May 26th, 2026

1106 days after my accident in the Moroccan High Atlas, every medical appointment feels a little like a mountain stage: you always hope to catch sight of the summit, while knowing there are still a few tight bends left before you reach it. My today’s consultation with Professor Krause marked precisely one of those important moments in this long journey.

After a fresh series of X rays, the assessment was both encouraging and realistic. The first piece of good news is that I still need to wear the VACOPed, the imposing orthopaedic boot that has accompanied me for the past six weeks. Unfortunately, there are not yet any orthopaedic shoes high enough to stabilise the calf properly. For those unfamiliar with the device, imagine a plaster cast that decided to pursue a career in military engineering or robotics. Solid, efficient… but certainly not discreet.

The tibia still requires a period of stabilisation. On the other hand, the fusion of the ankle is now perfect. I can therefore gradually begin putting weight back on the foot, with the ob

This milestone symbolises genuine progress. Yet, as is often the case with complex medical situations, every step forward also reveals the lasting consequences of the road already travelled.

The staphylococcal infections that affected my ankle over the past years caused significant bone damage. In order to remove the infected and non-viable tissue, part of the bone material had to be removed, resulting in my left leg becoming more than two centimetres shorter. This difference will now need to be compensated through adapted footwear or specialised orthopaedic solutions. Otherwise, the imbalance could eventually lead to scoliosis. An appointment this summer with the orthopaedic specialist will determine the most suitable approach.

Professor Krause also took the time to explain, with great honesty, the long-term consequences linked to the arthrodesis and the insertion of the “tibiotalocalcaneal” nail. The ankle is now fixed, but this stability inevitably comes with certain functional limitations.

The loss of the joint’s natural mobility permanently alters the walking pattern. Walking now requires more energy, which may lead to quicker fatigue in the calves, knees and sometimes even the back. Stairs, particularly on the descent, become more technical than before because the foot can no longer roll naturally through movement.

Uneven terrain also presents an additional challenge. Cobbled streets, hiking paths, snow or unstable surfaces now demand constant attention. Since the foot has lost much of its adaptive capacity, balance becomes less instinctive.

Footwear choice will also play an important role. Particularly stable shoes, sometimes combined with so-called “rocker sole” technology, may help improve walking and reduce strain on neighbouring joints.

Even when the procedure is considered successful, some residual pain or swelling related to physical effort remains common, particularly towards the end of the day or during changes in the weather.

Complete recovery remains a long process. While a gradual return to walking is possible relatively early, internal bone consolidation may still require between six and twelve months. In other words: the body sometimes progresses far more slowly than the impatience of the mind.

The long-term objectives nevertheless remain clear:

• Reduce pain, which fortunately is now very rare,

• Ensure lasting stability,

• Maintain satisfactory independence in daily life,

• While accepting that a return to completely normal mobility is probably no longer realistic.

In many comparable cases, patients regain a largely acceptable quality of life: walking normally, driving, travelling, cycling or undertaking moderate hikes all become possible again. However, certain limitations often remain when it comes to long walks, intensive sporting activities, rough terrain or prolonged standing.

The prognosis depends on many factors: bone quality, blood circulation, previous infections, the number of surgical procedures, body weight, nicotine consumption… but also, and perhaps above all, patience during rehabilitation. Patience that I have already had ample opportunity to practise throughout this entire journey.

Because in complex situations, the psychological challenge can eventually become almost heavier than the orthopaedic problem itself. Learning to accept a new rhythm, a new form of mobility and certain permanent limitations requires as much mental effort as physical rehabilitation.

That is precisely why structured rehabilitation, combined with realistic objectives and strong medical and human support, remains essential. After ten operations and three years of complications, I now realise that recovery is not simply about repairing a bone. Above all, it is about gradually learning how to move forward again.

I have also been able to drastically reduce my medication intake. The neuropathy now appears to be under control, and the digestive issues caused by the antibiotics have gradually returned to normal. The mineral supplements prescribed following the numerous surgical procedures have also been discontinued. The only medication I still need to take for another month is calcium, intended to support bone healing and density.

Continuing to wear this VACOPed has certainly not made this day any more cheerful! The weather forecast is announcing warmer days ahead, which will make wearing this device rather uncomfortable.