What's wrong with Russ?

This is what a left-foot should look like:
However, on 20/Mar/03, my foot looked like

That darkened region just below the ankle (on the "head of the talus") is a giant cell tumor.
Btw, this bone basically supports ALL of my weight; it is therefore very important!

The good news is:

It is not malignant (yay!).
The surgeon thinks it can be removed, and replaced with some bone, and I will then recover.

The bad news is:

Did you notice the word surgeon. Ouch.
And just who do you think is going to supply that replacement "bone"? (It will be my iliac crest.) Ouch.

(In "doctor-speak", I will be "uncomfortable".)

Btw, walking (without crutches) is a high-impact activity.

Assuming everything goes well:

• Thurs 29/May: Surgery
• 30/May - 6/Jun: Recovery (at home)
• ... - middle-of-Sept (or later!): in an ankle cast
• mid-Sept - ??: in physio

30/May: I'm back from the hospital.

The good news is:

My foot, and my hip, both feel ok. On a scale of 1-10 (with "1" being "pain-free"), I've been calling it a 3.

The bad news is:

The talus bone was pretty much gone when the surgeon went in.
[Damn damn damn -- if only they had diagnosed it correctly back in October, when it was less destroyed!!]
... this means I have to be VERY careful to make sure the graft (bone cells from my hip) take.

So I have to wear a boot 24/7. Which will be challenging, given the warm weather we are now having.

I'm still feeling a bit weak but basically ok.

After they cut the holes in me, they had to close the wounds. With staples! Honest!
(Note: these are a bit gruesome...)
Hip region     Left foot

16/June: The staples are out. Phew. They still do not know whether the graft will take.

1/July/03: Current views
Foot     Hip
    Boot -- orthotic I need to wear 24/7, to keep foot rigid and not supporting weight

Stay tuned for more, as it happens.

17/July/03: met with the surgeon, who tells me I am allowed

"movement without weight"

* ride a bike? Dunno.
* drive a manual-transmission car? Dunno.
* go swimming? Dunno.

When I be allowed to put weight on my feet -- eg walk without crutches?
Dunno.
(Dunno == the surgeon won't tell me.)
But NOT before my next MD appointment, which is 18/Sept. Sigh.

Btw, my interpretation is... I will be cast-free once three things happen: (this was updated 18/Sept)

1. The bone graft takes
2. The talus bone (with new material) is solid enough that it can bear my weight.
3. There is also a small "possible fracture" at the back of the talus. This has to "seal" up.

The bottom line is: The tumour is annoying, and I wish it had not happened.
However, I am also very grateful: this could have been MUCH MUCH worse. I understand this tumour has essentially zero chance of metasticizing, and there is an excellent chance of a complete recovery. (Knock on wood.)

Had this happened 50 years ago, it would probably not have been detected and addressed, and chances are, I would have lost the use of this foot, permanently. I am grateful!

18/Sept/03: I saw the surgeon today.
The graft is taking nicely.
Apparently there is a possible fracture at the back of the talus; this is why I am not supposed to put stress on my foot. This is also "trying hard to heal". Yeah.

So... I am now allowed to put up to 10lbs on my left foot. (How do I do this?
... other than dropping my weight down to 20lbs total... :-)

And allowed to go biking, and told to go swimming, daily if possible. Ok.

Next appointment will be in December. X-ray foot and lungs, to make sure things continue to go well.

New estimate: this may take as long as 8 months to heal "completely".

4/Dec/03: I saw the surgeon today.
The graft is taking nicely: the bone is growing through the graft (which is good!).
The chest X-ray is negative -- ie, no sign of metastasis there (again, this is GOOD!)

I should gradually add more weight ... eg, add another 10 lbs / week
... and get some exercise, like biking or swimming.
But no skiing, nor even putting full weight on the foot.

Figure another 6 months before things are more normal. Sigh. In the grand scheme of things, this is not bad... I keep telling myself.

29 Jan'04: After 6+ months using crutches, I started going solo. It felt weird at first, especially I kept trying to figure out what i was forgetting... Oh yes, the crutches... :-)

March'04: the "top" of my foot (talus) feels fine. But now my HEEL hurts. (Probably not that surprising, given that I am now putting weight on it, after > 1/2year of not.) Xrays show

• cortical irregularity and minimal osseos fragmentation at the dorsum of the talus
• No fracture is presentation. [...] bones are slightly osteopenic. [...] At posterior aspect of the calcaneus, there is a thin band of apparent sclerosis which may represent a healing stress fracture. [...] no plantar calcaneal spur.

X-ray from 25/Nov/04:

Dec'04: Surgeon says: everything is going as well as possible!

May'05: Surgeon says: Try whatever you want!

May'07: Met with surgeon for the 5th year anniversary examination... and given a clean bill of health: That is, the chance of getting a recurrence is very low -- comparable to getting a tumor, at all!

Last update: 30/May/07