After a 2018 car crash killed her husband and shattered her ankle, Heather spent years in pain with limited mobility. She's choosing below-knee amputation with an osseointegrated implant, a direct bone anchor that offers more stability and freedom than a traditional prosthetic socket.
Chapters
The 14th of July 2018, myself and my husband travelled to Portsmouth to our youngest son's graduation. On returning home to Weymouth, we were involved in a— RT— sorry, an RTC. And my husband passed away at the side of the road. My first memory was laid at the side of the road and thinking I was in some nightmare until I saw a policeman, and I knew that something bad had happened. And I had to try and give him information, and I was concentrating on that, but I kept asking for my husband. I didn't realize how badly I was injured. And then next thing I know, I'm in a helicopter going to Southampton Hospital and underwent emergency surgery on my ankle. I had I had a fractured sternum, laceration to my spleen, damage on my hand, broken ribs, but I think the worst injury was my ankle. Sorry, I don't mean to cry. I thought, I was in hospital for about 7, 8 weeks. All along, every consultant that came along, they kept saying, "It's a bad fracture, it's a bad fracture." Yeah, okay. But I thought it was going to get better. I came home non-weight-bearing on it. I couldn't weight-bear on it for 12 weeks altogether. And I kept going back to Southampton and they kept saying to me, "You've got to start using it." And I'd been going to physio and I was doing everything they were saying and I am doing it, but I It made me feel a little bit like I wasn't, but I was, because I wanted to walk. And after going to various other places, we eventually— they said that I could have a fusion, but the fusion was no guarantee, and that they thought I wasn't going to be much better off than what I am now. So then we started talking about amputation, and I spent a lot of time being pushed around supermarkets, seeing— because once it's in your head, you notice people— seeing people on their prosthetics doing their own shopping, walking, not having, you know, any— and I just thought, that's my best option, is either stay as I am or the amputation. So COVID delayed things but also gave me time to really think. My daughter was helping me, my sister-in-law was helping me with personal things, and so yeah, that was difficult to accept for a while. Um, having to go say to my dentist and because they haven't got a parking space, so then it's starting straight away to think, right, I've got to see if anyone's available to take me, and if they're available to take me, can they park right outside or close enough for me to get in? And it just induces that sort of, I've got to sort this out, and yeah, just, and that's the simple, simple things. Lisa, my case manager, I'd never heard of OsteoIntegration before and she mentioned it, so I thought, oh yeah, we'll explore that, you know, with the COVID we had plenty of time and I liked the idea of it. I liked that it was going to be more convenient, there was less chance of having, you know, rubbing on your your stump and stuff like that and falling. There would be— once I'm up and walking properly, I will be less in a wheelchair than if I went the traditional route. So this is why I came to that. And my kids, you know, they're just saying, "Mum, go for it. Mum, go for it." The idea of that, because it's literally just stick it on type thing, you know, turn a screw and it's there. And I know that to me that just felt more like it would be my leg. Up to this point, you know, I've not lived a normal life without my husband. So once this is done and I'm walking and all the rehab's done, I will be faced in life properly without my husband, so that's going to be a little bit of a bittersweet thing. But equally, I've got— I want to go on holiday again, I want to do a cruise, I want to get a little dog so I can walk it. I wonder, you know, I wonder— through this, I've just started being sort of trying to prepare me for surgery. I've just started having a personal trainer, and we've been sort of trying to get me muscles working and stuff like that again. I want to carry on with that and do some more of that and get even fitter if I can, lose a bit of weight, you know, it would be a bonus.
So there are 3 main bits to tomorrow's operation. The first bit is that we are going to do a planned elective amputation below the knee.
Yeah.
Okay, we'll talk about that in small detail in a second. The second part of the operation is that we are we're planning to put an osseointegrated implant into your residual tibia, which is the big bone down the front of your lower leg. And there are very— there are big advantages to doing that at the same time as the amputation, particularly in a below-knee scenario, which we've talked about, but we will just cover again those things because they come up in the bits that you need to know for the consent form. And the third part of the operation is going to be the rewiring of the lower leg. Okay, so with, with an amputation, there are various structures that are left blind-ended, and from the point of view of pain, the most important of those are the big nerves that are traveling down your leg. Okay, we know that this operation called targeted muscle reinnervation probably helps with that. All the evidence is pointing towards that it is helping. And we think that it helps even more if we do it at the time of the amputation.
Right, yeah.
That's what the evidence seems to suggest. So the purpose of that operation is to go upstream, so to behind your leg, behind your knee, and catch those nerves before they start to branch out into their final terminal ends. And then we are going to rewire them so that they now travel into the muscles that used to, or tomorrow will have used to, move your foot. Right. So those muscles that move your ankle and your foot, which you no longer need, will now be targets for these nerves to grow into. Right. And that has two great advantages. The first is that the nerve has something to do, has something to talk to, and that means that it won't grow into a new aroma, which is a painful ball on the end of the nerve, which is tender to touch. The second is that we think that by rewiring it, it gives some feedback and it reduces the chances of phantom limb pain.
