I'm Done

Emotionally and physically I am done with this foot.

I don't know how to handle the constant pain and disappointment that the surgery didn't fix it.

I cry every day during or after my exercises because there is no improvement.

Okay, sometimes there's improvement in one area but then another part backslides or starts hurting worse. I feel like we're chasing it but never catching up. It's frustrating.

My physical therapist is baffled. And the past couple of sessions I've gotten the feeling that she is now just going thru the motions. She's not putting much thought into the therapy because nothing is working. And that bothers me too. I don't feel she should just be going thru the motions.

Last Friday, I saw a different therapist because mine was out with her dying father. He is actually the co-founder and co-owner of the business. He took one look at my file and started asking questions and explaining things and really worked me over good. Actually caused a bit of pain with his massaging but it was what my foot needed as it was actually better over the weekend.

It didn't last, but I thought that maybe we were onto something. But then on Monday, it was back to the 'same old, same old' with my regular therapist. Like I said, I think she's mentally done with me. I may have to change clinics to get someone new to look at this with new eyes.

I see the doctor today for a two week followup on my orthotic devices. They're not working at all to alleviate the pain in my toe joint. In fact, the pain is worse I think. Not good. The doctor, too, is frustrated.

I wish I could truly just say "I'm done" and just live with the foot the way it is. But I can't. I have too much pain. If I compensate for the toe pain by walking on the side of my foot, then my tendon starts screaming. If I compensate for the ankle, the the entire leg and hip start hurting.

I'm in a no-win situation right now. I have to go forward but I can't see anywhere to go.

Ribbon Collection

I have inadvertantly started a 'ribbon collection' and even tho it should be inspiring, it's not.

In a previous post I talked about all the loss of family I've endured in the past 12 years (it's a lot!). Part of it comes as just part of life and the age I've reached. You know what I mean -- I'm 52 so many of my extended family are in their 70s and 80s and have/will reach the end of their time here on Earth.

But the big losses are those endured due to before-their-time illness.

And those have ribbons.

The collection started with pink ribbons in honor of my mother.

Then I added a dark green for organ donation in honor of my dad who is no longer with us. He had a kidney transplant.

My brother's and then my nephew's suicide added two yellow ribbons.

Now I've added a pink & blue ribbon for my niece's pregnancy/infant loss.

And a lavender ribbon for general cancer for both my niece and my friend who are both battling rare muscle cancers.

When will in end?

Here We Go Again

Saw the doctor on Tuesday.

She put me back in PT for four more weeks, mostly to try to get rid of the pain I'm having. We are now doing more massage and ionto-something, it uses electrical stimulation to force dexasone (a steroid) into the inflamed area. Got a bit of short-term relief on Friday after my first session so perhaps it'll work.

She also wants me to discontinue my walks and herding training. I can continue to walk but only in my ortho boot. I haven't been walking yet but probably ought to even tho walking in the boot throws my knee and back out of whack. I'm just too fat and I need to get moving to get rid of the excess weight!

The doctor said that we need to be 'aggressively careful' with the ankle. Kind of a funny term but basically we are still doing all my exercises but then babying it the rest of the time, being careful not to stress it too much. She also said that my ankle was 'unique' i.e. strange, weird, not normal. Also LOTS of ice.

Then my orthotics came in and I saw her again on Saturday. After putting them in my shoes and walking a bit, she asked me how they felt. The right foot (the bad one) felt fine. The big toe wasn't sure it liked it but it's sore and bruised from me walking on it while not aligned properly (hence the orthotics). But the left one threw my foot out in weird directions. I mentioned this and the doctor said that she was doing some corrective measures there too as my left foot is in as bad a shape as my right one was and that it's amazing that it hasn't bothered me yet. I'm thinking 'leave well enough alone!' but hopefully this will prevent the other tendon from tearing and not cause other issues. We'll see.

So anyway, I am to 'ease' into the orthotics -- an hour a day for a couple days, then two hours, etc. Weird feeling going from having my feet settle into one position and then to go back to the 'old' way. Hopefully the orthotics will ease the pain in my fused toe joint as that is what I need from them most.

I am now chronicling each day's pain (or lack of) as it seems like each day a different part hurts. I'll tell PT that the toe feels fine and then see the doctor and it's hurting that day so I mention it. Seems like I'm not telling the truth or something. Thus the 'pain diary' will help them see the big picture.

I return to the doctor in two weeks for a followup.

When It Rains . . .

So I imagine many have experienced this, hence the old saying "when it rains, it pours."

I have experienced this first hand several times in my recent past, clusters of bad news or happenings. In my case it's generally death-related.

And it sucks.

This will be a very depressing entry so I don't blame you if you bail on it now, but I have to vent since it's 'raining' again.

My sister's stepson 'started' the first downpour. He drowned while boating with his parents and young family. They were in the Mississippi River swimming when he suddenly said, "Mom, I can't make it" and went under. His little sister was close to him and she tried to get him to hold on to her. For whatever reason, he didn't/couldn't and he drowned, leaving behind a young wife and two baby girls.

I lost my mother to breast cancer August 9, 1999, after a five-year battle. Not that I wasn't prepared for the eventual outcome. Her type of cancer had a 50/50 survival rate and I, being the pessimist that I am, prepared myself mentally for the worst. I always figure if you're prepared for the worst, then good news is always that much better, while the bad news is eased by not smacking you aside the head with a 2 x 4.

My little sister was an optimist during Mom's illness and her eventual death was a blow she's never recovered from. She has cut herself off from her family almost entirely and that's sad. We all miss her so much. She brought so much to our family.

My little brother, too, was greatly affected my our mother's death. She was his lifeline as he was an alcoholic bipolar. He got married the summer before Mom died. We'd hoped that his bride would give him the support and comfort and understanding that Mom was providing. Unfortunately not as she was too immature and selfish. After Mom died, she demanded that he choose his family (and his support system) or her -- he couldn't have both. The lack of family support and the selfishness of his wife created a situation that he couldn't handle.

He committed suicide June 16, 2003, on his 40th birthday after his wife walked out on him in her continuing power struggle to control his life and cut his family out.

Again, not something I was surprised to hear of, his suicide. I'd been preparing for it since he was in his early twenties. He used to call me when he was in a depressed state, drunk and threatening suicide. But he was reaching out as he really didn't want to do it. We'd be on the phone for hours, until he sobered up and got the emotional support he needed. When his wife had him choose, she cut off that emotional support system. And I blame her for his suicide.

My dad had bad kidneys from an illness in his childhood. Just before Mom died, he had surgery to 'install' a shunt for kidney dialysis and he started soon after her funeral. I went to pick him up and go out to dinner with him once a week after his dialysis. Someone had to be with him until it was certain that his arm had clotted off. (He also suffered from blood clots and was on massive doses of blood thinners which caused him to start gushing blood from the needle holes after dialysis.)

In November 2003, he received a kidney transplant. Everyone thought it was a great idea. Everyone but me. Dad went along for the ride and since his heart wasn't committed to it, he fell into depression shortly after the surgery.

A lot of the depression came from the major change in his routine. Dad liked to sleep in -- most days until almost noon. It didn't help that he stayed up 'til all hours watching stuff he'd taped on two different VCRs. We tried to convince him to either not tape so much or to watch it in the daylight hours by getting up earlier. He was like a baby with his days and nights mixed up. His anti-rejection regime required him to get up by 8:00 am and take his 17 pills with food. If he could have just rolled over and taken them with water while staying in bed, he would have been more compliant.

He also didn't want anyone helping him except 'his girls'. Well, his girls had families, jobs, and a life besides daddy. We tried several times to get someone to clean his house. He managed to make them all quit within a month. We tried to get home health care CNAs in to help him bathe and do his therapy. Nope, no good. I'm sorry, but bathing my father just wasn't a comfortable thing to do. He didn't want his friends coming over to visit. He didn't want to go out to eat with them or go to the theater. He didn't want to cook for himself. It was a mess.

In February, 2004, he suffered a brain bleed. That's what they called it. Never classified it as a stroke or anything like that. It was my day to spend with him and I found a cop and my brother-in-law with him in his living room. He was having trouble recalling things like phone numbers or the emergency call button on the necklace he wore.

He went into the hospital and sunk into a coma for over two weeks. Several times we thought we were going to lose him but since he didn't have a DNR on file, they did everything to save him. My sister, the RN, had his medical power of attorney but she couldn't let him go. They inserted a gastric feeding tube that he promptly and continually pulled out when he finally regain consciousness.

But he wasn't the same man. The bleeding in his brain caused major brain damage. He could no longer communicate. He couldn't swallow to eat. He had to wear a diaper because he had no control over his bodily functions. He couldn't walk and could barely sit up. If his brain was at all aware of his surroundings and of what he couldn't do, he was in Hell. We had to put him in a nursing facility after the hospital would no longer keep him.

That was his worst fear -- being in a nursing home. Thankfully, he didn't last long. He died one morning alone in a hallway in his wheelchair. That was May, 2004.

In the midst of my dad's illness, my 'heart dog' Samantha Jo, my first border collie was diagnosed with lymphosarcoma in February 2004. I decided against chemo for her on various grounds and the prognosis was maybe three months. I got lucky and got almost seven. She suffered a grand mal seizure just before midnight and we put her down early September 2nd. She was not even 8 years old.

Then Labor Day weekend, 2006, my 17 year old nephew came home from school and instead of going to work killed himself in his home. His sister found him. He suffered from depression but seemed to have had a great weekend, going to a Cubs game with his mom and stepdad and then watching his Bears play a preseason game with his dad. No one saw it coming.

Then the rain went away for a while.

But in February of 2008, my niece was diagnosed with a very rare muscle cancer. And rare cancers have a very poor prognosis. She had surgery to remove the mass and surrounding muscle in her leg on August 11th, the anniversary of Mom's funeral. This past June, the cancer returned in her lung. Fortunately they were able to remove it.

Her twin sister (identical) suffered a miscarriage at 10 weeks, and has just suffered another, only this time at 20 weeks. She had to actually deliver the baby. She almost died from complications and is now suffering the loss of her daughter and the possibility that she'll never carry a baby to term. The worst is that it seems that it's her own body that is killing her babies. She has a uterine defect that doesn't allow the placenta to attach firmly enough for blood flow to the fetus. She is very distraught.

And now her twin sister has just been told that she once again has cancer in her lungs, only this time it is inoperable. Her oncologist (cold bastard that he is) came into her hospital room and told her that she should go home and prepare to die, that any experimental treatment that she had been considering was a waste of time. She is only 30 years old.

And now my friend also has a rare muscle cancer and no family support system as she is an only child with only a 90 year old mother. I'm not sure I can go thru another round with cancer, especially another one with a poor prognosis.

God help her, my nieces, my brother, my family, me.

When ir rains, it pours.

Getting Back to "Normal"

So I potentially had my last PT appointment on Friday.

My range of motion is about the same in both ankles and my strength is excellent except when pushing outward against resistance. That is where it still aches after I use it a lot.

The big toe and its fused joint is still swollen, but I am told that may take up to six months or more to reduce. The other toes are nice and slim, thank you very much.

There is still swelling at my heel, both in the back and the outside, and I have a lot of pain in that same area. It feels like I am ripping the tendon when I use it and I am back to short-gaiting since I cannot do a full stride with the roll since it stretches the tendon causing the ripping, tearing pain.

Non-weight bearing the ankle is pretty good. I can rotate it in all directions and do my strengthening exercises with little discomfort and that is only in one exercise. But when I put my (formidable, I admit) weight on it and try to stretch or strengthen I have problems.

I have lost a lot of the range of stretch on the slant board. This is a board set at a 30 degree slant. With my knee straight, I can do all the stretches -- toes forward, toes outward, toes inward. But bend the knee and I can barely get an angle on the ankle. It has really gone into a back-slide of progress.

When I see the doctor next, we'll see what she has to recommend. Probably will have me continue on my own with the at-home exercise program instead of sending me back to PT as there is really nothing more they can do for me as far as pain relief.  Unfortunately I am still having quite a bit of pain upon use of the ankle and the new drug she gave me is totally unhelpful and even the prescription Motrin that used to help is no longer helping much.

I have increased my daily walks with the dogs to twice a day, so I am now getting a mile under my belt, so to speak. It's still at a pretty slow pace, but I am working on the mechanics of properly walking still. The dogs love that we get to walk again.

I am also back to doing herding training with my younger border collie about three times a week. Luckily, I don't have to do a lot of walking on uneven ground with her anymore, but just enough to work the ankle. And of course, I pay for that in the evenings and need to ice the ankle and rest it.

Yesterday, I scooped the dog poop in the yard (which I've been doing about twice a week for the past couple weeks) and then mowed the yard! That's the first time I've done yardwork since before the surgery. Mike didn't take the care I do when he mowed the yard. It just looked sloppy and unkempt all summer. But now, even tho the crabgrass is brown and leaves the yard spotty looking, everything is even and it looks great. Another check on my list back to 'normality'. Next spring I have a bunch of work to do to get the grass back and the weeds and crabgrass gone. But that's for next spring.

I am not happy with the level of discomfort/pain that I endure on a regular basis. Flare ups after heavy use I expect, but if this constant pain is my new normal I might as well not have had the surgery done. It's about the same in the ankle as before the surgery.

Altho . . . the toe joint that had all the arthritis in it is much less painful. More stiff than painful and it is getting better. So I guess the surgery was good for that.

Doctor appointment on Tuesday. We'll see what she says.

OUCH!

That is on so many levels.

I finally caved in and called the doctor about my ingrown nail. On Thursday, she removed the edge of the nail and cleaned out the infection. There was about a quarter inch of nail buried in the flesh. No wonder it hurt! She was amazed at how much there was and yet I hadn't come in sooner. In fact, she pulled out the edge of the nail and started cleaning the infection and found another piece. Then another. And another. There was a LOT of nail buried in my toe. It should feel much better now.

I'm doing Epsom salt soaks twice a day and bandaging it. It feels better to walk on, but is still oozing blood onto my sock after I have had it in the shoe and walking on it. Guess that is to be expected.

But then yesterday after I came home from my Girls' Lunch date, it was aching to the point that I wasn't wanting to put weight on it. It didn't feel any better after I soaked it. And when I got up in the middle of the night, it was pretty ouchy and had oozed more onto my sock. This morning it is still sore and tender. Hm.

I have added a 20 minute half mile walk to my exercises. I am hoping to up it to twice a day but right now my ankle and tendon start screaming at me about an hour or so after I walk. If it subsided by the time I wanted to walk again, I'd do it, but it hasn't so I don't.

Funny how it doesn't hurt while I'm doing the exercise, only afterwards. It makes it hard to determine if I'm doing too much while exercising. This is the same problem I had with the previous two rehabilitations.

I am on a new pain pill that is marketed for arthritis and is a 12 hour dosing. The doctor is so worried about me taking a pill or two as I need it. I prefer the ibuprofen as I take only when needed and can reassess whether I need to take another one. Usually it's just the one or two a day. But this 12 hour dose doesn't give me that option (or at least not as rapidly). She wants me to take two a day for a month, and then the next month one a day, and then go off it. That's fine I guess but I'm not getting the pain relief that I get from the ibuprofen. I'll give it until I see her again, but if I'm not happy with it, I'll get a refill on my ibuprofen (or take massive doses of the OTC form). I just prefer the "as needed" flexibility of the shorter dosage.

The reason I'm adding the walks is that I find my knees, legs, and ankles are still fairly weak. Guess the "use 'em or lose 'em" axiom is correct. So I am using them. I have a dog show in less than three weeks that I want to show my dog in and I have to be able to do at least a slow jog around the ring probably twice, if not more. Plus I agreed to handle a friend's dogs, so that is several jogging requirements. I can do about four steps right now. So I am building up my legs back to where they were before the surgery.

It'll help to get rid of this extra weight I put on durning my down time this summer, too.

So my main issue I think is that the tendon still screams when I use it over the usual about-the-house walking I do. It tightens up, but rest and stretching exercises cures that. Rest cures the screaming, too, but I can't see living my life gimping about for several hours after I use it for just 20 minutes.

I'll discuss this with the PT people tomorrow and with the doctor when I see her again.