Monday 2 December 2013

What no amputee should ever do...

So last week I had an accident that saw me in more pain than I ever want to be in again.  I'm aware some people read this who are new amputees or have an amputation coming up or are considering there options so I'll share this in the hope that no one who reads it will ever go through it themselves.  Although my prosthetist pointed out, every one falls, no one falls twice.  I'm gutted that I didn't prove the first bit wrong, I have every intention of keeping to the second part of that! 

So what happened. To explain that you need to know how I secure my prosthesis.  I have a thick silicon liner that goes directly onto my stump, this then fits snugly into the casing of the prosthetic (sometime with a sock or two to pad it out more.  I'm really lucky, in that my stump is an exceptionally good shape and so the prosthesis stays on really well just like that.  It means that around the house, or popping out of the car at a petrol station etc, it's quick and easy to stick the leg on and my thigh gets plenty of air.  If I want it really secure, I put a sleeve from the prosthesis, up over my knee and onto my thigh - two reasons why I wear shorts in this weather (legs well insulated and if I need to adjust the fit, trousers are a nightmare), so I'll add that security if I'm going out.   If the sleeve is on, nothing will get that leg off.  It can take my weight, literally! 

I don't generally think of taking the bins out as going out and this is wear the problem occurred.  Bins are down a single step.  Having been lounging around the house the leg was just secured by friction, but when I picked up the bin to lift it over the step, I wasn't expecting what followed. 

What I thought had happened was that I stubbed my toe on a paving slab, it happens occasionally when you cannot lift your toes, so I stumbled to recover my balance.  What had actually happened was different.  My fake toes had got caught on the step and the prosthesis had come off so when I went to recover my balance, what instead happened was I landed with all of my weight, plus the weight of the bin I was carrying, straight through the end of my stump.  It was honestly up there as one of the most excruciating experience I have ever been through.  On the verve of throwing up from pain, I concluded that since I was stuck outside, the leg had to go back on and I had to get on with it even though I had no idea whether the stump was even in one piece still - the liner of course was still on.  So leg went back on (ouch!!), and I picked the bin back up. I didn't take it out as it wasn't that full but for some reason standing it up seemed important.  

Because I was both angry and ashamed of myself for making such a stupid mistake, I was determined to make as little of it as possible so didn't say anything but instead stumbled and hopped to the kitchen, sorted Morgans hot water bottle out and went to say goodnight to her.  

By the time I'd said goodnight, I realised there was no way I could make it out of the bedroom on the leg so I hobbled to my side of the bed and took the leg off.  It was a great relief to discover I wasn't unleashing a blood bath and that the liner nad protected it really well.  As the liner came off, the stump swelled before my eyes which was slightly alarming and it was then that Morgan realised something was wrong.  I went into early stages of shock.  I was light headed, I and felt sick again.  I also found myself suffering from horrific phantom pain, along side the actual pain whilst all the muscles in the leg went into spasm.  For some reason I still felt like I could ride it out, and just self medicated on drugs to help phantom pain and drugs for real pain.  20 minutes later of uncontrollable pain and muscle spasm later and Morgan was phoning NHS direct for advice and we were off to a and e for morphines and x rays! 

I was exceptionally fortunate to not have caused serious damage and only to have soft tissue issues.  A huge dose of oramorph and a really good nights sleep meant I felt much better in the morning, although having triggered so much phantom pain I will be on medication for that for a while before I start lowering the dose to see if it's gone... It may be gone already, it may be something I've triggered forever but only time will tell.  Thankfully, even if I do have it forever, I know it is managed well with Meds.  Having experienced it at it's worse, my heart goes out for those who struggle with regular or constant phantom pain. 

After a week of rest, generally the stumps feeling much better, although I tried the blade on again today and discovered I'm still far to bruised and battered for that kind of strain on the stump.  A gym session that was meant to be an hour starting with a warm up on the treadmill became about a minute on the treadmill and then an eternity icing a stump before hobbling off home!  Incredibly frustrating but I will get there!  

So the message of the story, never fall on your stump!!!   

Wednesday 20 November 2013

Six months on!

So november the 8th crept up surprisingly quickly and marked the 6 month mark following the amputation which has come around disturbingly quick.  Doesn't time fly!

So a few things have been going on.  Most excitingly in august we found out Morgan is pregnant which is incredibly exciting.  Baby is due at the end of April.  As thrilled as I am, there's no denying that it .  Suddenly I'm not working at my own pace, instead I need to be as able as I can possibly be in terms of strength, mobility and stability by April.  It's not just about me any more!  Daunting as this is, I do like a challenge and often operate best with a deadline!

Working towards that goal, I was pleased to pick up my first ever running blade last week from Jamie at pace rehab.  It's crazy.  The unit is so incredibly light weight and flexible.  First time you stand up in it it's actually a little disconcerting.  Feels far too much like nothing is there for it to be trustworthy but nevertheless it didn't take long until I was bouncing around the physio room outside of the bars (literally a couple of minutes).  It's a wonderful feeling to be so bouncy, for want of a better word, on my feet.  

When switching back to the walking leg, however much I love it, it feels so incredibly heavy! It's ridiculous.  First time I did it was in front of Jamie - he was keen to be there as he's been there before and knew I might nearly fall over - good for a laugh basically!  He wasn't wrong, nearly fell over.

There is a lot of learning to do and so in due cours I'm meeting with Hayley Ginn from Carbon Motion to do some running training.  I've not met Hayley yet but I've not heard a bad word and her reputations is fantastic - she worked wtih Jonnie Peacock amoung others.  I'm fairly sure she'll destroy me in no time though - in a phone conversation, when my prosthetist suggested she go easy and pointed out that I have a spinal injury and haven't been an amputee long her response was "guess you'll need to learn to man up a bit."  I think we're going to get along!! 

Until the training can happen, I'm applying some time to getting used to wearing it. I try to spend a bit of time each day wearing the leg. It's anew socket and a little different to the walking leg so I spend some time just trying to get used to the fit, bouncing around the garden with the dog and so on.  Tonight I tried my first jog!  I'll be honest, it hurt and was hard work.  Part of that was just that my running fitness is pretty much non existent.   A more substantial part was that my stump needs to adjust to the new pressures and stresses that jogging puts on it.  It'll take time.  Tonight I did what would normally be about a half hour walk, in about 20 minutes.   It went along the lines of run 50-150m, rest, repeat.  Ended up becoming a bit of a high intensity interval training workout.  Not my intention but it's a step close to running naturally.   I was pleased to find my back held up fairly well, at least to begin with.  It hurt, obviously (always hurts), but didn't really hurt any more than walking.  My concern was always that running would be hugely more painful than walking but so far it seems ok.  Watch this space I guess!   The aim is a decent 5k time.  Then the paratriathlon potential remains a potential...

In other news,  come the new year I'm signed up to train to become a personal trainer with premier training.  I'm really excited about this.  I'm sure the course will be hard work but I'm excited about helping people achieve their goals in life, in terms of fitness.  Long term I want to do a level 4 course in excersice referral so I can also work with people going through rehab process or dealing with disabilities or medical issues.  I think it has the potential to be exciting and satisfying work.   I've been amazed at the way a good level of fitness helps through a rehab process (in both the rehab process' I've done so far).  I'd love to help more people tap into their potential.  Hopefully I'll be able to do a decent job.  Like with the running, time will tell! 

Training and my own physio etc remains vital.  I was reminded of just how vital it all was a couple of weeks ago after pulling a muscle in my neck meaning I couldn't make it to the gym until I had recovered.  Through general business at the same time, I didn't have physio for a couple of weeks.  My body just siezed up!  It was crazy just how stiff and sore I became in such a brief space of time. I also found I quickly became so much more lethargic and lacking in energy.   It seems the human body, however battered, and beaten is still built to be used and moved.  Not moving enough for a couple of weeks led to a seriously painful couple of hours at Neurolink physio! 

Monday 19 August 2013

Three months on.

ohhh new leg
On the 8th August it was three months on from the day of amputation surgery, and what a crazily busy three months it's been and how dramatic progress has been. 

To give some perspective, prior to amputation I was told I would he at roehampton for 6 to 12 weeks so there was a possibility I would at this point have been writing about my discharge from hospital.  Instead, having been discharged after 3 weeks I covered that what now feels a very long time ago. 

bit of biking
On the 8th I was lucky enough to be in Wales on holiday with morgan and her family. This has become a bit of a yearly tradition and it's been fascinating to see how I've changed over the years.  If you go back to 2010 we went prior to my initial accident when I was fully able bodied, the following year I was pretty much Wheelchair bound, 2012 I was hobbling around on my feet with huge amounts of pain prepping myself for an ankle fusion. 

getting out with the pooch 

This year I was getting used to an amputation!  Just prior to the holiday I'd been fitted with a new leg so I had that To get used to but it was a big step up (thank you Jamie at pace!). Whilst walking is still hard work, it's so liberating to be up and walking and not be in huge amounts of ankle pain.  I pushed myself quite hard while we were away and did a fair amount of walking on uneven ground, a bit of cycling and a bit of almost scrambling.  All in all the back, the stump and the prosthesis held up extremely well and I was pretty much able to keep up with everyone most of the time.


Walking on dodgy ground


this was fun!
There is no denying it takes a lot of effort though.  I have read that as a below knee amputee, time on your feet requires about 20% more effort than for a non amputee.  I think I'm finding it easiert than it was prior to the amputation with my mashed up ankle but nevertheless, the challenge is now to be at least 20% fitter than everyone I know so I can always keep up!  It was great to be away though and we had some fun little adventures while we were out in Wales!



me and my incredible wife! 
Following the holiday, I was lucky enough to be invited to Loughborough by the good people who run the UK paratriathlon team for what was discribed as a 'talent confirmation camp's as a follow on from the day in Birmingham a few weeks ago.  It was a good couple of days but my word did it knacker me out.  There was an element of sitting and listening, finding out about the sport, it's background, the classifications and so on - that was the easy bit.  A lot of it was fitness tests in each of the three disciplines, some strength and conditioning work and receiving some coaching.  I did a timed 750m swim (just over 15 mminutes), a 10km bike ride on a watt bike (half of a triathlon distance but time was short, 18 minutes - very nearly sick), and as much running as the stump would allow for.  I only did 2 laps of a 400m track but I think that was more than was expected of me given how recent the amputation is.  My first lap took 2:54, the second took 2:30.  I was pleased with the improvement, although as one of the coaches joked, clearly I wasn't trying hard enough first time...  I think he was joking!

All in all it was a good weekend.  In a weird way, although it was my weakest sport I was most pleased with the running as I literally had no idea how I would do.  It helped that one of the physios there has taught amputees to run in the past and so gave me some feedback but I felt the improvement was good, particularly when compared to my first attempt at running back in Birmingham. 

trying some running

bumped into Jonnie Peacock, came over all star struck... 
ICE!!

I can't claim it wasn't a massive relief to get ice the leg afterwards, or to take the prosthesis off in the car for the drive home but it was a great experience in some incredible facilities.  What's next in terms of paratriathlon, who know! I'll hear from them in the next couple of week and see if they want to pursue stuff with me further. Whatever happens, Im keen to try and do a triathlon, I think it'll be a great aim as something to work towards! I also had the pleasure of watching Jonnie peacock and stef Reid (incredible paralympions) training on the track.  They are both so fast, it was inspiring to see, in the flesh, how quick and agile you can become on one leg!
Incredibly, throughout all of this, my stump held up perfectly.  When I went to physio and massage on Thursday I discovered my other muscles had coped less well.  My word was I tight in various places. Physio and massage always hurts - if it's not hurting its a waste of time, let's be honest, by my word, that day was something else. After two hours of pain, Natalie and Bex taped me up with sports tape and sent me home to watch the bruises develop - and they did develop! I felt better for it though, at least
I think so! 
little bit sore


Irritatingly, despite my stump holding up to all this abuse, after one quick bike ride yesterday, somethin rubbed in my socket and I rubbed a sore behind my knee.  Thankfully, its nothing too serious and it doesn't rub when I walk.  As long as I stay of the bike until its recovered I should heal up on no time at all. It's just an annoying part of life with an amputation.  Realistically I've done incredibly well not to get any sores so far as the risk is certainly greatest early on as the stump changes size.  Every step is a new learning experience I guess!




Monday 29 July 2013

Busy, so very very busy!

Last couple of weeks have been so very busy - great and good experiences but so so busy!  

Earlier in the month I had the pleasure of being best man at a mates wedding.  It was a real honour to be involved in their day but blimey the week put me through my paces.  Part of the nature of a marquee wedding reception is a lot of setting up, a lot of walking on uneven ground, lots of carrying stuff and a huge great pack down.  I like a challenge but before hand I can't claim I wasn't a little apprehensive about how the stump would hold up, whether my balance would hack it and the like - most best men worry about the speech, that was actually quite low on my list (Matt made it easy, he's a muppet :) )!  

I'm really pleased to say the day went really well, the leg and back handled everything I threw at them (on my feet in the heat all day every day for 5 days, uneven ground, ladders/balancing on the roof of my car, carrying stuff and so on), and the couple are now back from honeymoon and happy with how the day went which is the most important thing.  On the day, myself and the ushers decided the bouncy castle was calling at one point which was a fun thing to try.  I was a little concerned a screw in my ankle might of ripped a hole in it but I got away with it, it was fine. 

By the end of that week I seriously needed a decent rest but it just so happened that Morgan and I moved house the following week so we went from crazy busy with wedding stuff straight into crazy busy with packing and a house move.  I weirdly loved the challenge of just carrying on without a break and seeing what I could handle.  The move has really filled most of my time around the last two weeks between pre moving packing, doing a good 8+ trips moving landrover and trailer loads from one house to the other and all the unpacking.  It was crazy hard work but so satisfying to be able to do so much.  The comparison to the amount I managed between moving this year and moving last year was huge (Morgan and I seem to be getting into the habit of a yearly move, a habit we should probably break...).  Doing so many full loads meant when the removal men came on the Saturday they literally just had big furniture to move and we were almost totally unpacked by the end of the Saturday.  Was fantastic! Obviously, in and amongst all this I've been trying to keep physio going, prosthetist appointments happening, general rehab work going on and a pooch to look after.  

So Morgan and I (+poppy) our now settled into our new home and loving it.  It feels so much like home which is a real treat given how early on it is, but we could seriously do with a holiday... Good job we've got one on the way!  Although, saying that, holidays tend to be reasons for me to push myself harder than in normal life.  Ridiculously, between holidays, medical appointments, a para-triathlon training thing, I only have about six days in August where I don't have anything written in my calendar... Bring on some more busyness!! 
 

Tuesday 2 July 2013

New experiences!!

It's close to eight weeks post op now, which means I have been home for about four weeks which is in itself somewhat exciting.  A fair amount has gone on but there have been some key milestones.  

As the weeks have rolled on by I have been gradually attempting to increase my time not using my sticks or simply using the one stick.  Progress is quick but nevertheless it feels painfully slow - I think however fast a recovery may be, the patient never feels it is fast enough.   It was an exciting weekend on 22nd/23rd as it was a good friend, matts, stag do (for which I am honoured to be the best man) and so a decent group of blokes ended up in Norfolk finding various ways to make him look like an idiot.  It was an fun weekend and I was pleased to be able to spend a lot of time on my feet over the course of the three days.  

The Sunday and Monday ended up in fact being my first two totally stick free days which was a fantastic step forwards.  I didn't have to walk any particularly long distances in these days, nor did I go at much of a pace, but there was no point where sticks were used which was great. By the Tuesday I was unsurprisingly suffering a little and so the sticks swiftly came back out.  The increased strain has led to greater circulation in the stump and a reduction in the swelling. This in turn makes getting the fit right that much harder - every day now begins by padding out my stump with at least 3 and a half socks and so the fit is harder to get correct over the course of a day but I'm all booked up to visit Roehampton again on Thursday to discuss options with the prosthetist and to pick up my new foot which is ready and waiting.  I'm hoping I will persuade them to do a remould...  I guess we'll see what happens. 

This weekend was also fun!  Morgan and I went up to Birmingham with some friends because I had been invited to attend a Paralympic potential event day which we went to with very little understanding of what it would entail.  A night in Birmingham proved fun.  We arrived at the travel lodge quite late and asked the guy behind the desk where we could eat locally. His response was, "I go by hygiene rating, there's a few 2 or 3 star places around but if you want a full 5 star rating you want to go here!" 
Seriously Birmingham?? What's that about? Is kent so upper class and posh that I don't need to worry about what hygiene rating a place as I assume there all 5 star or were we just in a particularly crummy area? Still we went, got food at this buffet style place (which was incredibly busy - I guess if its the only clean place around that's inevitable) and then went to bed.



Following the worst night sleep imaginable, I got up feeling a little bit sick from the buffet, achy from a really rubbish bed and got ready for what was potentially a day of sport.  Once we made it to the uni where the event was taking place we found the sports area it was all happening in and were amazed at how serious it all was.  Having turned up with absolutely no idea of what to expect, it was a little daunting to discover this was an event seriously intended to find people who they felt had the potentially be fast tracked through a training programme as medal hopefuls for Rio 2016.   They had various fitness test and some representatives of specific sports.  It was an outrageously shattering day but I gave everything my all - despite a lot of gym work etc, I felt very unfit during the this day, I have a lot of work to do still when it comes to improving my fitness.  Various things were asked of me such as rowing, cycling, using a kayak ergo, weight bench and medicine ball throws.  The greatest challenge they set was a sprint... It been close to three years since I ran last and so soon post amputation I was far from convinced of the likelihood of being able to.  After a few practices in which I failed somewhat miserably to do more than a couple of strides, I made some adjustments to my fit and went for it.  I didn't attempt to practice, I just opted to commit and off we went.  The results were not impressive, instead I basically limped quickly but I was expected to do it 3 times and each of the 3 times I found myself faster which I was pleased with.  


This isn't to say I can now run.  I don't think I could do it again today and I certainly couldn't do it without a similar 10/15 minutes psyching myself up and practicing and adjusting my fit.  Nevertheless, it was flipping exciting to find myself able, and it gives hope that to run may become a real possibility.

Here's how ridiculous it looked (apologies for side on video);

http://m.youtube.com/watch?feature=plcp&v=cDufbuLZS1E

The next step regarding the Paralympic potential event day is to wait and just get on with life and doing sport for pleasure etc.   At some point in the future I will apparently be contacted following them having put all the data together and decided whether they want to put me through further testing or say thanks but no thanks. As much as it would be exciting to hear positively from them, I am not anticipating hearing much from them as I am well aware that less than two months post amputation is incredibly early days to be doing things like sprinting...  Only time will tell I guess.   

In other news, yesterday was Oliver, my brother in laws birthday and he fancied going cycling! Like running, this would prove to be my first bike ride in nearly three years.  It was a little nerve wracking if I am honest but Oliver, Sammi, Morgan and I went and gave it ago. It was so good to be back on a bike and to be able to propel myself at a pretty reasonable speed.  




It was a little iffy at times, the odd clunky gear change sent my fake foot straight off the pedal, and standing up to get extra power was (at this stage at least) a total no go but the ride was nice and has left me fully inspired to get myself riding again.  I'm only talking gentle trails at this stage, no seriously mountain biking but it was great to do.  

Also, a great way to exercise the pooch who ran determinedly along with whoever was at the front for the entire ride! 




Here's some proof!

http://m.youtube.com/watch?feature=plcp&v=Lui4OjSLuY4 (ignore the dodgy start)

http://m.youtube.com/watch?feature=plcp&v=DTAuqw7WhaU


And so the progress continues... 

Wednesday 12 June 2013

A whole week at home!!

It's now been a whole week since I was discharged from roehampton and it's been an interesting week of learning about how to live with this new prosthesis and I've made various observations.

1 - walking is hard
Whilst the progress I've made is incredible, walking is undeniably still a hard thing to do.  I'm pleased to say that my balance is good, walking will become easier (and is becoming easier - slowly but surely, I just have to remind myself of this fact), but with a five week old stump that is still a bit bruised and battered. It will get better but it will take time.

2 - my right foot is MASSIVE!
We discovered this whilst in Cotswolds.  I've been told with no doubt that I must keep the fake foot dry and so I thought I'd buy myself some decent boots that would help me to do just this! Whilst there my feet were measured by Steve (not sure he's measured a prosthetic foot before), but we discovered there is quite a difference in size. Not ideal!!
During my outpatients appointment I suggested we just amputate the toes on the prosthetic but instead a new foot has been ordered.  Hopefully I'll get it in the next week or so!

3 - my assumptions regarding socks were wrong...
I joked pre op that I would get through considerably less socks. Turns out I was wrong! I am currently wearing one sock on my biological foot which is pretty standard, but Im also wearing two thick socks, one thin sock and a think half sock on my stump, all of which is pretty standard by this time of Day! It's a lot of socks to deal with...  Getting the number of socks on the stump correct is a real and constant challenge.  its the key to getting a comfortable prosthesis And tiny adjustments make a huge difference. Learning to get this right is tricky, but I'm getting there!

4 - you have to make the physio happen!
It would be so incredibly easy to just stop the Physio/rehab activities when you get home after something like this.  I can walk a bit with sticks, I can get about (I'm back to driving - thank you DVLA) and so I literally have to remind myself what my goals are and what I hope to achieve!  By doing so I force myself to get up, to go to the gym, to do laps of the house or garden, just to keep moving forwards.  As  part of that progress today I challenged myself to walk all the way around the park (I'd taken poppy for a run around) with just one stick.  I was pleased with how it went but won't be getting rid of the stick for distances like that for quite a while.

And so there we go - progress continues and however slow it may feel, in reality I'm moving pretty quickly.
Happy days!

Tuesday 4 June 2013

Home soon...

New foot!
Having got my prosthetic last week I made good ground in terms of progress prior to the weekend! I reached a point by Friday where I was allowed out of the parallel bars with just a pair of walking sticks so I was pleased.  I even did the step - first time was without permission because it was there and I was so used to doing it in the ppam aid that I absent mindedly steps up and over. Shortly after that I got Abby (my physio), to watch me and check I was safe to do the step - I kept quiet about the fact I had already done it!

As Friday rolled around I discovered what an absurdly honest and honourable group these physios are.  It seemed that no matter who I tried to bribe, no one would let me take my leg home for the weekend.  I couldn't even sway them by pointing out that I was going to a fancy dress part dressed as batman and the Wheelchair would ruin the image...  In fairness to them, I had worked my stump incredibly hard for a couple of days and it needed a break. No matter how much I tried to convince myself I would only wear it a couple of times over the weekend, it's for the best that they didn't believe me - I've no idea if I would have been true to my word.

Scary outdoor steps!
Weekend came and it was great! Lots of time spent chilling out with Morgan and the pooch, a fun party with batman in a wheelchair with catwoman as company, a lovely BBQ with friends on the Sunday and an unexpected (but mercifully free) trip to the vets!  Jon, a friends of ours kindly drove me back Sunday evening to give Morgan a break, or in fact more time to do uni work.

So far this week has been mighty productive! I've had a further two days to practice with my leg and to learn all sort of things!  On Monday Abby took me outside of the Hospital to do some walking on terrain that isn't a perfectly smooth hospital corridor.  I was taken to the front of the Hospital and Timed whilst attempting a series of challenges which were, a flight of stairs, a  long slope with uneven surface, a grass bank and finally, all of the above as a timed circuit.  The minute the stopwatch came out I went into race mode and thought 'game on!' I don't want to brag but I absolutely bossed it and got some good times!  

Tricky outdoor slope
I surprised myself, and Abby I think, by discovering I could walk up stairs in a one foot at a time technique which was not expected, traditionally you would do good foot up, bad foot meets it for each step.  Down was the traditional technique which slowed my time down but gave me something to work on.  Going up slopes was surprisingly easy, down them, slightly more disconcerting.  All good stuff to learn.  Upon returning to the gym, it was decided that having done this practice and done ok, I would be allowed to wear the leg out of the Physio gym without supervision so Lunch consisted of a fair amount of walking lots and some time practising stairs... Probably not what physios had in mind!

This was the first attempt at stairs on my lunch break - my third attempt overall.

The best thing about this is that whilst this is all new, and I've still got huge amounts of progress to make, this was the easiest stair climb I've had in nearly three years! Already, going up and down stairs is less daunting and less painful than it was on my rubbish old ankle! Happy days.

The afternoon consisted of much more walking about, and then I hit the (non physio) gym to do some upper body work before Morgan, my parents and Gareth arrived to sneak me out for a pub dinner - my first trip out of Hospital on my leg which was exciting.  It was fabulous and a treat to have them all visit! Nevertheless, by the time I got back, when I was walking to the Ward it was an undeniable blessing to get the leg off.  It's less than 4 weeks post op so whilst I'm doing well, it is still a bit bruised and battered.  It's like someone punching a bruise with every step.  Worth it to be on my feet but a wee bit tender its fair to say!

As today rolled around, despite my leg being there waiting for me on the Ward, I started the day in my chair simply for the speed and convenience when it came to grabbing a quick breakfast and jumping (or hopping to be more accurate)  into the shower.  It was a strange thing trying to put the leg on shortly after showering.  Having stood on one leg with my stump dangling, combined with the warm water, it had swollen, not dramatically, but enough that I needed to use the thinnest sock I had to line my socket.  It didn't last long though so within no time at all I had to remove the leg, put thicker socks on and get the fit right again.  I guess it's these kinds of adjustments that I will have to get used to doing... 

Id say this is overkill as a sign!
Having spent a good length of time in the gym doing a more complex obstical course than usual so as to get warmed up I was given free rein. Given it was such a lovely day I was encouraged to use the rehab garden to practice walking (without a physio watching over me - shock horror) and to generally wonder the grounds looking for ways to challenge myself. The rehab garden is a nice space which has steps, some gravel, some cobbles and general uneven ground to practice on... For some reason, as the sign shows, it is deemed an unsafe place for both patients and visitors without supervision... I broke the rules many times in the chair but was surprised to have the physios encourage me to go it alone! I also retried my grassy slope and my stairs etc, all the while regularly checking my stump for damage and making sure I had the right number of socks and half socks to make the fit as perfect as it could be... The difference between one layer of fabric and two is extraordinary! Makes the difference between walking well with one stick (and even without a stick for very sort distances) and struggling with two sticks.  I've got plenty to learn regarding perfecting my fit!

This was my first attempt at one stick walking in the rehab garden with its interesting terrains... The socket fit was perfect at this point - unlike the video quality..

The scary and dangerous rehab garden... 
It's fair to say that walking, combined with a lack of sleep from nights on the Ward mean life is really rather tiring.  I proved this today by falling asleep lying in the sun over lunch... It was only brief but I can't ever sleep in the day even if I want to so I must be more shattered than I realise!
 
The afternoon was similar to the morning with lots of walking both inside and out. The key difference was that Abby re-tested my outdoor time trials! I'm pleased to say I broke all of my times from yesterday by significant amounts which was promising! It helped that I've now perfected a normal technique for walking down stairs where one foot follows the other in a faster more natural motion! Big improvements in time in 24 hours were satisfying but disappointingly there isn't a top gear style fastest lap leader board so I've got nothing to compare my times too!  I've suggested this gets remedied so I'm hoping Abby will be all over it! If she is quick I'll be the only name on it and so I'd be top of the board for a while at least... Probably won't happen though.

As things are going undeniably well, over the course of today Ive been struggling with the nagging question of why am I still here?  What am I gaining by continued presence as an inpatient.  I wasn't sure exactly how to ask the physio's this without coming off as rude so it was a relief to find they had been thinking the same thing.  After a bit of a chat and a mull it was decided that I am going home tomorrow, exactly 4 weeks post amputation, and after 3 weeks in rehab!  Not too shabby at all.  We concluded that the best bet was for me to go, experience some real world with my leg, see how I find it, what problem solving issues I have, what questions I can find and I go back to the hospital on Monday as an outpatient to talk through any issues and to do all my discharge test things (the tests they use to measure progress at my 6 week and 6 month review).  The hospital will keep my bed open for me until Monday just in case  any serious issues crop up, but certainly no one is expecting me to need it!  

I literally cannot express in words how unbelievably exciting this decision was!  I am properly and genuinely thrilled and cannot wait for Morgan to arrive to pick me up!  I have no intention of being a hospital inpatient again after today for a very long time - a life time if I can get away with it!!  Not because the experience has been so terrible or anything like that, my respect and admiration for the NHS remains huge - but I feel like I've had enough inpatient time to do me... 

I even got myself on a bike without pain - happy days!
I hope I'll keep in touch with some of the folk I've met in here.  Particularly Jude, a guy with a through knee amputation I was paired up with on a few times in physio. We got along well, and I think we have pushed each other hard to get to the next stage.  Basically we have been having a race!  It's fair to say I won but I did have the massive advantage of still having a biological knee... We were chatting today after discovering that tomorrow I'm off and we both felt it would be both great and fascinating to continue to track each others progress and to meet up in a few months time and see who is doing what.  Its amazing that although in many ways I barely know the man and I certainly haven't known him long, the time we have known its other has been significant for us both and  so I really want to know how he gets on in the future.  

Discharge tomorrow (or technically on Monday) certainly doesn't mean the end of the story.  I think its more likely that it will be like getting over the first hurdle.  The real challenge will begin when I am home and Morgan and I are learning how to deal with our new circumstances in the real world.  It's definitely going to be a process and not an instant thing but we will get there.  

A friend I used to work with asked me what I was most looking forward to post amputation.  I think she was expecting me to say climbing/kayaking/some kind of adventure, all of which are things I am hugely excited about.  I very much feel like I'm getting my life back through having this done and I am excited by what the future could hold, but nevertheless I gave her question some though and my answer was "a near pain free walk with my wife and my dog".  Its not the most adventurous thing I could look forward to but the idea of it thrills me!  It has never happened before, we've been for plenty of walks but every walk in the time we have been married (or had Poppy) have been under the cloud of excruciating ankle pain (it takes some enjoyment out of it), and yet now, on the horizon, in the not too distant future I see a very real chance of that happening.  I cannot wait!  

The blogs will probably become a bit less regular once I am out - things like, "I sat and watched a film, then hoovered the house" don't make for such interesting reading or writing, but if significant things happen or I try anything particularly new or exciting I'll reappear!  Thanks to those who have been reading and thanks to those who've been praying both for me and for Morgan having to deal with it all as well!  It means a lot and I believe it has made a massive difference in many ways!


Wednesday 29 May 2013

Today I walked!

After a fantastic bank holiday weekend at home relaxing with my awesome wife and the pooch it's fair to say that driving back to Hospital sucked.  We had had a great few days not doing alot but now it was time to refocus on the rehab for the upcoming week!  Hopefully this would be the week of the limb fitting so it had the potential to be exciting.

Tuesday started with Ward rounds in which I was taken off pretty much all my drugs.  Having experimented with taking less painkillers  this was very much what I was pushing for. I now take one drug twice a day to help limit phantom pain, which  I'm told I should be on for a minimum of 6 months, advice I will heed. 

Tuesdays physio consisted of the usual mix of ppam aid time (dull but important), core/balance work and core/balance work whilst paired up with Jude (another patient). I also found out I wouldn't receive my limb until Wednesday afternoon, maybe Thursday morning - gutted. By the time physio was all done, Morgan and her folks were nearly up here. Once they'd arrived we bunked out of the Hospital and headed out for dinner, a key part of keeping me sane is getting out of the Hospital on a regular basis... If I'm in too long my brain totally discombobulates!! 
Quick gym session once they'd left and I was totally ready for bed!

new leg - happy days!
Today rolled around and I'd been invited to go swimming.  It's a monthly thing where a couple of the physios take one impatient to an amputee swim meet for a splash about.  I was a little hesitant about it until I'd found out I had no chance of getting a leg until the afternoon at best.  Upon discovering that I was well keen to have a swim as it meant a break from PPAM.  Its a weird thing to swim with a bit missing.  Unsurprisingly my leg felt outrageously light in the water.  Due to poor technique I've always relied too heavily On my arms for swimming front crawl (technique made far worse from a period swimming post spinal injury where they literally just weighed me down), and so I barely noticed a difference, but breaststroke basically didn't work!  It'll certainly take some getting used to... Cant stand the stroke anyway to be honest, I only do it because my spinal physio says I should!

And so around came this afternoon and happy days, my leg was ready! Slightly weirdly, my foot isn't ready, so they have attached a basic foot they had knocking around and when my foot arrives in the post they will swap them over (a sentence you never think your going to say...). Anna, my prosthetist called me away from the gym so she could make on the spot adjustments etc but it was completely unneeded, it fitted beautifully and I felt ready to walk, all be it with a bit of a wobble and using the parallel bars for support, straight away!
The link shows the initial moments of being fitted and the walks down the bars.. 

After this I was sent back to the gym where I spent the next 45 minute just walking up and down in the bars whilst trying to persuade various physios to get me crutches or sticks to walk around the gym - none agreed.  But progress was progress never the less and by the end I was feeling a bit less wobbly and a bit more balanced. 

I even experimented with a bit of no hands action when no one was looking!  Its certainly not bad progress for 3 weeks to the day post amputation!

Sooo many laps of the bars!
So all in all, a productive week so far! I think my prosthesis looks the part and it certainly feels the part. Its extraordinary how normal and right it felt within such a short period. I guess because I have known it was coming for a long time, in my head I've been pretty well prepared but I am still amazed at how natural something so unnatural can feel. Now to learn to use it properly, and to learn when not to use it, or when I need to add more socks because the stump has reduced in swelling, or remove socks  because of swelling.  For the first few months I will apparently be making pretty regular adjustments to the fit and how much the socket needs filling it but its a small price to pay for a lack of ankle pain and the potential increase in mobility.  It'll be an interesting learning experience but I certainly feel we are moving forwards!  Irritatingly, I'm not yet allowed to have the prosthesis outside of the physio gym so I had to give it back at quarter past 3, 15 minutes after I was meant to have left so I blagged some extra leg time!  I'm hoping as soon as my foot arrives I'll be at a point where I can have my leg available to me as much as I want - physios must hate me, I'm quite pushy!  :)  I just figure if I push my luck with a smile on my face I'll get away with it - its worked in most situations for the last 25 years!

My aim is to be discharged in a week on Friday at latest. I'll tell that to my Physio tomorrow and try to gauge her response but I think its more than possible. I guess if she disagrees its game on and I'll have to prove her wrong! :)


Thursday 23 May 2013

Progressing fast!

It seems that I vented my frustration regarding the speed of progress and lack of challenges in physio a little too soon in my last blog.  Alternatively, perhaps one of the physio's stumbled across it and thought they would prove me wrong!  


Kneeling on a Swiss ball
Flipping hard work!
One way or another, in the last week I have been worked and worked hard!  On Tuesday I arrived for physio and I was told very clearly that we were upping the anti and had every intention of making me work harder - I guess that'll teach me for wanting to be challenged to a greater degree.  A lot of time has been spent in the Ppam aid which is great because its important but I've also found myself balancing on Swiss balls, either on all fours, lifting alternative arms/legs/arms and legs, or on my knees playing catch etc.  Sounds easy but try it - flipping hard work!  What doesn't even sound easy is doing single leg squats on a bosu ball, if you want to make your thighs burn I really do recommend it.  I also seem to have become a little bit of a challenge for one of the senior physios who likes to throw a bit of competition regarding who can do the better job with the balancing acts.  It's quite satisfying to be able to get up onto a Swiss ball, in a kneeling position, all with no support or balancing aids. 

Also been challenged into various activities with a guy called Jude, a patient with a through knee amputation who I'm getting to know quite well.  Challenges together included the likes of playing catch balancing on Swiss balls or kneeling on wobble cushions, or sitting back to back on wobble cushions and passing med balls to each other etc, all of which is happening in addition to all the other stuff!  

The inside of the negative
mould!
We've been productive in more ways than just increased physio though as today the wound has been checked and the doctor came to the conclusion that it continued to look spectacularly good and so the stitches were ready to come out.  The wound is now stitch free and nothing opened up so happy days I guess.  In even more exciting news, the doctors started talking about what my new leg should be and today I was casted so a prosthesis can be made.  The casting was a simple enough process, its literally lots of drawing on my leg, followed by a plaster cast which picks up all the drawings on the inside.  From this negative mold they will make a positive mold, which they will then make a socket out of that should fit me perfectly.  
and the outside... 

The plan is for me to have a moderate activity foot as my initial limb, which will have considerably more ankle articulation than a standard first prosthesis which, once mastered should allow me to walk over considerably less even ground be pretty active and mobile.  Once I'm settled into life they will give me my second limb which will have a high activity foot on it all ready for me to start climbing mountains, getting around properly uneven terrain and so on.  I'll also be having my limbs attached to my using a less traditional first limb system.  A standard first limb seems to be to use an effective belt to strap it above the knee.  Its great for simplicity but not good for high activity as its will cause a rubbing above the knee, so instead we are looking at over securing options such as a suction liner or something similar to keep the limb on which will allow a much better level of activity.  Happy days!!  Amazingly, having been casted today, I should be getting to try my first limb for the first time by Wednesday of next week.  I'm extremely excited as I'm sure you can imagine.

I've also just taken my last Oxycontin (hopefully), which is good news as its an extremely strong opium based drug which is really addictive so I have been eager to not be on it.  Hopefully the transaction to not needing it will go smoothly and I wont suffer as a result of it finishing.  Despite this I have upped the drugs to aid phantom pain, not because I am in any unbelievable amounts of pain but because it would be good to have none, especially in these early days when it is a more common problem.  Its good to be clear, if I always had this level or pain, it would be a shame, but it would still be better than the ankle pain I used to have, and because of the nature of phantom pain, firstly its likely it will settle with time, its still very fresh after all, and secondly, in my experience so far, using the leg (in the Ppam aid/on balls etc) seems to make pain less, not more and so it would not limit my activity like my previous ankle pain.  

In other news, Morgan continues to come up each day with different companions (family and friends), to visit which is amazing.  I've barely spent any time in the hospital where I've not been in phyiso, in the gym or in bed.  Pretty much any period of time I have been breaking out of the hospital to fine somewhere else to eat or something, anything to do that isn't being in hospital.  This place is, I'm more sure each day, the best place to be at this stage of amputee life, but its still so so good to get out, be with people who aren't patients and do non hospital things!  Its also great to see the love and support she is getting at home with people keeping her company at home, staying the night (massive thanks to Oliver in particular here, he basically moved in), people from church delivering food so she doesnt have to cook, friends and family helping with dog walking and so on.  A massive thank you to everyone who has been such a massive help, and a massive thanks as well for the prayer support we've been getting, both me for a fast rehab and for morgan dealing with everything as well! It means a lot to us both! 

As for now, its time to attempt to sleep on a 6 bed bay (a challenge in itself), before a busy morning of physio prior to a long weekend at home!! Don't you just love a good bank holiday!  

A good looking wound with
half the stitches out!

Monday 20 May 2013

Stuck in the Ppam Aid

A great looking stump by all accounts
After an awesome weekend at home with Morgan and the dog, last night we had the depressing drive back to the hospital so I would be here and ready for 8am ward round with the consultant this morning.  

This morning began with the knowledge that it would be the first day since the op that I wouldn't see Morgan and this quite frankly sucks! It was the right decision as its not a lovely commute to do every day and Morgan needs rest and wasn't feeling 100% (pray for a quick recovery), so hopefully a day of resting will be a great way of recuperating and getting some uni work done.  Rehab needs to be fast because I miss my wife!  My aim is, get a prosthetic, be discharged walking comfortably a couple of days later.  Its totally unrealistic but you have to cling onto dreams and aims don't you!   

Strap weights to work the stump
Ward round was fine and the stump is looking 'fantastic' and 'textbook' - surgeons words not mine and the wound is looking beautiful so I should be all set for stitches out by the end of the week.  Ironically, because it was ward round day then nurses were paranoid about the huge amount of things happening and so got the drugs out incredibly swiftly.  Given thats the only thing that ever takes time from my point of view, I was up, sorted and ready with all the time in the world!  Using my excess time I hit the gym for an hour before physio.  Bit of a gamble as I didnt want to be knackered for my two and a half hours morning physio and hour and forty five minutes afternoon physio.   Was a good call in the end though, did me good. 

Physio went well.  Spent nearly two hours doing core and leg strengthening work - predominantly I was playing about on a big swiss ball challenging my balance in as many ways as possible.  I was then stuck in the Ppam aid and wondering around the gym! 

Ppam aid assault course 
Afternoon physio was entirely Ppam aid time.  It continues to be good to get up on my foot and strolling around the physio gym but frustrations are certainly coming through.  My fitness levels are fast outdoing my stumps recovery despite that going as swiftly as possible.  I'm in a great position as I've been working on my balance and core strength with passion for the last year plus.  This means I'm finding the Ppam aid really easy to use, which in one sense is great but at the same time I like to be challenged.  There are only so many times I can walk around the gym without having a numb brain!  To try and up the anti, my physio set me up a little course to make it a greater challenge with a step, a slalom and some bits to step over... 
It was no great challenge.  This was the first time I tried the course; 

So this is what I'll spend most of my physio sessions doing for the next week.  Its the best way to prep me to be as ready as possible for a prosthesis when the time comes (hopefully Ill be casted for my first one next week).  Its going to take some positive mental attitude to keep this happening but its all working towards something bigger and better!  Patience is a virtue eh!