Sunday, May 31, 2009

Any Friday (May 29)

I was looking forward to Friday, mainly because it was a half work day and I could get a nice long afternoon nap in preparation for the Jen and I to go out to dinner, something we haven't done much in the past 7 weeks. After a long week - which they all seem to be lately - trying to get the phantom pain under control, I needed to get some extra rest so I wouldn't go face down in my soup appetizer at dinner.

I realized Friday morning my bagel supply was extinguished and I had to decide if I would go for the resupply. Thing is, I haven't been out much by myself in public and I don't think I have been anywhere without Jen. Seemed like a good time to try it myself, and I was a excited about the prospect of the solo trip. Plus I really love my bagels with almond or peanut butter with a banana for breakfast, so this added incentive that would stand in for courage.

Friday morning wasn't too bad, and noon came without any incident that would cause me to work late except for a short reboot of a server. With the reboot complete, I hauled myself downstairs after a short pit stop, and then headed to Charleston Bagel down the street for my big adventure. Got my handicap spot in front, briefly considered crutching in but not sure if using the credit card would result in a scene while I tried to sign the receipt, so I retrieved the wheelchair from the back and started in.

As I came to the door a woman was coming out and held it open for me; I thanked her and went to the order station. No one was there right away but they might not have seen me from my lower climes. I got my wallet and stood up, using my left leg against the counter for support, and was then seen and placed my order. Hmmm...I probably could have done this on crutches after all but the chair is definitely easier. I paid the cashier - really nice folks work here - and sat down for the return trip.

On the way out I noticed a table with a mom and two daughters, or so my quick glance took in. As I approached the door, I believe it was the younger one who quickly moved to open the door for me. I thanked her, got back to the Pilot and drove home.

I backed into the driveway and almost immediately knew I had forgotten something, the plastic bag I keep my meds and other assorted gimp items; some gloves, another plastic bag to cover my stump in should it rain, and a tape measure that I check the stump shrinkage or swelling. I mainly was concerned about my meds; the phantom pain was under better control but it was time to take the gabapentin. The pain had been building on the way home and I was thinking it wouldn't be long now, I could both get some relief and have a nice, long nap.

So now to Plan B (Plan B being in all truth and sincerity means Plan Blalock for the obvious).

Maybe the bag blew out of the Honda when I was getting my wheelchair out at the bagel shop. I would go by there first and if no luck, go back and check the office parking lot and then the office itself. If I couldn't find it, I would call the pharmacy and see what the refill policy was. I hoped I could avoid having to call the doctor's office for some sort of confirmation before I could get it replaced.

I cruised by the bagel shop and didn't see a plastic bag anywhere. I briefly thought about checking to see if someone turned it in to them but figured I'd be better off going to the office. I was getting tired, I hurt, and didn't want to spend any energy on unlikely ventures.

I took the elevator up to our floor, and started down the hall when I thought - didn't I make a pit stop? - and checked into the men's room. There it was, between the sinks where I left it when I washed my paws.

*******

On the way home that day, although I was getting near the limit of my fatigue, I started thinking about how kind people have been to me since becoming an amputee. And not arguably, they have been extraordinarily kind to me. Not an unkind word that I can recall. No impatience, no hint of animosity.

And I thought of how doors were opening for me, not just doors of understanding, but real doors like the one the woman and girl opened for me. I never thought in the moment that they did it out of pity of any sort, but of being helpful to someone who could use a hand.

Could you do this for others all the time, even most of the time, considering we all carry scars of one sort or another? Many are unseen, far deeper and more disturbing than the sight of a 56-year-old man in a wheelchair.

Could I?

Wednesday, May 27, 2009

Balancing Act

My dad's WW II ship LSM 447

Sometime over Memorial Day I pulled a muscle in my chest. I didn't get an "Ouch $&#!" moment, just found when I laid down for sleep Sunday that it was very painful over my left pectoral muscle area. It mainly hurts the last couple of inches before my back hits the mattress. It then hurts like hell and eases over a few minutes. It makes it difficult to get up and impossible to do my PT correctly.

So this along with phantom pain (PP) started the week with me in a particular grumpy mood of misery. Only a pain pill later in the day kept me from getting very dejected over my lot in life. I have gone from Gabapentin (neurontin) to Lyrica back to Gabapentin trying to get some relief. At 2 x 75mg and 3 x 100mg respectively/day, I felt my dosing significantly lower than what I read other amputees used, typically 1600 - 3000mg /day.

After emailing my CP, I finally called my doc's PA and asked for a nerve med adjustment on Tuesday. I was very tired of hurting and they bumped up my dosing to 3 - 4x 100/200mg, still low I think but there you have it. I do take 200mg and it takes the edge off but the trade-off is sleepiness for me. Afternoons at work are a struggle to do my job and stay awake. I am sleeping better at night so I will deal with this compromise as best I can and know eventually that the PP will get better.

I did very little PT given the PP and muscle pull this week, but I consider this largely my failing. When given a problem there is often more than one solution - and we don't skin cats around here. I may not be able to lie on my back and do my PT, but I can sit on the floor and still do the exercises with little loss of effect.

Speaking of PT, it is Sunday, May 31 as I write this and need to do a session. When I finished I want to write about Friday separately. I am also working on a time line to post the milestones of my amputation journey.

Also, please email me if you have questions or topics you'd like more information about. If you are an amputee runner in SC or near Charleston, I'd like to hear from you as I need a mentor!

Sunday, May 24, 2009

Pain Week

Some ups and downs this week. The phantom pain - not so phantom to the one experiencing it - has become the focus of my discomfort. The amputation itself was nothing compared to the daily battle with this aggravating nuisance of an invisible foe.

As an amputee, I find so little useful information is imparted to the patient about this evil adversary. There are no specific medications that provide the relief an aspirin may provide for a common headache. The drugs that are used may not be well understood in their actions. More doctors need to subject themselves to this condition in order to spur the research into understanding it better. Yeah, I'm kidding. Maybe.

Typically in the morning the pain is nearly gone but by mid-morning at work I am struggling to find some comfortable position in my wheelchair where the pain is tolerable.

Cutie enjoying my chariot of fire

I had very little sleep on Sunday or Monday, maybe 6 hours total. I did see my CP on Tuesday and got a smaller shrinker. My calf is still at the same size; I suspect my years of running have turned most of that muscle into gristle so it may not get all that much smaller. Tuesday night was also restless, maybe 4 hours of sleep.

Wednesday evening we had some Big Excitement. I had stopped taking the Lyrica the previous weekend or thereabout but found the phantom pain was becoming more obtrusive. I decided to punt back to the Neurontin and took 200mg before going to bed, hoping it would at least make me a little drowsy so I could get some sleep before I collapsed from fatigue.

I did fall asleep and had a feeling that I was able to separate the phantom pain from myself and at least ignore it for a while. Just after midnight my old cat Little decided she needed to visit the litter box so I had to let her out of the room. Jennifer heard me stumbling about and kindly opened the door to the back porch so Little could have a direct route to her destination.

Jennifer fell back into bed and a short time later Little was ready to resume her evening respite at my side and began her plaintive meows at the door. I let her in and noticed my Blackberry's light blinking and decided to check it...the email was an alert that the server room temperature was rising. Also had an email from my tech Tim who was asking about it. I tried to call/email/text Tim to tell him to go check it out to no avail.

So Jennifer and I had to get up and drive into the office after midnight, open the server room doors and set some fans up, and drive home. What had started to be a good night's sleep turned out to be a stressful evening of little sleep for both Jen and the gimp.

Thursday I barely made it through the workday. I had considered taking it off but my tech's hours have been reduced so I needed to be there in the afternoon. By the time I got home and had dinner I was nodding off on the couch. Jennifer suggested I call it night; I was so tired I wasn't sure I could make it to bed. It took a long time to get ready, I felt like I was moving in slow motion, a fish swimming in thick, murky water.

I slept about ten hours Thursday, woke up groggy, muddled through a half day of work on Friday, then slept about two more hours Friday afternoon.

I missed at least two days of PT because I was just too tired to think much about it. Later on Friday I did a light session and then two sessions on Saturday.

We did go out to eat Saturday night to a nearby Italian restaurant, Souri's. A bit of a chore getting my wheelchair in the door. Food was good but the real attraction turned out to be something, someone else as we were leaving. Bill Murray was having dinner behind us with a larger group. Jennifer stood and was staring - is that Bill Murray? - and I was wheeling out of the restaurant, thinking the man might want his privacy. Turns out he was happy to speak to Jennifer - some comment about not being a robot - and I was the greater fool for not making his aquaintance.

Outside I did talk to the neighbor of Bill's manager, we compared conditions; his being a knee that might not be in good enough shape for a replacement and mine, at least my knee is intact and in good shape.

*******

I have started reading the book "Phantoms in the Brain" by V.S. Ramachandran, MD., Ph.D., and Sandra Blakeslee. The main thing I want more information about is the mirror box. I am going to order one if it appears it might help with my phantom pains. I've written my CP to see if he has any experience or knows someone I can contact locally for help.

If you are considering amputation, I would highly recommend seeing what local resources you have to help you deal with phantom pain, to both prepare for it before the surgery and after. I have yet to talk to an amputee who had no phantom pain so be forewarned. In my experimentation it seems the nerve med and a regular pain killer like oxycodone may help but it is minimal, you can only tell the difference by not using any of it. Higher drug levels when you are in the hospital and under a doctors care will make it seem more tolerable, but once you have to deal with reality you cannot remain in that la-la state. I cannot be dopey and drive and do my job so the suffering continues.

I am tired of the pain and only one thing keeps me going, focused, and as Jen likes to say, eye on the prize.

I will fly again.

Thursday, May 14, 2009

Left Footed Road Warrior

I had a very good week this week, with the only nuisance being the phantom pain that is something like a thorn in the lion's paw. Where is my mouse anyway...? I still have some small spots of blood on my stump shrinker, presently a couple on the right side of the incision. I don't think this is anything to be concerned about, there is no indication of infection. I think I may have banged it a little trying to negotiate the tight turn getting into the company bathroom. Tonight I washed it out and will check it for blood leaks tomorrow. Other than that the stump looks great, very smooth, an amazing reconstructed limb.

I experimented with different ways to get my abbreviated self from the comfort of the couch to the front seat of the Honda. Initially this involved a light plastic chair that I would leave in the Pilot; I would and take it out to sit in as I folded up the wheelchair and tossed it in the cargo area and then crutch around to the driver's seat. This is this gimp's final 2003 Honda Pilot entry procedure.
  1. Pick self up and place in wheelchair
  2. Wheel over to fireplace and get crutches
  3. Cruise into kitchen, obtain lunch from The Jen or forage in bowels of fridge for suitable provisions
  4. Back chair into pantry/laundry room to door out to garage.
  5. Open door, place crutches against wall, open overhead garage door from wall console
  6. Back out into garage over about 3" threshold drop. No Fear!
  7. Grab crutches, and roll out to Pilot, position self parallel to cargo door
  8. Open cargo door, place crutches on corner of bumper, hoist self onto bumper/cargo area
  9. Collapse wheelchair, pick up by rear handles and legrest and place in cargo area
  10. Tilt chair down while shoving it against back seat.
  11. Get self on crutches, close cargo door. Must be careful not to fall down and flounder about
  12. Crutch to driver's door, place self in seat, crutches in passenger seat.
  13. Place stump on console with pillow
  14. Place left foot on accelerator and hi ho it's off to work RB goes
My short dog rests on the console

I have to catch myself from trying to do some things too quickly. I really do not want to fall and delay my progress. I am banking my non-falls to withdraw once I try running again. It will be worth it then as I have a nice soft field for the fall from grace's verticality.

With little fanfare, on Monday I drove myself to work for the first time since my surgery. There are many small goals like this one that keep me focused on journey's end, which will be another beginning with a return to running. I did have one dilemma though...I do not have my temporary handicap placard. This means either I park in a handicap slot and then ask someone to move the SUV or find a suitable regular space and roll up to the handicap ramp.

I decide on the latter as I am fiercely independent (you other rare Americans are nodding, I hear the rattling of heads) and try to do for myself. It all works out, and I successfully arrive at my desk and begin my day "Yes...yes...what's my name? For....your logon? Uh, it's your first name. No problem, it is Monday after all." (Although not word-for-word, this conversation did happen once.)

I find afternoons are more difficult because I am usually in sleep deficit and the phantom pains are more prevalent; I find it hard to get my stump in a comfortable position. It seems to this IT dweeb (a.k.a. dumbass) that my phantom pain may be limited to unhappiness of the deep peroneal nerve. Should this not improve I can ask Dr. Ohlson what we can do to mitigate this single aggravation. It may just take time; I also think once I'm running again that this low-level pain will withdraw to the distance.

I slept very little Monday night and Tuesday seemed to go on forever. In hindsight I should have gone home at lunch but I have a couple of projects that need attention. A fatal error as it turns out.

Our good friend Nancy came by to visit Tuesday night, around here geeks bearing gifts are always welcome and when those gifts are pizza and beer, well, you find the answer to life is not 42. Nancy is a cyclist at heart, a runner when she needs to be, and a swimmer when she has to be. Her nickname is "Nance" for entirely honest reasons.

I had not had a pain pill since the previous evening so I thought it would be okay to enjoy a tasty Sam Adams specialty brew.

(f/x Homer) Mmm....beer.

Towards the last few swills I started feeling remarkably relaxed. My eyelids starting gaining weight faster than Oprah in a donut shop. Whatever the conversation was I nodded when I thought it was appropriate and mumbled a few words that I hoped would pass as subliminal brilliance.

When I woke up my limbs felt heavy (remember Oprah?) and I had that post-nap lethargy that only dead people excel at.

"Wherrresnancyyy?"
"Gone home."
"Whaaa???"
"You fell asleep and were snoring. Baxter (canine cohort) was snoring. You two were snoring and Nancy left and went home."

I had looked forward to Nancy's visit yet her gracious co-host fell asleep and snored her home. I emailed Nancy the next day and she was very gracious in suppressing the snickers. She remains on the A-list and given the pizza and beer gifts, she goes A+.

On Wednesday, or so I remember it being Wednesday, who knows with this lackasleep disease at the helm, I had a trio of random acts of kindness applied to me.

As I was coming into the building the door was propped open with the ashtray post (for the smokers who must do the nasty outside). The door also has a heavy action and requires a little more umph to push open while watching the stump doesn't get smashed. I wheeled through and a woman from the front right office comes out and closes the door. Now I am not certain the door was open for me or if they had delivery or maybe the economy (that is, government created financial ruin) claimed another soul, but when that door closed I applied my newly born Reaganesque optimism and verbalized a thank you.

Later in the morning I got a call from my CP, Larry Wiley. I must admit I was beginning to think I wouldn't hear from him again until after my next doc visit, but here he was on the phone asking how I was and wanting to set up an appointment to see me next week. He mentions there is an upcoming event where I may be able to obtain a high end everyday leg...once I heard this the details went into the fuzz bowl; he has mentioned this might happen before but I've learned to live the old adage, hope for the best but plan for the worst. We will talk about this next week when I see him.

I learned Larry had been in Guate­mala...I did a little searching and found this article of a past visit:

http://tinyurl.com/raowpz

I am neither Catholic nor do I attend church anymore, but I do recognize a good man by his actions and deeds and I am proud to have him helping me.

I have mentioned in the past how caring I've found the O&P community to be. When I got home Wednesday evening, I had a package waiting for me from the Limbs for Life Foundation. Among the items was the book "You're Not Alone," a collection of amputee stories, a DVD, and some information about the foundation. In addition, there was a tee shirt from their fund raising race, the Bricktown Blaze 5k. I donned it and felt a sudden burst of emotion. A race tee. I have not run a race for nearly two years and here I was wearing a race tee for an organization whose sole purpose is to provide "fully functional prosthetic care for individuals who cannot otherwise afford it and raising awareness of the challenges facing amputees."

http://www.limbsforlife.org/assets/templates/limbsforlife/images/header1.jpg

I am hoping I can run their race one year, maybe 2010?

http://www.limbsforlife.org/

Quite a day, nothing I expected but it seemed a little like a Dickens Christmas novel, without the ghosts.

Maybe I should consider the hint.

Maybe I will.



Sunday, May 10, 2009

Mother's Day

I did not get my dry run into work as most of the day it was raining or threatening to rain. That and the fact I stayed up too late, slept late, did my PT then slept most of the afternoon away all dissuaded me from this arduous task. That I was just bone lazy had nothing to do with it.

We did drive over the rivers and through the woods to Mark and Debbie's house for Mother's Day. When we got there I found going up the few steps up into the house was a bit more challenging on crutches with one foot instead of two feet with one encased in an aircast. The bottom steps aren't so bad, but the top step suddenly has a vanishing handrail, only a column for steadying myself. I don't feel very confident, turn around, and take a seat on the porch. My entourage slides a foot stool over for me which I pull up on, recrutch myself and hop into the house and into a comfy chair.

We are listening to "Memory of Running" on the iPod while traveling. We started it a few months ago but haven't taken a trip for several months; with Jennifer toting me to work we cranked it up again. With the overcast skies, the book, and my now pensive mood, I started thinking again about my lost foot. I know, it's strange and morbid but I think about it sometime, that part of me, my body, just tossed away, likely cinders now, and they don't even have cinder tracks anymore.

I promised myself I will find what happened to me, someday, just to know for sure. I do know it is sent to pathology somewhere, and it is likely cremated and disposed of as biohazardous waste. I did read in some cases it can be sent to s funeral home for cremation and burial. I wish I had been at least given that last option.

Tomorrow I will drive myself to work if the weather cooperates. It has been quite dry and our yard needs the water. Jen is doing a good job keeping the plants happy but with everything else she has to do the rain is welcomed in our garden.

Saturday, May 9, 2009

Working stiff

There's been some delay in the blog posts since I started back to work. I thought I might begin with half days, but that immediately went to full time. First, Jennifer would have to come pick me up and take me home; not that she would mind, but a one hour lunch would turn into a two hour taxi ride. Second, it takes me longer to do many things in the wheelchair. I have multiple PCs in my office including a test bed for new machines and testing new technologies like virtualization. A half day hardly gives me time to touch several things I am working on in addition to the daily support issues that arise and need attention.

Once I get home, help feed the pets, change out of office clothes into retirement wear (pajamas), eat dinner, yada yada yada and usually have a pain pill somewhere along the way, the evening is short and my energy levels are at their lowest. I want to update the blog, but whatever creativity I have has taken a hike to nearest bear cave for a long winter's nap. So here it is Saturday and I am reviewing the past week. So that's my excuse for the quiet time; not much should happen until I see Dr. Ohlson on June 10th or so I hope.

*******
Blackface sheep on watch
After my 3 week work hiatus I returned to the hallowed halls of the workplace, where I have managed to spend 26 years of my productive life drawing, designing, sneaking up on coworkers with deadlines late in the evening with a quivering air horn in hand, messing with computer guts, running on my lunch hour, dumping water out of computer guts after Hurricane Hugo, crawling in the attic and dropping network cable, winning $10 betting gold fish cannot not survive being frozen in the company refrigerator, and fond memories of a particular city engineer affectionately known as "Grandfather." I decided in order not to spend the afterlife burning in eternal damnation that I should stop with 99.9% of the practical jokes. The 0.1% keeps the sanity meter centered and is known only to me. In the interest of full disclosure with a duly noted exception, my brother Mark refuses to answer any phone call from me on April 1. Strange boy, Mark.

So on Monday, May 4, the lovely Jennifer, with Baxter the good looking dog riding shotgun on his way to doggie daycare, and yours truly residing in the back seat, set out on our adventure. I am considering repeating "chicken pot, chicken pot, chicken pot piiieee" all the while but recall wise words of discretion and valor and resist the temptation. I had hoped to arrive at work early to avoid seeing anyone until I was at my desk. I didn't want any sort of welcoming committee...I know my appearance is different, but I am the same guy they knew, and any other differences they will not be able to see. The thing is I was not sure how I would react to a formal reception, and didn't want blubbering Richard to show up and steal the show.

I want to repeat what Jennifer tweeted that morning:

Just watched Richard going into work in his wheelchair. Like watching your child go into the building on the 1st day of school.

That was sweet to read that night, but was glad I didn't read it on the elevator or I probably would have had a sopping wet handkerchief.

Building access was a bit of a struggle, at least the handicap ramp was. Jen had to help me up and I am not that weak; the chair wanted to tip backward so I had to shift my weight forward while trying to jack myself up the ramp. The next day I pushed myself up backward so I could use my good leg for propulsion and that worked much better.

The day went quite well; several folks came by to say hi. My foot was not in a happy place and the electrical twitch in the former first metatarsal area was quite strong at times. I still had a pillow left over from my first surgery, and I found if I propped my stump on it I was more comfortable. The pain was a little higher than I had been having; my pain med was almost finished so I knew I wasn't going to get weaned off it quite as soon as I had hoped. I called in for a refill and also asked for a change from Neurontin to Lyrica to see if I could get any relief from the phantom pains.

I found bathroom access to also be a bit of a trial. Our bathrooms are off the lobby with a self-closing door to an inner foyer with additional doors for the bathrooms and equipment rooms. The lobby door has a heavy action and could be difficult for some. The door into the bathroom has lighter action but it's quite difficult for me with the residual limb support arm to get around the door and sinks. A larger chair might have real trouble.

For lunch I had a microwave sandwich, easy to make and I eat it at my desk. I am tired but I really don't want to have Jen drive all the way from downtown to pick me up plus I haven't gotten much done, so I tell her I will stay and I manage to keep my head off the desk for the rest of the day.

The only minor incident I had was entirely my fault. I have two new Dell servers to configure and place in the rack. I will need help picking the servers up and chunking them into their new home, but I figured I could at least install the rack rails which weigh maybe a couple of pounds. I grab the first set of rails for the smaller server, poke them in the front and click them in the back. Good, got the right one. Almost immediately Sharon from the front office steps into the server room and informs me that there's a problem with the phone system.

I look and yes, the Cisco system has done an automatic fallover from it's server to the router; this allows calls to still be sent/received but things like voicemail are not available. I look at the Cisco server and sure enough, it's lights out. I check the power cable (check the physical layer first...geekdom 101) and it is loose...the cable exits the rack enclosure on the bottom to a power strip and I had run over it. Mea culpa! My Cisco engineer had actually warned me about those cables but having two feet at the time I wasn't quite so quick to fix it. Old dog, new tricks, even a dog with an odd number of paws needs to learn a thing or three.

The rest of the week went okay, except for some general fatigue at times. I was not sleeping well because of the phantom pains. When the lights went out and the room got quiet except for a fan to provide some white, the phantom pains grew louder and made it difficult to fall asleep for a couple of hours. Normally if I can't sleep and get up for a while until I get sleepy, but getting out of the room is more noisy with the chair and I don't want to wake the OO or have Baxter give a guard's bark or two before realizing it's just...Him.

My stump is swelling about an inch during the workday, I don't think it is causing any particular pain and it does retreat in the evening once I get it above my heart. (And there's another reason for the delayed blog posts.) My left calf is about 15" and my right is about 13" in the morning. I'm sure it will get smaller as the muscle atrophies. I can fire it a little near the top if I concentrate on it, but I don't think that will help with my running mechanics.

I did take Friday off because I was in such sleep deficit and wanted to doze later than 6 am. I was able to get about 8 hours Thursday night and 10 hours Friday night. Oh, on Wednesday morning I had very little phantom pain; that was almost certainly the result of not doing any PT on Tuesday.

It is Saturday evening as I write this. I did a bit of left footed driving around the hood today after my PT, Jennifer went with me in case I ran over someone and they required assistance. Fortunately for that someone they stayed inside and under the covers so the drive commenced without incident. We talked to the neighbors some afterward; I can tell it's going to take some time before being vertical is going to feel normal in the stump. There is quite a bit of healing going on in the residual limb with the severed nerves leading the riot; unfortunately for them the end is near, about two inches away.

Tomorrow I plan a practice run to the office, complete with getting my wheelchair into the Pilot and myself into the driver's seat without the door closing on my stump, thereby eliciting the profanities I usually reserve for politics. I believe I will be able to drive myself to work next week, and hope I will be able to leave at lunch to allow Baxter to have a moment or two of privacy in the backyard. Also if I fit in an OCD level of The World of Goo while eating lunch I'll be one happy clam.

As I get ready for bed - but not before I post this! - I am having very little phantom pain.

Shhh...let's not wake the dead doggy....

Saturday, May 2, 2009

The OO and I

This is my wife Jennifer and I on Loch Lomond, Scotland, in September 2005. This was quite a dream vacation and other than flight problems leaving the States on US Air - compensated by being changed to British Airways and the best customer service I have experienced in my lifetime of flying.

I mention BA because I am 6'1" (age has shrunk me a wee bit) and along this time my ankle started swelling whenever I sat for a long time. As we slid into our cabin seats the attendant asked if I would like an exit row so I'd have extra room to stretch out a bit. I've never been asked that on any other airline. So I duff me cap to yea, BA!

During my last foot surgery I was less mobile and in more pain than now. Jennifer had to haul my carcass to work and pick me up in the evening for around 6 weeks. I could not tolerate having my foot much below my heart as the pain was excruciating...if you are a Bears fan and lose to Green Bay you know what I mean. She packed my lunch every day, took care of feeding the animals, cleaning the litter box, watering the potted plants, pretty much everything around the house.

This time I am more mobile and able to do things without the level of discomfort I had last time; but there is a physical change that is a bit more obvious to the casual observer. While I was in the aircast I could balance on it a little if needed, with the amputation that is slightly more difficult.

Jennifer had pneumonia back in March and I got the b-strain flu days after she was diagnosed so I couldn't even help her much through her illness. Here I am with my foot cut off - once again gimped up with Mother's Day around the corner - not able, along with the alleged assistance of sous chef brother Mark "The Cleaver" Blalock, provide Mother's Day dinner replete with kitchen cleanup and adult conversation with all moms present. The History and Military Channels are strictly off-limits to affirm the solemnity of the day's events. Most of the time anyway.

The OO, or Omnipotent One, (legendary for her to control of raceday weather for anyone other than herself and kin), a.k.a. Sweetness and Light, takes magnificent care of the Footless Patient, and I am obviously deeply in her debt. I am confident next year I will be up and about without any foot excuse whatsoever, and The Cleaver and I will be back to our Mother's Day tradition.

Tomorrow we restart our back to work routine, but we did make plans and a partial dry run for when I can drive again. That day should come sooner than later; and with a little luck we'll be driving to the races later this year. There's a good chance it will be raining that fine day, but believe me, it will be a good day to run.

Friday, May 1, 2009

May 1 - Phantom in the opera...quiet down front!

Over the past few days I have been weaning myself off my pain med. It has some unpleasant side effects, but let's just say prune juice stock might bring the economy back on its own accord. The med, oxycodone, causes fuzzy thinking, especially when working on the computer and/or trying to do any sort of problem solving. It tends to make you not care about the pain rather than have any sort of local anesthetic effect. Too bad such pain relief can't be localized to the area that is affected, to paraphrase Pink Floyd: 'hey, pain med, leave my brain, liver, and bowels alone!'

Thursday morning after breakfast the phantom sensations bypassed the nuisance stage and drove right off the cliff onto the rocks much to the dismay of the startled driver. My phantom pain is generally where I had pain/discomfort after my first foot surgery; the osteotomies of the first metatarsal and heel and the fifth metatarsal where the peroneal tendon attaches to the bone. I do not feel any phantom pain where I had bone-on-bone contact at the end of the talus. That pain bothered me most prior to the amputation and it's great I feel nothing but air there now.

I believe today's owie increase was caused by the two PT sessions I subjected myself to; specifically, the more the limb is moved vertically the more sensations I have in it.

There is a great deal of information, alternative explanations and research into phantom pain. I believe it is the result of a combination of interrelated systems; the sight and touch senses, the severed nerves, the brain's cortex, and the synapses.

Here are a couple of scientific articles about this phenomenon. The first has a pretty grip on the current understanding of phantom pain:

http://jcienciascognitivas.home.sapo.pt/05-11_vieira.html

I received several articles from one of my very helpful Twitter friends (www.twitter.com) and fellow amputee teal64. Here are a couple:

http://www.apa.org/monitor/jan07/pain.html

http://endthepainproject.org/phantomlimbinfo.html

The articles explain phantom pain as currently understood but only the amputee can describe the physical effect; it does vary but I've not talked to any amputees who say they not had any symptoms.

As I write this I feel that first metatarsal pin site has an electrical twitch turning on and off, stronger and weaker, and the same sensation but a little more numb in the heel. What helps? I've been trying different things like massaging the stump while flexing my left foot. Having a lot of sensory interaction also seems to help; in the hospital where I had more humans running around I don't recall having nearly as much phantom pain as long as the senses were being assaulted by the hue and cry of hospital life.

My plan is to try to tolerate this unpleasantness until I see the doc on June 10. I understand the next few weeks may be the worst for these pains and I should exercise some patience before embarrassing myself, like in those dreams where you are giving a speech only to become enlightened to the fact that tighty whities sans slacks are not the exactly the orator's choice for comfort.

I am taking the drug neurontin specifically for phantom pain relief but unless it is masking an even higher level of discomfort then it appears to be ineffective for me.

Tomorrow I hope to get out of the house with Jennifer and do a little shopping at Target for some PT exercise equipment and maybe have lunch outside at Calder's Buffalo Pub. Can't have a pint on the meds but I haven't been outside for more than an hour in over two weeks and I am in need of fresh air, sunshine, and the healing aroma therapy of pluff mud.

Summertime, and the livin' is easy