::Griffblog::

Ilizarov frame patients will be familiar with the daily ritual of pin site cleaning.

Every morning after removing old dressings and showering I have to clean all 15 pin sites using saline fluid and special polygon ‘lollipop’ cleaning sticks and any pin sites that are weeping or bleed have to be covered with a non-adhesive padded dressing.

Whilst I was in hospital this was no problem, I was provided each day with a kit of the fluid, lollipop sticks and dressings as required. And when I was discharged I was issued with a small stock of them to keep me going.

Back at home I researched the dressings and cleaning sticks I needed and it threw up some nasty surprises! The 5cm x 5cm Allevyn Non-Adhesive dressings cost £18 per box of 10. Even though I only have 5 pin sites that require dressing that is nearly £9/day for dressings alone or £270 per month!

The polygon lollipop sticks however, are only available in bulk packs of 300 and these cost £60+. I can’t be sure of the exact price as I can’t find anyone who sells to the general public.

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Well yesterday went quite differently to the way I had feared on Sunday! As many of you had predicted my fears were unfounded. The infection continues to improve and it’s so much better that we have now succeeded in applying a dressing to it, something that has not been possible at all since I had the op both because the frame is so tight against the skin and because it was so sore.

The Physio visit (which I had been dreading) went very well. I managed to walk quite some distance from the car park to the Physio Department at Frimley and instead of being chastised, as I had feared, for lack of progress, I was complimented on how much mobility I had given the frame and my being only 3wks post Op.

All the exercises they would normally offer, to mobilise my ankle and build up strength for walking and stairs etc they decided were superfluous as I have full mobility in my ankle and am already walking and managing the stairs. So I was left with some advice on increasing the mobility in my knee a little and have a return appointment in 3 wks to monitor progress!

I’ve also submitted a repeat prescription so that is the meds taken care of, the only thing outstanding now is the result of the swab taken of the infected pin Thursday. the GP told me we’d only here if it was bad news but you never quite know how long you should wait before assuming all is well! My course of antibiotics finishes Thursday so I’ll call her then to discuss the situation and ask if I need to continue with a further course.

The good news is lengthening has continued and so I’m very nearly half way through this phase with 12mm so far. Although we don’t yet know if the bone has grown at the same pace yet!

For the last few days I’ve been feeling very positive and happy so the contrast with my glum disposition today is all the more obvious.

The infection appears to be improving at least. During the daily pin cleansing and dressing this morning it certainly looks like the infection around the pin is receding which if true is great news but despite this I can’t shake the mildly depressed feeling I have woke with. I’ve been snapping at my wife and daughter. Given all they have done and are doing for me these are the last people I should be arguing with!

Part of it is possibly my first appointment with the Physio tomorrow. Although it is just an assessment I’m worried that they will mark my inability to raise my ‘bad’ leg onto a stool or into bed as poor progress. It’s difficult to know what I ought to be able to achieve by now but this is the one thing that means I am still heavily reliant on others for. If I want to get off the settee I need help to move my leg as I do when I sit down and the same applies for getting into/out of bed.

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Medical professionals will tell you that infections are not ‘if’ but when with ilizarov and TSF frames. The bone/skin interface of the protruding pins is a haven for bugs and they can take hold very quickly as a result.

So with little pomp I presented myself at my GP’s Surgery last week. A pin site had become increasingly sore and inflamed over a few days and the skin surrounding it had begin to break down.

Sure enough my GP agreed that it is almost certainly infected. A swab was taken for testing but hard lumps under the skin are an indication that a possible abscess had already formed. The pin wire goes right through my leg from front to back and both ends are infected, one minor, one bad. And so I am now on a course of very strong antibiotics.

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Wearing a frame as bulky as this presents a number of problems not least of which is transport.

To get home from hospital I was lucky enough to have the assistance of my wife’s parents who own a large 4 door car.  As my leg is locked straight I managed to sit across the rear seats with my back against the door.  I did the same when I had to return for a check-up this time relying on my parents.

We own a 2-door Mercedes convertible and I thought it was time I investigate how or indeed ‘if’ I could get into our car.  I’ll be honest and say that I din’t hold up much chance of getting in.  I’d had a bad day but took some painkillers and off we went.

Being a convertible, albeit a large full 4 seater, the rear is much narrower because of the hood folding mechanisms.  So although I tried I could not fit across the rear seats and  the only way I could get in was with the hood down.  Fine now but not so practical with winter approaching!

Next up was the front passenger seat. With the seat moved as far back as possible and the squab tilted down (thankfully these are electric and almost everything moved, lifts and tilts!) I got in.   With assistance I can get my leg into the footwell and jam it high up on the bulkhead.  This is necessary because the frame is bulky and my leg will not bend so it has to be horizontal from the seat cushion.  Using a foam pillow to raise my bum a little was enough to sort that out.  It’s not easy but once in it is relatively comfortable so long as we avoid potholes and sleeping policemen!

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