No progress ....

All is about the same .... absolutely no progress at the follow-up doctor appt. today. He didn't know why the foot was pulling off the ground, no toe movement, pain, etc. The long and the short of it amounted to me not working and exercising it hard enough. This was discouraging because I've worked harder on exercising in the past month, than in a long time! Meanwhile, time marches on with the same situation. Not sure what happens if we are still at the same place in 4-6 weeks, but I guess something will give eventually ..... I have to be able to wear a shoe at some point in life.

je

Started pt again....

Almost the weekend .... yeah! Not many new developments the past few days. I had students at work on Tuesday and Wednesday and both were really challenging days with behavior and keeping kids focused. I am glad they are over. Started physical therapy on Wednesday and Thursday of this week and did 2 - 2 1/2 hours each session. There is about a 1- 1 1/4" gap under the first three toes between the toes and the ground. I have to figure out something this weekend to put under the gap, because walking on the heel only is not easy or comfortable. The therapist agreed fully that I am walking on the heel area only. Don't notice any difference with the steroid injection in helping to relax the toes.

I tried to go for a walk last night. I managed to get the foot into a tennis shoe for thirty minutes, but the shoe even tipped up. I'm still wondering if it is a nerve issue, even though all the tests don't reveal anything. The therapist thinks it feels like my foot can't relax and it stays rigid & contracted all the time - it definitely feels like this. I'm seeing the STL surgeon late afternoon on Monday, as he wants to see the "gap issue" with the toes. I don't remember the toes being this way in the past three weeks, so this has just recently developed. I sent flap pictures to the TX surgeon .... he wrote back and said that he liked my toe nail polish. He thought the flap continued to look good, too! It has been a month since we were in San Antonio, which hardly seems possible.

I took my laptop to therapy today and sent several e-mails while soaking the foot for 20 minutes in the whirlpool .... felt good to "multi-task!" Have been enjoying sweet corn (from the family farm), iced coffee and breakfast smoothies this week.

Happy weekend!
je

Home from Chicago ....

We are home from Illinois ... it was hot in Chicago, but not nearly as hot as St. Louis. Wow! I neglected to mention in the previous post that my foot is starting to pull off the ground again, very similar to last year when it did not stay flat. I noticed this long ago and then it became more evident on Friday at the surgeon's office when she could put almost her entire hand under the front of my foot and we both realized that the foot isn't making contact with the ground. It is most obvious over the big toe area, but there is a gap of close to 3/4" that should not be there .... i.e. all the toes need to touch the ground. It is hard to not be a bit stressed about it, because in the past this was a major problem. There is no easy or good solution for fixing it.

Pray that this doesn't get any worse or better yet that the forefoot area relaxes and improves. I don't notice any difference with the steroid shot yet. The forefoot area must be packed with scar tissue because the doctor had to really work to even get the needle into the skin. Pt is Wednesday and Thursday of this week. Keep believing that it will improve!

je

Chicago Visit ....

We are done with the Chicago visit today and are headed back to the farm to stay with family. The Chicago orthopod spent about 20-25 minutes with us and listened carefully to everything that has happened in the past 4-5 months. She agreed that we have lost all the mobility and forefoot toe motion ... the forefoot is rigid and will not move. She thought the transfer area looked good, but agreed that what we have now is not functional.

She injected a steroid into the top of two toes .... it will take three days to see if it helps the area to relax somewhat. No guarantee that it will work, but we tried. I've had it done in the past and it had not helped. She recommended that I resume physical therapy right away and try it for the next 4-5 weeks and see what happens. I have an appointment to begin again on Wednesday. She agreed that the pain is likely due to the toes not working and not walking normal .... it is a shuffle motion now. She said that removing more bone in the forefoot might/might not work .... not really sure since it didn't work before. If the April toe surgery had worked, we would know it by now.

She gave me a smaller compression stocking that is thinner than the Ace bandage. My right foot is smaller than looking than the left foot. My left leg length is about 1/4" shorter (due to the hip problem). We didn't discuss what to do if nothing improves with exercise. No one wants to talk about "plan B" until you get there. She did everything that she could today and it was fun to see her. We will likely follow up with her in August. We did a little shopping today, but it has been rainy and hot here.

Happy weekend!
je

Headed to Chicago ....

We are off to Chicago in the next hour. I will have my laptop and will
find somewhere with wifi to update the blog. All is about the same this week - more swelling with warmer temperatures outside. We are taking a rental car to Chicago and got a white, Mustang convertible - very fun! I survived the two long days of teaching this week, but are really glad they are over. Two visit days next week (Tues/Wed) with students and then a break until July 31st.

Pray that our 11:30am appt. goes well tomorrow and for safe travels. I'd like to hear more than "exercise and see what happens," but my guess is that will be the advice .... we'll see.

Happy weekend to you!
je

Exercise ....

I did hear back from the Texas surgeon and he said that I could begin to start to exercise. If swelling or pain starts, taper off as appropriate. He wants me to let him know how it goes and he understands my concern about the loss of toe/forefoot mobility. Although I have not been doing pt, I have continued to exercise some on my own at home. I will meet with the Chicago surgeon on Friday and am sure we'll come up with the best plan. I am anticipate she will recommend that I exercise hard for the next month and see if any motion will return. There is still pain there when standing walking .... pain meds work for awhile and then I give in and have to sit eventually.

Earlier today I had an incident involving falling, but I am okay. Very thankful for assistance of a neighbor and that I didn't break anything. I thought I had perhaps injured the artificial hip, as it was affected, but an x-ray tonight showed that it is okay .... will just be painful for a few days hopefully.

We will drive to central IL late afternoon on Thursday .... meet with the Chicago surgeon at 11:30am on Friday and then we will return to IL to spend the weekend with family. I'll take the laptop and will find someplace with wifi to update the blog.

Pray in the Spirit at all times with all kinds of prayers, asking for everything you need. Ephesians 6:18

New Foot Pictures ....

There really isn't anything new happening this week ... standing and teaching the past two days has been really challenging. I was in pain really early in the day and then it just progressed throughout the day. Tomorrow is our last day of summer camp - whew! Still no toe movement, motion or flexibility. I am SO tired of wearing the boot shoe .... it is hot, bulky and just makes everything more difficult. It is not designed to wear for several months.

I heard from the STL surgeon earlier this week that there is a very fine line as to how much bone needed to be removed from the April toe surgery - can't be too much, but needs to be enough. Not totally sure yet, but it may be a case where more bone needs to be removed to be effective in my case. Supposedly more bone CAN be removed, but need to weigh the risk of opening it again. I am certain that the pain I am experiencing is coming from the toes not functioning.

I have an e-mail into the Texas surgeon asking him if I can resume exercise, if I get the two areas that are supposedly not healed to heal. I think his answer will be "no," but I am asking anyway.

Ready for the weekend, but that is sometimes hard as well, because I can't be out doing things as I'd like.

je

Imagine ....

Imagine …. What it would be like to?
- Not feel like more & more dreams are dying each day.
- Go one month without a medical or therapy appointment.
- Be able to walk around a store without being in pain.
- Walk around the block for exercise.
- Not filter every life event or activity through the “Does it involve
walking” question.
- Feel like I could do my job effectively (marketing, teaching, etc.)
- Sleep through the night without medication.
- Devote all the time that I spend now on medical junk to something worthwhile.
- Wear two dress shoes and be able to dress up.
- Driving correctly with my right foot.

And he said unto me, My grace is sufficient for thee: for my strength is made perfect in weakness. Most gladly therefore will I rather glory in my infirmities, that the power of Christ may rest upon me. – 2 Corinthians 12:9

It has been a quiet weekend filled with emotional ups and downs. Please know that the TX surgeon’s primary focus & concern is not getting toe movement back, as his main job was to get the incision closed (which it looks like was successful). I worked with the foot some on my own this weekend. I’m looking forward to Chicago in two weeks as I have not seen that orthopod since February, so it will be good to reconnect. As long as I don’t hurt the incision, hopefully I’ll get the okay to proceed with exercise and trying to get toe movement to return. Believe it or not, it is really hard to walk without toe movement …. It would be like a hand working with no finger movement. The area that is supposedly not healed doesn’t show up on a digital photo – it is that tiny.

I have to teach six sessions (an hour each) on Wednesday and Thursday of this week at an inner city camp. I’m taking two other staff members with me, but both will be long & tiring days. Hoping for a better week …
je

Back home ... tough news.

We made it to Texas and back safely. The San Antonio appointment didn’t quite go as I expected & I’m still processing it all. It was good to see Dr. I and fun to stop at the hospital to visit with nurses. He said …
- Still 2 spots that need to heal yet (1 above toes & 1 on the ankle)
- No exercise for two months. Stop doing physical therapy.
- Return to wearing the boot for two months; don’t try a shoe.
- Asked about swimming or walking on the treadmill and both were “no.”
- Pain issue – no suggestions; “live with it” for one year and see what happens.
- He wants to see me back in three months.
- He wants the swelling to go down further; continue daily wrapping with bandages.

I met with the STL surgeon this morning and he was surprised at the above recommendations, but said to go along with the advice. The toe motion (or lack of) now is not enough to wear a shoe or walk (i.e. step correctly). There is no flicker or toe motion left. The STL surgeon said today that he had hoped for better results from the April toe surgery. As of today, it has been eight weeks since the toe surgery (no toe movement left), so another two months would be no motion for 16 weeks …. it is too long is all I know to say. A normal patient can usually regain movement in the first 5-6 months after surgery, but in my case I have only 1-2 months after surgery. I am already at eight weeks.

Waiting another two months with no exercise or attempting a shoe were both tough to hear, because I know from past experience that the longer I go with no movement, the less & less likely it is to be regained. It is more stiff today than it was a week ago. I am also only doing about 10% (activity wise) of what I would normally do, which will continue with having to wear the boot shoe ….. so much for summer sandals.

I’m not sure why no one seems concerned about the increasing pain, but to me it is mentally draining & frustrating. Better close as I’m pretty down on it all tonight … it was hard to cancel all my physical therapy appointments today. This goes against my better judgment to comply with this medical advice.

je