Boot the Boot

Yesterday was my first day that I was allowed to be out of the boot all day!

I've been working on weaning out of the boot for the last week and a half or so.

I still don't walk "normally", or what I would consider normal anyway.  I think that will just take time.  I move pretty slow when walking, and I have a little bit of a limp.  As the day goes on my limp starts to get a little worse.  I can't say that walking is necessarily painful, but my foot feels stiff and a unnatural. I still have plenty of hardware inside my foot that I am sure is not helping.  I don't know how long it will take until things start to feel normal again, but I can say that I'm just happy to be walking.  My arch still isn't ready to support my barefoot, so I need to have shoes on, preferably with an insert, to do any walking around.  I have been trying to stand up more in the shower, rather than using my gimp stool, but my right foot still feels slippery on the tile.  Like my foot can't grip onto the smooth surface or something, so I still need to steady myself on the wall.

I did have a follow-up appointment this week at TOSH.  They took a set of x-rays, and this is the very first time I've taken a weight bearing x-ray on my right foot!  I was a bit sore afterwards, since I had to be barefoot and my foot is still not ready for that.  The doctor indicated that everything looked great, and had me schedule surgery on December 15th to remove the two screws.  I was very specific that the surgery not conflict with the new Star Wars movie release, since I already have purchased our midnight tickets on opening night!  He confirmed that my plate will stay in, mostly because the navicular bone does not get a lot of blood supply and taking it out may cause it to just crumble.  Ain't nobody got time for that.  Also, all of the screws will stay in the plate as well.  I guess I'd always just assumed that they would come out.  I can feel them, and it bugs me, but I'm sure after a while my foot will just get used to it's permanent guests.  There is also a screw head that is across my Lisfranc joint (at the base of my 1st and 2nd metatarsals) that is poking my inside arch.  It's been increasingly painful as I start to increase walking without the boot.  It has been really tender the last few days.  When I mentioned this to the doctor, he pressed down on the area to confirm it was the screw and not anything else.  My yelp confirmed that yep, it's the screw.  Ow.  It was so sore that day after he did that.  Jerk!  Lol.  I'm glad that screw will be removed in a couple of weeks.

Thankfully, I've got a lot of vacation time banked at work, and I will use most of it for my surgery and my holiday vacation.  My co-workers unfortunately won't be seeing me much in the month of December!

For Black Friday, Nate and I splurged a bit and purchased a spin bike for our basement gym.  Since I can't run, I actually couldn't even really walk for exercise right now, I wanted something at home that I could do for sustainable cardio.  I really have been limited to lifting weights with my Power Blocks, or my TRX.  While I love both of those,  I need to do cardio (says the extra 20lbs I've put on since surgery!) and that is not really an option with strength training.

Even when I can start walking enough to increase my heart rate enough to the point of cardio, let me remind you that it is winter in Utah.  Not only is the air freezing cold, and the ground icy, but we have this lovely thing called inversion, when the cold air gets trapped in the mountain valley, along with all the smog and pollution.  It's quite disgusting, and breathing the air outside is not pleasurable.  Most of January and February, when the inversion is at its worst, I struggle to breathe and often have horrible sinus issues. Exercising outside just makes it that much worse.  Here's an example of the lovely crap the Salt Lake Valley gets to deal with for the majority of the winter:

  
I also had a birthday this week!  I'm now at the ripe old age of 32.  Nate got me a gorgeous necklace
that holds my wedding ring, and took me on a hot date to Ruth's Chris where I had the most phenomenal surf & turf.

The last time I got fancied up was for our anniversary in August.  I was still on my scooter, non-weight bearing and I had to keep my foot elevated most of the time.  It was great to be able to go out without having "special needs" and I could be a normal girl for a night out on the town!  It also made me reflect on how tough this year has been on me (and Nate) and I am so grateful that I had my best friend by my side the entire time and I realize that I could not have made it through this without him.

Weaning

Probably the biggest milestone ever this week.....

I am weaning out of the walking boot!

I started on Wednesday, being allowed 2-3 hours out of the boot and in my tennis shoes, and the rest of the day in the boot.  Every other day, I get to add an hour to the time I'm allowed out of the boot.  Wed & Thurs, I spent 2-3 hours out, Fri & Sat, I spent 4-5 hours out, and today I'm up to 6-7 hours!  As per the usual, I've just been told to listen to my foot and if it starts to hurt, I shouldn't push it.  If I am hurting by hour 5, I should just put the boot back on.  I don't have to hit those hours every day, only if the foot can tolerate it.  With my weaning schedule, I should be COMPLETELY out of the boot by next Saturday!  

Balance on my right side is still a bit of an issue.  Pretty much all of my PT exercises focus on that.  I'm getting better at my single leg stance, and the goal is to balance 20 seconds on my right side.  I am doing pretty good and can hit 20 seconds, or close enough.  I've added a couple of new exercises, including walking with a band around my ankles, and balancing on my right leg while rotating a ball around my foot.  I hate my balancing exercises!  I get a break next week from a PT session, since it is Thanksgiving week.  But, I still get to see Dr. Van Boerum on Wednesday to get x-rays and he will decide when my next surgery will be.

My posterior tibial tendon issue seems to have resolved itself.  I'm not really getting much pain there anymore, unless I'm really overdoing it.  I've just been careful with it, like I've been told to do, and it has apparently done the trick.  Other than that, I really have no real pain to report aside from having some knee pain if I spend too long walking around in the boot.

Walking barefoot has been getting a lot easier, although I still don't do it very much.  I've been working on standing up more in the shower, instead of sitting on my stool.  My balance is still not where I feel completely comfortable, so standing on wet, slippery tile in the shower gives me a little anxiety, so I use my stool about half the time.  There also isn't really a way that I can shave yet, without sitting down.  But bathing, and getting in and out of the tub is a breeze now and much better than it was a month ago.  That makes me so happy, because I absolutely love bathing in my oversized, jetted, champagne bubble, chromatherapy tub!

Things are starting to get back to normal, finally.  I still walk pretty slow, and have a pretty decent limp, but I don't need a scooter, crutches, or a boot anymore.  I no longer look like a cross between Hector Barbosa and LL Cool J.  Although it was pretty awesome to walk like a pirate every day!

                                    

I keep making really great progress!  It's gone much better than I had ever anticipated when I first was diagnosed with the injury.  I'm so happy I've kept this blog.  Sometimes I go back and read my entries from June and July and I remember how depressed and hopeless I felt.  This blog has really helped me process my feelings, and hopefully it has inspired or found its way to help at least one person going through this!  

One At A Time Please

So, remember my last blog entry, when I was like "I don't have any pain!"?  Turns out, I spoke too soon, which I often do.  Allow me to clarify that I don't have pain in my lisfranc joint, or my navicular.  The newest problem to plague my right foot is my right ankle.  Grr.  I'd like to get healed from my Lisfranc injury first, without getting another problem added in to the mix.

I was at physical therapy, talking to Stephanie about last week's progress, and she always asks about pain.  I explained that the last few days of walking (especially Monday after I overdid it at work trying to be Super CC) my ankle was starting to get really sore, and kind of swollen and puffy.  She had my slip my foot out of the boot so that she could examine and I showed her where I was getting the pain.  She pressed down on a couple of spots (OUCH! Tender!) and judging my reactions, she was like "Oh, that's your blah blah tibial tendon blah"...which a google result showed me later as my posterior tibial tendon.

Apparently, this tendon gets really weak when it is not being used.  As I've not been using it for 4 months, and now I'm trying to do this fancy thing called walking, my tendon is having none of that.  Stephanie said that I was fine to continue walking, but I should not be pushing through the pain if the tendon is starting to get sore and painful.  If I am not careful, it could develop into tendinitis and once that tendon develops it, it is really hard to get rid of.  It feels like a little bit of a set back, because I was getting really used to walking whenever I wanted!  My only instruction was to just be careful with it, and to ice it with an ice cup if needed.

I got a new set of exercises.  Mostly they are balance exercises, which I HATE because they are SO hard!  Balancing on my right leg, balancing on my right leg while doing stuff with my left leg, and stepping up the step with my right leg.  Everything still feels so weak and wobbly and I need to hold on to something most of the way through the exercises, but it should start to improve and I can go longer and longer without having to hold on.  The best exercise though is that I get to "walk" in my shoe for 4 minutes a day.  Heel to toe, step with the left, heel to toe, step with the right.  I move so slow, and I teeter and wobble the whole time.  Who thought that walking could be so damn hard!

Next session... we will work on weaning out of the boot.  I'm kind of scared!  But also excited.  Mostly excited.  I see the Dr. on the 25th to get another x-ray and figure out when my next surgery is going to be.

This Boot Was Made For Walkin'

And that's just what I'll do.

Progress with walking has been fast!  Scary fast.

It's been a little over a week since I was cleared to finally ditch the crutches and walk unassisted, in the boot still of course.  The first couple of days, I was slow, wobbly and awkward.  I could only walk the first part of the day, then in the afternoon I would have to switch to my crutches because my foot was starting to ache and become painful.  I'm not supposed to push through pain and I have been a compliant patient.

But, as each day has passed, the progress has been exponential.  I began to wean off the crutches more and more, until I found myself only needing them early morning and late at night.  The foot is definitely the stiffest when I first get up in the morning, and it feels like I need the crutches to get myself going.  But after a couple of minutes of walking around and exercising the muscles, I can ditch the crutch and walk around with just the boot without a problem.

Walking barefoot (or without my super-stylish 1 size up supportive shoe with Superfeet insert) is still out of the question.  

I've been able to take a few steps on my barefoot, as long as most of the weight is in my heel.  I'm not really supposed to, but there was one night in the wee hours of the morning, where I had to go to the bathroom and I forgot to bring both scooter and crutches in with me before bed, so I had no other choice.  It was like a drunken baby deer stumble.  And sensations in my right foot are still way off, so stepping on the cold tile felt like a sheet of ice in Antarctica! (My left foot was fine, and the temperature felt completely normal.. so weird!)

Other than that, life has been getting more and more back to normal.  I moved back into my standup shower with dual shower heads (with my stool of course).  I hadn't been able to manage to get myself in it while I was in the non-weight bearing phase, so I haven't used it in almost 5 months.  It was pure heaven.  I love that shower and decided that I am never again going to use the guest bathroom shower!   The first time I attempted to get in to the shower by myself, Nate was protecting me like a papa bear!  He is so afraid I'm going to fall!

My PT exercises have been helping with walking and I'm seeing some improvements in my balance.  There's this one exercise I do "Single Leg Stance" (think Tree Pose in Yoga) and the goal is to balance on my right leg for 20 seconds in my tennis shoe without holding on to anything.  When I first started doing these last week, I couldn't even let go without starting to tip over.  After doing them for a full week and a half, 8 times a day, I still only can balance for a couple of seconds without having to grab on to something.  That one has definitely been the hardest and most frustrating.  The best thing is though, is I did get clearance to workout on the stationary bike.  I can FINALLY do some cardio.  And, I've discovered, my cardio SUCKS.  I have worked up to 15 minutes, and by the end, I feel like I might die.

However, the idea of walking is extremely appealing and I've found it very easy to over-do it.  I work in a very large office building.  On Monday, I went in to work, and just had a lot going on that day.  I ended up walking the length of the building several times, going back and forth between meetings and other activities and helping out some of my co-workers with things.  I was helping set up for a meeting and carrying Costco-sized cases of water around.  I was trying to be my old self and I pushed it too far.  That night, my foot was swollen like an overstuffed sausage link.  When I got home from work, I basically stayed off of it until it was time for bed.  The next morning, it was so sore I could barely walk with the crutches and my ankle was getting shooting pains with every step.  I decided to stay at home that day, and I actually used the scooter for most of the day to give it plenty of rest.  The next day, it was back to normal, and I could walk again.  But, it was a reminder that the healing process, is still in process.  It's slow.  It's a marathon, not a race, and I really need to listen to my foot and my body.  Just because I can do something doesn't mean that I should.  

I find it hard to believe that I'm STILL dealing with this injury 5 months after my fall.  

Lisfranc sucks.  

Bye Felicia

I was officially cleared to start walking without crutches this week!  And I have nothing but progress to report!

No scooter.  No crutches.

Last week, I weaned down to one crutch and upped my weight to 75% on my right foot.  I was told to bring my shoe and "Superfeet" insert with me to my appointment, but not to wear them in.  I arrived, and Stephanie had me change from my boot into my shoe (with the insert) first thing.   I hadn't worn a shoe on my right foot since the accident.  It felt so strange.  I took a few steps in the shoe with the crutches.  I felt almost like a baby deer taking steps for the first time.  My foot and ankle felt so weak inside the shoe; the boot is much more supportive for my leg. She then had me start out the session with 5 minutes on the bike, and then 5 minutes on the leg press machine.  I did a set of squats and some balancing exercises on the right leg, and she felt I'd done them OK enough to be cleared to start using one crutch, and 75% weight.  Yay!  I was pretty excited, not only was this major progress, but I'd be getting a hand back.  I could carry a cup of coffee with me from the kitchen to the couch.  I could carry a plate of food by myself to the kitchen table without a crazy balancing act.  I could carry my PURSE again!!

I spent the majority of last week working on that transition, and doing all of my PT exercises in my tennis shoe.  Mostly my therapist has had me working on balance on the right leg, and I am working on this exercise where I stand in a lunge stance, and have a piece of elastic tubing hooked to the wall.  Then, I draw my A-B-C's with the tubing in the air while balancing on my right leg.  I look like such a spaz doing it, I'm sure!  I felt like I had made a lot of progress, and by the weekend I was getting around on one crutch pretty easily.

On Halloween, I dressed up as a "Bloody Beaver" and went to the Utah Utes home game vs. the Oregon State Beavers.  I decided not to take my scooter at all, and just bring my crutches.  I was pretty nervous at the thought of not having the scooter as a back-up plan, in case I was in a lot of discomfort or unsteady during the night.  But, as always, I jump to worse case scenario in my mind, and I didn't have any problems at all.  I got some comments that the crutches made me move like a zombie and it was an "excellent addition to my costume".. =/  The people in my seating area in the stadium have been witnessing my progress through these weeks, and there was actual cheering and excitement when people saw me walking with a crutch!

Yesterday, I went to another PT appointment.  When I arrived at the PT clinic, the elevator was undergoing repairs.  So the receptionist kindly pointed out the stairs to me and informed me I'd need to take them.  Are you kidding me?  Who decides to work on an elevator during business hours at a podiatry therapy clinic?!  Good thing I'd gotten far along enough in my therapy to be able to do stairs, otherwise I would have needed to reschedule.  This immediately put me in a rotten mood.  But, once I met with Stephanie, she told me I was allowed to ditch the crutches!  This was awesome news!  I'm still supposed to have them handy because inevitably I will get sore and swollen and I'll need them in order to continue walking.  After 5 minutes on the bike & leg press, I did some balancing exercises on my right leg again, and then some step-ups with my right foot on to a step, all in my tennis shoe!  Then, we put the boot back on and practiced walking in the boot with NO crutches!  I thought I'd be wobbly and unsteady, but I was so excited I was zooming around the room.  She said I could walk as much as my foot would tolerate it, but when it started to get sore I should use the crutches so that there is no pain.  I did have some heel soreness, and Stephanie said that was normal as there is typically damage to the heel pad when breaking the midfoot, and the boot doesn't have any heel cushion.  She instructed me to buy a heel cushion insert and that it should help absorb some of the stress on my heel.

One thing I have loved about this therapy and approach is that it has progressed at such a pace where I am not having any pain when attempting to walk and do these exercises.  I do feel discomfort for sure, but not pain.  And I know when I'm pushing too hard, because I start to feel pain, and then I'll dial it back down a little.  I've needed incredible patience! It feels less impossible to walk barefoot, but still painful enough that I'm not going to attempt it.   I should not be taking any steps out of the boot anyway.

I will have 2 more weeks in the boot, then we will start to wean out of it, so that I can start walking and wearing shoes on my right foot again!

I was so happy after this appointment.  As Nate and I were walking to the car, the first thing I did was I reached over and held his hand.  I hadn't been able to walk with him and hold his hand in 4 months. It felt amazing.