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!