Back on my feet

I have been recovering steadily for a couple of weeks now. The swelling in my leg is minimal now and I can usually get the foot swelling down overnight so I can maintain a decent level of mobility.

I have been very fortunate to carpool in to work while I was in the early stages of recovery. Thank  you Lori. I have now been driving myself to the office for a week - although my car is exhibiting sympathy pains from almost three months of  neglect.

I've noticed a significant uptick in my psychological well being since being among my friends, family, and co-workers again. I can certainly see wisdom in not rushing into the next surgery too quickly - especially with the Christmas season coming up.

Not sure what else to write. If there is intelligent life out there reading these posts perhaps you could comment or ask me something. I don't have a date for the next surgery yet (in case that is the first question).

Ten weeks in

The Maples - 19th Line

Thanksgiving weekend has come and gone and I was reminded once again how much I have to be thankful for. I spent some quality time with family, ate a whole lotta food, and went for a nice drive with my love. Dufferin County looks great at this time of year - the county looks great at other times too but I'm not thankful for that at the moment. :-)

I had my final follow up appointment today - and the first with the actual surgeon - for the triple arthrodesis on the right foot. I wasn't sure if I'd get a stern rebuke for not wearing the air cast, but it played a part in my leg and knee pain, so I took a chance and went in wearing crocs. No warning ensued. Dr Stevens reviewed my new x-ray images and said it all looked great. The incision wound is healing well even though there is still some scabbing. He jiggled the foot in several directions and was pleased by how firm it felt - and pretty impressed with his own handiwork. I asked about physiotherapy or whether he would recommend a knee brace to combat the issues I encountered last week. He said I didn't really need either. He recommended extra anti inflammatory drugs as needed and a stationary cycling regimen. There is no further follow up appointment for the right foot.

Dr Stevens was proud of his work

I then asked if it was time to start talking about the surgery on the left foot. He had forgotten that I was getting both done, but agreed that it was necessary after doing the foot jiggle test there. I reminded him about the bunion and he made another note on the chart. The next surgery isn't booked yet, but he is recommending a longer wait. He initially said three months between surgeries, but now he said he'd wait till the new year. In some ways that adds some logistical hurdles but in others it makes things easier. The total time to recovery will be longer than I had anticipated but my wife and I will get some reprieve in between.

And we can celebrate Christmas in a less gimpy fashion.

Weight bearing woes

It has been a while since my last post - this writing thing takes some discipline.

Ever since I got the green light to gradually start weight bearing three weeks ago, I've been trying to stretch my mobility. I didn't feel like I was overdoing it but I now have some evidence to the contrary. I was gauging my foot pain and progressing quite well, in my own estimation.

My previous post documents my first visit to the office at the end of my first week of partial weight bearing. At that point I was doing very little actual weight bearing and was using my knee walker to get around.  I experienced tingling and discomfort whenever I tried to put weight on the foot.

On Wednesday of the following week, I spent my first full work day at the office. I was able to carpool with a friend who also lives in St Thomas. Thanks Lori. I was exhausted by the end of the day, and had quite a bit of swelling in the foot. I wanted to gradually build up to a full work week so I planned on going to the office on Wednesday and Friday the next week. But that was not to be.

Elianna Jolene

By Tuesday - six days later - I was still in too much discomfort to try again. I did go to the office on the Friday though. I suspected that some of my discomfort was caused by the tightness of the air cast, so I took it off for most of the day. I survived the day but my leg pain had continued to grow - from below the calf to the hip - oddly, the foot was doing better than the leg at this point.

We had a full weekend planned to celebrate my new found mobility - we were still expecting the leg pain issue to resolve itself. On Saturday, I had a massage. The therapist worked the foot a little and the leg a bit more. She told me to apply ice at the foot and heat at the thigh to help the circulation. We had a few more errands and then called on my newest niece who was three and a half weeks old but I hadn't seen yet. Then an awesome Saturday night church service.

On Sunday, we had a down day followed by an evening back at my brother and sister-in-law's place, the ones with the new daughter. They had family visiting from Alberta and we wanted a chance to visit with them before they flew home. My leg was still in pain but it was manageable.

On Monday, I had a few appointments - routine bloodwork, dentist - and errands. By the time we got home, I was in a lot of pain - focused in the right knee. It was very hard to find a position for leg where the pain was bearable. I tried to get a good night's sleep and hope for the best.

This morning, the pain was worse - I'm surprised that I actually slept at all. The knee is still swollen and hot. I contacted my surgeon's staff hoping for insight and instructions on how to cope. The surgeon was unavailable until later, so I took some painkillers and tried to rest. This was supposed to be a work from home day, but it quickly became a day of agony and unconsciousness. I am very grateful to Krista who sacrificed her plans for the day and stayed home with me.

My theory to explain the knee pain, is that the bones in my legs have been repositioning over 30+ years to compensate for foot pronation. Now that the foot is fixed, the bones have to shift back but much more quickly and the knee has to adjust accordingly.

I'm unsure of what tomorrow will bring. I continue to appreciate your prayers and positive thoughts.

Au travail!

I was a little gun shy about putting weight on my right foot after Tuesday's experiment. It was awkward, painful, and very unsteady. I resorted to non weight bearing exercises for a couple of days and felt better on Thursday. Time for another attempt and I was feeling ambitious. I decided to visit my workplace on Friday afternoon for the annual "associate appreciation bbq" since my work mates would already be outside and I wouldn't have to brave the stairs to see them.

James B test driving

Or so I thought. The rain was just heavy and steady enough to force the bbq inside so nobody was waiting for me when we arrived. Well, we're here, might as well make an attempt at the half dozen stairs to get into the building - I could use the elevator and my knee scooter once inside. I had tottered my way down three stairs at the house and was none the worse for wear. I was pleasantly surprised at how well my progress went. It was slow going and awkward around doors but I made it inside fairly easily. I enjoyed a hearty welcome from my peeps and spent a fun 90 minutes in the office. Thanks folks!

I was quite sore and very exhausted when we got home, and am thankful for a down day today, to recover. Even so, I expect to be working at the office a few days next week. I won't be taking the knee scooter so it could be a bit rough, but I'm aching to get out of the house again.

Phone call

Today, I got the phone call from Dr Steven's office as Dr Snider suggested. I am to start gradually putting weight on the new foot - no two week wait. Yay!

So this morning, minutes after the call, we had a roofer come by to give us a quote and I decided to try to walk outside and wait. I couldn't believe how much my legs were shaking just trying to stand up with weight on both feet. Six weeks of atrophy! I did make it to the porch with very small steps and leaning heavily on my cane. I was very glad to come back in though. So this "gradual" business is for real. My foot is very swollen at the moment, but I will continue to exercise it and take the odd short walk - and I do mean odd.

Thanks for all your encouragement everybody. I am approximately 25 percent through this journey now - in terms of duration. Although in some ways, the journey is the rest of my life.

Man, next  year is going to be epic. :-)

"Oot in a boot"

We checked in with the fracture clinic at Grand River Hospital and confused the reception staff. My surgeon, Dr Stevens, was not booked today. In fact he is never in the fracture clinic on Mondays. So what in the world could have happened? And could we come back tomorrow?

Well, "what in the world" did happen, and we couldn't come back tomorrow. So, they booked me with Dr Snider, who saw me three weeks ago when my first cast was removed, staples extracted, incisions inspected, second cast applied. For the last visit, we knew Dr Stevens wouldn't be there and Dr Snider would step in for him, but today's visit was supposed to be the first follow up with my surgeon. 

Apparently the receptionist was on autopilot last time. Appointments booked on Mondays are usually for future Mondays, so the reminder that the appointment was supposed to be with Dr Stevens didn't get the traction it needed. We didn't know that a Monday appointment assumed a follow up with Dr Snider instead of Stevens. Anyway, we let it play out and it's all good - except we didn't get answers to all the questions we came in with.

I'd been sitting in the fracture clinic waiting room for five minutes when the x-ray technician came for me. But I still had the cast on so he said he'd try again in a few minutes. Fifteen minutes later, a different technician came for me again, but I still didn't have the cast off, so she made sure the fracture technician knew about the holdup. I had the cast off quickly after that, and got my second look at my emaciated leg. Who knew that muscle needs to be exercised to maintain it's strength and bulk? Ten minutes later the third x-ray technician came for me and I was ready.

All this while I had been chatting to an old man who had a fifteen year old hip replacement go bad. Apparently arthritis had started eating at the material around his prosthesis and was causing a lot of pain. He was at the hospital for an injection for the pain. Again, my knee scooter got a lot of attention. Business opportunity, anyone?

My hardware

Anyway, the fracture technician had told me to come looking for her when the x-ray was complete so I went scouting. I found her and was asked to sit on a bed and wait for her to finish with a boy whose arm she was casting up. We noticed a monitor with an x-ray image and hoped we would get to see my foot. Sure enough, when it was my turn, we got to see the hardware in the foot. I'm sure glad the foot doesn't feel like the x-ray looks. 

Dr Snider reviewing my x-ray

Dr Snider declared that the incision wound was healing nicely and the x-rays looked good. He said he wasn't sure what Dr Stevens would say but he recommended that I remain non weight bearing for another two weeks, in an air cast and then start putting weight on the foot still in the air cast. He said I should go with that assumption until (and if) Dr Stevens contacted me with different instructions. I am allowed to have a bath now - if I can get to it... we'll see how that goes. We are both disappointed because we had expected to start weight bearing gradually immediately.

We made a follow up appointment - on a Tuesday this time - with Dr Stevens. The day after Thanksgiving. Irony? I'll have to learn to be thankful before I get the news I want to hear. Gotta love God's sense of humour.

So, I'm back in my barracks for another two weeks, but I'll try to have that bath soon. Krista will be ever so grateful. :-)

A few hours pass...

I've had that bath now. I marinated for a few hours and scrubbed off layers upon layers of dead skin - I stopped counting at thirty. I am now cleaner than I've been since... well since birth. Actually there are still more layers to remove but that'll have to happen some other day. The trip up and down the stairs, and in and out of the tub, etc was too traumatic to document.

Moment of truth

So, I've been neglecting my documentation duties - d'oh, that sounds a lot like work.

It's been three weeks since I had my second cast installed.  Tomorrow this cast comes off and x-rays will reveal how my convalescence has gone so far.  If all is well, I will be able to start putting some weight on the operated foot while wearing a "boot".  I feel like I can expect the best case because the foot hasn't been feeling bad at all - besides losing muscle.

I have been getting very restless and often wake up to both feet kicking and twitching.  I am very ready, emotionally, to be away from my bed during the day.

I'll post again tomorrow, with a positive report. ;-)

Cast away...

Today, was a full day.  Woke up at quarter after five - with the alarm set for seven thirty.  I had a nine o'clock appointment for my routine bloodwork, so we had some time to kill at home - but that's what cheerios are for.

Leaving the house requires a little gymnastics to get from the scooter inside to the scooter outside and down three steps.  Weight bearing is easy to take for granted.  We stopped for a cheese & egg breakfast sandwich at Timmies - because it was hours since first breakfast - and made it to the appointment ten minutes early.  It only took a couple of needle prods to get the required sample and it we were off to Grand River Hospital in Kitchener.

I sat in the back of the car with my funky leg stretched out on the seat. A bit awkward, but I had experienced a fair bit of discomfort on the drive home from Kitchener three weeks ago, so I wanted to avoid it this time.

The drive was relatively uneventful - besides truckers crowding our lane.  We arrived with plenty of time to spare, which suits us introverts just fine.

The technician had to fight me a bit because the cast cutting tool vibrated and tickled like... um... like something very ticklish indeed.  (creative writing classes paid off)

It was interesting seeing all the layers peeled off my foot.  The blue fiberglass carcass, followed by cotton, more cotton, gauze, more gauze, and then the bare incisions held closed by a dozen staples each.  The technician was not impressed by Dr Stevens' cast handiwork but assured me that he was good at "cutting".

Dr Snider was in charge of the fracture clinic today so he inspected the foot and the healing progress.  He declared everything to be on track and called for a three week follow up for the next cast to be removed. Sept 10.

I was offered my choice of colour and quickly narrowed it down to orange and lime green.  Orange won out because I married a half Dutchie or whatever the reason.

The technician, was very adept at assembling the new cast.  First gauze hosiery.  Yeah, hosiery.  Then lots of layers of cotton.  Then the hot and wet fiberglass wrap, which took under five minutes to cool, harden and dry.  Very neat.  Apparently St Mary's Hospital doesn't have fiberglass cast technology, so if I have my next surgery there I'll be downgraded to plaster.  We'll see how that plays out.

I learned that the looseness of the first cast was due to muscle loss - after only three weeks.  Doh!  Looks like I have more gym visits in my future.

I decided to try sitting in the front with a pillow on the floor on the way home and it worked out well.  We stopped at Costco for a Montreal Smoked Meat sammage - yummy.  Then we caused a run in between two cars fighting for the handicap parking spot we were vacating.  The car that just arrived snuck into the spot before we could do anything about it.  Argh.  Evil sucks.

Anyway, we got home and spent the evening documenting our day and laughing at the comments on Facebook   Thank you, Mr Betterley.

Home alone

I've reached another milestone in my convalescence journey.  Tomorrow, my cast will be removed and the foot will be inspected.  I'll get to see the surgeon's handiwork for the first time.  They'll remove the staples / sutures (I'm not sure which were used) and recast the foot.  Hopefully this time the cast will be smaller and lighter.  I'm expecting another three plus weeks in the new cast.

I have a few questions for tomorrow, including how long before I can comfortably let my foot dangle instead of keeping it elevated.

I've been working from my bed for a couple of weeks now and haven't always been as productive as I'd like.  Thankfully, my work folks have found a way for me to participate in meetings - thanks Andrew.  Calling in to a speaker phone worked rather poorly.

Today, my wife is enjoying Watermelon Fest at church.  She deserves some time of celebration - she has given so much already in taking care of me.  "In sickness and health" sounds mundane but it is such a blessing when it is lived out.  

I love you Krista.

Outing

Thank you to Anne Enns Quiring for mentioning the use of a knee scooter for greater mobility. I hadn't heard of this sort of device and neither had my occupational therapist or either of the suppliers of assistive devices in town. But one of them did some hunting and found a scooter in a sister location. I've been using it for a few days now and I'm feeling more mobile than I was with the rollator walker I've been using.

Image from www.footankle.com

This morning my wife and I decided to go to church together. It was the first time out of the house for me in twelve days. The toughest, most awkward part of the ordeal was getting out of the house (and back in later), but it went reasonably well. This scooter packs up quite well too - an added bonus.

We made it to church and were overwhelmed by the excitement with which we were greeted. I feel very blessed. I did tire from dangling the foot in the church pew so I retired to the foyer, planted myself in a chair and put the foot up on the scooter.

The outing went so well, we decided to get my hair cut before coming home. I feel five degrees cooler now than with the shaggy mane I was sporting.

This afternoon, we had a nice visit from my co-worker, Teresa. Thanks for dropping by. I've been away from the office for more than two weeks before but somehow this feels longer already. It's different working from home semi-productively, aware that I could be much more helpful in the office. And there's enough drama in our office for a TV show. You've seen "The Office"? We've got them beat, as I'm sure the comments section of this blog will bear out.

All in the mind?

I've wanted to write a personal blog for many years and I've always bailed out when I realized that there is so much to be said that anything I do say will feel out of context without the full story.  But I think I need to do this as personal therapy, so here goes...

Photo by Femke Photography

Tonight, my wife is editing some photos for a wedding she photographed recently, and she made a comment about a decision the couple had made, and how it had made her job as a photographer more difficult, especially not knowing of the decision in advance. It got me thinking about our wedding and how disappointed I was that I couldn't really enjoy it. Bro-Tip: for all you husbands out there, be careful how you broach the subject about being disappointed in your wedding.

I'll back up a little, for some context, at this point. I'd had cortisone shots in both ankles a few days before the wedding.  I'd known I'd be standing a lot during the wedding, and walking a lot on our honeymoon and I didn't want to have to limit my standing or walking too much during this time.  Hence the cortisone shots. And yet, I found myself budgeting the time on my feet.  I sat outside the church while waiting for the bride. I walked in at the appointed time and sat down at my first opportunity.  We had decided to sit together during the sermon, so this wasn't a surprise.  Each time I had to get up for a part of the ceremony, I thought about the most economical way to get seated again. So, when the minister rushed us through the rose ceremony where we give flowers to each other's mother, I didn't fight it - I rushed through it and sat down. Even though I was nowhere near my pain threshold yet. My head was not at the wedding at all.

July 31, 2012

I'm now nine days into the convalescence period of the triple fusion surgery on my right foot. "Triple arthrodesis" for the nerds out there. I've had a lot of time to ponder what life might be like after both feet are surgically fixed and completely healed. The estimate is that within ten months of surgery, I will be completely pain free in my feet. I have no real concept of what that will be like.  I haven't been pain free for more than three decades. Am I mentally prepared for that amount of freedom? Will my mind refuse to believe it and insist on remaining crippled?

Well, that's all for tonight. Let's see if I can bring myself to continue the blog...