Excuse Me as I Quote Kobe Bryant

Last Friday LA Laker Kobe Bryant stepped wrong on the basketball court and ruptured his achilles. Twenty-four hours later he was in surgery, but not before a 3:30 am Facebook post.

This is such BS! All the training and sacrifice just flew out the window with one step that I've done millions of times! The frustration is unbearable. The anger is rage. Why the hell did this happen?!? Makes no damn sense. Now I'm supposed to come back from this and be the same player Or better at 35?!? How in the world am I supposed to do that??

I have NO CLUE. Do I have the consistent will to overcome this thing? Maybe I should break out the rocking chair and reminisce on the career that was. Maybe this is how my book ends. Maybe Father Time has defeated me...Then again maybe not! It's 3:30am, my foot feels like dead weight, my head is spinning from the pain meds and I'm wide awake. Forgive my Venting but what's the purpose of social media if I won't bring it to you Real No Image?? Feels good to vent, let it out. To feel as if THIS is the WORST thing EVER! Because After ALL the venting, a real perspective sets in. There are far greater issues/challenges in the world then a torn achilles. Stop feeling sorry for yourself, find the silver lining and get to work with the same belief, same drive and same conviction as ever.

One day, the beginning of a new career journey will commence. Today is NOT that day.

"If you see me in a fight with a bear, prey for the bear". Ive always loved that quote. Thats "mamba mentality" we don't quit, we don't cower, we don't run. We endure and conquer.

I know it's a long post but I'm Facebook Venting LOL. Maybe now I can actually get some sleep and be excited for surgery tomorrow. First step of a new challenge.

As a professional athlete Bryant reached this "what now" moment a bit faster then I did. I believed Dr. Hubbard, my first surgeon, when he said I would be back to normal in 6 months. I went into that first surgery grateful that, after almost a year, the pain would stop. Excited that I would be back to normal, able to get back to travelling and taking longer assignments without having to work through pain and ice and elevate every night and pray I could walk the next morning.

Fifteen months and a second surgery later and I'm having to relearn how to walk properly and wondering if the neuropathy is permanent. Not to mention that even if I can finally walk normally without pain, my career is basically non-existent and I am back to starting from the beginning, or having to move in a new direction. Unfortunately, unlike Bryant, I don't have years of 8-figure salaries behind me. At this point I'm just hoping my insurance will agree with my physical therapist on how many more sessions I need.

As a friend pointed out, after two years and two surgeries, I could practically write a book on the subject. Here are a few of my top tips for Bryant and others:

1. Make sure you have a good rapport with your surgeon. You are trusting them with your life and future. If something does go wrong, like you can't feel your toes, you want a surgeon that takes your concerns seriously and is more concerned with responding to your needs then making a magazines top doctors list. A sense of humor and self awareness are also important - I will never again trust another surgeon who can't laugh at himself, or gets paranoid when I mention I have a surgery blog.

2. Know your body and fight when something doesn't feel right. If number 1 is covered you shouldn't have to fight. Within four days of my first surgery I questioned why I wasn't feeling my toes. My doctor kept putting off my concerns until I told him I was going to see a neurologist, at which point he tried to steer me to his choice. The anesthesiologist later said he should have been notified by the surgeon the first time I made the complaint.

3. Find a really good physical therapist with a sense of humor. All therapists are not made equal and the number of years experience does not mean they are right for you. I had originally chosen a larger PT practice in a neighborhood hospital believing that it would be better equipped and have excellent staff, then I had the opportunity to work with a private practice therapist in a one-on-one setting, now I am back to a larger group setting, but linked to a specialized hospital. At the first center I had to push to see one therapist consistently - they were happy scheduling me with whoever was available. This was both a help and a hindrance - a new therapist didn't know my progress level, but might have a new exercise that I found helpful. Having Christine be solely focused on me for an hour was great, both for pushing me and ensuring I was doing the exercises correctly. Also helped that she specialized in feet. So, by the time the second surgery arrived I knew to ask for recommendations beyond the list the hospital provides. I'm even getting used to the hour-plus commute each way to see Bob twice a week, and I have begun to train yet another set of Starbucks baristas on how to make my chai.

As for a sense of humor, if they are doing their job you are going to find yourself wanting to kick your therapist - the movement of my right foot has become a very good indicator of how much pain my left is in. They need to know how to keep you motivated and engaged.

4. You are going to feel stupid and frustrated. Warn your family and friends. Things that were easy last week may not be easy again for awhile. After my first surgery I found myself afraid of my shower - one leg, water and rubber-tipped crutches, not a great combination. Simple household chores become herculean tasks on crutches or knee walker. And later you will get frustrated that physical therapy is not progressing as quickly as you want. (Don't actually kick your physical therapist.) Some of that frustration can and will spill over into your personal relationships. You don't mean it to, and you feel bad when it does, but your life has taken a sudden turn you did not expect and it's not just 3 am when those scared thoughts creep into your brain.

5. Keep perspective. Whether you are a pro-athlete, photographer or work in an office you are going to spend a lot of time focused on you, your foot and getting better. For those of us who can't work while we recover it becomes easier to isolate and fixate on yourself and your recovery. Think about doing some volunteer work, I met some amazing veterans overcoming huge challenges who reminded me in the grand scheme of things my achilles is nothing. Have you ever wanted to try painting or writing? You have a chunk of time between weaning yourself off the pain meds and the splint being removed. Later, even with daily PT, there is going to be some time to fill. The perfect time to try a new hobby. Have you ever thought about playing the bassoon?

6. Be willing to ask for help. That is still the hardest one for me. I have always been stubbornly independent. Even asking a neighbor to take my recycling to the basement, or get my mail is hard. So, while I say understand that things are suddenly difficult and it is okay to accept the help being offered by friends and family, I know that gracefully giving in to the need for those offers of assistance is not easy. Also understand for some, those offers are their way of saying they care about you.

7. Know this too shall pass. Yes, I have been dealing with this for two years, but my challenges have been different over those years. And as I have dealt with each issue I have learned something new. There may be life-long repercussions from the tear, and for me from the neuropathy. But right now, I'm in a better place then I was a year ago. Who knows where I will be a year from now. I will not be the same person who was looking through her lens instead of her feet that I was two years ago, but in some ways I'm not sure that's a bad thing. To quote Emerson "Life is a journey, not a destination."

   

24 Degrees

Did my first exercise on a Power Plate vibrating platform. Not a fan! Had to keep my chin rolled down to my chest or the vibrations were overwhelming to my head. But after doing three sets of thirty second stretches on it, Bob was able to measure my dorsiflexion (how far I can bend my ankle towards my toes) at 24 degrees. Since before my surgery I couldn't get my ankle to neutral (zero degrees) this is a great improvement. Now if I can get my walking gait better.

Still having pain through the inside of my ankle and Bob found a muscle knot in my calf today that almost got him kicked when he tried to massage it. Still not good at standing on my toes, but found going up on my toes on the leg press noticeably easier today.

After PT it was off, through the building maze, to see Dr. Ellis. He seemed very pleased with my progress and thought I would be a new person by the time I see him again in six weeks. He said Dr. Shetty had called to talk to him about my neuropathy and I told him about my EMG later this month. He gave me a new PT prescription and I gave him triple chocolate, double toffee cookies - seemed like a fair trade.

Touch Your Toes

It has been just over four weeks since my surgery. It feels like longer! At least I am in matching sneakers, not something I had attained a month after my first surgery.

Because of my schedule I am having PT every third day for two weeks - Tuesday and Friday last week, Monday and Thursday this. Probably a good thing. Still having a struggle on the leg press and Bob added new stretches yesterday that had my right calf protesting. He also has me working on my hip strength as he noticed I'm doing a bit of a swivel when I try to climb stairs foot over foot. I swear by the time I finish one round of home exercises it's time to start the next. On my own I have added practicing stairs on the three steps between the elevator and my apartment.

On a happier note the swelling in my left foot has gone down enough that I could wear my red polka-dot Keds this weekend. They add a bit of whimsy and garnered a few compliments.

Still battling the disassociation with my foot, though since starting with Bob I have some signs that I might be regaining some feeling in my big toe. Instead of just looking at it, Bob has recommended touching it. He said sensory input from fingers may help my brain. So when I put on the Topricin, I also feel my foot, explore my toes and heel. So far I've learned I need to get a pumice stone and work on removing some dead skin.

I have to say that getting up has become significantly easier. Before this surgery I would lie in bed and worry about how long it was going to take for me to feel secure walking. I would stand up and windmill my arms as I tried to get my left foot to flex enough to allow me to stand. Now I can just get up without having to over think it - my only worry that my slippers will slide on the wood floor before I have full weight on them.

I feel like if I could just get my talus (ankle bone) to pop back into proper alignment every thing else would be fixed. I have to assume Bob agrees, or he just like pulling on my foot.

Basically, I went to Dr. Hubbard to fix one problem and he left me with a myriad of others. Because of the neuropathy and the achilles tightening I rolled my foot out to the side which tightened the tendon on the inside of my ankle and partially tore the peroneus brevis tendon on the outside of my ankle, and allowed my talus to shift locking my ankle. All of which Bob, Dr. Ellis, Dr. Shetty and I now have to fix.

Remind me again why hitting people with my cane is bad?!

Grunting Through the Easy Stuff

Stand on your toes. Go ahead, I'll wait. You can even hold on to the couch or wall. Should be fairly easy.

Not for me.

Had physical therapy today. I learned that Bob has very strong hands as he gripped my ankle and worked on manipulating my bones. Then he had me roll my foot, like I would when taking a step. Ouch. But nothing compared to what came a bit later.

Then it was time for standing on my toes. I found myself throwing almost all my weight to the right foot. Bob decided that wasn't hard enough, so he asked me to only use my left foot. That did not work, so we moved to the leg press and tried it there.

Using both feet, with my right doing most of the work, I could press 50 pounds up on my toes and then  let my heel flex beyond the bottom of the foot brace. He had to remove all the weight before I could use just my left foot, and then I felt like I was pressing 500 pounds just to get my foot to move less than an inch. I found myself wanting to grunt like Maria Sharapova during a Grand Slam tournament. I also felt a bit pathetic, that something that should be so simple as standing on your toes is absolutely beyond me at the moment.

By the time I got home after 2 subways, 2 buses and a combined 11 blocks of walking (that was just after I left HSS), all I wanted was to put my feet up for a bit. When I got back up a but later my ankle was so stiff it hurt to flex to neutral. And I am expected to abuse myself with these and 10 other exercises five times a day!

I just keep repeating the mantra that this will be worth all the pain!

Dr. Shetty, my neurologist, called yesterday and agrees with Bob that I may have had the lack of feeling in my heel before this surgery, but because I was not walking properly I did not notice. No suggestions on how to handle the disassociation I am still having with my foot. She did order another EMG - now scheduled for late April, just shy of a year after the first one.

Someone asked me today what to do if the feeling never comes back. I don't know. I'm trying not to think like that. Hoping a positive outlook will produce a positive result. Originally everyone - Dr. Hubbard, Dr. Tsai, Dr. Shetty - kept telling me the feeling should come back in a year. It's now been 14 months and Dr. Shetty (the only one of the doctors I am still in contact with) says it could be 18 months. I couldn't find any information on the Neuropathy Association website. Seems they tend to focus on illness related neuropathy.

I have to push it back or the fear of never being able to walk normally again will overwhelm me. Bad enough that Bob has ordered me to keep the cane until my gait is a bit better - especially when my cops keep telling me I will be arrested if I start hitting people with it.

Right now it's time to do more stretches!

PT Drama and New Shoes

Today was my first appointment with my new Physical Therapist. Bob was recommended by both Dr. Ellis and Mark (my pre-surgical PT). He has over 20 years experience with a focus on feet and seems to also have experience with nerve issues.

Had a minor bit of drama at the beginning of my appointment when the therapist I had seen on my last two sessions wanted to know why I wasn't seeing him and implied that since he had done my initial evaluation I was supposed to be his patient. How does one nicely say that he was a place-holder until Bob returned from vacation and had he been the therapist I was assigned to, I'm not sure we would have been a good fit?

Nothing against the first PT, I am sure he is very competent, but he had me doing a few minor exercises like rolling my ankle, pointing and flexing my foot, and using a dog leash to pull my foot and stretch my calf - all without weight bearing. They are all good basic exercises, but he also talked about taking it slow and not doing anything more strenuous then the bicycle until the swelling in my ankle had dissipated. In contrast, Bob jumped in with two new floor stretches as well as two new bed stretches specifically designed to remind my nerves they go all the way down to my foot. He's pushing me to run through the routine at least 5 times a day.

Bob is doing what I really wanted and needed, which is treating me like one of their athlete patients. Though it was a bit disheartening to hear him say it could still be months before I would be discharged from PT. After two years, two surgeries and too many physical therapists to name, I am getting tired of the whole process!

The only complaint I have is the same one I had with Carlos, but hadn't realized until I saw Christine. Because it is a large facility the therapists see more than one patient at a time - though this seems to be two at a time as opposed to Carlos' schedule of four. But it still means the PT is jumping between patients, meaning both that my appointment doesn't begin on time (Bob didn't come get me from the waiting room until 15 minutes after my scheduled start) and that I am left alone to run through a set of exercises and then twiddle my thumbs until the therapist returns.

On the plus side, Bob could push my foot past neutral today. In fact, when Bob pushed, my left foot flexed further then my right could on it's own. He also said my heel pain, recurrent blister and calf cramps are from my foot having spent so long in the equine position - and that the pain is likely to get worse as I begin wearing sneakers full time this weekend. I am now trying coconut water to help with the cramps.

After PT I did something I haven't done in a very long time - I went shoe shopping! Admittedly it was for sneakers, but beggars and all that. Earlier this week it occurred to me that all my sneakers (by all I mean my two, possibly three, pairs) are designed for walking or cross-training, and as such they have built-in heel lifts. So today I spoke to Steve, Dr. Ellis' PA, and confirmed I needed flat sneakers - Bob actually recommended earth shoes, but not until I'm a bit further along. So I went to DSW and picked up a pair of red polka-dot Keds and gray Roxy Castaway high tops.

The negative of moving from air-cast boot to sneaker is that my walking speed - already fairly slow - will, for  awhile, become sloth-like. Always something to look forward to!

CRAMPS

Around 3:00 am I began to wake up and started to turn over when I was brought wide awake by a giant cramp in my left calf. I could not seem to move my foot in any way to lessen the pain. Finally it began to pass and I started to straiten my leg, which started everything up again. It took about 5 minutes for the cramps to finally subside. I kept my knee bent at an odd angle and finally fell asleep.

Then this morning, as I straitened my leg to prepare to get up, the cramps returned. This time, just relaxing after the first cramp caused a second. Later, trying to do my morning stretching exercises caused another round of cramps - needless to say, I did nit finish them.

Even just sitting here, I feel twinges as if my calf muscles are just waiting for an excuse.

The Psychology of Neuropathy

When the nurse removed the splint yesterday I remember looking at my foot and thinking it looked wrong. I knew it was my foot and yet felt disconnected to it. Then as I mentioned, when I felt my ankle and discovered the lack of nerve response I wanted to cry.

The disconnect continued when I removed the boot to go to bed last night. I again stared at my foot and even took cell phone photo of it.

But I felt like I had no connection to it. Later in bed, I tried to position my foot in neutral. When I looked down I could see the angle of my foot, but when I closed my eyes I couldn't have said where on the bed my foot was and if pushed would have said my toes were down almost in a ballet en pointe position. 

While the pain was less this morning, the psychological component was still there as was the lack of sensation, leading to a very nervous shower. I felt safer in the air-cast boot, as I knew my foot was tightly encased. 

With this worry in mind I played phone tag with my neurologist this morning while having my physical therapy evaluation. I also did some internet research when I got home, but could not find any articles or abstracts dealing with psychological disconnect and neuropathy. But it feels like it should be related, especially as my sciatic axonal neuropathy presents with hyposthesia (loss / lack of sensation). I will try to talk to Dr. Shetty when she gets back from her conference, especially if this emotional component continues. Just what I need, new and strange foot issues!

On the positive side, I was able to get around in the boot with just my cane while outside and no support in my apartment. I even took a bus and subway home from PT (the return of my sociology study of who offers me a seat on mass transit); stopped at Target to pick up a few items; and was able to walk the six blocks home - albeit slowly. 

The physical therapist sent me home with simple stretch exercises, though he seemed loath to start pushing me to stretch while standing until next week. Did tell me to bring a left sneaker to my next appointment. 

Relatively quiet weekend ahead as I try to balance my need to stretch and move with not over exerting myself and doing more harm than good. 

In Theory

I hurt! In theory I wanted the splint gone and with it the knee-walker. In actuality, I was very happy to cheat and use the knee walker for a few minutes this evening to feed the cats.

My foot and ankle hurt, my calf hurts, even my hands hurt. But as I explained to the guys who drove me home when I had the cab drop me off at Barclays Center so I could stop at Starbucks, I am supposed to be putting weight on the foot and walking. Heck, I even start physical therapy tomorrow.

The FDR Drive had surprisingly light traffic and I arrived at Dr. Ellis' office about 20 minutes early. I had assumed he would be running late, so I packed lots to keep me busy. Decided to finally start reading the Time Magazine cover story on health care in America. That became a bit ironic when he sent me for a sonogram to check for a blood-clot. The one amusing spot of my wait was trying to figure out why the young woman opposite me thought wearing 5" (maybe 6") platform ankle boots was appropriate for an appointment with a foot surgeon.

The nurse removed my splint and I found my self tearing up in fear. Even with the general anesthesia and the minimally invasive surgery, I couldn't feel my ankle when I touched it. And later when Dr. Ellis had me stand on my bare foot I felt like the floors were all slanted as I could not feel my heel. (I will call Dr. Shetty, my neurologist, in the morning,)

Dr. Ellis wants me up and moving ASAP to ensure that the achilles does not have a chance to tighten again. It was a bit disconcerting to hear him say he basically ruptured the tendon. He again described putting in the cuts and forcing my foot to neutral. And today when it was out of the splint I noticed it wanted to curl in and did not like when he pushed the ankle to a ninety degree angle from my leg. As I mentioned he had me stand and put as much weight as I could tolerate on my left foot and work on bending my knee.

Dr. E says stretching is my top priority. He wants me working on the foam angle in my bare feet tonight and starting physical therapy three times a week as soon as possible. Since no billionaires decided they needed an unlimited supply of triple chocolate double toffee cookies, I am starting PT at the HSS rehab center tomorrow morning. My pre-surgical in-hospital physical therapist had recommended someone in that center who supposedly has 20 years experience specializing in feet. He is on vacation, but I should be able to start with him as soon as he returns. In the meantime, I have an evaluation with someone else at the practice. Not looking forward to my long commute (car service tomorrow, but eventually one to two subways and a bus each way) three days a week, but, if at the end I can walk, it will all be worth it.

Dr. Ellis is pushing me forward quickly. I only get the air-cast boot for a week before he wants me in sneakers and I see him again in three weeks. Since the pads of my hands hurt from gripping my crutches tightly, both before and after I was allowed to put weight on my left foot, that seems like a herculean challenge. I'm just trying to figure out if I can get to and from PT tomorrow with just my cane.

For now it's all about putting one foot in front of the other. 

Achilles Seeks PT Sugar Daddy

I spent the weekend talking myself out of texting my last Physical Therapist. While I was sure my saying thank you would be appreciated, I didn't think interrupting her weekend was the best way to do it.

"Physical therapy is important" is a phrase I have heard from both of my current surgeons and my neurologist. My neurologist adds "especially for you," referring to my neuropathy and the hope that proper PT will help my nerves reconnect to my brain.

I am aware of how important physical therapy, and the right physical therapist, is to recovery. After all it was a year ago this week that Dr. Hubbard put me in a cast for 11 days after I possibly pulled my achilles seven weeks after my first surgery, when my physical therapist at the time had me use the BAPS board. After my knee surgery, my recovery improved greatly when I changed physical therapists.

Six months after my first achilles surgery my health insurance stopped paying for physical therapy, saying they  didn't see improvement. After my open letter to Beth Israel, the hospital began to cover the cost of my PT. Eventually Dr. Hubbard recommended I see a physical therapist who had worked at Beth Israel before starting her own practice. I only saw Christine for two months, but discovered having a therapist who specialized in feet and spent an hour one-on-one was very beneficial. I didn't even mind traveling to midtown twice a week and had finally trained the local Starbucks baristas on how to make my Chai. I will never know if seeing her from the start could have saved me from Achilles 2.0, but she was the therapist I wanted to text this weekend as I began to realize how important the strength and balance exercises she ran me through were helping me maneuver through my daily activities in the week after my surgery.

I was hoping to return to Christine for my physical therapy after this surgery, until my insurance shot down that idea. Which is where my need for a Sugar Daddy comes in. Christine does not take my insurance and my insurance will not cover any of the cost if I go out of network. I could argue that Beth Israel should continue to pay, since some of my need for physical therapy is still related to my neuropathy, but I'm not sure that is a fight I would win outside a courtroom.

I realize that much as I liked Carlos, I need a therapist who has a real focus on feet and achilles and someone who will work with me without getting pulled to other patients during my appointment. Ideally, I want that person to be Christine, but simply can not do math that allows me to spend $400 - $600 a week and feed the cats or myself.

I am hoping that when I see Dr. Ellis tomorrow he will let me exchange this hot, annoying splint for an air-cast boot and some walking around. If so, we will discuss my return to physical therapy.

If it ups the incentive, for the money to see Christine, I'll bake at your beck and call.

Is WebMD a Bad Invention?

Been trying to decide since 9:30 pm last night if I should call the Resident on call and ask if they think I have a blood clot in my calf.

I have had some localized pain in my calf for the last two days and last night had a horrifically bad cramp (not fun when you can't move your ankle or massage your calf muscle). I did manage to get my fingers an inch or so down the back of my splint and my calf felt hot.

All of these can be explained away by surgery and being in a splint, or according to the internet, be symptoms of a blood clot in my calf. With no way to do a physical inspection I can't tell if my calf is more swollen then the first few day post-surgery, or how the skin color looks.

I also discovered that I am on less Lovenox then I was last surgery (Blogs are good). My first achilles surgery I was on 30 mg injection twice a day, this time I am on a 40 mg injection once a day. Does this make a huge difference?

And it's not like I can just go to my local ER as they may need to remove the splint to examine my foot, and I'm not certain I would trust them to get it replaced in a way that would make Dr. E happy.

Last night I held off calling because I simply didn't want an answer that might involve my having to go to the hospital that late at night. But with my history of clots, this is not something I should ignore.

I finally decided to leave a message with his service for the Resident on call. Will update later with the outcome.



90 minutes after my message with the service I got a call back from the doctor on call. He didn't feel I needed to worry about the cramping and pain, but said I know my body best and if I get too concerned, or start to have breathing issues, I should go to my local ER. He thought the ER doctor could do a doppler behind my knee without removing the splint. He also said the efficacy of 40 mg lovenox once a day vs. 30 mg twice a day is the same. (So why would any doctor prescribe two shots a day?)

So I sit and mentally note every periodic twinge, or pain in my body. And I definitely need to get my lovenox refilled today!

New Series

To amuse myself (and avoid the heavier work that is waiting for me) I have begun taking a daily photo of my cats interacting with my foot. I have entitles the series 'My Left Foot with Cat'. Paes will be making the majority of appearances as he tends to consider my lap his rightful nap spot.

I thought about Photoshopping my foot into some of my existing photos, but if I'm going to do that much work I might as well be focused on the projects I should be doing.

So here are the first five days

Cat, Odd Pain & Boredom

Day Three. Happy to discover that I have at least one pair of jeans with a cuff wide enough to fit over the bandages. Psychologically it helps to be wearing something other then sweatpants. I have spent most of the last two days on the couch with my foot elevated and a cat on my lap.

Remembering my knee-walker experiences last year, I expected to push forward faster. Instead I have been stymied by a new, sharp pain on the outside of my leg where the muscles attach to my shin or knee. I kept thinking that a hard part of the brace under the bandages was digging in, but the pain is located above the top of the bandages. I mentioned it to the nurse who called to check on me Sunday, but her only recommendation was to take some Tylenol and it would go away. It hasn't. Though it only starts to hurt when I am on the knee-walker, it makes using the knee-walker for more than necessities very uncomfortable.

While I do have my crutches, the problem then becomes the cat. He keeps getting under the knee-walker and I am forever trying to get him to move so that I don't run him over. I fear that he would be just as bad if I were on crutches, only I would not have the stability to stop and maneuver to avoid him. I do not need or want an ER visit because the cat tripped me and I went splat.

So I sit on the couch surrounded by books, magazines, DVDs and my computer and slowly go stir-crazy. On the plus-side, with the probability of rain and snow the next two days, the world outside my windows won't look quite so inviting! 

Achilles 2.0 - New Surgeon, New Hospital

So today was S-day. My surgery was scheduled for 9:30 am, so of course I had to be at the hospital by 6. If you have never ridden an uptown 4 train at 5:00 am on a Saturday morning, I highly recommend it for it's theater alone. My favorite was the rough-housing women being yelled at for waking up the homeless person. I did have one man tell me he had been on a knee-walker too as I was carrying it up the stairs at the 68th Street subway station.

Spent the first half of my pre-op preparation listening to a querulous woman complain that she needed her pain meds before surgery and say some rather racists things about the nursing staff. Her surgeon arrived as she was reaching her crescendo of obnoxiousness and told her that the hospital staff were there to help her, but if she didn't want that help it was her decision. She shut up. I did not applaud, but wanted to. I understand nerves (I had plenty of my own) but that is not an excuse for being rude and derogatory.

Eventually I was wheeled into my operating room and climbed onto the table. I remember the anesthesiologist giving me a sedative and then disjointed memories from the recovery room where I could hear people talking to me, but could not open my eyes as my brain seemed to flash random thoughts and my right toes were cold.

I eventually woke up to my left foot looking like this.

My surgeon performed a minimally invasive procedure where he made three 2mm incisions through my skin, nicking my achilles and then forcing my foot into neutral. He said he could hear and feel things pop and pull, but even with the cuts couldn't get past neutral. They then designed an open plaster mold (see above) that holds my ankle in neutral and forced my foot to stay that way until the plaster dried. 

Dr. E is hopeful that I can go into the aircast boot when I see him on March 14th and begin putting weight on my foot. He says the issue is not putting me in the boot too soon and risking me popping my achilles vs. leaving me immobile for too long and having the achilles tighten again.

On a side note: I like Dr. E, he seems to have a sense of humor, gets my dry sarcasm and is willing to laugh - not something Dr. H seemed capable of.

So by noon I was awake, with Betty called and on her way to get me enjoying a tuna sandwich and cookies, hoping to get the plastic taste of the breathing tube out of my throat. And a little after 1:00 pm Betty & Steve were driving me home and picking up my new batch of Lovenox. 

I am now ensconced on the couch with a cat on my lap (who I do have to admit is less then impressed with the smell of plaster, iodine, etc coming from my foot, nor does he seem to be a fan of the pillows needed to elevate) looking forward to some home-made matzo ball soup and trying to stay awake until it's time to feed the cats and take my motrin and lovenox. I am not in any pain, so no Tylenol needed.

Hmm, what did I put on my Hulu queue?

Adding Another Voice

11 days to surgery. Today was a visit to my primary for my pre-op physical. I knew the tests, came ready to have blood drawn and pee in a cup. What I wasn't expecting was for my primary to say "Everything is fine, but I want you to see a Cardiologist."

The problem is that a small sinus arrhythmia showed up on my EKG. Not a huge issue, until you combine it with general anesthesia. So my doctor wants to get a second opinion from a specialist.

This brings the number of doctors involved in this surgery up to six (not counting my primary and previous foot surgeon). My new surgeon has been consulting with my knee surgeon, anesthesiologist, neurologist, hematologist and now cardiologist. Luckily only two will be in the operating room, or it would be very crowded.

And I am left with six days to fret over this finding until my appointment with the cardiologist next Monday. Bright side is that my primary shares an office with a cardiologist, so I was able to make an appointment quickly.

I guess it's back to moving furniture to make my apartment more knee-walker friendly.

Happy Valentine's Day, I Want to Break Up

How do you break up with your doctor? Type that into Google and you get over 71,000 results. The few I looked at tended to be overly general, some simply said you should listen to your instincts without giving a real answer.

I did it by voice mail. I was ready to speak to the Office Manager, but instead I got her message. So I simply said "I have decided to switch to Dr. ___. Please forward my files to his office and needless to say I will not be coming to my appointment next week."

It's been coming for a while. This is, after all, the doctor who has had helped make the last year miserable. Thirteen months after my achilles repair surgery I still don't feel much of my foot and I have what my knee surgeon and new foot surgeon refer to as an "equine" walk.

If I'm honest, my new surgeon is the one I wanted to see two years ago when my achilles first tore, but I did not feel I could handle his nine-month waiting list for new patients. I only got to see him now because my foot issues were starting to impact my knee and my knee surgeon did not want his hard work to be for naught. He called the new surgeon and got me a jump in the queue.

So, now I have a new foot doctor, who on our first appointment scheduled me for an achilles lengthening surgery on March 2nd. He answered all of my questions, showed he had a sense of humor, and let me know he would be in contact with both my knee surgeon and my neurologist, before sending me to meet with an anesthesiologist to discuss how to ensure this surgery does not have an adverse effect on my already damaged nerves.

I have two weeks to get the house ready for the return of the knee-walker, stock supplies and get all of my pre-surgery tests and authorizations. This has to go better then the last time. If I'm honest, I'm terrified. I now have an awareness of all the things that can go wrong.

The new surgeon refused to openly criticize the old surgeon. The consulting anesthesiologist said the old surgeon should have told the old anesthesiologist immediately when I first complained of not feeling my foot. (Something the old anesthesiologist had also said.)

So I have broken up with my old foot surgeon and already started a new relationship. As with all new relationships you look forward, with high hopes and positive energy. Happy Valentine's Day.