part of my skeleton -- likely the proximal part of right my shin.

I still have a lot of questions. My biggest concern is quality of life. To be honest, I'd seriously consider amputation . It's extreme, but even though I'm not a radiologist, I can see that my ankle is in terrible shape. Because of how the bones have deteriorated, I'm not a candidate for ankle replacement. I may not even be a candidate for a fusion -- the bones are mush.

So, needless to say, this delays my snowboarding trip quite a bit. I'm hoping I get to keep the hardware when Dr. Buchanan removes it. I'd like to see how strong this material is. I don't understand how it could break.


Monday, July 26, 2010

Check-Up Week Has Arrived

This picture in no way relates to this post, but I had to bring up something I saw while watching the A-Team.

First, the bad guys are trying to take out Mr. T. Rocky Balboa is the only man that's ever done it, and it took him two tries. Second, they're taking shelter behind cardboard. The bad guys were receiving heavy fire, so they made a smart decision to seek out shelter. Unfortunately, they chose cardboard.

I see my orthopedic surgeon on Wednesday after a six week hiatus. I'm assuming I'll get new X-Rays to see how I've progressed. My last X-Ray was from late April (below). As you can see, my fibula had not healed. I'm hoping that gap has closed, otherwise I might need more surgery to fix it.



Another issue that's come up: the two screws sticking out of my tibia might make wearing a snowboarding boot extremely painful. My physical therapist recommended that I look into a custom boot that relieves some of the pressure over that area. I'm going to bring this up on Wednesday.

This past week was one of the hardest weeks I've had in a long time. I could barely walk with a cane. The swelling and edema was pretty awful.

All of this pain doesn't change my snowboarding plan -- this guy is still going in February, pain or not.

Wednesday, July 21, 2010

Physical Therapy 2

Today I received something extremely stupid in the mail. It's a two disc set of Physical Therapy's greatest hits. The album artwork was printed on your standard 8 1/2 by 11 inch white printer paper and wrapped around a DVD case. All the trimmings of a high quality production.

I think my favorite hit is "Eving Tide." I'll try to listen to it while I watch the sunset in the eving.

Update on the ankle -- I've got a ton of pain in my tibia and calf. I've resorted to applying ice to my ankle as much as possible to reduce the swelling and pain. I visit the doctor again on the 28th -- six weeks after my last visit. Hopefully my fibula has finally healed. We'll find out next week.

Monday, July 19, 2010

Optimus Prime Fights Pressure Ulcer

Although it's a pretty sweet name, any real American knows that Pressure Ulcer wasn't a Transformer. But Optimus Prime is currently dominating the pressure ulcer under my big toe (the leader of the toes).

It was either this or Hello Kitty band-aids. The choice was obvious.

The ankle is struggling a little bit. I worked out yesterday on the stationary bike and the elliptical machine. Today I've had really bad soreness over my tibia -- enough to put me back on crutches. Hopefully some rest and Ibuprofen will take care of the pain. Physical therapy should be awesome tomorrow if this continues.

Spunky discovered a new bed making technique. By turning her bed into a sandwich, she's able to get some pillow action going. Pretty smart move for a dumb dog.

Saturday, July 17, 2010

Dynasplint

Yesterday I was fitted with a splint to help me with my dorsiflexion. The company that makes these splints is called Dynasplint. A rep from the company met me at my physical therapy clinic to adjust the splint and teach me how to use it.

It has an adjustable tension on each side of the splint. The way it works was counterintuitive. The goal is not to apply a lot of tension. Instead of an intense short stretch, the purpose of the splint is to apply a smaller stretch over a longer period of time. Eventually, I'm supposed to wear this at night so I can get an eight hour stretch in.

Surprisingly, my ankle is sore after wearing it only for a few hours.

The rep thought I was an idiot, so she took a permanent marker to one of the straps so I'd remember not to adjust it.

I'm supposed to wear this thing for about 6 to 8 weeks. After that, I'm probably going to get another splint for my plantarflexion.

My great toe is still struggling. I've got about 65 degrees back in it now, but the joint at the tip is still very stiff.

I'm very pleased with my progress, but it's still difficult when going out with friends. When I don't get a chance to elevate my ankle, it really starts to cause some problems. I'm hoping that eventually all of that pain will go away.

I've also started riding a stationary bike to curtail obesity.

Thursday, July 8, 2010

Physical Therapy

About a week ago I started my post with a stupid definition of physical therapy. While doing some Google'ing, I discovered that it's apparently a band.

Less than a week ago, my friend Andy asked me for my address. Like my friend Jim, Andy belongs in that group of friends that's constantly putting me at risk of receiving something extremely stupid in the mail. But since I'm usually putting my friends in a similar position, I figured I'd bite and make sure he had my address.

Now we arrive to today's mail.

Wow. This is going to be awesome.

A couple of things. First, they're in the classic, "the cameraman caught us staring across a weird pond," pose. Evidently, the dude wearing the fanny pack in the front, not the side, did not hear about the business casual dress code.

There's absolutely no way this can get any better. But before I listen to it, let's check out the playlist.

The editors at Sweatshop Records really let a lot of things slip. I'd better write them. I'm sure they still exist. Someone needs to please explain to me how a straitjacket will help me relax.

Here's a taste of the music. There are no vocals -- it's all instrumental.

So thanks, Andy, for this wonderful gift. Listening to it is equal to the enjoyment I get out of my real physical therapy.

I'm continuing to get stronger. But unfortunately, my pressure ulcer on my great toe has returned.

I've got to start wearing a gauze pad around it again until that dude heals up.

My toe nail might be in the process of falling off. It doesn't look too hot at the moment.

Not sure what that is at the bottom of the nail.

On a good note, you can't tell that this is foreskin.

Monday, July 5, 2010

Happy Birthday, America!

Brooke and I have lived in our apartment in Chinatown since 2005. We've heard we might have a good view of the 4th of July fireworks, but not once have we stayed home to see if this was true.

I spent the day at a friend's apartment by the pool. I was stung by a gigantic bee and dominated Mike Tyson's Punch Out on the Nintendo. I had bet Nate that I could beat Mike Tyson in less than 5 attempts for $20. I did not win.

Since Brooke had to work, I came home to hang out with her and the Spunkster. Turns out we have a sweet view of the fireworks display.