Decision

Yesterday I met with my doctor again. We reviewed the CT scans together, discussed all my options, went through questions, models, the whole shebang. There are so many unknowns and firsts with my case, all piled together onto a plate of “here, this is all you get, but you have to decide, anyway.” There are so many variables that are n of 1, this ultimately comes down to me making a bit of an emotionally driven decision rather than a purely fact-based one.

I thought about throwing darts blindfolded or sending out a survey (in jest) but ultimately talked it through with David and Jen. I needed to hear their perspectives and wisdom. David and my kids think the metal is effecting me way more than I realize – I’m grouchier than normal apparently – so this was their chance to voice an intervention and place their votes. Jen has been through all of this with me and on her own journey so she knows this stuff AND me, plus she’s amazing at asking me the right questions to get me to think from new angles. She always shows up with the appropriate vegetable.

Options

I still have the same three options. Read them in detail here, but in short they are:

Move to a single screw (or possibly crisis-crossed double screws) if there is enough bone growth to support it.
Replace the current plate and six screws with identical titanium parts.
Keep the current metal and suck it up until it heals, someday.

Talking with David and Jen was fabulous, but I also like to write it all out. The act of writing followed by a review helps me see things with the best clarity, so here are the pros and cons for each:

Pros for moving to a single/double screw:

Much less metal and seated into the bone so I should not feel it.
No more surgery afterwards.
New surgery means introduction of fresh healing elements – new bone grafts, new PRP, new bleeding.

Cons for moving to a single/double screw:

This would be a permanent fixture.
Longer downtime immediately afterwards (~6 weeks) since it is less stable that option 1 until more bone grows.
No guarantee that this is even doable until he sees the bones in surgery.

Pros for replacing everything:

This would alleviate the metal allergy issues. The remainder of the recovery should be more comfortable.
If it is still physically uncomfortable like the current metal is, we can take it out once the bones have fused.
New surgery means introduction of fresh healing elements – new bone grafts, new PRP, new bleeding.

Cons for replacing everything:

I may still have the physical discomfort that I have currently.
If we choose to remove it, that would be one more surgery.

Pros for doing nothing and continuing on as is:

No surgery until the end.

Cons for doing nothing and continuing on as is:

Continued allergy issues with potential long-term damage.
Continued physical discomfort at metal sites.
Continued physical limitations due to both of the above.
My family will want to send me up the river for being grouchy.

Thoughts and Decision

The piece that is the most compelling to me is that with either option 1 or 2 we will introduce a fresh set of healing elements that are not possible with option 3. A turbo boost to the healing. While I am patient and not looking to rush the process, I like the idea of making it more effective and efficient. I feel like that part plus removing the allergy issues (which cannot be helping the healing process) may be the key to getting this all wrapped up. I don’t mind the possibility of one more surgery afterwards in favor of feeling better now and giving a boost to the healing. I am SOOO CLOSE to feeling good!

Like an arrow being drawn back in order to fly forward, I’m electing to give this a shot. It will be either option 1 or 2, TBD in surgery, a fun surprise to wake up to.

So, I have pushed the GO button and will get a date soon. I feel settled and happy to have made a decision. I am grateful to everyone around me for supporting whatever I decide, but also helping me think through it all.

Game On, Decision Made, Let’s GO!

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