Saturday, October 13, 2007


What now?

OK, it’s been a few weeks again, so what’s new since last time? Well apart from giving Mum a break so she could go home and do some stuff for herself for a while and having my brother stay for a week and a half to make sure I didn’t do anything stupid, the last few weeks have been fairly busy, mostly with trips to the doctors and staff at the hospital as an outpatient and some progress with my house renovations. I had a session with the rehab Doctor and met my prosthetics guy for the first time. We discussed my current situation and made a decision on the type of leg I will use for the first few months. A script was written for the leg and sent to the government for funding approval.

I then had a meeting with the Doctors at the infectious diseases unit to discuss my progress in dealing with the MSRA infection I picked up while in hospital. It would appear I’m doing well based on simple examination of the leg and blood test results, however some scans are needed to properly assess the infection status. This will determine whether I can stop taking the drugs and then just monitor my status with regular blood tests, or possibly at the other end of the spectrum require lifetime medication and maybe even another surgery to remove the metal plate in my leg. I sure hope not the latter two. I’ve had enough time in the hospital bed thanks very much!

The little bastard MSRA:

So it was back to the hospital for three days this last week for these various scans. First was a normal bone scan on Monday, then one using a technetium isotope to look for infection hot spots. A few “warm areas” were seen but these were inconclusive, so it was back on Wednesday for another irradiated white cell scan. I’ve had this scan twice before and described it in this post. That was then followed by a sodium colloid scan on Friday, which is designed to isolate out real hot spots from those that are just due to bone marrow left stranded after the amputation surgery. As yet I don’t have the full results. There is one more potential scan they may require – a gallium scan but hopefully not.

Meanwhile, the government funding approval for my prosthetic came through, so I made a visit to the artificial limb clinic to be sized up for my first leg. That involved a few things, a pencil line around my right foot, presumably to match the other side, leaving a good pair of my walking/running shoes with them and taking a cast of my stump with key positions marked. George (the prosthetic specialist) also showed me the different systems, including his own funky carbon and titanium model with fully self-controlled vacuum system to keep the leg on nice ‘n’ snug. I learned that this first leg may not last long (a few months maybe), as my stump will change form significantly and that I will change to a different style of fitting next time. Even then I may need a third leg fitting in six months.

So, the prosthetic is currently under construction and I’ll be trying it out in about two weeks. It’ll be the bog standard govt issue leg but given the short useable life span of this first leg, no point wasting money on some fancy gear. Bit like buying your first bike I suppose.

The worst part about all this of course has been the time it all takes. It’s now more than six months since my accident and I’m not walking yet. The bike will be many more months away yet, so patience is key. I still get pretty tired, getting about on the crutches is certainly not ideal and combined with my lack of symmetry now it completely buggers my lower back – sometimes getting up is quite painful. Early nights and often lie down rests during the day are needed to relieve this.

Then of course I have to start losing weight, really hard when you can’t exactly do much exercise.

One other thing I did amongst the less interesting stuff (like trips to the bank and chemist) was to test drive a car. You see my nice Subaru Impreza is pretty useless to me now since I have no left foot in order to operate a clutch. I really like that car but I have to be rid of it. So while I did test drive the new model Impreza with an auto transmission, I also tried the VW Golf. The Golf’s six-speed auto transmission was light years ahead of the Subaru four-speed offering and for that reason alone I’m likely to go for the Golf. Shame for the Subaru – it does everything else well but the four-speed auto transmission lets the motor down.

Anyone want to buy a 2006 Subaru Impreza with low kms and in perfect condition?


Treadly and Me said...

I once knew a bloke with an A-K amputation who drove an old Kingswood--he modified the gear lever so that he could operate the clutch by hand. Used a power-assisted brake unit connected somehow to a T-shaped grip, as I recall. It was a real hack-job, but then so was the car. Hmm, probably not something you'd want to do to an Impreza I'm guessing...

Bernie Hayden said...

"The bike will be many more months away yet,"
Alex, what's the reason behind the Doc's keeping you off the bike? It seems like non-weight bearing exercise would be, well, just what the doctor ordered. You've likely come across our local legend and inspiration here in the upper left corner of the USA but thought I'd forward a link for others to see:

Seattle Times article about Brett Wolfe

Alex Simmons said...

Thanks Bernie
The real issue is range of motion of the knee, which at the moment is insufficient to turn a crank. I also am dealing with some pain when the knee moves - not hideous but it is there at the moment, so I want to get through these things first. Also my first prosthetic is not designed to enable pedalling - I'll need a new style of fitting for that which will come when the stump settles down a bit and I can migrate to alternative fitting types. These things cost as much as high end bikes, so I can't just blow my dough on a super fangled new leg that won't fit after three months.

Bernie Hayden said...

Maybe I'm having trouble understanding , us Yanks are well know for slaughtering the English language :-) Not everyone can be a Brett Wolfe but wouldn't riding the trainer with one leg be an option? Not suggesting you shoot for a 24 hour mtn bike solo (2min 40 seconds would be about my limit single leg pedaling) but wouldn't the aerobic exercise on a trainer be worth it; at least for the calorie expediture?

There's the whole thing about bi-lateral vs uni-lateral muscle development but I don't think that's an issue unless taken to the extrem and even then I don't know that it's definitive. For example, tennis players don't have one arm significantly stronger than the other.

Looking a little farther down the line, do you see PowerCranks as having any particular value in your rehab? These are the gizmos that have a clutch bype mechanism so the crankarms aren't locked together. It would be sweet if you could get the PT to "prescribe" them and have insurance pick up the tab ;-) .

Alex Simmons said...

Believe me, I am keen to turn those pedals again but one legged doesn't appeal. Getting on/off the bike is in itself a safety issue I have to contend with (I'll learn in due course). I'm considering a range of possibilities, with a shorter left crank to start with. Powercranks are not a solution for anyone IMO.

But first, let's learn to walk and build up a bit of basic strength in the knee/leg. I still need crutches at the moment, even with the leg on.