Well, it has been a while since my last update. I've been pretty busy and was focused on surviving a crazy bachelor trip party there for a while.
Jon did have his surgery two days ago, on June 24th. It was an outpatient surgery that took about an hour and a half. His orthopedic surgeon, Dr. Jones, wasn't too sure what he would need to do to fix his troublesome tendon until he had his ankle opened up. It turned out that the tendon is actually in pretty good shape, nice and healthy, but that it was quite a bit out of place. From what I gathered, he had to remove the sheath around the tendon, split Jon's bone just above his ankle and carve out a groove for the tendon, move the tendon back over into that groove, and then re-wrap the tendon in its sheath. This will eventually make the tendon heal into that grooved bone and solve the problem of the tendon flopping back and forth over his ankle bone. Its pretty amazing, but after about 6 weeks I guess that the sheath will heal in place, forming scar tissue and attaching itself to the notched out bone. Also during the surgery Jon had his achilles lengthened. Dr. Jones made another incision higher up on his calf for this, and while he didn't go into it too much, from what I gathered I think what is done is some small holes are cut into the tendon and then stretched out. Once the holes heal, the tendon will be longer. I may be wrong on the actual procedure, but whatever the case, he said that Jon will have another 5-8 degrees of motion in his ankle with his upward flexion. This doesn't sound like a whole lot to me, but I guess it will help reduce some of the stress on his ankle, hopefully reducing some pain and helping his stride.
Jon's recovery this time seems to be going well. Obviously he is in pain with such an invasive surgery, but it is nothing like right after the accident. He is back in his wheelchair and back to sleeping on our main floor, but being able to use his arm and not having the pain in so many areas like last time definitely helps. He is in pain at the two areas of surgery in his leg when he points out where it hurts, which makes sense. He has accidentally flexed his calf muscle a couple times in the cast which causes him a ton of pain as well. However, he is not on nearly as many pain meds as last time and seems to be doing pretty well. Despite a bit of nausea right after surgery, he had his appetite back that night, and in my opinion has looked and felt better than he did for at least the first 6 or more weeks after the accident. We have both said that things seem to be going pretty well after this surgery and we both thought he'd be down longer and feeling worse than he does. He still wants to continue therapy on his elbow, and I'm planning on taking him later today to do so. Its good that he's feeling well enough to get out a bit and allow the therapist to cause him more pain hah.
For recovery, he is in a hard cast for two weeks, then back into his soft boot for 4 more. It sounds like keeping his ankle immobile so the tendon can heal in the correct place is the important thing, more important than keeping weight off of it like last time. He can put his foot down a little bit now while in the cast, and will be full weight bearing (depending on the pain) while he's in the boot. It sounds like he'll only be back in the wheelchair for the two weeks and after will at least be able to walk around short distances with his walker or cane. He's not excited to be in the hot sweaty boot for the whole month of July, but I'm sure he can tough it out.
Prior to this surgery, Jon had been doing quite well. He was walking without a cane and almost no visible limp. His range of motion on his elbow is improving, but slowly. He is able to cross his arms casually and comfortably, which is a big improvement over a couple of months ago. On the bachelor party he was a trooper, able to climb rocky hills, jump off the top of the houseboat, go down the water slide, and even climb up the rocks and go cliff jumping with us. Since he was back he has been swimming for some exercise (it is hard to pull underwater with his right arm so he always swims towards that one side which I find funny), has gone rock climbing, and has even played racquetball (which he regretted for a couple days). He has tried biking but putting the weight into his handlebars hurts his arm too much, so he tried out some recumbent bikes. A recumbent bike is one where you're sitting upright in almost a chair with your feet out in front of you, and your handlebars up higher so you're not leaning on them. Here's a picture for an example - http://img.alibaba.com/photo/10798856/Recumbent_Bike.jpg . He loved the bikes and is excited to get his own but obviously needs to get past this recovery for now. Its pretty cool because I wasn't sure if he'd ever be able to do some of those things again after the accident, and I'm sure he'll be back into it all again after this recovery.
I'm sure most if not all of you know, but Allison is back living at home, which is great. She came home about a week ago and really enjoyed being able to sleep in until noon or later for a few days, but is now back into therapy mode. She has outpatient therapies at Sojourners almost every day. She is seeing her physical therapist and speech therapist 3 times a week, recreational therapist 1-2 times a week, and her psychologist for keeping track of her mental progress about once a week. She has surgery to remove a cyst on her vocal cords towards the end of July that was formed due to the intubation tube. Once removed, it should fix her scratchy voice after 5 days of no talking at all. The cyst on her vocal cords is around the size of a blueberry, which apparently is quite big and is displacing her vocal cords completely. Her therapist was surprised she could talk at all right now, but its not causing her any pain or anything. In fact, I think Allison is not really in pain at all right now. She is up to running on a treadmill for 15 minutes, with warm up and cool down totaling around 2 miles. She is studying some of her medical board material with her speech therapist as part of her therapy and is thrilled to be doing so again (I don't know what's wrong with her, excited to study?!). At her release on Thursday, her psychologist said she is testing average or above on every measure of her brain right now, but that it still needs to improve before thinking about work again. Some of the measures, while average for her age group, need to be well above average to succeed in a high stress medical environment. The good news is that her mental recovery is still on the upward trend and they expect that to continue. The game plan now is to keep with her current therapy schedule and let her recover from her surgery in a few weeks, then take the full day-long battery of neurological tests again to get a clear picture where she's at and what is next.
Oh I almost forgot, but on Wednesday while Jon was in surgery Allison and I went up to the 4th floor where both Jon and she stayed in Spectrum. I pointed out Jon's room and then we moved on to the ICU. Allison has no memory of Spectrum at all, but she brought some thank you cards for the people who cared for her there. She had worked in the surgical ICU for a while so she had some contacts there already, and she spent time talking to different nurses and doctors. We had a visit from Dr. Hogeboom (sp?) who was her primary doctor, and from several nurses which either worked with her as a doctor or worked on her as a patient. Everyone was amazed at how well she was doing and how good she looked, especially when she told them that she got out of residential care just last week and that she was non weight bearing for 14 weeks. It was good for Allison to visit with some old friends and coworkers, and for them to see their patient up and walking and in good spirits.
Well, that's it for now, thanks for reading.