Surgery guide this week .....

This has been the week to be extra thankful for the ability to wear a shoe .... it would have been rough on the piggies with 15 degree weather and snow! Believe me, I'm being extra careful where I walk, avoiding all ice, and playing it extra safe.

Over the past several days I've been able to help a co-worker that broke both arms at Hidden Valley last week. This gal is rather new to St. Louis and had never had surgery before. I hooked her up with the best arm/hand ortho guy in STL and we have met several times in the past few days and discussed what she needed to do, not do, medications to ask for, etc. Today was her surgery, so I stopped by and all was going as planned. Can you imagine two arms in casts? Her family was extremely appreciative and it felt good to use some of my "ortho knowledge" to help someone else. I'm sure her nurse wondered where she got the list of IV drugs that are the best! I really do need to seriously pursue something career related in the medical field.

This week is the fourth week of physical therapy. We took more range of motion measurements today and still very little progress. Strength is improving though, not much swelling left, and the coloration looks much better. I really don't think we are going to see more improvement in ROM, but I can live with that. I was at the gym at 7:30am this morning .... our office was closed, so I managed to squeeze in an early am workout.

I'm still having NO PAIN, which is a major blessing! The foot gets tired, but that is nothing big. If there is pain w/exercise, it means I'm doing too much. I'm still amazed at the turn around in progress since the November surgery .... it has been faster than any previous surgery. Last night I sipped hot chocolate, played a relaxing CD and reflected where we were last January and what a difference a year makes .... never give up!

Hope you are staying warm,
Jenny

Boot Fiasco ....

New pics of the foot .... the incision is starting to blend in with my normal skin color and is the best it has looked in a long time. I am at the "8 month mark" with the artery transplant surgery.

It has been a good weekend filled with lots of walking and exercise. Mom spent the night at my house on Friday night and we had "Girls Night," which was fun! Saturday night I walked around Chesterfield Mall and back to the car without any pain - yippee!

I went into a shoe store at the mall and tried on a pair of dress boots. I put both pairs on, zipped them up, and walked around a little bit. I always thought I would buy a pair at the end of this ordeal. Well, they fit fairly snug and I decided that I still needed to keep wearing something super comfy as opposed to trendy quite yet. As I was taking them off, the zipper on the boot on the operative foot got stuck and the boot would not come off for anything! The sales lady wanted me to just try to slip my foot out. I said, "You don't understand, it is impossible for me to slip the boot off as my foot has had mega surgery and now have very little foot flexibility." She probably thought I was crazy for trying them on, but it was a zipper problem!! After twenty minutes of pulling, praying, and prying, we got the boot off my foot ..... it will be a while before I try on boots again. I seriously thought I was going to have to buy the boots and take it home and cut it off - whew!

Physical therapy on Wednesday and Friday of this week ... beginning next week, I have 125 kids every day at work in February. I see lots of days wearing my good tennis shoes.

Hope you have a great week & stay warm,
Jenny

A+ Day for steps .....

Record day today for steps ..... 10,058! This is a little under five miles of walking and it is the most I've done in one day. I can't even begin to tell you how big of an improvement this is - it is HUGE step forward for my foot! It was definitely an A+ and blue ribbon day in the walking department! I went to the gym tonight, but didn't do any cardio w/walking, since I had met the goal for the day & just did other exercises. I had kids at JA today and I do a lot of walking on student visit days.

Now I really do wish the Dallas surgeon could see it. I plan to send some pictures, but it is definitely better seeing it in person.

Just for comparison I'd say I was doing the following:
November, 2008 - about 500-800 steps per day (at most)- before the tendon surgery
December, 2009 - 1-2,000 per day - post-op; after cast came off

Calling it a day for today .... needless to say I'll sleep well tonight.
Just wanted to share my "step news" for the day!

je

Exercise, Walking, & Driving

I e-mailed my Chicago orthopod an update on Monday and she sent me a note back today. I shared with her that it is like I have a new lease on life now with the ability to wear a shoe and walk better .... she continues to be really happy for me! She thought that I likely wouldn't get any additional motion back in my forefoot, but said that the pt will help with strength and getting back to a more normal gait. She thought I was working really hard w/pt and exercise and cautioned against burn out.

Today I did a bit much at the gym, so I will back off a bit. I know what I did too much of, so I'll stop .... it becomes a pain issue, so it won't happen again (believe me). I was watching the presidential events on TV and exercising at the same time, which time wise proved to go on longer than normal.

I got a really good (comfy) pair of new shoes over the weekend. They are made in Hungry and were pretty pricey, but worth it for the comfort. Someone had given me a Visa gift card and I had been saving it for new shoes someday. This is only the second pair that I've bought and I'm done now for awhile. Some shoes that I had previously work and some don't .... still sorting that all out.

One of the individuals that called me for a foot doctor referral (several weeks ago)had surgery today by my STL surgeon. She had surgery done incorrectly by a podiatrist, too. If you learn anything from my surgery saga, it should be to not let any podiatrist do surgery! If it involves putting you to sleep for an operation, go the orthopedic route. I felt good about helping this gal find a new, good doctor.

For almost the past five years, I have driven with my left foot. Not ideal by any stretch, but it was the only way to continue driving. I am an expert at it now and you'd never know if I had not told you. So, I'm trying to switch to driving with the correct foot and get used to using my operative foot. I can do it, but it feels far from "normal." Switching back and forth between gas and brake is slow for me - I'm going to continue to try it for little trips at the beginning here.

I've walked 8,666 steps today (4.10 miles), so I'm headed to bed. Still sleeping really well, which is grand ... I had great doubts that I'd ever get back to a normal/natural sleep pattern.

Sweet dreams!
je

10,000 Steps ....

It has been another good week filled with walking, wearing shoes each day, going to the gym, and very little pain. Still sleeping well and am off all pain/sleep aid medication.

Pt continues .... we took measurements today (2 week mark). There was a little improvement in one area, but the majority of it (range of motion) was still the same. Two weeks isn't very long to see an improvement. I've just about come to the conclusion that the reflection in measurements has no correlation with how hard you are working! You can work your heart out and see very little or no improvement. The important thing is really that my walking gets better, strength improves, and that wearing a shoe feels more natural - no one will ever ask me to bend my foot to a specific degree. Swelling is improving. Because of all the hardware inside the foot & w/so much being fused, some motion will never return .... this is okay though, as I just need enough to get into a shoe and "toe off" w/a somewhat normal gait.

I am supposed to try to be walking 10,000 steps each day. You read it right - 10,000steps! This is a lot of walking .... the average person walks 3-4,000 on any given day. I have a pedometer that measures steps, but I've only done it two days this week. Today at pt we did this new exercise where I had to balance on the operative foot, while standing on a foam piece and moving a 5 lb. ball in a circle ... not ready to "show off" the pose quite yet!

Talked to my San Antonio (plastic guy) dr. via e-mail this week. He thought my foot looked great & he said that there likely will be a little swelling over the transplant area forever ... he said to use the compression stocking when it starts to look like a breakfast biscuit. He told me to stay out of all surgeon offices this year .... I will!

Every day this week I've seen people that have seen me once a year for the past four years and have never witnessed me in a shoe ..... it has been like "Happy Shoe Day" everyday. I'm not getting tired of it though and it is a joy to celebrate it each day.

Thanks to all of you that leave messages .... I love reading them!

Gratefully thankful,
Jenny

Good weekend ....

It has been a good weekend and bordered pretty close to what I would have done on a weekend years ago. On Saturday I returned to the gym, as my Chicago dr. & physical therapist thought it was okay for me to start slowly again. I biked 6 miles and then sat on the edge of the pool and practiced kicking in the water (ankle motion needs help) for about fifteen minutes on Sat. & today. It didn't really qualify for a "workout," but it was a starting place. The swelling is starting to diminish - always looks really good at the beginning of the day and then gets puffy as the day progresses .... it is nothing though, I'm fine with it!

I ran errands, did cleaning, bought a new pair of shoes, & cleaned out my refrig on Saturday. I enjoyed a DVD and mudslide drink (no pain meds anymore - yeah!) on Saturday night. I haven't been able to spend much time in my basement because of the stairs involved, so it has been nice to be down there more now.

This afternoon I went through boxes, bags, and containers of wound care supplies. You can only imagine how much gauze, bandages, tape, and prescription medicine I've collected in almost five years. With every surgery they give you these surgical socks to wear during the operation .... I have a BIG collection. Every hospital orders socks from the same place! I kept the important stuff and happily said goodbye to the rest. I need to decide what to do with all the pictures that I have from this long journey.

The past two nights have been the best sleeping nights for me in the past five years, for which I am really grateful. I've slept from 10pm-8:30am without waking up at all. After you sleep with medication for years, you start to think that your body will never again be able to sleep naturally - glad to know it is possible. Stress really does affect your body ... often more than you realize.

Pray for stamina this week .... I have really long days on Monday, Tuesday and Thursday this week. I'm starting to think more about how I can use my experience to help others. I am a stronger person today because of it all, but it isn't about me and it is my desire to have the experience be honoring to Him .... we'll see what doors open at the right time.

Wishing you a joyous week!
Jenny

Good week ....

It has been a good week and pretty uneventful, which is nice for a change. I had pt on Monday and Wednesday and we worked really hard on the foot/leg at both sessions. When we lengthened the tendon, which is at the front of the shin area, the tendon in the back of the shin becomes weakened somewhat. It is sore to massage it, but that will improve with time. My therapist says we need to build some more muscle bulk on the back of my calf .... just what every woman doesn't want. He wants me to go to the gym this weekend and try the bicycle or kicking in pool water.

I've been able to wear two matching shoes in my normal size all day at work this week. I can't wear any shoe, but a flat/loafer style is fine. More shoe choice will come with time, but for now I am elated with any shoe! Yesterday was the first day that I stood most of the day. The foot felt very tired by the end of the day, but pain didn't present itself which is a massive improvement. Today I realized that this is the first week in 4+ years that I have gone an entire week without taking narcotic medication ... thankfully, I was able to stop it easily. I have an entire drawer full of opaque tights with only one leg in them that I used with all my casts - think I can pitch those this weekend.

I am finally sleeping better and through the entire night. All the various medications, surgical tape, cast material, etc. have caused on-going skin issues, but they those are beginning to go away. It is amazing how it all goes together and skin problems seem to take months to go away fully. I've never had skin issues before, so I think it is a all symptomatic of surgery/stress/medication reactions.

I find myself delighting in the simple things more than ever now .... driving myself to work & stopping for coffee .... being able to do whatever I'd like in the evenings and even walking has a new meaning. The thought that my foot situation won't consume this entire new year is one that I'm still grasping - it is what we've waited for forever, but at times I still find myself in disbelief. January and February will be "transition months" as I hopefully bring this all to a close and slowly move back to a more normal lifestyle.

God continues to be good!
Love,
Jenny

Good first pt session ....

Our first pt session went well this afternoon. We spent an hour just "evaluating the situation" and then another hour w/the therapist manually working on the foot. It is a little sore tonight, but not bad. He agreed that we finally have more to work with this time and there should be a much greater success possibility. My co-pay is now huge this year, so we're only going to meet twice a week for the next 4-6 weeks. There is still some edema in the foot (operative side is 1 1/2" bigger), so we need to get that fluid out - everything will then function even better.

Forgot to share two other good things that I learned at the Chicago appt. last Friday ...

1. The possibility of something called "Foot Drop" was a big risk with the last surgery. Essentially the foot gets overcorrected and the foot drags on the ground. It is not really correctable and a big hassle. I don't have it and won't get it! If it was going to happen, I'd have already seen signs of it by now & there are no indications that it will occur later - yippee!

2. There was a possibility that I'd need to purchase this nerve/walking device that I'd wear around my calf & it would "tell" the foot when/how to function. My cost was going to be $5,000! It appears that my brain signals and foot signals are working together well and the timing for the correct muscle to fire at the right time has just happened naturally. Esentially the foot and brain have figured out how to work together and it somehwhat "self-corrected" with the right signals and the right time.

I don't have students until January 15th, which will give me over another week to keep gaining strength and stamina. I am able to wear a shoe all day now fairly comfortably, so that is huge improvement. I'm sure it has easily been well over two years since that has occured.

I was looking at old foot pictures from last spring over the weekend and was again reminded at how far we have come and the substantial progress we've made .... most pics are too graphic for the blog, but just having the foot healed (no wound issues) and seeing it stay flat to the ground are big praises to begin the new year! Everyday I now encounter someone that I've known for 3-4 years and this is the first time that they have seen me wearing two shoes ..... am guessing that will go on for quite a while!

Hugs,
jenny

Excellent Chicago trip!

Whew ... just got back into town a little while ago from the Chicago trip. I drove 700 miles in three days. Every time I go to Dr. P's office I forget how far into Chicago she is located - almost to the Wisconsin border. It was a great trip though!

Dr. P was very excited to see me and we spent the first minute or so hugging each other. She thought my foot looked spectacular! She agreed fully that we made the right decision with the Dallas surgery & couldn't believe the difference in improvement. My situation of having a contracted tendon as an adult was rather unprecedented, so no one really knew totally what to expect on outcome. She said that being able to wear a shoe is the critical component and since I can now do that I should see greater improvement with pt, walking, feeling, coloration, etc.

She watched me walk with and without shoes and felt that there was some rehab needed still, but not as much as she had anticipated. She felt like 4 weeks of physical therapy would likely be enough. Improved strength needs to occur in my foot and I need to get to the point that I'm comfortable driving with the right foot again. She said that everyone should practice standing on each foot several times a day to keep foot/leg/calf muscles strong .... she suggested doing it while I am waiting in lines for things throughout my day. I'll likely do another follow-up appt. with her after therapy has finished at some point. She also said that eventually I should be able to wear a shoe with a small heel (up to 1 1/2"), but this may take a long time for everything to stretch out muscle wise that this is comfortable.

It was fun to visit with relatives and it was one of my happier trips .... how many times have I driven home with little or discouraging progress. I am still relatively early in the recovery progress still (at 8 weeks), even though it feels like much longer since November. Gradually everything should feel more natural as time passes and the foot becomes stronger. Need to go unpack and get things organized. Thanks for continuing to pray!

Jenny