Follow Up in Bethesda

Kyle and his parents returned to Bethesda this week to meet with his orthopedic, vascular and plastic surgeons for follow up appointments.  The Deems left Pittsburgh on Monday afternoon and headed for Bethesda.  The drive went well and they settled in for the night and rested in preparation for Kyle's first appointments the following day.

Kyle sleeping in the back seat on the drive to Bethesda on Monday.  Photo by Elsie Deem.

On the computer in the hotel room - Elsie noted even the handicapped room was a bit tight in spots.  Photo by Elsie Deem. 

Kyle was discharged from Bethesda NNMC on Sunday, July 25th.  His first out-patient appointment at NNMC was scheduled with one of his orthopedic surgeons about three weeks later on Tuesday, August 17th.  The doctor reviewed Kyle's x-rays and the position of the spatial frame.  It did not need any adjusting at this time because the frame was supporting his bones in a good position for healing.

The doctor expressed their plans to keep the frame on his leg for six months.  This was the maximum time Kyle had been told the frame would remain on his leg for, so everyone was a bit disappointed it wouldn't be for less time.  But the doctor assured him he was healing at an appropriate and expected pace and he would walk again, it just may be a little while.  The orthopedic surgeon wants to follow up with Kyle in two months.  

The white dots and markings seen throughout his leg are pieces of shrapnel from the gun shot.  Kyle's body may force out some of the smaller pieces but some of the larger pieces will remain for his lifetime.  And yes, he will probably be setting off metal detectors at the airport. 

Following that appointment, Kyle went to meet with one of his vascular surgeons.  The surgeon Kyle met with was very informative and thorough.  Unfortunately, while feeling for a pulse for a long time on the back of Kyle's foot/ankle area, he told Kyle his artery was failing; this was information the doctors knew since the angiogram they had performed on Kyle back in the middle of July.  The lack of pulse confirmed this report.  This was the artery surgeons in Afghanistan had tried to repair by grafting a vein from his left leg and placing it in his right leg.  This combat surgery just didn't last and there is nothing they can do at this point.

He also had lost another artery from the original wounding.  Kyle will have to recover with one of three arteries functioning in his lower leg.  The doctor was encouraging saying he had enough blood flow to make a full recovery with, but he just had no reserve.   The vascular surgeon wants to see Kyle in six months, once the spatial frame is removed. 

The next day, Kyle met with his head plastic surgeon (he remains to be one of Kyle's favorite doctors whom he has the utmost respect for).  They needed to do some cleaning of his leg, debriding his wound and removing dead tissue.  They bandaged it up after and want to see Kyle back in Bethesda in four weeks to check on its healing progress.  He will need to be very careful to keep it clean from any infection.  

Kyle snapped this photo on his cell phone and texted it to me.  I was a bit surprised to see it pop up on my phone.  The doctor used a scalpel and a pair of tweezers to debride the wound, removing dead tissue.

The wound inside his right leg after the cleaning.  Photo by Kyle Deem. 

The inside of Kyle's right leg after the cleaning.  Photo by Kyle Deem.

An assistant talks to Kyle after the wound cleaning is complete and discusses some details about his wound with him, along with sharing stories from Afghanistan for she had also spent time working there.  Photo by Elsie Deem. 

Kyle on the sixth floor at Walter Reed Hospital headed for neurology on Wednesday afternoon.  They were planning to do a nerve conduction study on his right leg but it didn't take place because the doctors at Walter Reed were unaware of the spatial frame and overall physical condition of Kyle's leg.  The study would give a fairly accurate report on the functionality of the nerves in Kyle's leg.  Photo by Elsie Deem.  

Since they couldn't do the nerve conduction study, Kyle talked to two doctors about his leg and they answered many of his questions.  Everyone felt that was time well spent and appreciated the doctors time with Kyle.  Elsie, Kyle and Bill went back to the hotel and packed up their things and got on the road to drive back to Pittsburgh that afternoon.  They would return to Bethesda in four weeks.  Photo by Elsie Deem.