Wednesday, April 29, 2009

Twilight

Emotionally the toughest the day for losing my foot was when we scheduled the amputation on March 18, 2009, coincidentally my sister's birthday. I had hoped we would have done this back in January and I'd be in my temporary prosthesis right now, but the AFO brace delayed this decision a while. Although I was relieved to have the surgery scheduled, I did have an out should we want to pursue the other options as I mentioned in an earlier post. Over time I had given amputation a great deal of thought so it was never a shock, but the reality of the decision on that March day was close.

When I left the doctor's office that morning - which happens to be across the street from where I work - I knew what I had to do but couldn't quite believe it was happening, that a date was set, that I was going to have my right foot severed from my leg. I found I could not go back to work right away, and drove around in circles while I steadied myself. I rubbed my lower leg and tried to imagine it gone - what would they do with it? Could I bury the ashes around a tree I planted? That thought continued to haunt me, it seemed both morbid and honorable at the same time. I could hold my own ceremony for a part of me bound for the far field, the windy cliffs of forever...

Back at the office I seemed to be in control only to find tears in my eyes with no warning; first they come and then the realization, like a newly cut wound, of what I was doing.

I was thinking today about how I have had a lifetime of running; from running around the block at Salisbury Acres and going cross country through the soybean fields and nearby clay mines; of being a very late blooming half mile runner who missed his senior HS year due to a stupid left ankle sprain to later that same year winning the local Explorer Scouts Olympics 3 mile x/c race at Parris Island; running for years for the sheer joy of it, fun local races and marathons; and meeting my wife through our love of running.

It is a pure sport; in a race it is, in the end, about time. No refs making knuckleheaded calls, no breaks for crowd noise, no one to take up the slack when the going gets tough but yourself. Alone, nearly naked, a start line, a finish line, and time in between. Competitors, aye, but all race against time.

I had a lifetime of running, but it had cruelly orphaned me, twisting out the deep roots in pain and deformity. A blink of the eye and it was gone. Done. Memories of running last week, last year, or even last century are just that - memories, and there is no comfort in the thinking, only in the doing.

Now I realize I have been given a greater gift than I could have imagined, a second life as a runner. Not that I ever felt I deserved an end to the first, I never wavered from my passion. But this is a new beginning for my old love, I will see things in a different slant of light, and just when I thought I had seen and felt it all, the light changes and the twilight defines the familiar in a new illumination, a brief holiness before the universe appears above.

Oh, I am a lucky, lucky man. Maybe running is embracing me after all.


I learned not to fear infinity,
The far field, the windy cliffs of forever,
The dying of time in the white light of tomorrow,
The wheel turning away from itself,
The sprawl of the wave,
The on-coming water.

excerpt from "The Far Field" by Theodore Roethke

Monday, April 27, 2009

April 27 - A stitch in whine

First, the photo at right. My wife Jen did a quick edit of my Valley of the Sun marathon thumbnail pic and put a running foot on my leg...how cool it was to see this today! Mucho kudos to my sweetie.

I had been dreading this milestone day as getting stitches out ranks right up there with a root canal and brain freeze for a few of my unfavorable things.

It's something of an expedition to get my half-legged butt into the SUV. Jennifer holds the front screen door open while I hop out the door and then down a step to the sidewalk. The slight slope isn't much but enough to give a nervous pause for balance. She unlocks the Pilot's doors and I make a boneheaded head first entry into the back seat. No problem really, just not as safe as going in backward with the butt-cushion available for crash control. The chair is not lightweight and Jennifer has to wrestle it into the cargo area; I try to help from my perch but can only assist in guiding it a bit. Off we go across town to the West Ashley office to take the next step.

Dr. Ohlson's PA greets us at the office and takes me down to x-ray. Good people may not be able to change someone's mood who is determined to be bleak, but when you feel such positive warmth it's impossible, at least for me, to be anxious at all. Still...today there are stitches involved but now the edge is gone and I haven't blown blue smoke from my hot rod chair wheels blasting out the door.

I get to sit in my chariot while x-rays are made...later in the examining room Dr. Ohlson and I look at them together. There I see my amputated fibula bridged over to my tibia, held in place with a single screw through a piece of bone. Very neat, it's going to be a terrific weight bearing foundation which should make prosthetic wear much easier since the distal end can absorb impact more like a natural foot. Dr. Ohlson inspects the stump; the skin color is natural and there is no weeping or discharge...looking very good indeed.

He tells me to come back in 6 weeks and after that I can get my tempoary prostheses. Next milestone!

Now it's really showtime...

My experience this time around was nothing like any previous suture removal. When I wrecked my cousin Danny's 50cc motorcycle just a couple of years after being thrown under the bus, and I had a number of stitches on my right knee. As Dr. Taylor began removing the bandage, I remember seeing this goop stretch up from my leg to the bandage and hearing the good doc call to his nurse..and this is no exaggeraton...COME NOW I'M LOSING HIM! My blood pressure dropped and I passed out. This among other incidents caused my fear of this otherwise benign day.

I was expecting a tug and stinging from the awakened incision site and maybe enough pain to result in watery eyes. Instead I watched as the nurse gently worked the thread out of my skin, nothing more than a mild sensation, no stinging, and no whining from the newly courageous patient. After all these years the promise came true: this won't hurt much.

The nurse applied Steri-Strips over the entire length of the incision and then I rolled the shrinker up my leg. Back at the main desk I made my appointment and got an application for a temporary handicap placard. I intend to use it only for the time I need the chair or have some complication with my prosthesis that requires me to use those convenient parking slots.

Jennifer brought me home and went back to work. I did my own PT session at home, worked on this post a bit, ate way too much...and always trying to get caught up on correspondence. I have made some friends via Twitter, kind of fun to use and just another way to communicate, something of a crease between IM and email.

Been another full day with more to come and I embrace what is yet to be. You just have to live long enough to see and feel some things. Some never get that chance. Live your life, fear is the only darkness.

Live.

Sunday, April 26, 2009

April 26 - The Great Outdoors

I slept okay last night, I got my hours in but had to get up several times for the usual pit stops and once to let the senior cat out of the room for the same call of nature. "Little" is 15 years old, so she gets a little extra freedom these days.


After breakfast I did a long lower body workout, I want my right thigh to lose as little mass as possible. Jennifer took Baxter to the beach so I didn't have any help holding down the mat, given the food we have in the house I think he may be relieved of that chore if I don't close The Pit.

*******

I finally went outside today. Jen and I took Baxter to an open field in our neighborhood. With minimal help I was able to negotiate the chair out the front door, down one step to the sidewalk, and then down the driveway to the road. The driveway does have a bit of a grade compared to most houses here so I had to slow myself a la Fred Flintstone to bleed off speed.

Our good neighbor Charlie was out blowing yard debris out of the curb; Charlie and his wife are among the nicest people on this planet, and I know they will understand what we am going though. Still, although I was ready to be outside I wasn't ready to chat about Ertl amputations, carbon fiber feet, and running again in the near future. I just want to go outside, see the flowers I planted, walk the dog with my wife like we use to do, enjoy the sunshine and blue skies, and avoid the flying teeth if at all possible. I had been telling my neighbors I needed one more operation to fix my problem and I can't imagine they thought amputation was the answer.

I hurried down the road, saving the conversation for another day. It did feel good to be outside, and although I was a little self-conscious of my appearance, it bothered me less than a zit on the forehead, which I was sporting just before surgery. Nature really tries to dissuade the older, wiser among us from being attractive rite-of-spring-break types.

It was fun watching Jennifer throw the kong toy for Baxter to chase, he is quite a sprinter and with his fur and mane flying he was Super Dog...we need to get him a cape. Jen and me too. Okay, Baxter and me. And little silver wings for the feet. Any more would be a fashion faux pas, apropos for Baxter but ridiculous for moi.

On the way back I found getting up the driveway a bit challenging. I'm no Sisyphus and good thing the chair has brakes. After a bit of pondering Jen got my walker and I hopped in the house as the steps up proved too tough to negotiate on our narrow walk. I also had a problem with cars and trailers parked on the sidewalk; I haven't mastered the levitation exercise yet and, as mentioned, we only recently discussed superhero wear.

Tomorrow I will most likely get my stitches removed. Right now this is the only thing in my recovery I am dreading. I've had stitches from the top of my head (basketball) to the bottom of my feet (bullfrog catching) and most points in between so I have earned my scars and dislike of those tiny lines of parallel holes in my flesh. I chewed on a cloth when the PA played tug-of-war with them in my foot last time and my jaws were sore for days afterward. Grrr....

Just saying a 'man's gotta know his limitations' and pulling thread out of my wounds is right at the top. Pics to follow. ] ;-)

Friday, April 24, 2009

April 25 - Come Saturday Morning

Slept great last night except for having to wheel into the bathroom 4 times. I use my Backberry for a headlight and was thinking one of those LED headbands the ultrarunners use would be perfect for this task. I'm sure Jennifer would love for the fashion police to stage a two am raid and catch me.

I got up around 7:30 am and hopped into the shower to get ready for my PT session at 9. I have previous experience from my last operation getting the daily grime removed old rusty so this operation is routine. Two Harris-Teeter plastic bags, one over the stump and one split and tie around. Try that with your green bags and stay dry. ;-)

Cathy the PT arrived at 9 am and we checked out the healing. The stump still has good color and it appears to me the dressing change itself causes some tiny bleeding at a couple of sutures. There is no active drainage so I think we're still on schedule for Monday removal of the stitching. I hope they can put me under for that...jeese ah hates stitch removal.

Back to the PT...I learned some new exercises and she demonstrated how to do some push ups...it was great, she was doing standard push ups with the hand clap, I told her she was just showing off. I did manage a few sans applause while balancing on one foot later, not quite as impressive but still better than a robust nosebleed had I tried her variation.

I got a wonderful card from Kristen, J.R., and Jack. I don't have a scanner at home so this substitute pic will have to suffice. It never fails to make me smile. Kingpop loves you, Jack!

Later in the afternoon I did another workout from the printouts they gave me at Roper. Tomorrow I will do two or three workouts, not overdoing anything, just trying to keep the right leg from atrophying.

As I write this I have the burning phantom discomfort, man I wish I could put those flaming phalanges in a bucket of ice water. I often massage the stump to help, but just as often reach for the heel or piggies to give them a rub especially if I am writing and not looking at the leg.

Never did take the chariot outside for a ride. The neighbors are aware that I had an operation but I don't think any know exactly what I had done. I don't want to shock them - many have small children - but I'm not quite ready for it today. They are great neighbors; most did the bridge run and know I've been on the d/l for a long time.

So I hope to make my first public appearance tomorrow, no foot and all. I'm sure it will be fine, it's like the first time you ever wear tights on a cold winter's day. Eventually the mental scars heal long after the laughter subsides.

Besides, there's not a lot to see with shrinkage equalizing all men great and small.

Happy trails, kemosabes.

April 23 - 24: Lose 5 - 7, Gain 5 - 7

April 23

I met with my PT person, Cathy, and my nurse, Linda, who will work with me until I go back to my magical life as El Director del IT. I plan to start back May 4, working half days and then full days as long as I can keep the swelling controlled.

Both women have the same good attitude, it comes to mind that this usually means the people love their jobs and/or the companies they work for. All I know is that positive = good, negative = bad, and ah hates Chicken Little.

I won't be under their care for very long, but they will make sure I am doing my exercises (try THIS without a foot, Balboa!) and that Baxter isn't chewing on my residuum while I am napping.

April 24

I fixed my favorite quick breakfast, toasted bagel with natural almond (or peanut) butter topped with wheat germ, sliced banana, orange juice and french roast coffee. I took my pills and vitamins while catching up on the latest way to to reduce debt by digging a bottomless pit. But that's why I'm in IT, and not a lawyer.

I did my own PT today, all the exercises I was given plus I took a short walker tour of one of the flower beds where the daylilies are starting to bloom. While I was doing my floor sets, Baxter sidled up to me and laid down. He's such a sweet dog.

The photo is one Jennifer took of an early bloomer. I planted a number of bulbs two weeks before my surgery and they are starting to gush color. "Come look at us!" they tempt me through the front door...see above.

I had some delicious homemade vegetable soup (that came with the casserole delivery), pasta salad, bread and cookies for lunch. I tried to nap but I've couldn't quite doze off. After I do PT for a long time I feel my phantoms toes burning. The sensation rose slightly over the threshold from uncomfortable to maybe a 2 on the pain scale. This lasted until I went to sleep and was fine this morning.

I kept thinking about my old roommate Joe. He was having some complications and I wasn't sure he'd even be in the same room when I called. More good news...he is improving and sounding so much better than when I left. When I got off the phone I had to sit silent for a few moments. Thank you for taking care of Joe.

Jennifer and I discussed my coming home post...it was hard to put that into words as it was as much feelings as it was events. I am very happy to be home. As I write this I see a palmetto tree framed in the front door, potted flowers along the sidewalk and an anole in search of his lunch. Much to the dismay of my sweetie, I like to leave the front porch light on for the tree frogs as much as security. Since there is a small wetland in our backyard, the population of China pales in comparison to the numbers of mosquito and no-see-ums (flying teeth) bloodsucking angels from hell. Because we are near barrier islands where sea turtles nest, you often see "Lights Off For Sea Turtles" bumper stickers on 95% of the Volvos in the area. I prefer "Lights ON For Tree Frogs" because I don't believe in animal discrimination. ;-)

My mom has been staying with us the past few days to help Jennifer with my maximum caloric uptake (MCU^∞) and has been doing a fine job of stuffing me with chocolate chop oatmeal cookies, coffee cake, creme cheese squares as well as a number of get well soon goodies from my compadres. My sister Marcia picked her up just before a brownie was extruded through my gills.

Felt sleepy around 10 pm and we called it a day. I am beginning to think my dead foot is in hell because it burns so much. Hmm...

Wednesday, April 22, 2009

Blue day

Thinking of my friends in rehab, brothers and sisters in the here and now.
The longer the journey, the sweeter the arrival
Listen...
Friends are calling you home.
Run to them.

*******

We are all tested in life, some as infants, others in twilight, most along the way.
There is a time to bend, and a time to stand firm.
If you break it was because it was necessary.
This we can control, that we cannot.


*******

I never made promises lightly,
there have been some that I've broken. but I swear in the days still left, we'll walk in fields of gold
-Sting

April 22 - Wild Nights

I'm going to keep this one short as it was a rather uneventful and I am a bit behind in my posts, email, phone calls, okay, a lot of excuses but I do need a break.

I've not been doing PT because we needed to make sure the redness in my stump (I still prefer "residual limb" but it takes longer to type) was not inflammation but because it had been down too much.

Some very good news is the leg has cleared up with only a tiny bit of redness and a drop or two of blood evident at on a couple of sutures.

My mood is better, the impatience is gone, and I am sleeping longer with 3 or 4 pit stops during the night to take a pill or big boy business.

My office sent us a turkey breast from Heavenly Ham. Management has been 100% supportive of my decision to get an amputation as well as my running over the years, allowing me to run at lunchtime during the winter months. A great place to work and I am hoping the housing market ease soon so we get busy again...as busy as a one legged man in a butt-kicking contest. Yeah, we have the personnel to do that!

My foot discomfort mainly consists of phantom sensations along with an occasional twitch of the calf muscle near the distal end of the residuum. I am taking the drug neurontin for the phantom pains, not sure right now it is effective for me. I can feel my heel as I write this; also have a moderate burning sensation on the ball of the invisible foot and various itchy spots, etc. I have found if I gently massage the stump it helps relieves the discomfort a bit.

The worst pain is when I put my stump straight down after it's been up a while. The blood rushes to a place that is being actively healing, and for maybe 10 minutes I am one unhappy camper. The good news is this does stop hand-banging hurting unlike my other surgery which was determined to set some sort of endurance record for pain, pounding me for about 4 weeks before it started easing up a bit. The only good thing I can say about the pain management for my first operation is it gives me a reference to compare the amputation to. My surgeon said this would be easier and I would recover faster and so far he is spot on.

It took me a little while to go to sleep. I was trying to catch up on my correspondence and this blog and went to bed some time after my wife. My personal bedtime quirks is I am usually feel warm when I go to sleep and cool when I wake; I start with just the sheet and as my molten core cools I add blanket(s) or cats until warm. My feet are very toasty and I usually pull the covers above them...so last night my phantom toes were on fire and even with the covers pulled above my stump they were not appeased. I felt the need to douse them with cool water but I was convinced that would not have the desired affect either. So I lay there for a long time with my missing piggies having a virtual barbecue somewhere south of my stump.

Glad I didn't stick around that party, somewhere I eased into the arms of a deep and peaceful sleep, only disturbed by the need to: pee, pee, take pain pill, pee, take neurontin, pee, get up.

Wild nights indeed.

*******

My friend Eric's surgery an initial report is: no cancer! OMG what good news that was! I know he and his family shared a few good tears, those sparse tears of joy. I can't wait until I see them again, they are a close knit family and now that bond is tighter yet. Love is like gravity, unseen but powerful enough to bend light.


Tuesday, April 21, 2009

April 21 - Poets and Saints

Jennifer at the Grand Canyon

I was released from Roper Rehabilitation Hospital today. Since I thought I was going home yesterday, it was a bit strange. Joe and I had said goodbye twice because of PT schedules; no one should leave a friend without a farewell.

There was no PT scheduled for me so I worked on the blog, caught up on some email, drank a lot of water and hence, practiced my bathroom wheelchair skills. I felt like I should wheel over to the gym and nurse's station to say goodbye; also to my fellow patients I had just started to know. I heard voices of the familiar drifting into my room but no one returned. Everyone was in sessions or making rounds and I thought I should stay put and wait for my release papers to be served.

This happened around noon and my wife came over to retrieve her abbreviated husband. Transportation was called and a young man with a large cart came by for my stuff. Jennifer went to get the SUV while my entourage and I headed to the elevator.

"How are you doing today, sir?"

"Great!" Yes, I rarely had any bad feelings whatsoever during my stay. "And you?"

"Great, and that makes two times I've heard that all day - you and me." Damn, I think, that sucks. "Hey, I understand you're a runner."

"Yep, and will be back later this year."

"I'm a runner too, hurdles, relays, 400m...haven't run in a while but need to get back."

We chat a bit until Jennifer arrives...he asks about races and I tell him to check the local running stores or go online to active.com or running.net. I slide into the back seat to keep my leg up and my stuff is piled into the cargo area.

I did not like leaving my friends behind or a place that changed me so much...for the better.

We stopped by the drugstore to fill my prescriptions and drove the short distance home. As we pulled into the driveway I felt I was losing what I had learned, that my old impatience was returning, that life inside the hospital and rehab was more honest and clear than the trivial mutterings of daily life. Fretting over the daily minutia is a distraction of monumental proportions.

Let it go and live.

I hurry into the bathroom to gather myself. Already the world has closed in around me, once again proving the fragility of all things human.

"Do any human beings ever realize life while they live it - every, every minute?"
"No. The saints and poets, maybe. They do some."

- Thorton Wilder, Our Town

I miss the poets and saints I left behind. I feel out of place in my own home.

Okay, time to get it together and face the new world. How could I understand what I know now without having gone down this path? How can anyone describe the Grand Canyon in words or music without being there? When you run, can you explain how it feels to a running agnostic?

Bury this knowledge deep, down, down, down to the core. Make it a part of who you are.

I place my hand on the knob, take a deep breath, and open the door and shuffle forward with my walker.

Hello World.

My wife gives me a kiss and we start anew.

RB on the edge

"That's what being a man is all about, boy.
It's just doing what's got to be done."


- Robert Newton Peck, "A Day No Pigs Would Die"

*******

RB + JB

I am home now, over my little self-inflicted crisis. Life is more simple in the hospital; few distractions and the focus is on recovery. I discovered more about life and myself there in a few days once the distractions and a foot were removed. But life is hardly that simple, forces pull us this way and that; we are obligated to do things we'd rather not; and we lose sight of the only thing that matters, and that is the tie that binds.

Love. Only love.



Monday, April 20, 2009

April 20 - Day of (mostly) rest

It's been another action-packed day with thrilling twists and turns and crashes and burns. I will post more later tomorrow while using this body as a placeholder but

I finally got the all-clear to go home.

We have 6 new additions to the family that hatched while I was being reconfigured...either black-capped or Carolina chickadees in a bluebird house that has a TweetyCam in it. Looking forward to manana mis amigos...

Forward troubles Illinois, lock the front door, oh boy!
Look at all the happy creatures dancing on the lawn.
Bother me tomorrow, today, I'll buy no sorrows.
Doo, doo, doo, Lookin' out my back door.

- John Fogerty

*******

As promised, the stuffing for the filler, a bit later as I don't have several hours alone anymore to compose my thoughts-

Passionflower - official flower of IIAGDTR

After my breakfast and shower I asked again about being released. I needed to be looked at by the rehab doc before we could proceed so I would go on to PT and see him later in the afternoon and hopefully be discharged.

Joe, my roommate was born in 1928. I enjoy talking to him...I still have to remind myself to shut up and listen to someone who has lived a full life and who arrived at today through the pages of history. My dad was born in 1927 and lived through the same pages, found humor in the worst of times. I don't recall him ever complaining about any of it.

It didn't occur to me until later that in one of the greatest changes of my life, a man of The Greatest Generation like my dad was there to share the experience with me.

My first PT session had me sharing a table with my former roommate. The therapist had to work with him quite a bit, I don't know the specifics of his ills but they are obviously extensive and his quality of life, at the present, is rather minimal. Over and over I heard the same thing: the less fit and motivated a person was, the more difficult it was to rehab them. There are more of these people than their opposites, with most gathered around the lower midsection of fitness.

I was able to do my exercises without incident and tried to make sure I did them correctly. Part of me felt like a detached observer of the assembled group, but like an infant is a natural swimmer, I did not feel like an alien either.

Last exercise was two laps around the rehab room block. It took me a little longer because I started noticing photos of athletes on the walls signed with notes of appreciation to the rehab staff. Note to self when the time comes...

As I left the first session a woman came up to me and gave me a hug...I could not place her face, being off on Planet Richard thinking about some of the things I have written above. She pointed to her badge...Maxine! She had a cleaning service that took care of our office for years. Being in IT I saw them after hours way more than most, just the friendliest folks you could imagine. It appeared to me her entire family had found the fountain of youth; the lottery of life is often won with a healthy helping of good genetics.

My second session was upper body with hand weights and the rickshaw. And guess what subject came up again? Do these people ever get tired of talking about running? Hope not.

Back to the room and thinking about being home tomorrow. I don't go to session three since I expect to get my walking papers any second and I want to rest the leg. As I am reviewing in my mind how much has changed my 800m teammate and PT assistant pops in to say goodbye. She is off to study PT perhaps as soon as next month, and I have sensed since the moment I met her that she has a gift. I gather PT as a profession can be extraordinarily rewarding but also, given the lack of motivation of many Americans, frustrating in equal measure at times. My friend is a supernova of positrons...and many will be fortunate to be in her care.

Okay, so I was choked up by her kindness, many forces have been at work reconstructing the bent and the broken.

Soon Dr. Warmoth from rehab came by to check me out before discharge. Off with the shrinker, remove the pads...now that doesn't look quite right. The end of the stump is quite red. A decision is made to have Dr. Ohlson come see it later in the evening. I suspect having it down, even though it's not being actively used, has caused some pooling of the blood. However, it is important to make sure it is not inflammation, which would be a bad thing.

In the meantime there was some office work to deal with, it does not enhance my mood at all and for the first time since my surgery I am feeling those negative waves, man. It later turns out the problem I fixed was not a problem in the first place, so I try to let it slide can't quite restore my reborn faith in humanity. No, I will not let the insignificant incident into my house.

Out, damn'd spot!

I am fitted for a wheelchair and walker; I get as narrow a chair as possible to accommodate my rump, thinking it will be easier to pass through some doorways. Feels a bit like sports car...I take a deep breath to gather in the new car smell...nope, that is something that is most definitely not the new car smell. I look about and only find a lot of me to blame.

I have crutches at home but doubt I will use them. Not having an additional balancing point - a crooked foot that is - makes them awkward to use.

I believe it was about this time that Larry Wiley calls and we talk about the redness, and then he gives me a bit of news that centers me again - no guarantees, but it is possible I will be sponsored - potentially given a prosthesis since I will be active and out doing races and running 24/7/365. Well maybe not that often...I have promised that we will try kayaking. = :-)

Dr. Ohlson comes in with his assistant after 9 pm. They take a look and a poke or two - not painful to me - and the good doctor pronounces I can be released tomorrow. My mood immediately brightens; we've got a tourniquet on the emotional bleeding. I did not want my experience to end up as a drug-induced mirage, with so many bright beginnings lost in a head-on collision with a runaway freight train. Note to self: Tracks have trains, the track has runners.

See ya spot.

One more night...time to turn off the light. I feel my strong heartbeat's low vibration in my bed. I raise my leg, and in my mind's eye see it complete with a curved running blade.

Hello Jato.

low and fast and without effort. we are flying. in the night.

*******

Sunday, April 19, 2009

April 19 - Movin' on up

It was rough last night...for my roommate and me. I am writing this from my new digs, one room down from the old joint.

My old roommate apparently had dementia in addition to being an amputee. He was not supposed to get out of his bed and there were alarms - loud ones - that sounded whenever he decided to tour the facilities. He felt the need to go on walkabout on a random but frequent basis 24/7 and he has been doing this ever since I was wheeled into the room.

After a agitated night and a number of incidents, each and every one with at least one alarm and then the arrival of one or more nurses to tell him he needed to push the call button any time he needed to get out of bed, they finally put him in a wheelchair and took him out of the room around 1 a.m. So from 1 until 7 am I slept deeply with the fishes and awoke to hear unsettling snoring from my newly materialized roommate.

What I'm about to describe is something he had tried the day before with less success which I found unsettling and unsafe. This morning I noticed him moving around and I prepared my inner child for the alarm...I see his foot on the floor, my curtain is being pulled back, and a mostly naked man started grabbing the cups on my tray table. I pushed an empty one toward him thinking he was looking for the urinal bottle and had no idea where he was. He stumbled slightly and about then the nurse corp joined the fray.

I am a mostly patient person but having dealt with this the night before all day and again this night I did not feel safe in this room. Had he fallen on my stump and destroyed my surgeon's beautiful work and caused who knows what kind of complications...well...I asked that one of us be relocated.

So here I am in another room with a roommate who is lucid and I'm happy to be here. Too bad this experience colored my otherwise excellent care.

Shortly after The Incident the rehab doc took a look at my stump...it looked amazing considering I had my lower leg cut off just 6 days ago. One spot had some fresh blood which could have come from undressing the bandages themselves. I had to wait a bit for some special gauze that resisted sticking to a wound. My nurse took care of the rebandaging the distal end where the stitches are present and applied the shrinker back over my stump. Looks good!

Physical therapy was very enjoyable today. I got started right after lunch and was allowed to drive my own wheelchair to the gym. I quickly made the acquaintance of Mel, who’s above the knee (AK) amputation and other injuries were the result of a drunk driver's crash into him. We made quick friends and he showed me his prosthesis, how it used a vacuum system in the carbon fiber socket, and we talked about how he was enthusiastically working toward playing wheelchair basketball. A positive attitude is the wine of recovery! We chatted while using the weight machines, the one I used was called the rickshaw because, I deduced, if you back your wheelchair into it and do weight presses, you look like you could be planning your new transportation career in Singapore.

After this I was taught some more exercises for my right leg and then joined an assembled group to perform additional coordination exercises that will be otherwise useful in daily life. It was very enjoyable despite each person's individual limitation, everyone was trying and I witnessed a part of life hidden from me in the past. Or do we hide from it?

Since I plan to go home tomorrow I felt badly leaving the group when we had finished. Not sure if I will have PT tomorrow but we learned as much from each other by our actions as we did from the therapists, who were always friendly, positive, and helpful. I never felt like a stranger and I found the bond of shared adversity strengthen our individual resolve. I saw one woman who never played basketball in her life flick the wrist in a natural Jordan-esque fashion when tossing a ball into a barrel. Lots of smiles and I did not see any pity for anyone's condition. Just a few friends enjoying each other's company on a lazy Sunday afternoon.

*******

Last night my friend Eric, his wife Shelley, and their youngest daughter Madi visited me after enjoying the Family Circle tennis tournament on Daniel Island. Eric is one of my closest and oldest friends; I've known Eric since the 4th grade, Mrs. Matthews’s class at Summerville Elementary school. I have a class photo at home of us sitting at our desks that I try to scan later and add to this post.

We lost Eric and Shelley's brother-in-law Galen to cancer last year. Eric and I had spoken yesterday and he informed me he was going into the hospital tomorrow with surgery scheduled for Tuesday. There appears to be something growing in his lung although preliminary tests have not found any malignancy.

I am rooting for you my friend, my brother, and I know your family and friends are holding you in their hearts and minds.

Photo: Jennifer Blalock - Sullivans Island Palmettos


Saturday, April 18, 2009

April 18 - Caught in a shower

No, I haven't been steekin' up the joint, I've had in situ baths to avoid being cordoned off as hazardous waste but this morning I had a real shower utilizing a shower stool, shampoo, and was able to shave the stubble from around my beard. No Geico caveman commercials for me, that bums me a little but maybe my brother will want to be my stand-in.

I'm now dressed and waiting for pain meds then PT...it's been 6 hours since the meds so that is good. I did have some strong spasms in the calf muscle near the stump while I sat at the sink, but fortunately this went away after a few 'gotcha sucka.'

My first PT session was targeted at preventing things from tightening up and limiting motion. For example I am keeping the back of the knee flat on the bed instead of on a pillow or otherwise flexed. As a runner I should be flexible enough to kick my own butt with my heel although in practice I don't . The extra range of motion makes the gait cycle easier over the miles. I should mention when I stopped running in 2007 that I could only occasionally kick my own butt. Coach Luc didn't mind picking up the slack.

We did a sort of modified downward facing dog as I had to hang my stump over the edge of the trainer's table at the distal end where the stitches are located. This is so I didn't put any strain on the sutures. For the next exercise I laid on my left side and did some straight right leg lifts, and finally laid on my back an pulled my right leg toward my chest.

I used a walker to hop to the session one but came back under my own power in a wheelchair. I have been pushed in one before, but it's fun learning how to drive it like a tank. I think any athlete could benefit from a good wheelchair upper body workout; still I have a hard time imagining them used for this purpose unless some race-winning benefit could be found.

After about an hour break I headed back for session two. This was mostly light weight lifting...I'm rolled into a weight machine designed to accommodate a wheelchair. I did upward and downward presses designed to build upper body strength. The young woman who guided me to the gym was an 8oom runner in HS, same as moi. Several of the PTs either ran or talked about running and shoes and mileage oh my! Of course I was most happy to talk about my sport and tried to temper my enthusiasm to avoid the glaze of death. But they seemed very enthusiastic which was contagious. Hard to believe I wasn't running yesterday...I think in some part of my brain it believes the same thing. It does believe we will run again.

After a nice lunch I had PT session three which was touring the hallway with the walker while trying to mimic a somewhat natural gate cycle, I tended to walk as if I was stepping over a barrel or overstriding as a runner as opposed to putting my foot straight down.

The leg has been pretty good all day with the exception of the spasms this morning; I have been noticing some swelling about the shrinker. The rehab doc pulled it off to check the the stump before I left my prior hospital room, but when he put it back on it was below the kneecap; before it was over the knee a bit. As soon as my nurse comes by I am going to ask about it and have emailed my prosthetist too. Things have gone too well to let a little detail cause any setback...I am righteously spoiled by the success so far.

Speaking of said nurse, she just stopped by and fixed the shrinker. She said they always put the shrinker over the knee (baring some other concern) and my prosthetist concurred. A little disappointing but in the spirit of being your own best advocate, speak up!

These pics were taken on my Blackberry from my hospital bed. I plan to go home tomorrow unless there is some problem getting discharged. Yippie yi yaaaaay!

I am definitely having more swelling but I hope it is just a transitional thing due the low shrinker and the fact I was using the stump down more at PT. There was no direct pressure on the stump at therapy, and it's only been since Tuesday that it was reconstructed to what you see here:

Dr. Ohlson's Artwork
TADA! My new right limb - note the Blackberry
(pic by Larry Wiley, CP, April 16, 2009)

Friday, April 17, 2009

April 17 - Head 'em up, move 'em out, rawhide!

I had a good night's sleep, about on par with my
normal pattern. I was awakened around 4 am to have my vitals checked, and I finished the previous day's blog before falling asleep until breakfast. There is a good chance I won't be able to do that in the new ward as I have been deported to rehab, leaving my beloved room number 7020 behind. I hope I was able impart to the staff there how much I appreciated all they did for me, god bless them everyone.

After breakfast I did my Hall-Hop Corridor Walker Tour 2009, single sleeved event tees to be distributed at a later date. I thought I'd be going to rehab this morning, but by the time the paperwork was completed it was after 6 p.m. At lunch time my friend and coworker Steve Blackwell dropped in for a good visit before he headed home. Steve mentioned how yoga cured some back problems that have pestered him for years. Jennifer and Nancy used to do yoga, because of my foot I didn't bother trying...I might reconsider once I get my new toys. All I know is I love saying "downward facing dog!" every time the pooch stretches.

Whoop-ee-ti-yi-o get along little doggies,
It's your misfortune and not of my own.
Whoop-ee-ti-yi-o get along little doggies,
You know that Wyoming will be your new home.
- Woody Guthrie

Right now I'm trying to remember when my open wound drain was pulled out of my stump. I think it was this morning after the arm IV was removed and I decided maybe I should become a plasticized triathlete, in particular the omnipresent hairless male variety. Well now I am hairless where the follicle roots were excavated by the lightspeed removal of the medical tape. Wait a minute...how can I whine when I know some pathetic guy who just had his foot amputated?

Oh crap, that was me.

Speaking of amputations, a doc from rehab examined the residuum and we talked about the history a bit...I credit poor Jennifer for not drooling and then falling unconscious as I discussed the details again. I truly don't mind because the professionals need the information to do their jobs, but if I lose my voice I'm sure Jennifer can accurately regurgitate "Dwyer osteotomies of first metatarsal and calcaneus, blah blah blah talus debridement and peroneal tendon repairs,blah blah blah" Zzzzz....

I am going 5 -6 hours between pain pills, getting ready to have one now after 5 1/2 hours. I might need more in 15 minutes as...

Roper Rehab is basically a hospital in the hospital. I now have a roommate, a gentleman who is snoring as I write this after losing his remote and setting off some kind of rather irritating alarm twice...I think it warns when he is about to fall out of the bed. I was thinking I might not complete this post tonight, but upon this recent development I will be able to translate "Crime and Punishment" into French by daybreak, learning French in the process.

Oh me oh moi.

While I was going over my history with the Jessica my rehab nurse "Dwyer osteotomies of first metatarsal and calcaneus, blah blah blah talus debridement and peroneal tendon repairs,blah blah blah" I went to point to where I had my talus debridement on right foot. I reached down and to put my finger on the scar and had to laugh.

I was pointing into thin air.

Thursday, April 16, 2009

April 16 - The incredible shrinking man

Today was a little less intense than yesterday but I'm still taking those baby steps forward.

I slept much better last night which I needed so I could be an active participant with the staff instead of a dumb fence post. First baby step was using a walker to hobble down the hallway and back. It was a little humbling but a journey of a thousand miles...begins with a single hop. My therapist was very encouraging and I felt like I had my own cheering section as I breasted the tape in world record rabbit time.

My bandage was changed by my dedicated prosthetist Larry Wiley. He also brought me some goodies including a DVD entitled "The Biomechanics of Lower Limb Amputee Running" and several magazines. In short order my nurse Kari dressed my incision and Larry rolled a size 5 shrinker over it. He was very happy with the length of the residual limb and the precision work of Dr. Ohlson. Larry took a pic that I will update this post with when I receive it. Oh yes I will!

Just before Larry arrived I started having more pain in the stump and I got my oral meds and a shot of morphine. I hadn't had any percocet since the wee hours of the morning. It's a bit of a compromise to have pain relief or less cloudy thinking, right now I side on pain relief but over the next 10 days or so it will start to subside. Most discomfort is from the swelling and pressure when the limb is lowered just like my prior surgery.

I spoke with Barbara Hiott, my case manager, and I found I was approved for inpatient rehab. I am going to stay two more days for that and hopefully/likely go home on Sunday. Can't wait to plop myself on a shower stool and wash my hair.

By the way, if you are ever lonely I suggest buying a urinal bottle. The moment you decide you can't wait another second to employ it, a knock at your door will announce some genuinely helpful individual wanting to give you a sweet painkiller or deliver the morning meal. Yes they knock but in your haste to try to arrange the props so as to prevent deep belly guffawing on the guest's part, all sorts of memorable accidents ensue that hopefully you can keep secret. A friend in need...is a friend who really has to pee!

I feel the need to again praise the hospital staff here at Roper, truly I can't do this enough. My younger, somewhat smellier brother Mark was born here, the only native Charlestonian in the family. In the late 50s (yeah, I knew dirt when it was clean) I was trying to catch a bullfrog in a pipe in Melrose subdivision. I slipped on the ditch bank and deeply cut my right big toe on a broken bottle. My dad was a pharmaceutical rep and was packing his car as I came whimpering across the Bevin's yard leaving a trail of blood in the morning dew. He didn't hear me and my mom came to the door and took care of business, informing my dad his son was bleeding to death and off we went to the Roper ER. Later when I got the stitches out they bought me a portable/standup swimming pool and it was one of the happiest days in my life up to that time. I distinctly remember saying "I love you dad" and "I love you mom" and "Thank you thank you thank you" all the way home.

So what I wanted to say is I have a history with this hospital. The staff that take care of me are deeply caring, compassionate, good people. They often see the best and worst in patients, but I gather it is those successes large and small that give them the fortitude to handle the challenges. I'll write more on this later...but for now: thank you thank you thank you. Making a real difference in people's lives is where these heroes go about their quiet work.

My wife Jennifer came by in the evening after a not-so-short detour to the house to walk Baxter. She works at MUSC down the street from Roper. We sit side by side and watch teevee and polish off the incredible chocolate cookies friend Betsy made for me. The drugs have enhanced my space cadet standing so she is cutting me some extra slack...for now. I am finding some disturbing advantages to hospital life, and I cannot be blamed for chaining myself to the comfy chair on discharge day.

Well I know I am rambling a bit, I'll be getting some more pills soon from nurse Katie and then it's off to a night of good dreams. I am very comfortable and peaceful here, strange and not strange. Here I will begin again, and I feel a fundamental change in my life, a changing of the light.

No, but I saw how everything had changed
Later, just as the light had; and at night
I saw that from dream to dream everything changed.


(From Presences by Donald Justice)

The Indomitable Human Spirit

"Never regret either you did what you had to do to go where you need to in life. We all have goals and this is just a step toward you reaching them."

Amy Palmiero-Winters

Wednesday, April 15, 2009

April 15 - Man in slow motion

So much happened today and I am a wee bit run down. Sorry if my enthusiam is tempered but I wore out the victory gong yesterday.

I had a steady stream of health care professionals this morning. It started with PT in moving around with one leg and I used a walker to hop across the room to my comfy chair. I talked to the chaplain and we discussed a member of his church who had also been down the multiple surgery path to end up with an amputation and his life back. I had some more therapy to build the puny runner's upper body to lift the mass of jello out of the chair and then back to the quivering sitting position.

There were two other ladies I talked to, one was the case manager and the other was a chaplain. We can all understand how many people have difficulty with this operation, I wish they didn't have to have the debilitating depression or anxiety than comes with an unexpected or planned procedure. If there is time, becoming educated about how lives are enhanced from the procedure offers the kind of real hope that has real meaning.

All day I received flowers, emails, cards and some visits. Our friend Nancy dropped off some Godiva chocolates, and these have managed to vanish into thin air. Judy and Mike sent a beautiful floral arrangement and Carleen brought flowers to me that have a story best left for later since I can "hardly hardly" as my dear old dad was fond of saying.

My good friend Betsy stopped by in the evening with a 24" x 36" greeting card created from a check print signed by my coworkers with comments, so it's recycled. I should say I have a Scottish ancestry and being green and being, uh, economical (aka cheap) are the same wee beastie.

Betsy also brought some killer chocolate cookes that seem to be chocolate injected with chocolate, dipped in chocolate and then infused with a double chocolate emulsion. I could only manage one and broke out in hives that spelled H E R S H E Y across my forehead in neon colors.

Leg is doing okay. Last night one of the nerve blocks pulled up stakes around midnight and I was given an oral med pain killer. I had my pills for tonight and they are kicking in...these cause the fuzzy thinking I am so familiar with and it will take me as much time to write the next few lines as it did to write everything preceding this sentence.

My doctor's assistant stopped by and we discussed the dressing change tomorrow, the shrinker, and the possibilty of doing some impatient rehab to help me prepare to function with my prosthetic. Nothing specific for the healing leg, this would be balancing, lifting the quivering mass of jello out of the chair and then dropping it back without missing the target and kissing the floor with my broadway backside.

It's nearly 4:30 a.m., so naturally this popped into mind from the movie Witness:

Eli Lapp: 4:30. Time for milking.
(John Book played by Harrison Ford is trying to milk a cow)
Eli Lapp: You never had your hands on a teat before.
John Book: Not one this big.

I'm up because every so often a staff person comes in to check the vitals so I thought I'd wrap this post up. It's going to be another action-packed day on Thursday so I should get some sleep, which I am doing better at tonight. Pain level is between 3 and 4, nothing bad considering my procedure.

Sweet are the uses of adversity,
Which, like the toad, ugly and venomous,
Wears yet a precious jewel in his head;
And this our life, exempt from public haunt,
Finds tongues in trees, books in the running brooks,
Sermons in stones, and good in every thing.

- William Shakespeare
I am one lucky man.

Tuesday, April 14, 2009

April 14, 2009 - A journey of a thousand miles

I actually slept well last night, better than I expected. Turns out to have been a harbinger of good things to come…

I am writing this from my Roper hospital bed. Back when I was looking into ankle fusion I read all sorts of stories from people who had horrid experiences in the hospital and subsequent stays. The people providing my health care are their polar opposites, caring and helpful and just good people.

We arrived at 6 am; got a little paperwork done and maybe 20 minutes later I was taken to the prep-op room. The nurse there got the IV started and soon we met with Dr. Ohlson. We went over the Ertl procedure and discovered his mentor was a doctor at Union Memorial, one I had read about when I was first looking into foot and ankle reconstructive procedures. That seems just like the way everything was falling into place today. He decided I could have a 7" residuum with my amputation which will give me more area for the socket. I had research the optimal residual limb length quite a bit and this definitely fell into the quite acceptable range.

I mention this because as my prosthetist Larry Wiley, with his engineering background, knows we can spread the pressure from the future socket over a larger area. We runners can appreciate having less chance of developing hot spots that would lead to the skin breaking down and causing all sorts of owies and nastiness.

The anesthesiologists were superb. We discussed pain management in detail, I believe three things were employed but two were nerve blocks - they are nothing short of miraculous! Only wish I had had one with my first surgery as it would have prevented any anxiety about waking up in pain post-op.

Once we got in the OR I was moved to the operating table and I don't remember much until I woke up in the recovery room. I wasn't loopy or in any pain whatsoever!

Jennifer was there shortly after I opened my eyes and later my brother Mark and my mom Betsy visited for a few minutes. One thing my mom noticed was how calm I looked. I can say all day I have been in the best spirits and I believe it is for two reasons. First and most obvious, I'm done with the surgery and it went extraordinarily well. But for the first time in years I had NO pain whatsoever. I knew that the almost constant discomfort made me feel impatient and irritated at times with all things and everyone. I finally had a little peace and quiet in my body.

Dr. Ohlson was pleased with the surgery and told me he had spoken with the prosthetist. They plan to change my dressing and put a shrinker on the stump on Thursday. FYI, "residual limb" and "stump" are different terms for the same thing. I imagine I will go home Thursday afternoon but right now I don't know for sure.

I do have phantom sensations of my dearly departed doggie. Prior to the surgery it always had a dull numbness if I was just sitting and I feel that same thing right now. I can feel my heel resting on the bed – my stump is on a pillow - and have felt tingling in the arch and ball of the foot. But nope, those little piggies have gone to the market for good. I want to impress these are sensations, not pain and should dissolve over time as the brain figures out the nerve endings reside elsewhere.

Jennifer has been with me most all day except when she left to feed the pets and decompress a bit at home. She is still recovering from the residual effects of a nasty bout with pneumonia and I guess the inflammation really wore her down. She came back this evening and we watched a little teevee together before she left. Hope she feels better soon; the fatigue factor has prevented her from training and enjoying life lately.

So that’s my first day as an amputee. I have had amazing support from so many people, indeed, some who hardly know me. Blessed? I don’t know why but I do know I have had a day like no other. I can’t think of a better start to this new chapter in my life, and it will inspire me to the end of my days.

The new me

Reunion

Old friend

You have been with me every other step of the way
From first light we stumbled into everyday

As you depart know when time has done his worst
we will laugh and run along the high road
high above the sorrow
high above the pines

and we are flying
with wings

Monday, April 13, 2009

Blackbird

Blackbird singing in the dead of night
Take these broken wings and learn to fly.
All your life
You were only waiting for this moment to arise.

- Sir Paul McCartney

*******

I was driving into work this morning, with a short detour to the vet with Lexie aka The Big Jungle Cat, when this song popped into my head.

Nice.

Sunday, April 12, 2009

Easter marathon

Jennifer and my step-daughter Becca went to church with the in-laws while I went out for a bike ride. I planned this about a week ago, wanting the symbolic 26.2 mile bike ride before my surgery. I bought a low-end but all carbon Trek Madone 4.5 last year and it was a near-religious experience after riding my 30 y.o. Ross steel steed. Still haven't named it yet, guess The Bike has decided I am not yet worthy to whisper it in my ear. I will name it "Rambler" if it doesn't inspire me soon.

I was still recovering from my April '08 foot surgery when I bought the bike to get outside and some semblance of a workout again . It was very hard to pedal with the right foot and I could only go maybe 15 mph mostly under the power of my left leg. I remember the first time I cracked 20 and hit a high of nearly 30 a couple of weeks ago with a stiff tailwind.

I can't say I love biking like running, but I certainly understand the appeal. I have to ride in my running shoes on plain pedals, no clips or cages, so pedaling fast is a bit tricky. Amy Palmiero-Winters has a cool bike prosthesis, which ends in a cleat, not a fake foot. Not sure I'll ever be that serious but it looks great to me. I should say I don't care for having a cosmetic leg at all, give me a great industrial design that does the job, hey, I gotta be me.

Half day at work tomorrow, then off to buy a few last minute items before getting the race face on. I mentioned to Jennifer that when I think about the surgery now it's like pre-race jitters, you just want the gun to sound so you can get going. But you also question what the hell you are doing, and why, exactly, are you doing it.

Crossing the finish line is the answer.

Friday, April 10, 2009

IIAGDTR


Jack Crabb: You'd better watch out. They're whittlin' you down. You can't afford to lose any more of your parts.

Mr. Meriweather: Every business has a particle of risk.

*******

I developed my running phrase - it is a good day to run - after Grandfather in the book "Little Big Man" by Thomas Berger. The movie is a favorite of mine too. I believe the original phrase was a Lakota war cry.

"The buffalo eats grass, I eat him, and when I die, the earth eats me and sprouts more grass. Therefore nothing is ever lost, and each thing is forever, though all things move."

When facing death, Grandfather says:

"Come out and fight!...It is a good day to die!"

So no matter what the weather, the adversity, or other obstacles before you, remember: IIAGDTR. Say it next time you stand shoulder to shoulder with the other warriors waiting for the starting gun:


(My intact right leg in black shorts/gold stripe at the CRBR)

IIAGDTR!

*******

"Men, today we die a little." 

- Emil Zatopek at the start of the 1956 Olympic Marathon

Wednesday, April 8, 2009

Random Thoughts Part I

One year ago today I was having extensive surgery on my foot...took about 4 hours. The Ertl amputation for next Tuesday is scheduled to take a mere 3 hours.

* * * * *

Talked to the surgeon this afternoon, went over the last details. Residuum. Epidural. IPOP.

I can't believe it at times. Surreal.

* * * * *

Feeling a little stressed, occasionally curse what is about to happen to me, what I am doing to myself.

Later I was driving Jen to pick up her car at the shop...she and our friend Nancy had been chatting about kayaking...we have talked about getting some boats. Nancy said, you know Jen, when he gets that new running leg you're never going to go kayaking!

And that makes me smile. Okay, the day after a long run. No, really we will. I promise! :-)

Tuesday, April 7, 2009

Part Two: How I got there from here

I tried to walk a little further every week. Along with light jogging on the treadmill, I forced some movement in the near-rigid ankle joint with various sadistic stretches. I peaked at about 2 miles of very slow running - my dead granny could walk faster - on the treadmill and couldn't go much further. A bit later I started hurting more on the inside of the ankle joint with an occasional sharp pain radiating down my foot and up the leg. I kept at it but finally had enough.

I saw Dr. Ohlson this January (09) and we talked about joint distraction and again about a tibial osteotomy...I finally cornered my courage and asked: "What about amputation...I know I can run again by losing my foot." It was good - and a relief - to hear him launch into a description of the Ertl procedure. This is important as some surgeons are not properly trained to do this specialized amputation. Dr. Ohlson mentioned the possible complications like neuromas that might require some revision but that the Ertl amputation should actually be a little easier to recover from than the prior surgery.

http://tinyurl.com/d4vhtr


Initially I talked to an orthotist he recommended who suggested I try a custom brace in order to save the foot. I knew this wasn't going to work and was dejected by another delay. I felt like the orthotist did not really understand me as a runner. The cost of the custom AFO (ankle foot orthosis) was not trivial, and I hated to throw money at something that my research (including email with the manufacturer) indicated had nearly a zero chance of success. Still, I set up a fitting for it while thinking this just wasn't the right approach to my problem.

At this point I made an appointment with the company who made my orthotics in the past. I met with Larry Wiley, CP, Jared McNeill, CPO and Ricky Miller of Floyd Brace and in a short order felt a huge relief and surge of hope...they understood what I was talking about in getting my life back as a runner. I called and canceled the other brace fitting.

I contacted Amy Palmiero-Winters who answered my questions and concerns from an athlete's point of view. I also got a lot of questions answered by others...all in all the Prosthetic and Orthotic industry and community are a very helpful and caring people. I know they are proud of what they do.

So now I am waiting for my surgery on Tuesday April 14, 2009...a week from now I should be an amputee and hopefully with an epidural and feeling little to no pain with a new chapter of my life opening.

Ironic, isn't it, that I have to lose a foot to be able to run again? For me the choice, although not easy, is the only one I have. It's not about being brave or courageous or anything that lofty, it is about having my life back. I am extraordinarily lucky to live in a time when this is possible and I thank all those who are giving me this chance.

I would like to thank two I've not met, but whom I greatly admire: Jan J. Stokosa, CP, and Bill Barr. I read the book "Whole Again" and it made me appreciate how far we've come in the past few decades, from something with near-medieval suffering to bringing lives back with little or no limitations.

Yes, I know there can be complications and for some this is not the thing to do. But for anyone who has a passion in life and that passion is killed...what would you give to get it back?

An arm and a leg?

I want and will have this back. Me 'n Jen at the races

Monday, April 6, 2009

First Runner, Only Runner

My mom told me I ran before I walked. This pic is from an old home movie at White Point Gardens ("The Battery") in Charleston, SC. My brother Mark is a newborn so I am about 7. I still have the cowboy shirt I am running in.

I really didn't think of running as something apart from myself when I was little, it was only later when I lost a school race did I realize I wasn't Running, that others did it and it wasn't mine alone, and Running wasn't Me. How could anyone be faster than me, it made no sense and was difficult to accept. It was a first step to losing childhood naivete, something better learned sooner than later. We have an old home movie of that PlayDay race at Oakland Elementary school, and the instant replay contains the truth...

It is nice to have that old zen memory, of being that pure without effort a lifetime ago. I am looking to catch a glimpse again.

Jato and me


Oscar Pistorius ("Blade Runner") image courtesy of www.ossur.com

I already have a name for my running foot, which I won't receive until later this year or early next..."Jato." This is from the book series "Tales of the Otori" by Lian Hearn (pseudonym for Gillian Rubinstein).

I started listening to these books while driving to our Greenville office and got hooked. Jato is an ancestral sword that comes to its master.

http://www.lianhearn.com/

http://tinyurl.com/cd98c3

Sunday, April 5, 2009

Part One: How I got there from here

Where to begin...the first real sign of a problem was after the 1997 Chicago marathon, when about two weeks post-race my right ankle ballooned as if I had sprained it. I ended up seeing an orthopedist who recommended custom orthotics.

At this point I'd like to drive home this huge lesson I've learned per my wife Jen: YOU MUST BE YOUR OWN BEST HEALTH ADVOCATE! Doctors may either not know all that is available to them or not think to tell you about things like aggressive surgery or - yes - amputation as an alternative. From what I know from this Monday morning armchair call, there was a much better chance had I had corrective surgery at this time (1997) that I might have avoided this surgery now. If you are having foot or ankle problems see someone who specializes in this area, not an orthopedist who might specialize in hip replacement. Do your own research, ask questions, talk to others, check out forums, and educate yourself as much as possible. Be aggressive, it is your life, your one body, don't assume anyone else knows what is best for you.

Over the years I tried different orthotics and got the most cushioned running shoes I could find (Nike Vomeros rock!) and was able to run with ever increasing pain. The peroneal tendon area was often very sore from my ankle to a protruding 5th metatarsal. Around 2002 I started feeling a little numbness in my right foot when running, more so when doing track interval workouts where generally you are always making left turns. I also found I could not move my lower leg very far forward when doing calf/achilles stretches.

Things continued to get worse, and in mid-2007 I decided I would try to run one more Boston qualifying marathon and if I didn't get my time that I would focus on running some 800m and 5k races. Around November of that year I found the pain was so awful that I was forced to quit training. I was referred to Dr. Ohlson who is a foot and ankle specialist.

After taking x-rays and looking at my foot, as well as presenting my case to his peers, his take was "dude, your running days are over." Any of you runners reading this think about that being said to you.

I said doc, look, Oscar Pistorius has no lower legs at all yet nearly qualified for the so-called real Olympics and me, with an intact but damaged foot, can hardly walk? Here my courage failed me, because I wanted him - the physician - to bring up the subject of amputation. Instead, over the next few weeks of x-rays and MRIs we decided to try some aggressive surgery in an attempt to fix things well enough so I could run again. Seemed reasonable, right? Besides, even now in hindsight, how many times would I be asked "so you cut off your foot without trying anything else?"

On April 8, 2008 I had foot surgery that included: Dwyer osteotomies of first metatarsal (big toe) and calcaneus (heel), talus debridement, peroneal tendon repairs, and some holes drilled into the bone to try to stimulate cartilage repair.

I was not expecting to be in much pain when I woke up from surgery, but let me tell you the first thought that ran through my brain was "this is almost as bad as having my foot run over by the bus!" Holy guacamole! It felt like my foot was being ripped apart in several directions.

The pain was very bad for the first week, a bit better the second week, then steadily got better for several more weeks. Putting the foot below the heart caused the nastiest discomfort but eventually time won the campaign and I started PT.

In the end all of the peroneal pain went away, but in the joint bone-on-bone contact and the deformity from the arthritis was not helped by the osteotomies. We have discussed a tibial osteotomy...in hindsight I would have preferred this to the calcaneus but I am convinced with the amount of arthritis and joint deformation that this would not have been successful either.


On to Part Two....

Thursday, April 2, 2009

My Gold Star Team

Pic from left: Me, Jennifer, Connor, Nancy, Becca, Chris


Those who have helped me down this path.

  • Jennifer Blalock: my wife, best friend, triathlete
  • Gary and Nancy Starrett: Supreme in-laws
  • My Loving Family: Mom, Mark and Deb, Marcia, Chris & Becca, John Ryan & Kristen, Jim & Myrna

Brian Frasure - photo courtesy www.ossur.com

No regrets

(pic from left, me, Jen, Ken, Monica, Tommy, Bill, Marian)

I do not think it is possible to live life without regrets, but I am proud of this:

I never, ever took running for granted. Never.

I have considered the day when I could not run, and decided it may be today but not tomorrow. It all passes in the blink of eye.

I am amazed how adversity can illuminate life,
even if you can't see it at the time.

Do not wait and for god's sake do not whine.

(Coach Luc is lurking.)

http://tinyurl.com/c86j4k

The result of not knowing what you are doing

I nearly lost my foot the first time due to a doctor's incompetence. When I was taken to the ER a family practice doc worked on my foot. Clearly I should been sent to an orthopedist; I have no good answer why this did not happen. My foot was immediately put into a cast and I was sent home.

A short time after this, maybe two weeks or less, we went to Durham, NC, to visit family. My foot began to pulsate in pain at my grandparent's house and finally my parents took me to Duke University hospital. I recall them cutting off my cast and the doctor saying 'if you had brought him in an hour later he'd probably have lost the foot.' My foot had swelled in the cast and compromised the circulation.

I went home in splint, a bloody blister rubbing my heel for good measure, then spent perhaps a week in the Summerville hospital with my foot elevated before I got another cast. The bus driver stopped by and I was told she had been terribly distraught over what had happened. I was just a dumb 10 year old kid and really did not blame her. She only stayed a few minutes and I said 'it's okay' and probably little else. Some school official also apologized. I doubt a lawsuit ever crossed my parent's minds in 1963. I was told other doctors eventually asked Dr. Quack to leave town.

Several things caused the accident, but in truth the overcrowding of the school bus precipitated the event. Our stop was not the last one on the route but it was the last one where you had a chance of getting a seat and not having to stand in the aisle all the way to the school. Lurching around corners, getting poked by your pals, dropping your books and having them scattered about were just a few of the fringe benefits from not having a seat.

One day, and I don't think they planned it, it just happened, a few kids had gathered up the street from the bus stop. The driver for whatever reason stopped there and we all had to scramble to get on the bus. After that day we started forming two groups in hopes of improving our chances to getting a seat, as we smaller kids usually lost out. No advantage is too small in the survival of the weakest.

I was standing at the unofficial stop the day of the accident and you guessed it, the bus drove past, we started running like mad to get in line, and I was knocked down by Emmitt (according to my sister). I can't say I remember seeing him, just an elbow to my chest and then....

Anyhow this pic is from about two weeks after my surgery of April 8, 2008. The front of my foot with the hammer toes was the result of the bus accident. I've had this all my life and it has actually caused few problems outside of blisters. As arthritis set in I became a severe underpronator/supinator as my ankle deformed outward and twisted my foot beneath me. Until I had this surgery I didn't know my foot was quite so deformed as I normally don't look at it from the bottom!

I roughly estimate that I got about 40,000 running miles on this thing, but I suspect I will get little on the trade-in.

One last word in this verbose post...while I was in the hospital I heard unbridled, primal screaming coming from outside the hospital. A kid had been cutting the grass and tried to pour gasoline in the mower's tank and it exploded. I think he was burned over 70% or more of his body. He later died.

Now that is tragedy.