Thursday, November 29, 2007

A Shrinking Violet

Moi? Ha, not really.

But I do know that my leg stump is shrinking and that's both expected and desired as I progress. I know it has shrunk in the five weeks Schooner and I have been together, as Schooner has been a fraction big for my leg of late, meaning I've had to put extra thick ply cotton socks over the leg so the fitting is nice 'n' snug.

The fitting has to be real tight so that your leg is well secured but also so that there is minimal movement of your leg inside the fitting as you walk. As my leg got smaller, it allowed some vertical movement inside the fitting, which in turn rubbed a bit of skin off my shin. I couldn't feel that part of my leg (no nerves there at the moment) so I didn't know I'd rubbed anything off until I took Schooner off at the end of the day. Sod. The other sore has healed fine, so now I have to get this one fixed.

Anyway, today I had another visit to the Limb Centre at Redfern where George, the prosthetic specialist, had a look at me walk and inspected the stump and fitting. Then George whisked Schooner's inner liner away for some additions to reshape it and make for a more snug fitting. Once that was done, then a few walks up and down the corridor to inspect my gait resulted in an adjustment to the angle of the pipe section between Schooner's upper mould and his foot. That's resulted in an improved gait. With allen keys twisting industrial grade bolts, it was just like having your cycling cleats adjusted by Steve Hogg! My gait still ain't perfect but with trousers on you may not even know I didn't have a real leg.

Today was also the first day I got about without a crutch. Granted I didn't do huge amounts of walking but certainly more than I've attempted before and I can walk at a reasonable pace, standing tall and looking ahead, as long as the ground is flat. Once there is a camber or slope, then I have to be a little more careful.

Speaking of trousers, I haven't been able to wear any, as I can't get the cuffs over Schooner's outer moulding (suppose that means I have no flares in the wardrobe)! Even if I could, I wouldn't fit into anything as I've, er, grown my waisteline a tad you could say. :(

So Mum turns up from a trip to the shops with a pair of trousers that'll fit the waistline and maybe squeeze over Schooner's "skull". Well only just and with a bit of fighting they do. No matter, a trip to Aunty Hil sees the sewing machine out and a short hidden zip installed at the bottom of the inner leg seam - problem solved! Nice one.

Another nice thing to note was George saying I've made as much progress in five weeks as some people do in 50. With that in mind of course I pump him for when we can fabricate something to get me back on the bike, even just on the trainer. Puhleeaasse? Can I? Huh?

"Let's look at it in the New Year - we'll sort something out - we can do anything". He's right of course and knows that the money to set me up now would probably be wasted in eight weeks as the leg would change so much any expensive fitting made now would be useless.

Patience Alex, patience.

PS - the pic above is from this site:

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Thursday, November 22, 2007

Mr X-Ray

I had an appointment at the rehab clinic today to see my Rehab Doc and the Prostheticist. I took them through my progress since getting my new leg (Schooner) 4 weeks ago. They had a look at my stump, Schooner and his associated bits. Then I got up and did a little walk for them to show them how I was going.

The look on their faces sort of said it all - as far as they're concerned, I am going great guns. Excellent progress, they were a little amazed in fact. My stump has shrunk somewhat (it's meant to) and so I will be in to see my prostheticist again next week to make some adjustments to my fitting to make Schooner sit more snugly onto my stump.

The only down side due to the improvement is the up 'n' down motion of my stump inside the leg fitting has rubbed a bit more skin off the shin. It needs to toughen up a little but really I shouldn't be able to move much inside the fitting.

Doc also thinks it won't be too long before I can move to the next type of prosthetic fitting (a silicon sheath version) that will enable a cycling leg to be made up. I still think it may take a couple of months.

While at the hospital, I decided to pop into Radiology to see if they could give me a copy of the x-ray images of my leg. Apart from 'grumpy pants' behind the counter, it wasn't too painful to get organised and a little while later I walked out with a CD with images of my knee, including before my first operation, after operation to insert the plate and screws and again after amputation. Thought I'd share a few with you.

First the original fracture of tibial plateau and the fibula. You can click or right click on any image to see the full size version.

On the left is the front on shot and you can see the multiple fracture of the tibial plateau (the top section of the bone below the knee) with the main displacement running diagonally from bottom left to top right.

On the right is the side on shot, with the fracture being at the top of the tibia bone on the right.

Here's what they put inside to pull it all back together. Again front and side on shots.

The plate runs across the tibial plateau and down the tibia with six screws running through the plate into the bone.

There is an extra screw through the two separated sections of the tibial plateau to hold them together. You can also see the staples holding my skin together after the operation.

And here are the shots after my amputation.

You can clearly see the shortened tibia and fibula, where they have been cut/sawn or whatever it is they do.

At the bottom of the image on the left, you'll see a dark patch. That was where I had a stubbon hole in my closure would that wasn't healing. It was about 2 inches (5cm) deep and took about 10-12 weeks to heal properly.

So that's what it looks like from the inside. All those screws and plate are still inside. I'll spare you the real life shots!

The other bit of good news is it looks like my scans from last week (a white cell scan and a sulphur colloid scan) show an improvement, which is great since I've been off the antibiotics for a month now. Looks like I have the all clear from the infection.

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Wednesday, November 14, 2007

Phantom of the Ditch?

OK - latest developments...

The Ditch

I reported the other day about my first few tentative steps without crutches. Well since then I've also ditched one crutch and spent the last few days just using the one crutch to get about. A walk around my local street and another day walking around one of those old warehouse conversion shopping centres - you know the ones full of homewares stores. Big and lots of dead flat floors with hardly anyone about - great training territory actually!

Apart from walking about, while there I picked up an external hard drive for the PC, as I'm getting a bit tired of backing up to disks, so have set up an automated option. I was also looking for kitchen stools to go with my new benchtop. Yadda yadda, I found some I like but didn't buy today. Another day perhaps.

So today, I decide to give the no crutch walk thing another go and wouldn't you know it, I was walking semi-normally. Way to go Schooner! Good enough to get around the house sans crutch but a far cry from a long walk. Still, I've only had Schooner (my new leg) for three weeks today, so I reckon that's not bad going. I even carried a cup of tea with me, from the kitchen and down a few stairs to my "home office". I couldn't keep it up all day but not a bad start.

The only downer is I've rubbed a small patch of skin off my shin - I can't feel it as the nerves on that part of my skin are non-existent, so I only found out when I took the leg off. It's not that bad but I have to take care of it and make sure I don't get an infection.

Also today dropped in to say gidday to my buddy Steve Hogg at Pedal Pushers (my LBS). Steve runs Cyclefit Centre and if you want to know anything about making a bike fit a rider, Steve's your man! Steve (and wife Margaret) also made some visits to me in hospital - one day he looked at me in the eye and then walked out of my room to keep going down the corridor to find me - I'd lost so much weight at the time he simply didn't recognise me! When I make it back on the bike, Steve's going to take on the challenge of fitting me again.

The Phantom

People ask me and wonder what it "feels" like. Well since I've been using the leg again these last few weeks, I've noticed more senstations coming from my non-existent foot. Sometimes referred to as "phantom" sensations and not an uncommon phenomenon for amputees. Mostly I get a light pins and needles like sensation from the ball of foot and toes area. Sometimes sensations of light pressure on other parts of my "foot". No pain fortunately. It's weird though, I have to admit. But strangely reassuring, like sitting here at the PC, it's like I have a real foot still down there with a really tight sock on it.

You also notice some of the little things, like lying in bed and your foot has an itch - you can't just use your other foot to give it a quick rub/scratch.

All up - I have a new level of freedom which is continuing to improve.

Keep biking!

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Saturday, November 10, 2007

Tip Toe through the Tulips

Well, not quite.

I did something new today. What's that ad say - "how long has it been since you did something for the first time"? An airline ad I think.

Anyway, as reported in my last post, I've started walking along on my new leg, which I've decided to call "Schooner" by the way, with the aid of crutches. I've been gradually able to walk further, with a walk to my local shops and back last weekend (that's about a mile) and another cruise this afternoon of a kilometer or so. My knee is getting stronger, a little less pain as I begin to bear my weight on it walking.

So what's new? I started this walking caper last time I wrote. Well today I tried to take some steps without putting the crutches down on the ground. Up until today, this resulted in immediate pain and feelings that the knee would give way, quickly getting me to put the crutches down again.

Well today I tried again, and low an behold the knee held up, just, with no pain. It was a bit wobbly. So I tried another step and it worked again. Very small steps mind you and not exactly a pretty gait but I got from the lounge room to the kitchen without the need to put the crutches down.

OK - so I have done this before, when I was a baby and took my first steps - but in this case I qualify since I can't remember taking my first steps as a baby.

It was a pretty weird feeling I have to say. So while on my walk around my local streets today I walked while holding up the crutches for about 10-15 metres. Again, slow, not exactly super steady but just being able to do it was a great feeling. Well done Schooner.

It's nice to do something new. Why not give it a go yourself?

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