[RAILhead]

Why in Hades not, eh? You know you want to see my toe post-amputation and while it heals, so here you go. First, though, some background for those that don't know what led up to this...

The nutshell is that I was diagnosed with a granular cell tumor on my right great toe, and the only way to remove this tumor was to amputate my toe down to the first joint. The reason for this is because when you remove a tumor, you take a certain amount of margin (good tissue) to help ensure you're getting all the tumor out of the area. In the case of a toe, by the time you take the tumor and margin, you've got nothing left of your toe — so off it comes.

The chances of this being cancerous is slim, but they removed lymph nodes from the back of my knee as well as from my groin to test for microscopic disease traces. I am confident I will be determined to be 100% cancer free by Monday, the 28th.

ANYWAY, here are pics of my toe...

Here's what it looked like before surgery. You can see how the tumor was taking over my skin and everything, and how it was causing my nail to separate. NASTY!






Day 3 and Day 7, iPhone. You can see the bruising starting to kick in on Day 7:







Day 7, high quality:







Day 10, high quality. You can see the swelling and bruising starting up:








More to come...!

[ghporter]

As a photodocumentarian, you rock. I think it's also a good thing for your recovery; watching the process slowly unfold doesn't tell you much, but being able to photographically compare how things look over time is very helpful.

How long do they expect the big honkin sutures to have to stay in? In my experience with hand surgeons they leave 'em in for around two weeks...

[RAILhead]

Technically, I could have had them removed the 29th or 30th, but my Doc is booked, so he wants to wait until October 6. Not crazy about how my body may react to that extra week, but we'll see -- but to be honest, that extra week will help ensure the incision is that much more secure, which is good. A boat load of pressure is pushed against that area when I walk (when that time comes again, that is), so there's a very real concern about the site splitting open. Every bit of support will help, so I'm good with the other week in that sense.

[mattyb]

Great pics !!! You need to change the background though, maybe alter the white balance a touch as well

When will you be able to walk (or hobble) on it?

[ThinkInsane]

Not for wussies? This from a guy that has to go to some fancy doctor just to get a toe lopped off?

[tooki]

Step 1: Go to CVS to buy a) rubbing alcohol, b) very fine-pointed cuticle scissors (find the ones with the sharpest point and thinnest blades, and c) high-quality tweezers.
Step 2: Soak b) and c) in a).
Step 3: Bye bye sutures! (The longer they stay in, the more "railroad track" scars they leave, so removing them on the standard day 12 is ideal.)

(FYI, I practiced this just two weeks ago, so I ain't makin' it up! And I see that you also have monofilament sutures, which do not hurt when you remove them, they just slide out.)

[ghporter]

Tooki's right about sutures making more "railroad track" scars the longer they stay in, but with a wound right there, I don't think aesthetics are going to be a huge issue. And he's also right about the particular kind of sutures you have-they DO just slide out, which is probably one reason the surgeon chose that type for the closure.

From a purely clinical standpoint, the character of the scar won't be a huge issue, as there will be a period in rehab when the residual digit is "hardened". Which sounds pretty ugly but is really important-that particular area did not grow up to bear the pressure and weight (quantities or patterns) that it will not have to deal with, so as with any amputation, the scarred area will need some encouragement to callus up a bit.

By the way, that looks like some very nice work by the surgeon. There is both sufficient skin and in an appropriate pattern to properly close the digit without having to resort to grafts, and it still looks like there's some pulp over the end of the remaining bone (good for cushioning). Very nice. When it's healed, it'll probably look very smooth and finished. Just short and therefore weird.

[tooki]

Weird... or awesome! You now have the opportunity to make up some story about how you lost it fighting a bear or nazis or ninja pirates!

[ghporter]

Nazi ninjas with pirate bears as allies. That's the ticket! Or should it be Nazi bears and pirate ninjas? NO! Of course not! Pirates are the mortal enemies of ninjas! Nazi pirates and ninja bears it is!

[tooki]

:: Literally LOL!!! ::

[rickey939]

Why is the TV off?

[RAILhead]

Originally Posted by mattyb 

Great pics !!! You need to change the background though, maybe alter the white balance a touch as well

When will you be able to walk (or hobble) on it?

Hey, when you get yer toe schwacked, we'll see how much you care about backgrounds and post-processing.

But seriously, I can "walk" with crutches right now, but I can't put any weight on my foot to make much difference outside of the most basic bit of balance. The healing is still full swing, so I'm keeping it elevated at all times, except to hit the head or shower. So, it still hurts like a motherscratcher when gravity sends blood to my foot.

That said, it'll just depend on my body and how quickly it recovers. I'm guessing I'll be putting more weight on it in a couple of weeks.

[RAILhead]

We weren't going for aesthetics, correct. But what he says jibes with what you're saying, in that it'll end up nice and round and basically a short looking toe with no nail. In December, I will working with Touch Bionics in Chicago/NY to have a custom LivingSkin aesthetic prosthetic built for me, as well. This will make it easier for me to keep flip-flops on my feet and not have to worry about them popping off.

Regarding the work, my Doctor is Merrick Ross, the big cheese Surgical Oncologist at MD Anderson Cancer Center. When all this went down, I got a hold of my Dad's oncologist and asked him to pull some strings, and pull them he did — Dr. Ross is the guy people from all over the world wait months and years (if they're able) to have do their surgeries. According to *everyone* at MDACC, he's the absolute best surgeon at MDACC, and one of the best in the world. His nurses couldn't believe I got in to see him so quickly, since there's a waiting list for him just to see people. I am totally thankful and blessed to have him as my Doc, for sure!

Grafting was out of the picture, just because of the tremendous pain in the arse it would be with no known degree of benefit until it was all over. In the end, it may not have worked, and since such an amount of my toe had to be removed, it just wasn't worth the effort.

Originally Posted by ghporter 

Tooki's right about sutures making more "railroad track" scars the longer they stay in, but with a wound right there, I don't think aesthetics are going to be a huge issue. And he's also right about the particular kind of sutures you have-they DO just slide out, which is probably one reason the surgeon chose that type for the closure.

From a purely clinical standpoint, the character of the scar won't be a huge issue, as there will be a period in rehab when the residual digit is "hardened". Which sounds pretty ugly but is really important-that particular area did not grow up to bear the pressure and weight (quantities or patterns) that it will not have to deal with, so as with any amputation, the scarred area will need some encouragement to callus up a bit.

By the way, that looks like some very nice work by the surgeon. There is both sufficient skin and in an appropriate pattern to properly close the digit without having to resort to grafts, and it still looks like there's some pulp over the end of the remaining bone (good for cushioning). Very nice. When it's healed, it'll probably look very smooth and finished. Just short and therefore weird.

[tooki]

I dunno that I'd worry about the bionic toe, I'd be glad to have one less toenail to clip!

[RAILhead]

Here's one they made:



And of course, it's not really mechanical — it's just a placeholder.

Their website: Touch Bionics

[tooki]

I dunno, i'd be rocking the ninja bear fight toe!

[RAILhead]

But I love my Sanüks too much,

[ghporter]

Originally Posted by RAILhead 

We weren't going for aesthetics, correct. But what he says jibes with what you're saying, in that it'll end up nice and round and basically a short looking toe with no nail. In December, I will working with Touch Bionics in Chicago/NY to have a custom LivingSkin aesthetic prosthetic built for me, as well. This will make it easier for me to keep flip-flops on my feet and not have to worry about them popping off.

Regarding the work, my Doctor is Merrick Ross, the big cheese Surgical Oncologist at MD Anderson Cancer Center. When all this went down, I got a hold of my Dad's oncologist and asked him to pull some strings, and pull them he did — Dr. Ross is the guy people from all over the world wait months and years (if they're able) to have do their surgeries. According to *everyone* at MDACC, he's the absolute best surgeon at MDACC, and one of the best in the world. His nurses couldn't believe I got in to see him so quickly, since there's a waiting list for him just to see people. I am totally thankful and blessed to have him as my Doc, for sure!

Ahhhhh... MD Anderson is THE place to have any oncological work done, and this Ross guy gets like a zillion Google hits just from his name. Very impressive. Kinda like Denton Cooley in cardiology.

Oh, and it's nice to be on the same page as someone that impressive. I guess I got it right.

[RAILhead]

Yep, MDACC is the best place to go when Life throws a curve ball.

[RAILhead]

No new pics today (I'm waiting until tomorrow for Day 14, and y'all are gonna love the bruising!), but I thought I'd pop-in to report MD Anderson has officially determined me to be CANCER-FREE.

[sek929]

I hope you buried that toe deep, I wouldn't want a Cancerous Zombie Toe coming after me.

Also, that's pretty f**kin metal

[ghporter]

Originally Posted by RAILhead 

No new pics today (I'm waiting until tomorrow for Day 14, and y'all are gonna love the bruising!), but I thought I'd pop-in to report MD Anderson has officially determined me to be CANCER-FREE.

Woo FREAKIN' HOO!!!! So now instead of a "potential relapse," you're just another person with some "body modification" and a cool story. Good deal!

[Jawbone54]

Dude...I just saw this thread for the first time tonight.

Unbelievable. Here's hoping for some quick advancements in recovery time. Some prayers going your way (for the results from the other tests as well). The good news: you don't play guitar with your toes.

Keep this thread up to date, man. I'd love to see how things are working out.

[RAILhead]

Originally Posted by Jawbone54 

Dude...I just saw this thread for the first time tonight.

Unbelievable. Here's hoping for some quick advancements in recovery time. Some prayers going your way (for the results from the other tests as well). The good news: you don't play guitar with your toes.

Keep this thread up to date, man. I'd love to see how things are working out.

Hey man — you missed my post just above! ALL TESTS CAME BACK NEGATIVE! No cancer! ANYWHERE!

[Jawbone54]

Wow...I just skipped right along there...

CONGRATULATIONS! MY RETROACTIVE PRAYERS WORKED!

Glad to hear it, man.

[Face Ache]

Originally Posted by RAILhead 

ALL TESTS CAME BACK NEGATIVE! No cancer! ANYWHERE!

Good stuff.

[RAILhead]

Here's a lo-fi iPhone pic from this morning, Day 13. How's this for some freakin' bruising?



I finally knocked the living crap out of it yesterday, too. I was getting something from my indoor shop (I'm walking on crutches, remember), and I turned to leave, and hit my toe right freakin' on the SHARP, 90°, wooden corner of my table's leg. Sweet mother, it was some of the worst pain I've EVER felt. It was that deep, nauseating, chugging pain...

Anyway, I have a feeling some of the swelling would be down a bit more if I hadn't done that — and it looks like it may have bled just a wee bit throughout the night.

I still feel like I'm walking on a ziplock bag full of blood when I try and put weight on my foot, but that swelling has already started to come down a bit since yesterday, even.

Better pics later.

[andi*pandi]

I'm both glad of your cancer-free verdict and that your choice of image hosting is blocked at my work.

[osiris]

I wish you a speedy, healthy recovery. Glad the cancer only got off with a piece of your toe, and left you intact.

[OreoCookie]

Glad to hear you're officially cancer-free.

[RAILhead]

Originally Posted by andi*pandi 

I'm both glad of your cancer-free verdict and that your choice of image hosting is blocked at my work.

That sucks! Dropbox is blocked at your work...?

[olePigeon]

Do you get to park in good spots now?

[olePigeon]

Do you still have your amputated toe? You could hide it in cup of chili from Wendy's, then sue Wendy's.

[RAILhead]

Yes, I will have a temp handicapped parking tag, and no, I couldn't keep it because they had to test it (I wanted the bone),

[The Placid Casual]

:O You were 120% right when you said that in comparison to my chainsaw injury thread, that the 'toe' was cooler... /respect

On a serious note though, so glad that things came through negative on the Cancer tests, must have been a huge relief.

Fingers here are crossed for you to make a very speedy recovery!

(Just took a look at your blog too, exceeding jealous about the Mesa Boogie Rectifier, very very cool kit! )

[moonmonkey]

will this effect walking at all?

[RAILhead]

Not a whole lot, supposedly. I'm still on 2 crutches, so I can't say for myself just yet.

[ghporter]

Your gait will change-noticeably to you, probably not to most people. The great toe is the "push off" platform, so losing a significant chunk of it will change the surface area used for the power portion of each step (the final foot contact with the ground before the foot rises is a huge part of the amount of power generated in each step).

[Jawbone54]

The good thing is that the entire toe wasn't removed. The half that you still have should help.

[RAILhead]

Yep.

Just got back from MDACC — the incision in my groin where they removed lymph nodes is infected. They said it's pretty common, no matter how good your hygiene is — and mine's top o' the line. Giving me the max human dosage of oral antibiotics first, and if that doesn't work, I'll be admitted. I was prob about 6-12 hours away from being admitted if I didn't get in when I did, so hopefully the pills will work.

Ugh.

They said everything else looks great, though, so that's good.

[kmkkid]

Why would they do multiple surgeries at once?

Isn't that bad for overall healing of each area?

Good luck on your recovery, and it's great you don't have cancer.

[RAILhead]

They knew my toe had to come off, and they also needed to screen me for cancer -- so that's why they did the lymph node removal.

[ghporter]

ALL cancer surgeries include investigative excisions of nodes and surrounding tissue. It's GOT to be done, and is most effective when the patient only has to be anesthetized once (which is safer too).

Good luck on that oral antibiotic. IV stuff tends to make you feel like doodoo for a while instead of just really bad for a while like orals do.

[RAILhead]

The infection seems to be under control. I still have the redness, and some of it is expanding slightly — but that was before the pills really had a chance to kick-in. The main thing is that I'm no longer running any fever, and the Docs assure me that's what I need to watch. White counts also confirm nothing is raging uncontrollably inside, which is great.

The stitches come out Tuesday at 8:00am, so I thought I'd slap some iPhone pics up really quick, before Frankentoe gets a makeover.






The bruising/swelling has dropped dramatically, and I'm actually able to walk pretty well with just 1 crutch now. You may notice a dark, red spot on the left portion of the incision, and that's the left-overs from where I stubbed the living daylights out of it against a sharp table leg. Worst pain ever, man. Sweet Moses!

I don't know what the wrinkles are from — I didn't notice them until I saw the pics. Maybe the tension of the sutures...? Whatever it is, it doesn't hurt, so I'm not worried about it.

There you have it! Stay tuned for more pics once the sutures are out, unless you lot feel particularly brave and want to see what a groin lymph node removal site infection looks like!

[ghporter]

Aside from the "HOLY CHROME!@!!!@@ WHY WHY WHY???!!!???" toe stubbing evidence, that looks like a very well healed incision. It's hard to say that those are "wrinkles" and not just some pigmentation variation; the picture is focused on the end of the toe, so it's not clear enough to tell. But that's nothing to worry about; the whole thing will look substantially different in a month, and even more different in 6-more like a short toe than an altered one.

[RAILhead]

What's really kind of funny, is that the hair is starting to grow back, and I'll soon be able to use it as a comb-over for the incision until it heals.

My foot swelling is doing great, and I can mainly feel it just under the great toe joint. Of course, side by side, you can see the arch of my surgery foot is probably 1/4 larger than my left — but it's not so much like I'm walking on a "ziplock bag full of blood" as it was.

So here's a question for you: when will the blood quit rushing and flooding the toe? I understand the body sends blood to a wound to facilitate healing (to put in major laymen terms), and I know that you also elevate your foot to keep all the blood from pooling like gangbusters — but why is it that as soon as I stand, I can physically and visually tell blood rushes to my foot? Is it the fact I still have a wound and the body is still sending "extra" blood, so the area accepts it more? Why don't my other toes turn red?

When will the redness upon standing stop? Not that I care, just curious...

[Jawbone54]

A toe comb-over...

PLEASE post pics.

[ghporter]

It will take quite a while for your vascular system to "learn" about the reduced need for blood past your great toe's joint. The blood vessels grow, expand, and shrink in response to need, but they don't do it quickly. I suppose this is in case a change is temporary. But you also have to remember that when the blood returns to the system through veins, it's tiny valves in the veins that keep the blood moving upward, and those veins are overloaded with fluid leaking from tissues that have been operated on, and the tissues around the wound that were disturbed. The leakage will be there for perhaps 6-8 weeks, gradually decreasing as the wound heals, but you should see a major difference in the "blood rushing to the toe" effect in as little as 3 weeks.

[RAILhead]

Heading out to get all my stitches removed from all 4 surgery sites. I'm still fighting the infection on my leg, but it hasn't gotten worse (and I haven't had any fever since Friday), so I'm hoping they'll continue oral meds and not admit me.

Stay tuned for pics later today!

[The Placid Casual]

Originally Posted by RAILhead 

Heading out to get all my stitches removed from all 4 surgery sites. I'm still fighting the infection on my leg, but it hasn't gotten worse (and I haven't had any fever since Friday), so I'm hoping they'll continue oral meds and not admit me.

Stay tuned for pics later today!

Best of luck today, hope all goes well!