Today I got  a phone call from my Orthopedist Dr. Cheng today, he wanted to follow up on the results of my blood draw yesterday. I am currently free of infection which was as expected. My doctor laid out three options as he saw them which I will detail out shortly. I feel the need to say for the record this upcoming surgery has me very scared, I know that the path I started down last year has lead me to this point, I am resolved to see this through till the end, but the specter of self doubt has reared its head and I am worried.

My surgeon laid out three options, some of this is things he told me others are things I have learned along the way.:

Option 1: leave everything as it is, I am in one piece for the most part, I have a dislocated hip and a failing pelvic allograft that will continue to fail until it either becomes necrotic or my body simply absorbs it leaving me without a functional hip and pelvis. In the short term this is the safest option as I wont be having surgery and its at least livable. This option doesn’t keep me moving forward though and eventually it will fail and I will have to make some harsh decisions. I am not currently willing to accept this option although part of me is attempting to argue for it because I have become used to the status quo as it were.

Option 2: We go back in remove the failed allograft and replace it with a custom built synthetic allograft. This option carries all of the biggest risks, I have a good chance of infection, I have a good chance of reaction or toxicity from the materials. This option is complicated by the fact they have to remove my old allograft with all of the screws and plates while contending with a sizable amount of heterotopic ossification or H.O. bone, which has created a shell around my dislocated hip and is making it difficult to reduce my dislocation. This option is also quite expensive as he told me several times, the costs for the appliance and the hospital stay could easily top 100k, the mildly entertaining thing for me is that the hospital is on the hook for that until my surgery. The time line for this is several months, I am not entirely sure how long but between 3 and 6 months, I’m hoping for sooner, This option by far and away carries with it the most risks but also the most reward, if it is successful I will have a fully functional left leg again, I may have to walk with a cane or have to use a scooter for long distances, possibly a special shoe to help level things out, but I will be in one complete piece, providing I don’t manage to dislocate the stupid thing.

Option 3: Amputate the left leg, this option seems to be the stupidest option of all of the ones presented. I get it he suggests this because its cheaper, and easier for him. This option is the only 100% certain option to make sure I don’t have any further issues with that hip and pelvis, which is no brainer. He is concerned that I could develop an infection in that area, which lets be honest I will, and that it could spread to other areas, which yes again this could happen, I could also develop an adverse reaction to the titanium, which yes I could. I declined this option.

So what happens if I get an infection and refuse to remove the leg (which I cant quite figure out how this will fix the infection) they can go in and clean out the infected tissue and I get to have a would vac for awhile and be on serious antibiotics again with all of the negatives that comes with, I could have a wound drain for a long time, which I will walk into the bathroom to drain,. If I develop an adverse reaction tot he metal, well they can remove the whole mess, put a spacer in the pelvic hole and remove the trochanter for the hip replacement and I have a flail hip, the same thing I have now and we can revisit this in a few years, again I will have two good feet.
The systemic infection, well lets visit that shall we, self preservation is high in me , obviously if my life comes down to a choice between dying or losing the leg, well I will make the smart choice, but I want to exhaust all other options before then, because I owe it to myself to come to the point where I have done everything possible to save as much of me as I can, a life lived with regrets is not a life at all.

I will be writing instructions for my wife about my wishes if things go south, included in those instructions will be the fail safe of stabilize and close me up, honestly I am ok with a flail hip, that gives me a tomorrow, and another shot at the apple.

The next few months are going to be really hard on me, I am certain that my personal relationships will be strained, my work life will be hard, and I know I will be dealing with a great deal of emotions.

Welcome back true believers, we are in battle mode one more time