Wednesday, March 13, 2013

Taking The Plunge

As a kid in Tulsa, we'd beg our parents to drag us to Big Splash Water Park to escape the blistering summer heat.  They had (and still have) the tallest water slide in Oklahoma -- the Silver Bullet.  The Silver Bullet actually had a twin, but Big Splash kept it out of operation.  The story was some poor kid flew off the other slide and met an unfortunate and premature end.

My anxiety and excitement would always grow with each step up the stairs.  When I got to the top of the Silver Bullet and looked down, I had never been more certain in my life: this was the dumbest thing I'd ever done.  On the way up I had the option of aborting the Silver Bullet for three mediocre slides.  But there was no turning back.  I had to take the plunge.  The other slides weren't nearly as fun.

In the last several months, my ankle pain has gotten worse.  I use a cane more often and acute arthritis now hits me on the medial side of the joint.  Ankle replacement and ankle arthrodesis (fusion) promise short term relief.  But the risks of failure are high, especially with my butter soft and piecemeal ankle.  And the rewards are small.  More surgery is a guarantee.  These are mediocre options.

I've known this for a while.  I need an amputation.  I need a Silver Bullet.  

Yesterday was my last visit with Dr. Jeng at Mercy Medical Center in Baltimore.

The x-rays show mixed results from the August 2011 ankle distraction arthroplasty.  The anterior (front looking) comparison above shows an improvement in joint space.  If you look at the medial joint space (on the left), you'll notice the gap is larger between the medial malleolus and the talus.

The lateral comparison isn't as good.  There's no noticeable improvement in the joint space.  It appears the anterior portion of the tibia is in direct contact with the talus.

There's no doubt, the distraction arthoplasty is adding joint space.  But it's not doing anything for my pain, and that's all that matters.  Dr. Jeng agreed.

I asked if we could move forward with an amputation.  Dr. Jeng agreed.  Of the three options it's the only one that can get me back to snowboarding, running, and my normal pre-accident routine.  But Dr. Jeng won't be performing the amputation.  He hasn't done one in several years and told us that he sucks at them.  Instead he's referring us to a vascular surgeon.  Dr. Jeng said he could connect us with some guys he knows, but he suggested we find someone closer to home.  He asked that we find a good vascular surgeon and a better prosthetist.  

So I've got my referral.  Because I've got a PPO, I technically don't need it -- but because this is an elective amputation, I probably need it to convince the vascular surgeon.  It's a little surreal to read this referral.  I'm at the top of the Silver Bullet.  It's scary.  It's frightening.  

But I can't wait to jump.  

I can't wait to run.  

I can't wait to snowboard.

Yesterday was my last visit with Dr. Jeng.  It was surprisingly emotional.  That guy rocks.  He asked that I stay in touch over email and let him know how things work out.  I'm going to miss working with him.

After the appointment Brooke and I decided to ease up on the gravity of the day and hang out at Eastern Market and buy some food.

Then we finished it with a couple of drinks to figure out our next steps.  

I haven't updated the blog regularly in a while.  Frankly I didn't have much to say.  Just that the pain was getting worse.  That's too depressing!  

I'll be updating more regularly now that things are picking back up.  My next couple of posts will provide some details about what I can expect with a below the knee amputation (sometimes called BKA or BTK).  My plan is to learn more about the procedure and start shopping around for awesome vascular surgeons in the local area.

I also wanted to thank everyone for the awesome support.  I'm really excited (and scared) about the next and hopefully last step to recovery.  But I know this is the right thing to do.  I can't wait to get back to normal life.  I can't wait to take the plunge!


  1. I'm so happy for you and Brooke as you move on. This has been a long, painful road and that ankle of yours has taken many a beating. All four of us send our love across the pond!

  2. We love you too, Tonio. We will be praying for comfort, wisdom, and a really great surgeon. BTW, we have discussed it with the boys...I think Josh is convince you will be a Love you so much.