Sunday, October 14, 2007

Two steps forward, One step back - Oct 14

Last Wednesday, I went to my second outpatient physical therapy appointment. I like my PT, whose name is Amy. She is exuberant and positive about my progress. She also spends time talking to me as a person, not just as an injured leg. Because the Orthopedist prescribed full weight bearing, she has worked with me on standing and walking.

One immediate priority was to find footwear. My Berkenstocks did a tolerable job of containing my foot. Unfortunately, the straps pressed into my pitting edema. (Pitting edema is the congealed swelling in my foot and ankle. It has turned waxy, and can be moved around under the skin. Herein lies my latest party trick; I can press my finger into my ankle leaving a deep depression much as one might do in soft wax). The sandals also made it hard to practice the normal movements of walking.

On the way up to Maine (to pick up the pooches at Melissa's parents house), we stopped in Freeport at the L.L. Bean mothership store. A very eager and sympathetic saleswoman helped me out. She empathized and told me about her three toe surgeries. She was a thin Southern woman with big, round eyeglass frames. After a myriad of unsuccessful attempts, we found a shoe that fit me and allowed me to practice walking. I am now the proud owner of some size 11, 4E New Balance sneakers. Essentially, I live in a double-wide.

The two steps forward part is this:
I found that I could bear more weight with the shoes. In Maine last weekend, I walked a quarter mile loop around Melissa's house, including a portion along a trail in a field. (A quarter mile isn't that long - think high school track). A few days ago, I walked in and out of MGH to go to my physical therapy appointment. I walked in and out of the mall to deliver my haywire MacBook to the Apple Store. I walked with Melissa and the dogs in Forest Hills Cemetery, an exquisite green space for walking and contemplation. The more I tried to put weight on my foot, the more I felt like I was handling it.

Then one step back:
That evening, my ankle throbbed and throbbed. Melissa tells me that I groaned a lot in my sleep. When I tried to walk on it the next day, I could hardly manage slight weight bearing. I have spent the last few days sitting in bed. Making the journey to the bathroom felt like the limit of my endurance.

The psychological journey was much longer than any of the walks that I took. When I was able to stand and walk on my foot, I felt so hopeful. My mind quickly skipped to the future and extrapolated a quick recovery. The world was bright and sunny.

Then, the pain in my ankle coincided with a few overcast, rainy days in Boston. The outlook of the world seemed grim. I was sure that I had done inexorable damage to my ankle. There was a discrepancy in professional opinion between the orthopedist in Colorado and the one in Massachusetts. The CO doc didn't want me weight bearing until 10 weeks (mid-October); he was concerned that my ankle had been compromised. Please tell me I'm not the only one who jumps to the worst conclusion. Has anyone else had a passing pain in their chest and assumed that a major artery was blocked? Has anyone experienced back pain and assumed slipped disc or worse? Not that those worst case fears overwhelm me; they're just the first messages to flash on the screen.

I am happy to say that my outlook has swung back to the middle. I spoke to both orthopedists (in CO and MA). It turns out that the discrepancy in opinion is not as large as I had interpreted. I have not done damage to my ankle; I simply pushed a little farther than I was ready for (which is what Mark's do best). Today, I have been able to put more weight on my foot again, and the gap between my current function and hiking a mountain is a little less vast.


Bones said...

Sooooo, how is the bone union going?

Had a friend who thrashed his hip two years ago, going on three years in crutches...but lucky to be alive. I was following his blog about some travels in Chile, where, he tried to convince his doctor in Colorado that he should be able to ski in Chile....., needless to say, she said no. Take it slow cowboy!

Nathan said...

Dude, pushing yourself and then feeling pain and wondering if you've damaged something is so incredibly normal... I remember rehabbing after knee surgery. I'd push myself really hard and then feel a pull in my hamstring or a popping in the joint (followed by pain and maybe even swelling) and I was sure I had injured it again. Probably the worst thing is to feel badly for your enthusiasm about those moments of strength. Take it easy, sure. But when you feel like putting some pressure on, roll with that too! You've got to feel the normal swells and valleys of life.