In 2010 i suffered a spinal injury and smashed ankle. Incredible spinal recovery but ankle not so good. On 8th may 2013 I became a below knee amputee. I thought I'd blog about the experience as my wife and I go through another rehab experience, another recovery, and adapt to life living with amputation. Also on twitter @senior_josh
Wednesday, 20 November 2013
Six months on!
Monday, 29 July 2013
Busy, so very very busy!
Tuesday, 2 July 2013
New experiences!!
Wednesday, 12 June 2013
A whole week at home!!
It's now been a whole week since I was discharged from roehampton and it's been an interesting week of learning about how to live with this new prosthesis and I've made various observations.
1 - walking is hard
Whilst the progress I've made is incredible, walking is undeniably still a hard thing to do. I'm pleased to say that my balance is good, walking will become easier (and is becoming easier - slowly but surely, I just have to remind myself of this fact), but with a five week old stump that is still a bit bruised and battered. It will get better but it will take time.
2 - my right foot is MASSIVE!
We discovered this whilst in Cotswolds. I've been told with no doubt that I must keep the fake foot dry and so I thought I'd buy myself some decent boots that would help me to do just this! Whilst there my feet were measured by Steve (not sure he's measured a prosthetic foot before), but we discovered there is quite a difference in size. Not ideal!!
During my outpatients appointment I suggested we just amputate the toes on the prosthetic but instead a new foot has been ordered. Hopefully I'll get it in the next week or so!
3 - my assumptions regarding socks were wrong...
I joked pre op that I would get through considerably less socks. Turns out I was wrong! I am currently wearing one sock on my biological foot which is pretty standard, but Im also wearing two thick socks, one thin sock and a think half sock on my stump, all of which is pretty standard by this time of Day! It's a lot of socks to deal with... Getting the number of socks on the stump correct is a real and constant challenge. its the key to getting a comfortable prosthesis And tiny adjustments make a huge difference. Learning to get this right is tricky, but I'm getting there!
4 - you have to make the physio happen!
It would be so incredibly easy to just stop the Physio/rehab activities when you get home after something like this. I can walk a bit with sticks, I can get about (I'm back to driving - thank you DVLA) and so I literally have to remind myself what my goals are and what I hope to achieve! By doing so I force myself to get up, to go to the gym, to do laps of the house or garden, just to keep moving forwards. As part of that progress today I challenged myself to walk all the way around the park (I'd taken poppy for a run around) with just one stick. I was pleased with how it went but won't be getting rid of the stick for distances like that for quite a while.
And so there we go - progress continues and however slow it may feel, in reality I'm moving pretty quickly.
Happy days!
Tuesday, 4 June 2013
Home soon...
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| New foot! |
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| Scary outdoor steps! |
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| Tricky outdoor slope |
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| Id say this is overkill as a sign! |
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| The scary and dangerous rehab garden... |
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| I even got myself on a bike without pain - happy days! |
Thursday, 23 May 2013
Progressing fast!
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| Kneeling on a Swiss ball Flipping hard work! |
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!
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| The inside of the negative mould! |
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| 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!
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| A good looking wound with half the stitches out! |
Monday, 20 May 2013
Stuck in the Ppam Aid
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| A great looking stump by all accounts |
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| Strap weights to work the stump |
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| Ppam aid assault course |
Friday, 17 May 2013
Welcome to roehampton!
So on Wednesday, exactly one week after surgery I moved to roehampton, with the help of Morgan, her Brother Oliver and his girlfriend Sammi!
It was nice to get in the landy for the journey even if I wasn't allowed to drive it - come on DVLA, get back to me and clear me to drive left footed!!
I was sad to say goodbye to Parkside. Having a room to myself was a treat which I am already missing - the only person I'm eager to share a room with is Morgan and so 5 blokes (all, I think over twice my age), in my space is simply not the same! I'll also miss the food. Parkside is a private hospital, an expense worth incurring to get the surgeon Mr Ward who, along with being keen to be filmed, by all accounts is renowned for being incredibly good man to have chop your leg off, without NHS waits enduring pain and limitations. I'll also miss the food at Parkside. Here at roehampton, back under the care of
the NHS (which, for the record never ceases to blow me away!), is a little more basic food for the masses...
In reality, I digress given the food I eat and the sleeping arrangements are of no importance or interest to anyone bar me! The biggest issue is that not only am I in a WiFi free zone but signal is something which simply doesn't exist on the ward so I am connectable everytime I go outside/to the entrance foyer of the hospital so don't expect quick responses to texts/calls/tweets/messages/comments...
So having made it here to Roehampton around half twelve as previous planned we had the odd moment of turning up to the bed which was due to be mine and discovering the man who had the bed before me hadn't actually left yet so we dumped my stuff and made a subtle retreat to find some food! I didn't feel it was my place to boot the guy out, or put him under pressure - thatd be all kinds of awkward!
So Wednesday in all honesty, very little happened. I briefly met Abby, my physio who told me where to go Thursday morning where we would get started. Beyond that I answered lots of questions so that the nurse could check their records were correct and to be honest that was about it beyond getting to meet some of the other patients!
Thursday morning and rehab began with a being in the gym by half nine having had breakfast, a shower and set myself up for the day! It was good to get started with some core exercises, leg (what's left - my short leg as Morgan calls it as a nicer term than stump), and hip exercises as an aim to help to prepare my body for the stresses of prosthetic limb wearing when the time comes. Having spent the last year or two making improving my core strength and fitness one of my top priorities, it was satisfying to really make my physio scratch her head to try to find ways to think of exercises that would challenge me! It was satisfying that in the end, she was giving me exercises which I could do but with a lot of effort which I then challenged her to try and she really struggled - not bad for a bloke with a titanium crammed spine!
I'm really aware of how lucky (don't believe in luck but you know what I mean), I am. If your going to loose a leg, being otherwise fit and well, and knowing in advance that it will happen allowing you to put in huge amounts of prep work makes a huge difference to the rehab process (so far at least)!
Part way through the morning I was pulled out of the gym to have the wound examined (new hospital, they like to check these things). Having taken the dressing off, the nurses response looking at it was "Mr ward really is the best!" I concluded from that that it was all looking good so happy days on that front. Because it was all neat, clean, not oozing, or wet I'm now just covered by a standard glorified plaster dressings just to keep it clean. Following that I was presented with my stump (or little leg) compression sock. Basically it's a snug fitting tight that compresses the stump to limit swelling and help mould it into the best possible shape. That's right, I wear tights and will forever - get over it. Any time I am not sleeping, or wearing a prosthesis, my stump sock sill be donned. As Morgan kindly pointed out, it looks very sexy - I imagine she was being totally genuine at the time! I've avoided getting any ladders so far so Im doing well.
After a busy morning it was lunch back on the Ward, followed by Morgan and Milla (friend from Carroty wood days) arriving which was lovely and at about half two I made a move back to the gym for some more physio. Because the wound was looking good, I was given the chance to get myself up on my foot in the ppam aid. The ppam aid is like an inflatable prosthesis which covers your whole leg and allows you to partially weight bare. It's part of the training process and it helps with swelling, desensitization, and to practice getting on your feet to some degree. Because it covers your full leg you have no knee movement so it's an odd movement but it's good to be on your feet. For my first go I was just working within the parallel bars but I was amazed at how well it went with various laps of the bars done just on the first go. It's fair to say it hurt a bit but less than in was anticipating given the bruising and the wound! In theory, when I next get in the ppam aid I'll be using crutches as apposed to the bars!
Following physio, Morgan, Milla and I made a break from the hospital and had a little run away to be anywhere that wasnt a Hospital. We headed up the road not knowing where we were heading and ended up in Barnes where we had a wonder (they walked, I wheeled) before going out for a meal. It was really nice to get some freedom and some non hospital food with company of my wife and our friend. Upon return to the Hospital they left for home and I went to the gym, blagged myself an induction there and then, had a workout which felt extremely refreshing before attempting some degree of uni work... Progress is being made, I'm not sure it's my best work but itll do!
As Friday morning roles around its looking all set for another day of phsyio. Accoreding to my timetable (which gets written up on a whiteboard above my bed each day for the following day), I'm expected in the gym from 8:30 til 14:30 with an hour and fithteen break for lunch at midday! Hopefully it will prove productive and beneficial.
Stump continues to do well. Pain well managed by the drugs although I do need to keep weaning myself off the oxycontin as its opiot based and extremely addictive apparently. Phantom sensation remains a very regular thing pretty much all the time but not really bothering me... Phantom pain springs up occasionally here and there as a sharp shock, generally if the little legs been still too long. If I get it moving/gently message the stump it settles down pretty well on the whole!
It's incredibly weird being here and going through another rehab process! In many ways it's incredibly similar to the Stoke Mandeville set up which in some ways is good because it gives me the advantge of knowing roughly what to expect and so on, but at the same time its hard work for morgan and myself. Theres that real sense of you know what, we've done this before and don't have any desire to do it again.
Ultimately though, it's what we are doing so we may as well do it well. One of the inpatients was talking about what seemed to be the average stay for an impatient and how well they could walk when they left. It was interesting to listen to his views but in my head I was just thinking stuff that, there is going to be nothing average about my stay! I WILL either progress stupidly fast and be discharged much faster than average or I'll stay an average amount of time and be discharged with mobility levels that are unheard of upon standard discharge! Hopefully both of those things! I have come to the conclusion average people get average results and so I refuse to be average!
Monday, 13 May 2013
unveiling the stump!
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| 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.
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| me, not at my peak! |
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
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| my cake, with candles (right under the smoke alarm!). |
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
Friday, 10 May 2013
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!

























