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Trust and doctors

Dan learns that his ankle replacement surgery wasn't successful

Trust is a funny thing.  How does the saying go?  “Trust takes a lifetime to build and one second to ruin.”  That’s not exactly true, though, is it?  In fact, in some situations trust can be given as fast as it’s destroyed – one second.  We trust so many people each day with decisions that range from inconsequential to life altering, and doctors especially seem to gain our trust within the span of just one visit, which sometimes lasts less than fifteen minutes.

Why am I bringing up the subject of trust and doctors?  Well, as you may have read on my Twitter or Facebook page, the ankle replacement that I had done about a year ago is now, officially, a failure.  This past week, I went to see a specialist, and the exam didn’t go my way, it seems.  I was told that the original replacement was put in crooked, and that it would have to be removed.  On top of that, my ankle would need to be fused.

Like most of you, I had only heard the term “fused” a few times before, and only knew the basics.  From what I understood, my ankle would be locked in place at a nearly 90 degree angle, and the bones given time to grow in to the new configuration.  After that, my ankle would be immobile, but my foot would rest flat on the ground, which it hasn’t done for years.  That was all there was to it, I assumed.  Unfortunately, at my first opportunity, I read up on ankle fusing, and discovered there was much more to it, much to my chagrin.

First, the tibia and the fibula are prepared by lopping off the bottom half of the end of the bones to make them flat.  Then, the top of the ankle joint bone is cut flat as well so that the tibia, fibula, and talus (top of the foot) rest flat against each other.  After that, three screws are inserted to keep the bones in place while they grow together.  My doctor also added the bonus of having an external bone scaffold hold the bones in place.  Finally, after keeping off the foot for 8-12 weeks, an ankle brace is fitted, and special show modifications are made.  Since the ankle cannot move at all, a “rocker sole” is required, which allows the foot to, in essence, roll inside the shoe to make walking seem more fluid and help to prevent a visible limp.  It is major surgery, and if everything doesn’t go exactly right, or the bones don’t heal correctly, it could result in another botched procedure.

So, here I am now, completely disheartened that I have to go through an even more painful surgery to correct something that I thought was over and done with.  I trusted my doctor when he said he would be able to do the procedure, and I expected him to tell me he wasn’t able to do it if he thought it wasn’t possible.  Granted, I did have what amounted to a “softball” of bone where my ankle used to be, but all the more reason my doctor should have made it clear there was a chance the operation could fail.

As I said in the beginning of this blog, it all comes down to trust.  The surgeon that did my ankle had been my surgeon for years, and I was convinced he knew my body better than anyone.  Due to this fact, I quite probably rushed into a procedure that, in all honestly, might not have been possible.  I never got a second opinion or even entertained the fact that my doctor could have been wrong.

What’s worse is that now, as I review my attitude towards all of the medical professionals I see, I realize that I almost never question the determination of my long-time doctors.  Inexplicably, I don’t even question the judgment of doctors that I see rarely or even once!  Somewhere along the line I became lazy, and I am putting trust in people simply because of what they are.  The sad fact is that doctors are just as fallible as everyone else, and me more than anyone knows from experience that medical professionals can be and sometimes are just plain wrong.  My mother can vouch for that fact, as she has run down many a nurse during my hospital visits to correct some incorrect dosage of medicine or un-schedule a superfluous procedure.  Yes, it means more work, but I now have to pay a hefty, possible life threatening, price for my complacency.

Despite this incident, though, I don’t want you to take this as a blanket indictment of doctors and their tendency to always assume their diagnosis is the correct one.  Far from it actually, for without my doctors and their almost prophetic ability to predict symptoms and discover the cause of illness I would be bedridden without question.  Doctors are there to help you, plain and simple.  Even the rude ones I have met have only been lacking in their bedside manner, not their intent to support the Hippocratic oath.

Exploring the medical world, especially for those of us who are ill, is a daunting task. Much time and effort is expended in reaching a diagnosis, I know, and when you finally hit that finish line, the last thing you want to do is go back to the beginning and start again.  I can’t make you do it, though, and you don’t always have to.  All I am saying is for you to use my ankle as a cautionary tale and a reminder to question everything. Yes, I know it’s a pain in the butt, and I know that it may cost a bit more, but it’s worth it.  You don’t want to end up like me, with a second operation on tap to completely undo and redo what was done the first time around.

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