April 24, 2007 - Vanderbilt University Hospital Orthopedic Trauma Center

A month ago I had my six-month appointment with Dr. Kregor, described
in the last two entries.  I hadn't heard anything from them, and my ankle
continues to be a real problem.  On April 14th we had our Spring Celebration
of Craft at the Appalachian Center for Craft, and I was on my feet all day
doing demonstrations.  When I awoke in the middle of the night, I had to
use a cane to get to the bathroom - the ankle was swollen and very painful.  
The following day I needed to go to work to fire a kiln, but the ankle 
wasn't much better.  First thing Monday morning I emailed Dr. Kregor, 
asking if he had talked to Dr. Tressler about the ankle issue.  The next day 
I got a call from the Trauma Center, asking me to come in today.  This time 
they did the X-rays with me standing up, bearing full weight on the ankle. 

In the image above, Dr. Tressler made some pen marks showing the darker 
area where the extra bone has grown.  You can see the circle he drew. The 
extra bone is very faint, but it basically fills the curved depression that 
should be there at the front of the talus bone.  This condition is  called talar 
exostosis
, and in my case it results in total loss of dorsiflexion.  Unfortunately
this means more surgery.  I am scheduled at the Cool Springs Surgery Center
in Nashville for May 7, the Monday after Commencement.  Dr. Tressler will
do an incision in the side of the right ankle and perform a talar cheilectomy
(removing the excess bone from the front of the talus) and will also do a right
gastrocnemius recession
, with an incision into the calf to snip one of the
muscle cords on the back side of the calf.  As I understand it, after over two
years of no dorsiflexion at all, the cords and muscles are very stiff.  Even
after removal of the excess bone, it would be difficult to recover
significant dorsiflexion.  With one of the three cords snipped, it will
be much easier to stretch out the remaining muscle mass. 

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