Birks

Sunday I bought my first pair of Birkenstocks. I tried on a pair of Chacos Friday and looked at shoes on Saturday at Belk. My foot didn't seem to want to fit into anything other than the Birkenstocks so I paid out the bucks and now have a pair of granola crunchin', tree huggin' Birks for the next umpteen years. I wore them to work on Tuesday and left my walking boot in the car, just in case it would be needed. I survived the day and it was nice to give my calf some exercise. The walking slowed down though from the boot to the shoe.

At my PT appointment on Monday, I arrived early so while waiting in the car, I took off my boot and started massaging my foot and bending my toes. Rather than put the boot back on, I walked into PT with my new shoes. The therapist seemed happy because that opened up a few more exercises for me to do with my shoe on. I still did the balancing act on one foot. It was easier in the shoe over being completely barefoot. Today at work, I balanced for 45 seconds in my shoe. Until the shoe gets broken in, the sole is very stiff, which is what my foot seems to need right now.

Walk with the Dogs

Today I took a walk down the trail from our house with hubby and the dogs. It was slow going in my boot but I went almost the whole way before turning back; about a 10-15 minute walk. I did it after my morning therapy when my foot was loosened up. Tomorrow, Mar 30, will be the 3-month marker.

At Friday's PT, one of the new exercises was to stand on my foot, one legged, and time myself. I couldn't make it 5 seconds without losing my balance. Today I timed myself on my left, good, foot and made it a minute. Then I timed myself with my right foot and made it 15 seconds. This was at the end of my therapy when the toes have been manually bent to loosen them up. Try balancing yourself. Your foot does a lot of minute detailing to keep your balance. That's what my right foot can't do right now, but I do have hope!!

Weight Bearing

My therapist called the doctor's office to find out if I could put weight on my foot. I was given the okay during therapy. Around the house I can wear a stiff soled shoe just a little bit. I can't walk through so the foot needs to stay flat. She said that would give me a lot more things to do in therapy now that I can stand on that leg. For starters, I can now start to stretch out my calf which is all flabby from 8 weeks in the cast.

Tonight I put on one of my sneakers that has a more stiff sole. I expected the shoe to fit tight, but it was tighter than I thought it would be. I'm feeling so sorry for my dogs, so I strapped on their leashes and walked them to the end of the driveway. My idea was to get to the pavement on the street where the walking would be easier. I decided after the 100 yard walk down the driveway, I probably shouldn't push it too far, so I came back to the house.

More pictures of the foot to show progress.

Space between the toes and weight bearing!

Game Ready

Tuesday was the 12 week/3 month mark. My therapy continues to work through my ankle rotation, and getting my toes to bend. I spend about 25-30 minutes each session and have been fairly faithful to do 3 sessions a day. Sunday was a busy day and I only did two sessions.

This past weekend I put on a Teva sandal with a stiff sole and walked from the bedroom to the kids bathroom; very carefully. I also have spring fever and am dying to get back on my bike. I had a flat tire and didn't really know how to change it so I took my bike to the shop on Saturday and had them change and check both my tires. One tube needed to be replaced, and the other tube was fine. When I got back home I gave riding the bike a try, with my boot on my right foot. The boot is big but I could carefully pedal. I rode up the street, up the hill, to the end of the street, and back home. That was enough for a test drive. I still had on my clip-in pedals which I'll be changing back to my regular pedals that came with the bike. So when I went to therapy Monday morning and told of my adventures, I was scolded. She ended the session telling me not to do anything silly like ride a bike, and walk in a shoe without been given permission. She said "Not like you'd do anything like that at all, I'm just saying".

Monday and Wednesday PT session ended with an electrical stimulation and cold therapy at the same time. Four electrodes were placed on my foot and then my ankle and foot was covered with this sleeve. So one machine, Intelect, caused the electrical stimulation. The other machine, Game Ready, made the sleeve get cold and it would tighten and loosen like a blood pressure cuff. The temperature went from 51 degrees down to low forties. Something new so of course, I took some pictures. The sleeve was a little big for my foot so the blue straps were added to help out.

The Game Ready is used for athletes to get them back in the game quicker. "Game Ready leverages NASA spacesuit technology to simultaneously deliver intermittent compression and adjustable cold therapy in an all-in-one, easy-to-use system." I believe the electrical/ice combo for me is get circulation back in my foot but I'm happy to know I'm being treated like an athlete.

Another highlight from the weekend was the wonderful spring weather. Friday was a spring break holiday for university employees (i.e. me), so we had a three day weekend. I tried to get outside all three days. I raked a few leaves, made a fire in the firepit, swept off the deck. It was great to be free of my crutches. Also, I wore blue jeans all three days!!! First time to wear jeans since Dec 30. I took more pictures because what's a blog without some pictures here and there.

Physical Therapy

When I got to work this Tuesday morning I had a voice mail from the physical therapy about setting up my appointments. The physical therapist I wanted to see was taking off the rest of the week (it is spring break) but she had a 3pm appointment on Tuesday. I was anxious to get started on this PT stuff, so I took that slot. What I found out before even going to my appointment was that my PT will be for 3 times a week, 30 minute sessions, and insurance covers 80% so my cost is $15 per session. Well, do the math. $15x3x4=$180/month. My prescription is for the next 6 weeks. Anyway, as usual, I'm concerned about my personal cost in all this.

So I got acquainted with my therapist. I had gone on the recommendation of some other friends, and from the get go, she did seem very attentive. I printed my x-rays from this blog to show her the broken bones and she seemed happy to have the printout. My ankle is stiff from being in the cast so she measured the angle of moving my ankle up & down, using my good foot for comparison. I suspect she'll measure it regularly to track my progress. So as not to stress the metatarsals which are still healing, she showed me how to stretch my toes up and down, and ankle up and down and sideways.

On Monday, I had asked the doctor about hydro therapy. When I brought up hydro and massage therapy, it must have made him think that maybe I would be better off going for some PT because that's when he offered up giving the prescription. I'm persistent enough that I don't think I would have walked out of the doc's office, not making sure I had outside therapy. I knew I could not do all this on my own, and I would need someone to push me past the pain barrier that I would hit. So my PT brought up the contrast bath without me even asking. I start each session out with the contrast bath to loosen up a bit. My contrast bath will be soaking my foot for 2 minutes in hot water, 2 minutes in ice cold, 1 min. hot, 1 min. cold, 1 min. hot, and end with 1 min. cold. The PT's young assistant fetched the two buckets of water. The hot bucket WAS definitely HOT!!! I asked how hot it was supposed to be. 98 degrees. I asked if they actually took a reading. The PT said with a smile, "She's supposed to" Another wards, she is but maybe she didn't. Well, it wasn't until I got home that night, I realized she couldn't have taken a temp. reading. It had to have been 105-110 degrees based on my water at home which was 98-100 degrees. I really like hot water and this was almost unbearable. So I'm going to take my own thermometer next time.

One of the exercises was to try to grab a towel off the ground with scrunched toes. You know how you can curl up your toes and almost pick up a pencil. When I scrunched my toes, you could hardly tell they had moved. The therapist said something like "No, really, move your toes". I'm like "I'm squeezing as hard as I can squeeze and I can definitely feel something but you see no movement". Today at work, it did seem like my toes moved ever so slightly so I feel like a little progress after 4 sessions. The doctor had said that I may never get that kind of detail with that foot but I guess time will tell.

The therapist wanted to know when exactly I could be weight bearing in a shoe. I guess I walked away from my doctor's appointment not really understanding when I should try on a shoe. So she's going to call and find out. She agreed with me that from the x-ray the 2nd metatarsal doesn't look very strong. I'm sure she doesn't want to risk damaging the metatarsals anymore.

My first visit lasted a little longer than a half hour. I was sent home with a sheet with all my exercises. At home I made a schedule for the next week, since I won't go back until next Monday. It's going to take about 25 minutes per session and I have to do 3 sessions a day. I'm going to do one in the morning, maybe one at work, or the day I have PT will count as one, and then one in the evening. If I can't do one at work, I'll try to fit two in the evening at home. I still have the 20 minutes of bone stimulation, too. So we're talking 1 1/2 to 2 hours of stuff to do.

We went shopping for new pails since I wouldn't want to stick my foot in anything we already had at home. When this is all done, I'll have two new pails for cleaning my house, which desperately needs it, at this point. I also bought a countdown timer, and a meat thermometer. The PT will just become another routine in my evening. I also got setup at work to do the same therapy. It's a little more difficult to figure out how to get hot water, and cold water. I found a countdown timer for the computer so I can sit right beside my computer. I can even use the timer for each toe. I set it on 1 minute and move each toe back and forth, then move to the next toe. The timer will repeat over and over, counting down from a minute or whatever time you give it. I have a refrigerator so I can freeze ice cubes. The lady next door at work has a water heater. The kitchen sink is somewhat nearby but the bathroom is a ways from my office (for pouring out my nasty foot water). At home the water coming out of our tap is over 110 degree so I cool it down with some ice cubes. The ice water is about 40 degrees. The first time in for 2 minutes really hurts.

That's all for now about PT. Now I need to be good and do my best with it.

Seventh Visit to TOC / 11 Weeks

Today it took a few minutes for the medical assistant to figure out I didn't have a cast. She kept looking at the computer and reading the chart, then looking over at my foot, and then back to the computer. Finally she said "Didn't you have on a cast?". Nobody freaked out too bad about me not having a cast on. I'm sure I wasn't the first person to get sick of a cast and remove it.

Okay, so that out of the way, I went for my x-rays. This time I had to stand up for a couple weight bearing x-rays, a top view and a side view.

The foot on the left looks really good, huh? Wish the one on the right was that nice looking.

Back in my room, they displayed two previous x-rays for comparison. My first x-ray taken in Huntsville was at the main TOC location but all the other x-rays have been at Dr. D's main office. I guess the x-rays the day of the accident taken in B'ham are still down at St. Vincents. So anyway, this office only had a history of 3 x-rays. I put them together into a side view and top view.

side view

top view

You can see the progression of the 2nd & 3rd metatarsal starting to join together. The side view looks scarier to me. The doc is still concerned about the 2nd metatarsal and brought up the S word again (surgery). He also mentioned fusing my first metatarsal to the joint and mentioned it like it was really no big deal. I reminded him that after the joint is fused there would be no turning back. At this point, pain is to be my guide. I will stay in the boot , until at some point if I want I can put on a stiff shoe. If there is immediate pain to walk, then stay in the boot. I go back in 6 weeks to see him. If at 5 weeks, I have had pain when walking, then I need to call the office to get a CT scan appointment so he'll have the results for my next office visit. The CT scan shows more detail than the x-ray.

He did lots of manipulation of my foot and I really didn't have much pain. He was showing me how to exercise my toes to try to get more movement so I inquired about therapy. He agreed that I could go to therapy. I told them I wanted to go to Johnson & Hayes so they said contact J&H and then J&H would give me a call to set up the appointment. J&H didn't call today yet. I believe it's supposed to be for 3 times a week. I had a recommendation from some friends on using a particular therapist at J&H and this location is convenient for appointments en route to or from work and not too far from work if I have to leave work in the middle of the day.

I got the one last stitch remaining removed. I'm such a wuss that I thought it would hurt but the medical assistant snipped it, removed it and I felt nothing.

The boot is the same boot I came home from the hospital but then it was more for protection. Now I can actually walk around in it. It gives a rocking motion to my gait.

I bought a tube of stuff called FOOT REPAIR / THERAPY. It has Aloe Vera, Tea Tree Oil, and Chamomile, smells like peppermint, has lots of different kinds of oils, and feels really cool. I think hubby wanted me to show it to the doctor and joke, "see this is all I need at this point". It's really great stuff. I put it on about 6 times on Sunday because my foot is so scaly.

Don't Try This At Home

Okay, so I'm so excited about getting my cast off, I decided to take it off myself. Actually, I've been experimenting this week walking with both legs, putting a little weight on my foot. The weight ended up mostly on my ankle and my metatarsals seemed well supported. So today I had to do a lot of running around with my son. While he was at guitar lessons, I ran an errand and left my crutches in the truck. It seemed easier to walk in the store than to drag my crutches out of the back of the truck. But I stepped in a puddle and the cast got all wet under my foot. Plus the padding around the hole where I do the bone stimulation has gotten moist and nasty from the ultrasound gel.

I haven't had much training in cast removal but I paid attention with my first cast. I would have never tried it had this been my first cast. I did a little internet research to see if anyone had removed a cast at home. I came across a Dremel tool as an idea. The Dremel was to be my last resort because I knew it would also be the most dangerous. I really didn't want a trip to ER to get stitches and to explain that I had cut my leg trying to remove my cast. I tried a box cutter and wire cutters. There was no way that would work for the entire cast. About this time hubby and daughter returned home from a soccer trip. They caught me in the act and inquired why I was doing such a crazy thing. They must have told my son because he came downstairs and took all my tools away, out of my reach. But he failed to take the Dremel tool. He said he hid the other tools but I found them because he didn't really hide them very well.

I didn't really know how to assemble the Dremel tool, but hubby was now to the rescue, and he put the cutter tool on for me. The manual even said it was for cutting through fiberglass, along with wood, plastic, and other harder objects. Surely, it would cut quite nicely through my skin if it came in contact. Yikes.

The fiberglass was in three to four layers. I could make it through one layer with no risk of cutting my leg. That put me at a point of no return. Getting through the other layers took time, patience, and being very careful to not let the Dremel blade go too deep. There's a lot of padding under the fiberglass but still. The padding sometimes tried to pull the blade in. The hardest part was around my foot. There was four fiberglass layers because of the bone stimulation port needing more support.

Once the top part came off, the rest was easy.

The real curiosity was the foot. The scar from the stitches looks a lot better after five weeks. The white on the toes is fiberglass dust.

There is still one stitch near my third toe. I joked with the kids that I'd remove it, too. Guess I'll leave that for the medical assistant. I'm not really sure why there is even a stitch there. That's the open fracture area that was at risk of infection because it was open for about 2 weeks.

Cast removed, first thing I did was go upstairs to wash my foot. I have been dying to submerse the foot in water since the New Year. I used my crutches because I didn't dare put any weight on it now. The bottom of the foot had this moist peeling skin. I'm glad I didn't leave the cast on until Monday as that would have gotten worse. I shaved my leg.

I can now start trying to get range of motion back into the foot. My ankle is pathetic. It has a little movement. Toes are pathetic, too. I guess all this will just take time.

I hadn't done my bone stimulation today so I checked out the strap that came with the kit.

It will be really awesome to sleep tonight without the cast. Maybe I'll get a more solid sleep. My appointment is at 9:30 on Monday. I will probably get scolded but I feel like I've saved all of them some time. We can go straight to the x-ray. This Tuesday it will be 11 weeks since December 30. I'm now into my next phase of recovery. Yippee!

Medical Tab #2

I got the claim statement for the fancy dancy Exogen 4000+ Bone Healing System - Bone Stimulator. As the company representative had warned, BC/BS only covered 80%. I now owe $616. That puts my tab close to $1000 now for this idiotic injury. Until I see the x-ray on March 16th, I still won't be convinced that I even needed the bone stimulator. I have continued to do it faithfully and daily. I noticed last night I had done 29 treatments now. When you turn on the machine, it displays in big numbers (I don't need my glasses to read it!) the number of treatments completed.

My foot is pretty dried out so every day at work, I've been putting some Vitamin E oil on the toes. There's a lot of slack in the cast now so I can rotate my foot in a little circle which I do periodically throughout the day.

Nine Weeks

Today has been nine weeks since I came home from the hospital and have been on crutches. 11 more days until I get the cast off.

I struck up a conversation with a soccer dad at the game Tuesday night. He broke his leg in a motorcycle accident 12 weeks ago. He's in a walking boot but still has crutches. He walks slowly with his crutches and boot, putting a little weight on his broken leg. So when I get my cast off, I may be walking again but actually may be slower to get around without crutches. Also, I may not be able to ditch the crutches right away. I think I'm getting up too many hopes. I better settle for slow progress.

I Drove to Work

Today I drove myself to work, 17 miles. I moved my stuff back into the SUV rather than the pickup truck. The SUV has a few more comforts. Electric seats that move up/down, forward/backward, and the seat even tilts sloping down or back towards your butt. The floorboard is flatter around the gas pedal. Overall, my left leg just seems more comfortable in the SUV. The left leg does get tired but I think it's because I can't seem to relax all the way. Once I got on the interstate, I put on the cruise control so to give my leg a rest. Like in the truck, I can now keep my right leg down on the floorboard rather than propping up into the other seat. That's added comfort right there. But by the time I get to work, the toes are ready for some elevation. They turned a little purple. I'm ready for some freedom to come and go to work, leave to go to soccer games, etc. I don't think I'm supposed to drive with the boot, either, so maybe I can take off my boot to drive with my right foot, and then put the boot on when I get to work. So many unknowns right now!

Upstairs Bed

Last night I slept in my own bed upstairs, with my hubby, and without a bunch of pillows propped under my leg. I tossed and turned dragging the heavy leg around but that wasn't too different from the daybed downstairs. The weight of the covers was one difference. I have a down comforter downstairs and it's just lighter and warmer on the legs than the covers upstairs. Once I move back upstairs, the down comforter will go back up with me. The other difference was the snoring of that person I've slept with for 22 years. I've worn earplugs for 10 or more years and even wear them when he's not around for a more sound sleep. So between the choices of downstairs, listening to the cat meow throughout the night; or upstairs, the snoring, and uncomfortable covers, I chose downstairs. I think I'll stay down there until I'm out of the cast.

Let it Snow

Today we got snow! That definitely warrants some pictures since it's such a rare thing for us. I can hear you snickering, those of you that aren't from the south. "You call that snow". "Yes, we do!". 1-2 inches can shut down the city. It was so warm yesterday, roads are probably just fine, but I'm staying home all day so I don't really care. I just hope the family make it back from the beach tonight and can get up the mountain. They've been at a soccer tournament for past 3 days. The high today in the valley is 37 and it's usually 4-5 degrees colder up here on the mountain, so it may not get above freezing.

I get my cast off in 15 more days on March 16th. I've had this cast on for 19 days, almost 3 weeks. I've done 23 bone stimulations, sometimes twice a day on some weekends. I just really, really hope the x-ray looks good on March 16th. Doc's orders for the cast was 4 weeks but the appointment was made 5 weeks out. I guess the healing I'll get in that extra week won't really matter in the grand scheme of things. I'm just anxious to get back to walking without crutches.

I know this is very shallow of me but I miss driving my car...

(it's a 5 speed manual)

My forefoot still feels tight like there isn't very good circulation and it still helps to keep it elevated. But there isn't much pain these days. But I've pretty much done whatever I've wanted as far as activities. I've been to a lot of soccer games in the past two weeks. Since everyone was gone this weekend, I had my freedom to come and go and the house gets kind of old. So Friday night I went to the movies and I went again yesterday. I wanted to catch up on some Oscar wins. I saw The Reader and Slumdog Millionaire. I drove the truck both times. I have the seat pushed farther back and I can now leave my foot on the floorboard and drive with my left foot, rather than propping my right foot over into the passenger side. It's more comfortable. I may drive to work some this week. My main carpool ride is out of town half the week so I need to get a ride in the morning with another guy who lives on the mountain. There are some soccer games to go to after work, so I may just drive myself on those days. I've bummed rides from a variety of folks in my building, mostly for the end of the day when I want to catch a ride to Grissom for a soccer game.

The new LCD TV broke about 3 weeks ago. The Sharp electronics sub-contractor has been out to the house to fix it twice. On those days, I stayed home the whole day. TV is still broken and it needs yet another circuit board. I'm a little ticked of the inconvenience but would really just like the TV to be fixed. Let's hope the next board will work. I may need to stay home another day or partial day this week.

I have missed most walking the dogs...

Other than that, not a whole lot of news about the foot. Just waiting to be crutch free!!!