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! 

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... 

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!

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...

unveiling the stump!

I realize its been a few days since I was last on here and its fair to say not a huge amount as happened in terms of the leg itself but thats to be expected this early on.  I've rested lots and have been enjoying having my own room and pretty good food while it lasts.  I'm off to Roehampton on Wednesday and will not be in my own room (I wouldn't want to comment on the food quality until I get there).  

I'm not used to it yet as such...

So what has been going on?  I've been doing my physio exercises on a pretty regular basis.  These basically consist of laying in various positions in bed and moving whats left of my leg in various ways for a few reasons; to help keep flexibility good, to keep as much muscle bulk in place as possible, to keep circulation good as possible (and to fill the time I guess..).  I've also been lent a hospital zimmer frame - how cool am I?! to get around my small room on.  I've done trips from bed to toilet, from bed to chair and other variations to and from those destinations.  Its exciting and I mean that genuinely though I realize it might sound a little sarcastic.. What is taking some getting used to is not needing to bed my knee to walk with the zimmer.  Its a little instinctive to bend the knee but of course that's totally unnecessary now my leg is considerably shorter!   Its nice to be able to get out of bed though. 

me, not at my peak! 

We've been playing with what drugs and how many drugs I should have for a while.  I'm told its important to stay as pain free as possible in the early days of an amputation as it helps keep chances of long term issues such as phantom limb pain at bay.  To begin with I was on some decent oral painkillers and a PCA (patients controlled analgesia - I push a button and something stronger than morphine hits my through an IV).  The advantage of this is that if I so desired, I could have more drugs up to every five minutes.  Its biggest downside was when I was asleep. Ill give you an example, on Thursday night I probably fell asleep about midnight and was well pumped with meds. I slept quite well until about four am when I woke up and whilst the four hours sleep were great, whilst sleeping I had of been unable to push my button.  This meant I woke up and was in so much pain.  I was literally lying holding my stump in the air because contact with the pillow it was on was just too painful, so I just watched painkillers drip their way into the IV and into my arm.  It was not a fun way to spend an hour or so.  
We seem to have the drugs/pain better managed now.  Having spoken to the medics, we actually decided to get rid of the PCA (bonus, no lines going in me now), up the strength of the oral meds and have oramorph (oral morphine) as a support drug as required.  Its been fantastic, and pain has been managed incredibly well since I have been on it.  Only real downside is that it leaves me as high as a kite feeling totally detached from the world around me, or sends me close to sleep.  As the pharmacist who visited today to check how I'm doing observed, that doesn't matter really - it seems my uni work is not her priority.  I am still on these drugs so I will blame them for any spelling/grammar/general lack of sense issues in the blog!

I had the treat of turning 25 on Saturday which was as lovely as it could have been all considered.   Well, apart from the new painkillers making me violently throw up first thing but that was before guests arrived so we draw a line under that!  I had Morgan, her auntie Kelly, and various friends come over the course of the day which was totally lovely - and they came with a spectacular cake!  Massively blessed to be visited by Jonny and Fiona, Jonny who had only been

my cake, with candles (right under the smoke alarm!).

discharged from stoke mandeville the day before after a 5 month stay - what a hero!  I cant claim it was the best birthday Ive ever had, but I can say it was the best birthday I've had in hospital, and the best birthday I've ever had with a missing foot so some definite wins there so thanks to all involved, including those who sent cards, gift, Facebook messages, texts etc.  All were very appreciated!  One of the birthday treats from Morgan was to be signed up to do a tough mudder event with some friends (look it up if you dont know!).  This is how awesome my wife is. I've not even got a prosthetic yet and already she has every faith that I can achieve this at some point in the future so me, Matt and Oliver will be doing this sometime soon as the team "five and a half legs" so watch this space. If anyone wants to join us we can always add more legs to the team! 

Beyond the birthday, I have had visitors every day, from my parents, to morgans parents yesterday, another of morgans aunties, friends and Morgan has been up every day. phone calls with a few others also help to take my mind out of the hospital.   The company is fantastic and helping to keep me sane.  There really is only so much day time TV a man can take after all. 

So hows life with the stump.  It remains weird but not terrible I am pleased to say.  I continue to get plenty of phantom sensation but generally not phantom pain which is great! Its very odd getting mild cramp or pins and needles in a foot that no longer exists, but its not painful and that's the key thing.  Morgan is getting used to it as well which is good.  She has touched it a few times which sounds odd but is universally considered a really good step towards becoming used to it.  That's not to say its normal now, far from it.  There are still moments when we are together and Ill stretch my leg and move it about when she is not expecting it and the sight of the stump takes her by surprise and I am swiftly asked to put it down which is fair enough.  Its one thing to get used to it, its another to have me wave the thing in her face after all!  Dan, a friend offered an interesting perspective when he told me "it almost looks too real."  He then explained himself and said because he is so used to seeing such incredible special effects in films and TV he looks at it and thinks, wow that really well done as an effect rather than - whoa you've got no leg.  The crazy world we live in I guess.

Little things surprise me, for example I got out of a hospital gown and into shorts and t-shirt a couple of days ago.  It took me three, repeat THREE goes to put short on on Sunday, simply because you instinctively  go to put the shorts over your foot, the foot not being their meant I miss judged it and missed my leg, simple as! Funny without a doubt, but also really odd!  

Big news of today was that the dressings came off the stump for the first time and I saw it down to the skin.  I'll be honest, I was amazed by how neat and tidy it was.  Its swollen and bruised, but much less so than I was expecting, it actually all looked really neat and tidy!  This surgeon knows what hes doing!  Its now wrapped back up in a much lighter and smaller dressing which is nice but it really threw me.  The original dressing was think and weighty and restricted my knee, so moving my leg felt s little like moving my leg used to.  Now its in a slimline dressing its extraordinary how light my leg feels.  Its like it floats!! I imagine I will feel somewhat differently when I am trying to get used to the weight of a prosthetic... 

I'm thrilled that help and love from others isn't just directed to me at the hospital.  Its been awesome to see the support Morgan has been getting from home from very kind people willing to be around for her, help with walking Poppy, even offering to move in to give her some company and support.  Oliver my brother in law has basically lived there for the last week and its great to know that however much it sucks that I am not at home with my lovely wife, she is being loved and supported by both family and friends in my absence!

Right, reading back, this is really long so I'll sign off as your probably bored, but I will add a link to the video of the stump being unveiled.  Its a bit long, and if your squeamish you might not enjoy the final minute but its there if you want to watch it.  I'd argue its worth watching just to see my surgeon enjoying being filmed - he seemed to love it, and tried to really engage with the camera.  
Hope you enjoyed reading! 

Heres the link, last couple few seconds seem to have been cut which is annoying so I'll add a screenshot below (bit gory, don't scroll down if you don't want to see)! -   https://www.youtube.com/watch?v=lfnAfnGtNos

I'm actually an amputee...

So two days ago the operation happened! I've been a below knee amputee since Wednesday.  I thought I'd share some initial thoughts but am on some impressive painkillers so this may or may not make sense...

It hurts - I realise this seems like pointing out the obvious but nevertheless I bet you were wondering! Whilst it does smart from time to time, it's certainly not the most painful thing I've dealt with, but it does hurt.  I'm on a fairly spectacular mix of drugs at the moment, I've been warned that the pharmacists won't be happy as if I overdo my PCA (patient controlled analgesia) I could end you struggling to breath so sensible use only! But it generally keeps it manageable.  sleep is an issue though. When I sleep, I cannot push the PCA button, so I don't get any gradual top ups, so last night at 4 (ish) there was a moment with such pain I was holding my stump in the air to keep it from contact with anything... Quick call to the nurse for some quick drugs were the way forwards!

Still feels right - it was a big decision to loose a foot to achieve more mobility with less pain.  Going into the op there was always a risk that I would come out of theater and think "what have I done?!" it's very common after an amputation to feel a sense of bereavement and loss so I realised there was a chance of feeling bad about it afterwards. I'm thrilled to say I don't. It still feels good and right.  That's not to say I won't have a stage where I wonder if it was the right choice but at the moment, despite post op pain and the frustration of bed rest, it feels like a positive step towards improved mobility and less pain!

Phantom sensation is odd - phantom sensation and phantom pain are two different things! Sensation is the feeling of the limb still being there and is extremely common, phantom pain is your brain remembering the pain of the limb and is fairly common in the early days of an amputation, for some causes real problems! I'm pleased to say at this stage, i've only been experiencing phantom sensation.  it's an incredibly odd thing to get pins and needles in a foot that no longer exists, or having an itchy toe. Even just the feeling of the foot being there. I've already had a couple of moments where I've looked down and taken a moment to work out where my foot is.

My wife is incredible - coming up on Three years ago, I gave Morgan a horrendous experience to deal with when I had my initial accident and she had to help me through an intensive care experience, through to the slow rehab (both in Hospital and continuing at home for the last couple of years), slowly building up further strength, better mobility and sadly discovering the issues of the ankle.  There is one thing I hate about this, and that's the fact I'm putting Morgan through this horrific experience once again. The next 6 (ish) weeks we're going to be going through this rehab process once again (which will continue at home after discharge), and it's not fair for her to have to deal with it all again.  despite that, she blows me away with her strength, her willingness to support me, her ability to appear with a smile on her face dispite it all. She is an incredible lady!

I'm excited about the future - despite all of the rubbish we are dealing with right now, I genuinely believe we are starting a new journey which is going to be better once we are though the rehab stage.  If I can master a prosthetic well (and I'm confident I will), I will not let anything stop me! I'm feeling positive that I should be able to have some real adventures with Morgan. I want to climb again and to paddle again. I want to take morgan to Petra - we were really excited about going to Petra on our honeymoon but when we arrived were then told it would be inaccessible from the wheelchair! Most excitingly, I hope this will allow me to be me more with nieces, nephews, and in due course my own children. To be able go run around in the garden with James, bethan and Harriet and Toby in due course. To be able to carry my own children (when the time comes) without being scared of the ankle giving way and me falling/dropping a child and as they grow up, to do some real family adventures!
And who knows..  Maybe I'll be in Rio 2016!  Better get training.

A long journey ahead - I have to remember, its going to take time.  It's good and important to be excited about what the future can offer as it gives motivation to push yourself hard but equally, I have to respond to my body and what it is telling me! Rest where rest is needed and be patient as I go through the process.

As the rehab process goes on I'm planing to do some blogging to keep a record of the experience... I know that as I was researching my options I found others accounts of their experience really helpful so maybe sometime in the ffuture this will prove helpful to someone!