Whew!  Interesting week. Last Friday when I saw Dr. Polun, he found a new infection in the right foot. He cultured it. I went on antibiotics (Duracef -- generic Cefadroxil 500 mg 2x/day) (with probiotics to offset the killing of the good bacteria as well as the bad by the antibiotics). Treating the wound with Povidone-Iodine (generic for Betadine).

Are you old enough to remember mercurochrome? Getting painted red on every skating scrape and skinning from falling?

That's the Povidone solution effect.

http://www.straightdope.com/columns/read/2518/what-happened-to-mercurochrome. To be clear, Povidone solution is not mercurchrome, it just paints like the mercury-containing liquid.

Ah, childhood.

OK, that's enough.

So on Day 123 since the surgery, having made a lot of progress, I had a setback.

I had pushed my doctor mid-July to let me pull the right leg into the shower and shower it. I'd dry it, and then leave it unbandaged for a while to further air-dry it. But the infection at the wound site was caused by moisture.

I remembered later that last week we had a couple of days of flood-watch downpours. One night coming back from the bus the only way to cross the street was through ankle-deep water. I got home right away and changed the bandage but...

The doctor was concerned. I was scared. The next day I mentally made bread dough with the fear and beat the crap out of it, whomping it down on the breadboard in my mind, punching and smashing it, yelling at it. Can't mess around. As I've learned throughout this recovery, to give into negative thinking especially the powerful negative of fear is a very bad and fruitless path. So I beat up the scared. And did what my doctor prescribed.

The other lesson of this time has been, while doing what the medicos say, then to leave it to God. Time to trust.  Friends prayed.

Yesterday, the vascular doctor, Dr. Kozloff, said the foot looked good, was coming along. Dr. Polun confirmed that today. So good problem identification, treatment plan, following the treatment plan, contolling the fear, claiming the healing in God's love -- hooray!

Another odd development has been stiffening, weakening, discomfort in the gooder leg, the left one, old stalwart that's been carrying the day -- though with physical therapy I've been strengthening the right quite a bit. John Jowers, PT, said my range of motion in the main player, the big toe, was ahead of schedule.

I've learned that if I rush across the street to make the light, I stress the better leg and have to use the cane again for the left. The next morning, after a good night's sleep, the left is better.

John gave me exercises for the stressed better leg. Sit on a high stool so my legs dangle. With a loop of resistance band around both ankles, keep the right leg down, and raise the left, then lower. 10 x. 3 sets per 1 session a day. That's a knee extension. Secondly, hold the right leg up and out, and raise the left, then lower it down, stretching the band. That's flexion. 10x, and 3 sets of that 1 session a day.

I had been babying the left leg while walking by stepping down on the ball of the foot because the heel pull hurt. With this compensation, the leg felt unstable, unreliable. John said to do the normal heel placement, but to do it thoughtfully, deliberately, and softly. This takes more time, and my steps are shorter. But I can feel that the back of the left leg is not so stressed, and that the footstep feels more stable.

I am so grateful to walk. I try to walk at least 6 blocks every day and more. It's so great to walk, y'all!


Friday 8/31/12

Truly, my healing foot is fatter. A lotta new stuff.

Wearing an old-lady stocking.

Icing the foot once and maybe a couple of times a day.

Trying to walk balancedly, normally, tho on the sidewalk I wander. Try to walk normally. Exercising.

John at PT showed me how to fold the long knee-high tough stocking in half, down, then stttrrrrrrretch the sucker over the toes, pull up, and tug and tug it up to the ankle, calf, knee.

Julia said her dad, in his 80s, didn't have the strength to use them.

I don't have the power of my nephew Geoff who does Brazilian jiujitsu. But I can get the stocking up to the knee.

Got the stockings and cold pack at Rodman's, 5100 Wisconsin Ave. What a great store! Food, wine, pharmaceuticals, and medical devices. All at prices cheaper than many other places.

Stockings $72 vs. $99 aat other specialty drug stores (like the one 4 blocks up on Wisconsin, a neighborhood of many older people, some who don't have transportation so they can be taken advantage of for that fact. Nice. Not.)

I've been begging for 2x2 gauze pads since I don't have a visiting nurse any more, but the CVS stores only carry a limited supply. Had to go back and go back. I use a box every 4 days. Stocked up at Rodman's at a $1 less a box...maybe to the light at the end of the tunnel. We'll see.

Also new: a little pain. I have been so blessed to have no pain since 2 days after the April 24 surgery. Something like a little electrical shock now and then. An "unease" walking because it feels like a squishy big thing connected to my leg; almost other-being resistance to new challenges like the Game Ready cooler at PT.

It is almost as if the right foot has a mind of its own; it wants to be normal like the left and doesn't want any transitional steps whatsoever. Fortunately, my brain and will, and the support of the PT folks can overrule the R ft.

On Friday, a throb in maybe the end of the 3rd toe, maybe the 2nd. John said it could be phantom pain. I remember my Mom's phantom feeling in her left leg below the knee, amputated. So strange. Our brain and their pathways are not amputated.

Keep on! Hang 10, and I'll hang 9.6.

Photo: Nephews Geoff, Kevin, and brother Pat.

8/18/12 Saturday

Good gait...I got good gait. That's what physical therapist John Jowers told me today. With 8 PT sessions, my big toe's range of motion has improved 20^o to 60^o upward.  

When I walk, I'm aware of putting the right foot down, not on the outside, not falling to the inside, but trying to center on the ball as the foot comes down.

Really no pain, just a little "waking up" discomfort as parts of the foot that were stationary for 2 months are getting used to moving.

John said my gait was strong enough that I didn't need to use the cane any more -- just if I were going to walk longer distances. It's collapsible so I can carry it with me.

I'd gotten used to it in my left hand so that I felt a little uneasy without it. But my balance is better, and it's good to give up crutches of all kinds when the time is right.

No more automatic seat provided on the bus tho.

Never mind. Courtesy is lovely, but walking normally is a real gift.

I'd rather walk.


                                                                                                                                          F 8/3/12

Is there anyone on earth who'd say -- physical therapy, forget it, waste of time.

PT is good stuff.

The subject comes up because I use a cane.

A guy at the Monday lunch celebrating St. Ignatius day, founder of the Jesuits -- Eric: "I don't know anything about it, but I understand it's really important to do the PT exercises as recommended."  A lady on the Ride-On bus from El Salvador. Her sister had foot surgery but PT was not prescribed, and a year later, she has difficulty walking and pain. I wondered if PT was not arranged because of insurance issues? Another lady on another bus didn't do the PT she was prescribed and has pain, also a year later.

Mary Lee, left, in the blue jacket, and Lee, in yellow (and my Christian Life Community), both had the foot surgery I did. Both emphasized: Do the physical therapy, faithfully, afterward.

So this past week, Friday, Dr. Polun said it was ok to leave off the heavy tall boot and start wearing regular shoes on my right foot as well.

I've been walking more, but have been surprised to feel -- weird. And tired.

Something about feeling off-balance. Something about wanting to protect the big toe and neighbors by walking on the outside of the foot.

I've felt I was bending at the knees, bending over. Discomfort and stress in the legs, hips.

John Jowers, the physical therapist/foot specialist I saw today at the National Rehab Hospital Friendship Heights clinic, said what I've been experiencing is normal.

So is the feeling like a little electrical shock at the end of the toes; that's the nerve coming active again as the swelling goes down.

Got some new exercises today. One involves standing, raising my heels while rising up on the balls of the feet. This requires the toes to bend.

Another is standing on the right (healing) foot, with hands hovering above a support surface, and holding for 30 seconds. "Only tap down on the support surface if you start to lose your balance," say the instructions.

Only? What if I'm rocking wildly from left to right on the right foot?

"Because two-thirds of our body mass is located two-thirds above the ground we are in an inherently unstable system unless a control system is continuously acting," says Dr. D.A. Winter in an article on human balance and posture control during standing and walking.

I remember my mother, encouraged by doctor and nurse to stand for the first time after the amputation of her left leg below the knee in 1997.

The loss of the sense of balance was terrifying to her. "God help me!" she shouted out. 

I feel that discomfort: I want to stop rocking. I will, after practice, says John.




I'm helped by practicing this one-leg stand with support at the kitchen window, using the frame for support.


Sunset, August green trees encourage balance.

---

Blogging: John told me some of his high school patients taking PT blog about their experience. (He was gracious not to say I was the oldest blogger he knew.) He said blogging helps them process the experience. That I can definitely attest to. Writing about the things that have happened since late April helps me understand them -- and appreciate all the help I am getting -- and my healing and returning to normal walking.

Ordinary walking! Hooray!

W 8/1/12