Surgery reject

The surgery had been planned for more than two months.  We returned to the US especially for it, well, at least partially for it, since we also planned to spend the holidays near family members.  Two pre-ops were scheduled for last week: one with my internist and one with the surgeon.  I sailed through those pre-ops with flying colors.  I didn't eat or drink anything after midnight last night.  All was ready.

Or so it seemed.

Whatever mischievous little imp of perversity that likes to remind us that WE are not always in control of our own destinies, no matter how well planned and thought out we believe they are, entered my world with a resounding impact this morning.  It took the form of a small blood blister on the little toe of my left foot.  Such a seemingly innocuous little blister changed the course of several people's lives today.

First of all, I hardly ever get blisters on my feet.  Nor have I EVER gotten blisters from either of the pairs of shoes that I have been wearing recently.  So this blister was the LAST thing that I expected to see.  Indeed, I had NOT seen it before arriving at the clinic.  It was also the last thing that the surgeon WANTED to see.

The surgery I need is an exostectomy, a medical term for the removal of "exostoses" or bony bumps on the bones.  As these can give rise to chronic pain and can cause damage to the structure of nearby nerves and tendons, surgery is recommended where pain is severe, the exostosis is pressing on an important structure and can be easily knocked or bumped, or is cosmetically unappealing.  All criteria apply in my case where I have a large bony lump on my left ankle that has begun seriously affecting my own quality of life, as well as the quality of life for those who, like HWMBO, must bear with me.  The surgeon himself described my exostectomy more colloquially as "taking a hammer and chisel to remove the excess bone."

Our best guess as to the cause of this lump is a long-ago untreated ankle injury.  Tests last summer practically ruled out a tumor - the worst case scenario.  After receiving two opinions where surgery was recommended, we had decided to follow the recommendations.  Crutches were arranged for, courtesy of Grandson Prince J, who had needed them recently for his own ankle stress fracture; prescription pain medication and gel packs for icing were purchased in advance; early Christmas celebrations were arranged and enjoyed; gifts were purchased, wrapped, some even delivered in advance; Christmas baking completed, etc. - only a few loose ends remained to be tied.  Among those loose ends is our seasonal recap of 2010 events.

The surgery itself was scheduled for 9:15 this morning.  I was to arrive at 8:15.  The alarm went off at 6; I arose, washed my hair, shaved my legs (sorry for that level of detail!), showered, and dressed in loose-fitting clothing as I had been instructed.  HWMBO, my personal chauffeur, packed the crutches into the car.  Off we set for the clinic where outpatient surgery had been scheduled.

All was proceeding on schedule until I got into the examination chair and removed my shoe and stocking as requested.  There showing like a bright red berry stain on my left pinkie was what was clearly a blister.  I could have sworn that it had NOT been there before.  I certainly had not noticed it.  Orthopedic surgeons in general are extremely conservative about such things and podiatric surgery is merely a subset of orthopedic surgery.  I remembered with dread the orthopedic surgeon in Switzerland who insisted that I have a dental appointment several months before my scheduled hip surgery there in 2003.  That appointment revealed that one tooth would require a filling.  A filling was not enough for that particular surgeon.  He insisted that my dentist completely remove the tooth in order to prevent even the most remote possibility of infection for the hip surgery.  This the dentist was loath to do and it required persuasion from both my internist and me.  Otherwise, the orthopedic surgeon would NOT perform the hip surgery.  It was the first tooth that I had ever had pulled up to then.

Today, my worst fears were realized.  The doctor took one look at the blister, shook his head, explained that such a problem so close to the operation site was disastrous in that the bone could become infected, took a swab from the blister for analysis, put me on a week's worth of antibiotics, and will try to reschedule the surgery for next week.  The surgery will only happen then if my progress on antibiotics warrants it.  Moreover, because we are in a holiday period, any rescheduling is likely to be difficult.  Sigh.

Whatever happens, I will not have the operation today.  It was not meant to be.  HWMBO has described me as a "surgery reject."  He is, unfortunately, correct.