why personal training...

As is often the way, time absolutely flies by!  I cannot believe we are into March already.  

Part of the reason its flown by at such a pace is that its been busy.  I've been working my way through a course with premier training to become a Personal Trainer.  Im pleased to say that at the end of last week I passed, and passed pretty well if I may say so myself! 

Having passed, Im now in the process of working out what to do with it and how to use it. Im eager to operate freelance to make fitness and exercise as inclusive as it can possibly be.  Whilst contemplating all of this its been hard not too spend a bit of time thinking about how far I've come as well since that fateful day in 2010  (this blog has only existed since 2013, in case you don't know - that was the day of the 30 odd foot fall, broken back, snapped wrist and ruined ankle...), and the way a passion for activity has, at least in part, helped keep my focused, progress my rehab, and guide my recovery.  

This is me about two weeks into my post injury life having just been winched into a wheelchair for the first time.  I'd love to say this was the lowest point but Im actually looking pretty good here compared many occasions in the days before this was taken.  At the time, this was a huge step (for want of a better word).  My legs were paralysed, my right arm had various canulars going into it, and it was a treat to have my left arm out of its vertical position in its sling.  A lot of this was crap but it was still a really positive step forward as it was the first step towards getting into a manual wheelchair and regaining some vague degree of independence.  

Since then its been six months in Stoke Mandeville, a rehab experience like no other.  A gradual process of learning to walk again over a very long period.  The realisation of just how seriously I had ruined my ankle as it became more limiting than my back, and was causing me to walk badly making my back far worse.  Three surgical proceeders to try and fix make the ankle something worth hanging onto.  The realisation that it wasn't. An amputation.  Another four weeks in hospital and countless appointments with the prosthetist (with on going physio throughout)!

Then last week I  earnt my t-shirt!  

There are a lot of things that have helped my get to this stage.  My faith is an important part of my life and has undeniably dragged my through some hard times and I hold it heavily responsible for my ability to keep positive pretty much whatever happens.   Morgan has been a HUGE part of every element of the recovery, from the great moments like successfully walking down the isle on our wedding day (ruined my for a week after), to making the decision to amputate last spring.  Its been a huge burden on her and I hate that fact but despite that, on a daily basis she has absolutely amazed me with her mental strength and her ability to support me through it all.  On a similar note, family have been a huge help and I consider us really lucky to have family on my side and Morgans, who are local and who would do anything to help us.  As much as I get frustrated with myself  at the help I need at times, its a real blessing that its there.  On a purely practical point, Im extremely fortunate that there is an ongoing legal case on my behalf.  Whilst it is a horrible process, it has meant that Im able to see and work with some spectacular physios and access some incredible prosthetics.  Later in March I will be trialling a bionic foot.  The sad reality is that its something that is a long way off being accessible without such claims.  

So where does fitness come in.  Ive always loved activity.  Thats not to say I was into your classic sports at school (never on the football team - couldnt have cared less), but never the less I was never happier than when I was being active, whether that was on my back or climbing or what.  As a rule, the greater the perceived risk, the more interested I was!  At the time of the accident, I was in good shape.  I was running most days, I was climbing and kayaking regularly, and biked a lot.  I also spent a lot of time working my core and training in ways to improve my climbing ability beyond anything.  There are two reasons why this proved a good thing.  1 - it meant I could handle more.  At least 4 surgeons have commented that my level of fitness is likely to have helped limit the damage that was done by the fall.  Put simply, the fitter/stronger you are, more muscle you have which helps protect the body, secure the joints etc, and the stronger your bones are! 2 - It gave me something to strive for.  It was incredible, laying in a hospital bed and realising how fast muscle wastage is.  I expected it on my legs as they were literally unable to move, but I was amazed by how scrawny my upper body became.  I was determined that in time, Id be in ok shape again in the future. 

Reality is that these things take time and its a process.  Regaining some upper body strength happened quite quickly but it came with quite a lot of body fat.  Working out how to train effectively from the position I was in wasn't easy and nutrition was, sadly, the last thing on my mind - in hospital, whether its first or last thing on your mind its challenging to get right.  

As the months have rolled on Ive had different focuses.  In the early days of learning to walk, I knew that my legs needed to be stronger and I needed to regain the muscle mass Id lost.  Challenging when putting weight through one of your feet literally makes you want to cry.  As I was preparing myself for an amputation, I knew one of the key things that would help with recovery was improved core strength to improve my balance and control as I moved onto a prosthesis and so I worked my core hard (one of the key influences in my 3 week rehab, as opposed to the 6-8 week rehab I was told I would need). 

really, whats not to love....

So why a personal trainer?? I genuinely believe one of the key processes in my recovery has been my fitness level, and my determination to improve my fitness level throughout.  Exercise also keeps me going on a day to day basis.  If I don't, my body seizes up.  Everything gets harder, everything gets more painful.  In reality, at the absolute best of times, if I walk for more than half an hour my back will start screaming at me but I know that if I go a few days without training its made worse still.  The body and mind are a bit like a car engine when it comes to activity, they work at there best when the engine is warm.  If I don't exercise for a few days, everything gets cold and seizes up, and starting again becomes a 10x harder.  I also notice it in my mental state (as does Morgan I'm ashamed to say...).  If I don't train, I get moody! Part of that is probably linked to the increase back pain and discomfort though in all fairness...  

It literally improves my ability to function on a day to day business and I don't think thats limited to me.  Its the case for everyone and so as a PT, I want to help people to find that for themselves.  I also want to help people to find something they love to do.  It frustrates me when people tell me they don't like exercise.  The reality is that the body was BUILT TO MOVE.  We are not designed for the sedate lives thats western culture slots us into.   Most of us spend our days moving from one chair to another and spend our days sitting down, not on our feet, not moving.  Our bodies are designed to be upright, we are designed to be mobile and active and a huge number of health issues would be reduced if we fix that problem (we also work better when we have good quality fuel but Im not getting into nutrition now or Ill be ranting all night),  Even if your mind doesnt enjoy exercise, your body does, and in reality, exercise comes in many forms, theres something for everyone!   For me, its not about turing everyone into bodybuilding champions and fitness models (although if thats your goal, great, thats what we'd work on), instead its about functional exercise to improve how well you function on a day to day basis.  That might be as simple as a client saying, "I want to improve my health and not be out of breath when I walk to work", it might be "I've got three kids who all have more energy and I cant keep up".  It will vary from person to person.   

My hope is that, due to my own life experiences, as a PT I'll be able to empathise with my clients.  I understand that its hard, I understand that sometimes it feels like the body just doesn't want to join in, but I also see the importance and know that the benefits are hugely more than just looking better with your shirt off (although theres no harm in that).   

So my goals.  Work as a freelance PT.  Im currently in the process of going through the practicalities of creating a business, getting insured, setting up a website etc (functionalfitness.org.uk - its still a work in progress, ignore the typos, spelling mistakes, and need for more content). 

Long term, I plan to do specialist work looking at exercise referral, working with people with disabilities, and rehabilitation work along side the standard personal training work but you know what they say, one step at a time....  With a baby due in April, there is plenty to be thinking about after all! 

And on that note, Ive just realised how late it is and so Im going to hope this makes sense and say goodnight...

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!!!   

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! 

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!

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.

http://www.youtube.com/watch?v=GFhGUjI10wQ

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..

http://www.youtube.com/watch?v=dQ8iauZL83g

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!

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.. 

https://www.youtube.com/watch?v=kD0iu7ASkxw

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. 

https://www.youtube.com/watch?v=MnBG-QPMMog

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! :)

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!

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; 

 https://www.youtube.com/watch?v=uVBFQoq_MUI  

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! 

A weekend of freedom!

On Friday, I had two goals; one - to get home for the weekend, two - to make progress in the ppam aid! 

I knew that on a Friday the day starts with a "game session" in the rehab gym as a fun, end of the week treat!  I totally understood why this is a good idea in terms of moral etc but I was a little concerned that it meant my first goal might be unreachable as the afternoon physio session was balance class, a core circuit training session.  Much to my relief, the game session was just the first hour (or half hour as the Ward were not entirely on the ball with the drug rounds so no one was there on time). 

It was quite fun having a game of Wheelchair badminton though I had to continuously remind myself to curb my competitive impulses to make sure I let my teammates get involved.  This became all the more important when I came unbelievably close to hitting someone in the head with the racket when going for a shot, thankfully he didn't notice, the physios on the other hand winced!

So from half 9 until 12 I was in the ppam aid practicing getting some weight through the leg.  The goal was get walking outside of the parallel bars. Goal complete! After a lap in the parallel bars my physio got the crutches for me to practice in the bars. I did a lap, and then kept going.  I was satisfying to be out on crutches wandering around the gym and as time went on I upped the anti and started doing a step, slalom and rough terrain.  In many ways, it feels so incredibly natural to be up walking and in many ways it feel so wrong because the foot isn't there.  It's all going to take some getting used to, although an actual prosthesis should feel more natural as I'll be able to bend my knee!

So goal one, to get home!  Now roehampton aim to get people home for weekends as its good for the psychological side of rehab, it's beneficial for discovering what life skills you might need help to relearn and nothing happens in hospital at the weekend anyway so I was all set to be going home on my first weekend.  However, dispite the above, the blanket rule on your first weekend there, so soon after surgery, is no way - you don't go home. The issue is that the wound is fresh and still held together with stitches. My consultant made it very clear, if you fall over, it will split open - how grim would that be! It took a lot of
pursuasion and some slight exaggerations on the wheelchair accessibility of the house for them to be persuaded but ultimately, they relented.  I think they read between the lines and realised what I was really saying was "I AM going home, but I'd rather do it with your blessing than without!"
As I told them, if I go home I'll be chilling out with Morgan, if I stay in Hospital I'll get bored and think of stupid things to do or go and explore the area in my chair...
They gave me a few rules which I've (pretty much) kept to!

So physio was done by 2:30, I was in the car with Morgan and Mark (Morgan's dad) by 3 and heading home!

Weekend at home has been absolute bliss!! We've done very little but my little family (me, Morgan and Poppy dog) were fully reunited! Poppy was both outrageously excited to see me and a somewhat perplexed by the Wheelchair but it's crazy how pleased I was to see her. Week and a half away from the pooch was far to long!  Also had the pleasure of having some good friends around for a Chinese on Saturday night which was great. The rubbish bit of going home for the weekend is the knowledge that tonight I travel back to the Hospital where I'll stay for another week but that's most of a day away so we are ignoring it at the moment! Instead, I'm just snuggled up on the sofa with my wife who's the best - happy days!

In other news I'm trying to move off the oxycontin, dropped down to 10mg twice daily.  Stump pain, generally good though its a little tender. Phantom pain is very weird when it happens! Like having an electric shock put through your foot (which no longer exists)!  At times it can be extremely painful.  It's interesting though, if I'm busy it won't happen, if I'm in the ppam aid or doing physio, nothing! If I'm not doing anything is when it's likely to play up.  It's as though when I'm using the leg in some way I con my brain into thinking nothing happened.  Phantom pain is really common in the early days after amputation and for most people it settles down over time. It's encouraging that I don't get pain when the leg is being used though, definitely a promising sign.

Final thought - blog is really long. I must be more concise! Sorry if you got bored...