April 9th, 2026

Yesterday, Wednesday, I had an appointment with my surgeon. There are some medical appointments one actually looks forward to, almost like a school trip. This was one of them. My surgeon, Professor Krause, was finally going to free me from my cast, or at least, that was what I was hoping. The idea of regaining some mobility, even partial and with the help of simple crutches, had put me in a state of anticipation I wouldn’t have thought possible for an orthopaedic consultation.

Reality, as often, had other plans.

The consultation brought both good and less good news. After the routine X-rays, essential for assessing progress since the last visit, Professor Krause’s assistant came to fetch me from the waiting room. We reviewed things together. I mentioned that in recent days the neuropathic pain had intensified: spasms in the foot, sometimes quite painful. Otherwise, the situation was stable. The wound, treated over the past weeks, was healing well: a disinfectant spray to promote recovery, followed by a simple dressing, nothing more.

Professor Krause then entered the room and commented on the images. He asked whether I was being careful not to put more than half my body weight on the leg. I reassured him: as I mostly get around by scooter, I spend little time standing, and when I do, the crutches are always there.

He then displayed the X-rays. On the side view, the answer was clear and not the one I had hoped for. At the fracture site, bone healing is not yet sufficient. The explanation is mechanical: with every step, a lever effect is created between the foot and the leg, generating considerable forces at the break. As long as the tibia is not solidly consolidated, every step carries a risk.

The positive side? Everything else is in order. The implanted rod, the screws, the additional plate, all are in place and well positioned. An outcome that could have been worse, but one that still falls short of a clean bill of health.

Farewell cast, hello monster! To avoid any complications with this insufficiently healed fracture, it was decided to remove the cast, good news, and replace it with a VACOped. For those unfamiliar with the device: imagine an orthopaedic boot with generous padding, designed to relieve pressure on the leg and, by extension, on the fracture. Duration: six weeks. Six more weeks. That is the hard pill to swallow, even if the other indicators are positive.

I won’t pretend otherwise: learning that another six weeks of caution would be required, when everything else seemed to be moving in the right direction, is not the news one hopes to hear. But medicine has a pragmatic way of ignoring our personal timetables.

As I left the two doctors, I ran into someone in the corridor with whom I had built a genuine connexion over the weeks, Mrs Pietropaulo: the one who had fitted most of my casts. A nurse in emergency care for many years before training in casting techniques, she embodies exactly what is best about hospitals: technical expertise combined with a calm, human touch. As always, the conversation was easy and natural.

Shortly afterwards, Dr Flückiger, the one who had performed most of the operations, came to check on me. We spoke at length about the situation. With a frankness I appreciate, he told me that in his entire career he had never encountered a patient with such patience. A modest but sincere compliment, and in the circumstances, not insignificant.

I took the opportunity to mention something that had weighed on me: the episode of the forgotten suture thread in the wound. Not so much the incident itself, these things can happen, but the fact that, in my already complicated case, it had represented an unnecessary additional burden. He assured me that the case had been thoroughly discussed internally. What stayed with me most was his way of responding: direct, straightforward, without ambiguousness. Of all the doctors and surgeons I have met during this journey, he is the one with whom the human connection has been strongest. A good dose of empathy, clear explanations, no unnecessary jargon. That matters when you are going through months of treatment. And to be fair: the complications stemmed from the staphylococcal infection, not from any lack of professionalism.

The taxi then dropped me off at OrthoTeam, where my orthosis had been made. An assistant arrived with the VACOped. At this point, I must be honest: compared to this device, my old cast almost had a certain nostalgic charm. The boot is bulky and generously padded, which, I prefer not to think about too much, promises rather “pleasant” days once temperatures rise. That said, one pleasant surprise: despite its size, the thing is surprisingly light.

Then the bill: CHF 550, covered by insurance. They say orthopaedics is a lucrative field, having seen this device up close, I understand why.

On the way home, I stopped at the pharmacy to collect my medication. To reduce the neuropathic spasms in the foot, the dose of Pregabalin, an anti-epileptic used to treat neuropathic pain, has been increased. If that is not enough, we will move on to something stronger. We shall see.

If I sum things up honestly: the overall picture is mixed. The implants are doing well, the infection seems under control, and the wound is healing properly. But the need to remain cautious in my movements for another six weeks is, to be blunt, rather demoralising.

I had been considering a trip to Burgundy next week. With this monster on my foot, that will have to wait for another time.

Recovery is progressing. Not at the pace I would have chosen, but it is progressing.