Aimless ambling...mindless meandering... profligate pacing...purposeless parading...time-gobbling trekking...wasteral walking.

Glorious galivanting on 2 legs among all the other human bipedalists.

Saturday in my new big black boot, walked to Bethesda and and omelet for breakfast at Daily Bread.

Walked on to Bruce Variety for a lot of white sox, because you can't wash the inside of the boot, and it gets hot in here.  

I've been cleaning up since I'm 2-legged again...all the clothes I've been wearing, handily stacked beside the bed, put away. The bin on the bed with cereal and dried fruit -- away.

Today, in the sandal, not the bulky boot, I tried the car. It started right up after 2 months and 3 days stationary. Valiant Kia Rio, noble Kia Rio.

There's still healing to be done, but it's great to be moving again.


Photos: 1-2 Looking at the ivy along Hillandale off Bradley, nice steps to stop and sit on awhile. 3-4 Pink hydrangas and those litte red waxy flowers at the car dealership on Arlington Rd. and Bethesda Ave.

6/27/12 W

Glucose garden, what's it about? Two things. Can a person who lives alone navigate on a third floor during surgical recuperation with one working leg? And, how does a person with a longtime sweet tooth live with and manage pre-diabetes and as much as possible, keep it from turning to full-blown diabetes?

The first I know the answer to: Yes, with more than a little help from her/his friends (and good medical attention). Now this is not exactly neat looking (in fact it's pretty damn sloppy), but my bed has held a bin with cereal, dried fruit, sometimes fresh fruit like apples (bananas ripen too quickly with a too-sweet smell), a hunk of cheese, crackers, juice, cinnamon. That has been for the time when I was really sick and getting out of bed was way more trouble than it is now. I think I'll retire the bin soon...but it’ll be easier to disburse the goods again when I am fully on two feet. Right now I'm heel-walking on the right foot.

The bin has also held bills, important papers coming in from the mail (thank you, next door neighbor Katie, for bringing my mail up). Also cables for my laptop computer. On the left bedstead: all the clothes I need, folded, at hand. On the right bedstead: meds.

How to consolidate the span of our reach and our needs as restrictions arise. The goal: good health.

The bathroom is 20 feet away. Clothes washed out in the bathtub from a tub bench and hangers. About the bench: new song while showering, to the tune of “There is nothing like a dame,” South Pacific: There is nothing like a shower! On a bathtub chair. You can never glare or glower, if you’re show’ring on a bathtub chair.

As for living in a glucose garden – uncharted territory, in good part, for me. I’ve been eating good breakfasts (oatmeal and fruit) for awhile. Somewhat prudent lunches. But my weight has yo-yoed for a long time, there’s a good deal of diabetes on my mother’s side of the family, and I am a sweetaholoic.

I was well forewarned by my mother’s experience in 1997, when she lost her left leg below the knee to diabetes. And by her valiant struggle to accommodate to that loss for the rest of her life.

But not enough was I responding to my own problems with glucose, evidently. How am I going to handle it now that thank God, I seem to be being released back into grateful mobility and ordinary life? Remains to be seen. I have a goal of never going through this again. How now to live in ways to support that? I’ll continue this blog from time to time on the subject.

There’s a third point to this blog. How is God, Creator and Sustainer of all creation, present in our world? In my humble opinion, God is at hand, God is afoot, God is about, while leaving us to our free exploration and discovery. God wants our participation, not us enchained.  

It seemed impossible that I could find a way to Shady Grove Adventist Hospital for hyperbaric oxygen treatments that were recommended as a way to save my distressed toes. As I sat in the hospital lobby the first morning waiting for the cab, I thought: This has gone amazingly well.

All of a sudden I saw the face of my mother’s good friend, Sr. Antonie Mueller, SSSF, School Sisters of St. Francis. Sr. Toni lived down the street from my mom and brought her a wonderful meal every Friday and they solved the world’s problems. She retired to St. Joseph’s Convent in Campbellsport, Wisconsin. I’d visit her when I’d get to Wisconsin. Sr. Toni was in excellent health in her 80s, gardening, sewing, attending lectures, reading, playing cards, visiting with her friends. She was taken ill and died unexpectedly in March.

As I sat at Shady Grove Hospital wondering why and how things had gone so well for me when they had seemed so impossible, I saw Toni’s face. Well, of course, she was saying.

Well, of course.

God is alive, God is at hand, God is afoot.


Photos: Bed bin, bathtub bench, St. Toni in May 2011, and Sr. Toni with her friend Sr. Betty. 6/21/2012 Th

Took my constitutional this morning at 9, back at 9:45 am before today's predicted heat.

Only 72^o now. Down and up the stairs on my rear, not to tax the right foot until the doctor says it's ok to. Hauled the collapsed knee scooter down and up with me, rode it a block to the mailbox, mailed bills.

Yesterday, I took my blue canvas chair down at 11, had a tuna sandwich, water and diet pepsi, and read and walked up and down in front of our place. Back upstairs at 2. A wonderful day. Slept baby-tired last night.

Building up stamina.

Understanding more what it's like to be a teenager again. Independence -- what a lure. Not ungrateful for all kindnesses -- far from it. Just...I want to do it myself. People with disabilities more comprehensive than mine must feel this more profoundly than I am. Independence -- what a lure. Totally alone -- totus solus? Something very tempting about that. I'm getting it now. Ahhh...alone.
Hmmm. One of my friends, an introvert (meaning not that she's quiet tho she is, and not that she's antisocial because she's not, just in the way she processes information: by herself first, then presenting it to others)...she said once: I need a lot of down time.

We all need down time. Time to ourselves. But it could be the apple in the garden. Ya gotta come back to the marketplace. I long to go to the marketplace. Thank you so much, dear neighbors, for calling on your way to Giant and stocking my fridge with food. I am eating so well because of you. But I long to go to Whole Foods and stand in the produce department, savoring the green beans and mushrooms, test-touching the canteloupe, eyeing the blueberries. Staring at the olive bread as if it were hewn by Michaelangelo.

I am trying a few steps with my clunky support sandal on.

http://orthoinfo.aaos.org/topic.cfm?topic=a00181 told me how best to use the collapsible cane. Standing upright at the sink not hunched from the knee scooter, remembering my mother washing the dishes after her left leg amputation (she called it her Standing Time)...I smile remembering her.

Creator and Sustainer of all, loving God, thank you for all of your blessings.

Dependence and independence. All ok.  Now for a short-step walk to the kitchen for a 2nd cup of coffee.

6/17/2012 Sunday - Happy Fathers' Day to the dads in our lives and the dad-like guys.

Today, the 3rd toe is pink and hale. Next week, xrays and a soft boot, and I'll walk out of Dr. Polun's office. Physical therapy scheduled. Going to be walking on two legs again soon!







Dr. Polun

 Shonnell and Carla

I'm not superstitious. But a lot of devices I own broke down before and during this challenging time. The Friday before the surgery, my laptop went bonkers. A possible fried motherboard. David Ashrafi of City Computers in Rockville fixed it.

The morning of the surgery, 5 am, my cell phone went. I could get and make calls from a white screen; no access to messages or my address book. A week or so later, after I added Mary G as an account manager to my Verizon account, she scoped out the current market, called me, and bought a nice new replacement phone.

Fran stayed over the first night and the the next morning the coffee maker went. The next time she came over, she brought one of hers.

Not a device but something you'd probably research and buy yourself...Julia searched the probiotics shelves of Whole Foods for a probiotic to introduce good flora into the system after the antibiotics cleaned out everything, bad and good.

Eucharistic minister Sr. Susan Wolf brought communion, and so did Julia Finley and her daughter Kate from Blessed Sacrament...and good long conversations.

Eliane brought groceries and wonderful cooked vegetables and rice.

Mark Jacobson, my financial advisor, also checked out the new kitchen.



Sherry Svares Sanabria and her painting...



 Jon safely back from Afghanistan...

 Former neighbor Kathy and a talk about geneological research...

 Trish with tales of her wonderful new granddaughter, Tess...

Bre on bongoes with her grandma Mary G and me on tamborines.

 

 

 

Distance learning: I'd email questions from time to time to nurse friends in Chicago and Maine, Ida, left, and Bianca, right. Ida and Shelly, center, are high school classmates, Dominican High School, Whitefish Bay, Wisconsin, 1960.

If you're in Alexandria Va., with a little time, stop at Carlyle House, shown here, where Shelly is a docent. 

 











One question has been, can a person who lives alone do this kind of daily living on one leg for 6 or 8 weeks? Answer: no.
I figured before the surgery -- which I prayed and expected would go well -- that I couldn't do it without asking for help. I don't like to ask for help. We don't, we Americans, very independent.

One thing my mother experienced in 1997 when she had her left leg amputation below the knee, was the unwanted advice  and worse, action, of folks who came in and changed things. She had everything exactly where she wanted it.

I don't. Julia walked wordlessly into my bedroom on one of the first nights with a box. She unpacked a reading lamp that clipped onto the headboard.

She reorganized the plug-ins (heater still in April, fan, adapters for phone, Kindle, blood pressure cuff) on the power strip. She took the little Waterford lamp I had beside the bed, put it in the other room, and cleared off the bedstead for meds.

Fran bought a new wastebasket for the bathroom and one for the kitchen (I've been experimenting, ok?), straightened out the dishes in the dishwasher, and cooked up a few meals. I was absolutely impressed. Better.

Suzanne, Jen, Eliane, Mary Lee, Melissa, Mary G -- calling on the way to the store, asking: What can I pick up?

What has been so fabulous is the fun conversations we've had up in here. Even when I'm bipedal again, I'm going to continue this party!

Photos: Melissa and Mary G., Julia, Jen and the upside down Eli, Mary J, Suzanne and Lucy, Lee, artichoke supper.

Toes...what's up with toes? When our fishy ancestors invaded the land, "air-breathing lungs and legs with digits (both of which seem to have evolved originally for use in water) were probably first of use to them when they still lived in shallow lagoons, marshes, and other wetlands, and had to wriggle through wet vegetation and survive in temporarily stagnant water. Their legs and lungs...started out as means of preserving their basically aquatic status quo, and only later proved useful for life truly on dry land." Evolution and human behavior, in Original Selfishness: Original Sin and Evil in the Light of Evolution, Daryl Domning and Monika Hellwig, 2006.

After taking an A1C test that according to one scale was normal and according to another was high normal, I went to an endocrinologist, Dr. Mahmood Mohamadi, who gave me a FreeStyle kit of a lancet holder and lancets for finger sticks and glucose test strips. Medicare requires patients to return a log of glucose scores to the pharmacy where the supplies are obtained, and I'm fine with that. I returned the first weeks' log to Dr. Mohamadi, who said my glucose looks okay, to occasionally test the levels and see him in 4-5 months for another average test, the A1C.

He recommended following a diabetes management diet: vegetables, fruit except for melons (too sweet), no sweets, whole grains (no white bread, white rice, pasta) protein balancing all. He'd given me pamplets to read on good foods. Nicky a few years ago recommended The Sugar Solution Cookbook, which I got, but haven't gotten into.  My daughter, the chef, suggested zucchini cut in noodle size in place of pasta, and I thought of kale steamed a little as another substitute.

The question is, can I get with the program? I don't do too badly, but I'm not fully in synch yet. I do know the payoff is in feeling good instead of loggy, tired -- and courting diseases like heart problems and microvascular breakdowns.

Our sugared society...one of my heroes, former FDA  commissioner David Kessler, went dumpster diving to find the ingredients of restaurant food sold in interstate commerce and documented the sugar, fat and salt addicting contents of a lot of our processed foods in The End of Overeating.  We can't afford this roller coaster, and our kids and grandkids are suffering with it. We need to change.

Day 6 of hyperbaric treatment, I shot up the stairs once home in olympic time.

Day 19 I began to feel it when the visiting nurse, Shirl, who comes Mondays, Wednesdays, and Fridays to change the dressings, applied the antibiotic ointment. I could feel it. I could wriggle my toes and feel it.  I was a wriggling fool.









Photos: To the 2nd floor; up close and personal; to the 3rd floor. Rear end and build up upper body strength.

On day 5 of hyperbaric oxygen treatment, I also had another medical appointment in Silver Spring with Dr. Phuong Trinh, an infectious disease specialist. He took the time to take a very complete medical history from me. My mom had had diabetes (onset at age 68) and in fact lost her left leg below the knee to it at 86. Her side of the family has a lot of diabetes.

My glucose readings were good enough but on one or two occasions went over normal. My eye doctor told me that that made me pre-diabetic, a designation you don't ever lose (and if you are lucky, it doesn't become full-blown diabetes). Other doctors had never really talked to me about diabetes.

Dr. Trinh said better than the glucose reading was an A1C test, or Hg for hemoglobin A1C. It tests for the average glucose burden over the past three months. He suggested that maybe, my pre-diabetes was a factor affecting the microvascular system. Vascular tests before and after the surgery were strong. So this was the one plausible explanation for: What the hell is going on?

Dr. Harry Huang, my eye doctor, encouraging me to be strong, exercise and lose weight, had said: Sometimes people with full-blown diabetes will have no eye problems, while people with pre-diabetes may develop the problems. We don't know why.

I whined to my friend Claudia that rather than improvement after the foot surgery, I was going up and down, down and up. (The 3rd toe began to show signs of distress about 3 weeks after the surgery.)

That's how you're doing it, Claudia said.

Made sense.

So on day 5 of hyperbaric, especially after 2 medical appointments out, I dragged ass up the stairs when I got home.

Stopping midway to catch my breath. Stopping at the top of each flight. For the record, there are 12 steps 10.5" tall on each flight, plus a turn and 2 more steps. But who's measuring?

I called my GP when I got home and asked his assistant? Had I ever had an A1C test? No.

An 8 x 11 notebook, coil-bound. That's how I keep track of everything I need to do, every day. Without it, I'd be in spinning confusion. I got to Shady Grove Adventist on Thursday, talked to Dan and Dr. Wenk, who also talked to Dr. Polun. I took notes on everything. How do the doctors evaluate progress, in my case in wound healing? Color and tissue viability.

Because of the flammability of the oxygen, great care is taken to keep any risk from the chamber. Patients/divers wear cotton scrubs, no makeup, no cream, no ointment, no deodorant, no jewelry, no bandages with velcro attachment (risk of a spark).  No petroleum-based products.  I was to go to the equivalent of 33 feet down, taking 10 minutes to reach that pressure, staying there for 90 minutes, and taking 10 minutes to repressurize. It sounded promising to me, it sounded promising to Dr. Polun. I was able to start the next day, Friday.

Fran took me out that day, and talked with Dan once I was in the chamber. I couldn't hear them but I could see their lively conversation on either side of the glass barrel I relaxed in.  It was like being in Starbucks with inter-table discussions around you.

A TV above the chamber and sound piped in bring whatever DVDs or videos you want. Over 30 sessions, I watched the Great Courses Understanding the Brain series, and a lot of movies I had missed lent me by Mary Gautier -- Akeelah and Bee, Remember the Titans, A Beautiful Mind. A bottle of water, labelless. It was pleasant.

You can feel the pressure as you are "descending" -- and as on a plane landing, you swallow, chew, yawn, and occasionally inhale, hold the breath and gently force the breathe interiorally into the ears to equalized the pressure.  There can be some pressure on "ascending." Same drill.  Don't give a thumbs up to indicate OK...that means "Take me up." Ok is the thumb-forefinger OK sign. Dan is very attentive to how the divers are feeling. I had only a feeling of well-being after almost 2 hours of each treatment.  And just to be clear, the chamber is absolutely stationary.

At the end of the Friday session, Dan told me Dr. Wenk recommended, and Dr. Polun agreed, that if I could get in on Saturday, they would open the unit for me. Once started, it's good to continue.  I called the cabbie.  He could do it. I was grateful to all of them.

Transport. How do you get around if you can't drive and have to travel?

Let me suggest that if you find yourself in a handicapped position needing transport in the Washington DC area, look at the Metro Access website, http://www.wmata.com/accessibility/metroaccess_service/. Download the application, fill out your part, take it to your health care provider to fill out his or her part.

You must take the original down to the Metro Transit Accessibility Center, 600 Fifth Street, NW, Washington, DC 20001.

I understand that if you call, a Metro Access van will take you there and home again while your application is reviewed. If accepted, it is a very reasonable cost.

I didn't do that. It was a rushed time. My toe was in distress, I had to act quickly.

Take a cab, Dr. Polun suggested.

Barwood couldn't guarantee that a cabbie would come to the 3rd floor where I live, take the knee scooter down the stairs so I could use it on the landings, put a wooden transfer chair at the top of the landing so I could move safely from scooter to chair to steps, and then stow the chair in a nook in the lobby of my building.

But the gentleman who first responded, Mr. Uessam Vaz, was more than willing to do so. He did the scooter and chair moving while I bumped down, and returning home, back up the stairs.

Let me give my rear a cheer, and God the glory!

Vaz -- or Wes (U is the letter for the sound W in Portuguese, the language of Guinea Bissau in West Africa where he is from) was a delightful driver and became a good friend.

If you want a good cabbie in Montgomery County Md., call him at 703-405-0482.

Hmmm, daily cabs. I thought about it. 




If I were on vacation, I'd have figured out how much it was going to cost,

I'd have that amount, and I'd spend it without worrying.

So it's not the Shenandoah, and
not Rehoboth, and
not Ocean City or Chicoteage and Assateague, but I - 270 is
really lush, green,
and beautiful this time of year.






Photos: The chair Julia's mom antiqued, used as a transfer chair from scooter to top step at the 3rd and 2nd floor landings for getting out and in the condo. Uessam Vaz. I - 270 going north, and I - 270 going south near Democracy Boulevard.

The next day, Wednesday, I researched hyperbaric oxygen treatments in Montgomery County where I live. One place it was available was at Shady Grove Adventist Hospital about 14 miles away. Shady Grove has a very good reputation. I called and talked to Dan Cohen. He explained that the chambers, two of them in the unit, were the size of an old English phone booth on its side. You are completely enclosed. The round chamber is made of acrylic; the person inside can see everything in the room and out the window, and talk by means of a phone. By increasing the pressure of oxygen to 300% versus the 21% we normally breathe, the oxygen gets into the flesh with therapeutic effects. Among other things, the treatment is used for wounds, for cancer patients, and can have helpful effects on persons with autism. The process simulates an underwater dive. Dan, a former navy man, was also a diver in the Gulf of Mexico among other places, and supervised folks who were diving. He talked the language of diving. I made an appointment to visit the unit the next day. I thought: I'm 69, deep water diving is not my thing, I'll ask him to just call me a patient having treatment. Hah! Dan is a force of nature. And, he really knows his stuff.

Photos: Who would have known that my friend, sculptor Robert Sanabria, created the soaring sculpture in the lobby of the main entrance of Shady Grove Adventist Hospital? A medic seeing me photograph the work asked about it. "He did a good job," he said of Bob, patting one of the hopeful wings.

I saw my doctor the next day, Tuesday...he was all right after the rear-ending by a Ride-On bus...and he confirmed that difficulty had set in on my right foot second toe. Maybe a third of the toe could be saved. Let's look into hyperbaric oxygen treatments, he said.
It takes time to process change, especially when you are feeling sick. I had to come to grips with the situation. What do you do when you're up against the wall? "I lift my eyes to the hills...Where is my help coming from? My help comes from the Lord, who made heaven and earth." Psalm 121 said it.

It occurred to me I had only one option: to be as positive as possible, because anything else, besides working against healing, would  toss me in a swamp I couldn't climb out of. No complaining, no giving into fear. Claim healing, trust God, do my best. Surround myself with positive people.

When I fell trying to get on the scooter, I called Julia across the courtyard.  Have you gone to work yet? OK, could you come and help me get up? She has a key to my place. And so good, she saw where I had fallen beside the bed, suggested I back up to the bed, put my elbows back up on it, and lift myself up. It worked. It is better if you can do things yourself.

Trish, whom I didn't know too well, came over when I was so sick, early on.  One day at a time, she suggested. Take it one day at a time.

Sound advice.

Photo: Julia and Trish, big snow of Dec. 1, 2009

At home that night, I lay in bed and thought: This is not ok with me. Losing a toe or toes is not ok. I'm going to fight for my toes.

Two days after that I saw a vascular doctor. It was not the one I'd seen prior to the surgery. You've got to have your vascular system checked and mine had been great. That doctor was out of the town. I have run into people since who love and swear by the vascular doctor I saw on April 30. Fran had dropped me off and was parking her car. He came out to the waiting room and said he didn't really think there was a point to looking at the foot because if the toes had spasmed, it was a waiting game; it would have to take the time to do what it was going to do. 

You know how you have to be your own advocate in medical treatment? You have to speak for yourself? If you can't speak, have someone to speak for you? We have to form a team with a doctor and his or her staff.

I insisted he look at the foot. He decided to do it in the waiting room. No one else was there but the receptionist. As Fran walked in, he said: Oh, that toe is gone.

I looked at her.  She looked at me. He said it was not the worst thing, that we need toes 1, 4 and 5 to walk.  I would be able to walk again. He said nothing could be done vascularly (which was the reason my doctor had referred me).  We left. I was devastated.

Photo: Fran at Carter Barron Theater jazz concert. 6/2011.

Two days later I saw my doctor. Bill, neighbor downstairs, took me to the appointment. The toes looked good. Felt good. I felt good.

Photo: Bill and Shanna

So I had a bunionectomy on April 24, and the two dislocated toes straightened. I hadn't had surgery since age 5 when I had my tonsils out.  My friend Fran stayed with me that night at home. Anesthesia was involved. Scary dreams later, itchy. Friend Julia came over morning and night the next few days and took photos of the toes which I sent to my doctor. He's done a lot of these procedures. Two nights after the surgery, Julia said: I don't like the looks of the second toe. I emailed a photo to Dr. Polun. He called and said: Can you get into my office? Julia drove and we got there at 10 pm. He took the pins out of the two straightened toes. No more pain. No more pain med. Oxycodone. No more bad dreams. 

Photo: Julia at the May 19 Preakness party.

So this is the Lane foot, or rather, a Lane foot. I understand from my cousin Helen Noll that it has befallen a number of the younger generation in the large and wonderful Noll family.

When I was born, and they saw that I had my Dad's feet, the story was they wanted to break my toes and reset them.

Today we know that infants and fetuses feel pain; then the assumption was that the non-speaking little ones didn't feel discomfort. 

My Dad wouldn't let them. Thanks, Dad.


It's a woman thing: I wore heels until 2000 when spinal stenosis was diagnosed and my back couldn't handle them.

The first thing you do, said the doctor then, is go home and get rid of all your high heels. 35 pair.

No problem with the stenosis after some physical therapy since. Walking is the best exercise for it. You see the connection?






Photos: A Lane foot, and shoes I can't wear.

They're making shoes like that, but not for me...
I'll take the purse and scarf, but can't you see?
Those sizes triple A, I've got just this to say...
I guess they're not...for... me.

http://www.youtube.com/watch?v=R_f_mMJAezM