Day 57 (197): New PT Clinic (Session #9)

Today was my first visit with my new therapist.  The clinic is only about 10 mins from my apartment.  It is at the medical complex of the major hospital here in town.

When you walk in, there is this automated check in system.  It's kind of like when you get a paper with a number on it at the deli.  Your number gets called out on the screens displayed there and you are directed to a registration desk.  They obviously have a high patient volume because that system is pretty advanced.

My therapist came to get me from the waiting room and took me back to a patient room.  I showed him my progress report from my old clinic.  He was glad to have some background information on me.  He re-measured a couple of angles and said that they were the same except for dorsiflexion of my right foot.  It has tightened up a bit in the last few days.  That is what happens when you miss therapy.  I haven't been since this past Friday.

His philosophy for my treatment is to get me to being barefoot tolerant.  He doesn't want me relying on braces, orthotics, or stability shoes.  I am not sure if that is a realistic possibility for me, but we can always try to get there.  I explained to him that I am a compliant patient and that whatever he wants me to do I will do.  I am all in.

At one point in the appointment, he said, "I want to get you to your goal of running."  Based on the look on my face, he said, "That is your goal, right?"  I hesitated, but agreed.  It wasn't until later that I realized why it took me so long to respond.  Running is my dream goal, there are many other more important and realistic goals for me to hit before that, like: being able to stand (in the shower, to brush my teeth, to dress myself, to cook), to not need my walker around my apartment, to be able to walk around the grocery store in peace, to be able to go shopping in a mall without worrying about how I am going to get from store to store, to be able to teach a full class without sitting, to be able to go up and down stairs without hesitation, to drive long distances, to swim, to ride my bike outside, to be able to walk longer than 20 mins, to not have to park in handicapped parking spots, to not have to wear tennis shoes at all times...you get the point.

My first goal is to be able to do activities of daily living and not have to wear tennis shoes every day, or use any assistive devices inside or outside my apartment, to no longer be disabled.

My second goal is to return to an active lifestyle (swimming, biking, going to the gym).

My dream goal is to run and race again.

Next, he asked me about the exercises I have been doing.  I filled him in.  It was a really long list since I have been in therapy for so long.  He was happy to hear that I already have such a strong routine.  He wants me to keep doing the same at-home program I have been doing (ABC's, foot circles, plantar and dorsiflexion stretching, band exercises, balancing on one foot, toe exercises, seated heel raises, etc), except for adding a few new "toe yoga" exercises.  He says that I need to have good control of my big toe, separate from my other 4 toes.  Basically, I have to lift the big toe, while pressing the other 4 toes down, and vice versa.  When he had me try this, I couldn't lift either big toe off the ground, another sign that my neural connections are fried.  He says these exercises will help strengthen the intrinsic muscles of my arch and foot.

We didn't do any actual therapy exercises today.  I really wish we had, since my next appointment isn't until next Wednesday.  The last few weeks, I have had 6 hrs of therapy across 3 sessions per week.  This week, I only had the one 45 min appointment and we didn't do therapy.  He only wants me to come see him 2 x per week, and each session at this clinic is only 45 min-1 hour. My therapy time will be decreasing significantly.  When I walked out, I was frustrated when thinking of my serious reduction in treatment time.  Going to therapy frequently and working really hard at all of my exercises is why I have been improving so quickly.  I had this sense of doom come over me while thinking about how much my progress will slow.  I am trying to keep a positive attitude, but I can't help but think where I would be today if I were still in my previous city and had already completed 4 hours of therapy this week.  This therapist already said that I have loss some dorsiflexion in my right foot.  This sucks.

I know that there is an adjustment period with every transition in life, so I am going to keep a positive attitude and hope that my first real therapy session with my new therapist will go well next Wednesday.  I can't predict what my future experience is going to be off of this initial appointment.  I know that he is a great therapist.  I could tell that right away.  I just have to learn to trust him like I did my previous therapist.

When I got home, I became motivated to take my therapy into my own hands.  My former therapist prepared me really well to do exercises on my own and would be mad at me if I let a small setback like this stop me.  I went straight to the gym in my new building and got on the bike.  I rode for 15 mins before doing squats, knee raises, leg abduction/adduction, shrugs, dead lifts, clean shrugs, and front and lateral step-ups.  After, I walked for 5 minutes on the treadmill at 1-1.5 mph, and finished with 10 more minutes on the bike.   Back in my apartment, I did my entire at-home exercise program including the new toe yoga exercises that my new therapist added.

Since I am on my own right now, I have to take an active role in my treatment and keep progressing myself as my former therapist would have.  This is one of the few times that it is beneficial that I have been through this all before.  Even though I know that I can do this, I can't help but miss working with my former therapist.

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Reflection

I have come to realize that...

YOU have to want it for YOURself.  

YOUR commitment to YOUR recovery and YOUR exercises is what will make the difference in YOUR ultimate outcome.  

Rain or shine, YOU just have to put in the work.  Every damn day.

Day 56 (196): 2/7 month update + DRIVING + 1st visit to new campus

*Right: 8 week (2 month) surgery anniversary*

*Left: 28 week (7 month) surgery anniversary*


Updates

Right: FWB in tennis shoe with stirrup brace, no assistive devices.  Only painful while standing more than a minute or walking more than 20.

Left: Daily pain where the tendon transfer was.  Nothing compared to before the surgery, and not enough to limit my activity.  The right is the limiting foot.

I still sleep with my legs elevated and ice at minimum once per day before I go to bed.  I can climb over the ledge of the bathtub to get into the shower, but I can't stand in the shower yet.  I have my bath chair in there and I have the toilet extender seat with the hand rails over my toilet.  If I don't have my tennis shoes on, I have to use my walker to get around my apartment.

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1st Visit to New Campus

Today, I went to visit my new university.  I drove for the first time!  I had no issues.   When I got there, I took a tour of my new department and met my new colleagues.  I also got to check out my office.  I now know what courses I am going to teach and have an idea of what my schedule is going to be like for the semester.  I can't wait to get started!

I wore tennis shoes with my stirrup ankle brace on my right foot.  I told brief versions of my story to my department chair and my program coordinator so that they will understand why I will be in tennis shoes for the next few months.  Both of them actually know my new therapist and have been to his wife (who is also a PT) for their own running injuries.  Oh the life of runners...it hurts so good, haha.  All of the labs and classrooms are pretty close to my office, so I   shouldn't have much trouble with these feet at work.  I will have to find a chair for teaching because I don't see my feet handling 50 min classes yet.

My new university is just over a mile from my apartment.  My program coordinator took the time to show me some routes that I can take with my bike.  He rides to work himself.  Once I am back to riding, I think I might try it.

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Reflection

Back to driving.  My feet didn't bother me at work.  I am excited to start my new job.  First PT appointment with my new therapist is tomorrow.  Mark this in the good day category.

Day 54 (194): Move-in day

My flight yesterday was pain free.  I used the walker to get through the airport, so that I could conveniently push my suitcase on my seat.  The flight was only 2 hours and my feet handled it fine.  I forgot to pack my blood thinners in my suitcase, so I was worried about the risk of blood clots.  I diligently pumped my feet and moved my legs during the entire flight.  

Since I am conveniently moving 2 hours from where my family lives, I flew into my usual home airport.  My brother picked me up and took me to our house.  I got to relax, elevate and ice my feet, and rest up for a night in preparation for today's move.  My parents finally arrived with the moving truck late last night.

This morning, we switched out some of the stuff on the truck, then we drove the 2 hours to my new apartment.  I had the help of my extended family with the move on this end.  My mom and I stayed in my apartment the whole time directing which rooms the boxes and stuff should go in.  I was able to preserve my feet big time.  We had no crazy deadline for using the elevator like we did on the other end, so the move went really smooth.

I moved into an ADA compliant compartment. My building happened to have one open that I liked, so I went for it.  It has all hardwood floors, making navigating with my walker and rolling around on my desk chair really easy.  The washer and dryer aren't stacked so I can do all of my laundry seated.  I can reach all of the kitchen appliances while seated as well.  The one thing it doesn't have is a walk-in shower, like my last apartment.  Climbing in the tub should be interesting.  Other than that one issue, this apartment should make it much easier to do my activities of daily living until I am back on my feet again.

My mom is going to stay with me this week so that she can help me get all of my stuff organized. That is going to be a big help.  Of course I wouldn't need all of this assistance if I didn't have the feet I do, but it does feel good to know that I have the support of my family and friends through this major transition in my life.  

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Reflection

From the moment I stepped off of the plane yesterday, I felt an overwhelming sense of relief.  I am home now.  I continued to have this feeling as I moved in today.  I really think that this is going to be a good new start for me.  I can't erase this horrific last year of my life, but I can move on from it.  

Day 53 (193): Bye!

Today, I say GOODBYE! 

Bye to the only place I have lived in my adult life.  

Bye to the place that I received all of my college degrees from.  

Bye to the place that has become my home away from home.  

Bye to the place where I found myself and then lost myself.

Bye to all of my training routes.

Bye to my old ankles.

Bye to my medical team.

Bye to the place that has made me the person I am today.

and today, I say HELLO to a new adventure.

Day 52 (192): PT Session #8 + Move day!

Today is the big move!  I spent all day yesterday packing and closing out my final affairs here.  I woke up early today to pack some more stuff up before PT.  While my parents went to get the moving truck, I went to therapy.  Yes, I went to therapy on the day that I moved.  I keep going back to the fact that being able to walk and do your activities of daily living is more important than anything else.  That is something that only people that have been disabled for any period of time will truly understand.  There is no way that I was going to miss a session.

It was such a bittersweet day.  I got on the public transportation train to ride my few stops to the clinic, since I still can't drive.  While I was riding, I kept thinking how it was my last trip to PT.  I had 26 PT sessions with my first surgery, spread across 3.5 months, and another 8 sessions over 3 weeks with this surgery.  With my total time at the clinic being around 2 hours a session, between working directly with my therapist, doing extra exercises and cardio, and icing, that makes 68 hours of my life spent at that clinic this year.  When I started, I only had the first surgery, and by the end of these 7 months, I have been through 2 reconstructive surgeries containing 9 procedures in total, with 2 calcaneal bone wedges, 4 titanium screws, and one pin added to my feet.  That is the bitter part, in addition to leaving my therapist and the clinic that has become my recovery "home."  It has been the mission control center.  The hub at the center of my recovery life.

While my work is not done, the sweet part is that I did feel a sense of accomplishment walking into the clinic today.  As soon as my therapist called me back, he said, "This is graduation day." The rest of the appointment felt like that.  It was a reflection on how far I have come and what I have accomplished up to this point.  When this year started, I obviously did not expect to have to go through a second surgery, and when that was confirmed, I didn't think that I would already be up walking in tennis shoes and an ankle brace without needing any assistive devices.  It was Day 77 with the first surgery, which puts me 25 days ahead of my old timeline.

After riding the bike for 10 mins and walking a couple of laps around the indoor track, the appointment started with an "eval."  My therapist measured the ROM angles and strength of my feet to compare them to my baseline measurements.  He created a progress report that I can give to my new therapist so that he will have this information.  It has only been a few weeks of therapy with my second foot, but my ROM is already almost equal to my left foot values.  While he was doing my measurements, he gave me this detailed running program that they rarely get to use in therapy.  It further describes what he was telling me on Wednesday about starting as an aggressive power walker and then progressing from there.  Based on my estimation from looking at the plan, it will probably take a year before I am really running again.  I can't start following this plan until my tolerance for walking increases and my overall ankle strength and stability improves.

When we were on the fitness floor doing exercises, my therapist wanted me to try heel raises while standing on an elevated step.  I was supposed to drop my heels below the 0 degree point (ground) and raise them as far as I could.  I could drop my heels, but I couldn't raise them to any extent.  Then we tried it on flat ground.  This time, I was just supposed to try to raise my heels. Nothing happened.  Next, he had me stand on the angled calf stretching block (toes angled up while heel is on the ground) and try to do heel raises from there.  I could just barely get my heels off the ground this way.  This was a huge wake up call.  This is really the first time that I realized how much my neural connections to my feet have suffered.  My brain was telling my heels to rise and absolutely nothing was happening, the same as before both surgeries.  With my left, I feel that I have the strength, but not the neural connection.  With my right, I have the neural connection, since I didn't have the tendon transfer, but I don't have the strength yet.  I absolutely will not be able to run again until I can do heel raises.  You need that in the toe off motion of the running form.  The feeling of my left foot scares me the most, because I have always been worried about how the tendon transfer would affect the function of that foot.  I am almost 7 months post-op with that foot.  With the full recovery being around a year, I am starting to run out of time for getting function back in that foot.  My therapist told me not to worry, so I just have to keep sticking to my therapy, and hope for the best.

After icing, I said bye to all the therapists that have worked with me and to the support staff at the clinic.  It was difficult to leave but I know that I have a bright future ahead of me, that I am WALKING towards, and will eventually be RUNNING towards.  I felt a sense of freedom, an air of relief, as I walked out of the sliding glass doors that one last time.  I have accomplished an incredible amount to be walking out after everything I have been through.  The most difficult parts are behind me.  No more surgeries, no more incisions and their beautiful scars on my feet, no more casts or boots, no more learning how to walk again, no more relying on assistive devices (FINGERS CROSSED for all of these).  In my new city, I will be focusing on progressing my right to the level of my left, and then progressing them both to high impact activities.

To my entire medical team that has worked with me up to this point, I have to say THANK YOU.  Words can not describe how appreciative I am of the AMAZING group of people that have supported me from day 1 of this journey.  And of course, a special shout out to my therapist, who taught me how to walk from scratch 2 times this year.

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The MOVE

When I returned home, the move was in full affect.  A few of my friends were already there helping my parents get started.  We all had to move everything as fast as we could, because the real issue was that we only had 4 hours to use the service elevator in my building. Crazy policy. Anyways, I put my lace up brace on my left and remained in my stirrup brace on my right and got to working.  I was literally on my feet for the next 6 hours.  I stayed in my apartment packing and staging stuff for everyone else to take to the elevators and to the moving truck.  This was an attempt to minimize my walking as much as possible.  We needed more time than the 4 hours they gave us, so we managed to use the elevator for about one extra hour.  I also had to push back the key exchange meeting with the realtor.  We literally were still moving stuff out of the apartment and down the regular elevator 10 mins before the realtor came.  We were so rushed, that I ended up vacuuming my whole apartment, as my family and friends were moving my final stuff out.  I have only vacuumed once or twice since my first surgery and normally just a room.  I vacuumed the ENTIRE apartment.  Needless to say, my feet were so painful by the end of the move that they just went numb.  I literally couldn't feel them anymore.  When we were finally done, my parents started driving the moving truck towards my new home.  There are only 2 seats in the truck, so I am catching a flight in the morning.

We finished the move just in time for me to go to one last happy hour with my friends.  I had to heavily rely on my walker to get around because my feet were so tired from PT and the move. That night, I tried to go to sleep, but of course my feet were throbbing the entire night, even after taking a Percocet.

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Reflection

I am leaving my current city with some things unresolved, but I have to move on.  Everything doesn't get to end with a shiny bow tying your life together.  I know better than most that life doesn't happen on your terms, it just happens.  I have quite a lot to look forward to and a lot to look away from.  I am hopeful for the adventures that are waiting for me in my new city.

Day 50 (190): PT Session #7

To continue the project that I was working on yesterday.  I wanted to figure out what day it was with my first surgery that I transitioned to the tennis shoe and ankle brace.

It was Day 70.  Today, is Day 50 for the second surgery.  I am 20 days ahead of schedule. 20 days!

Day 50 of the first surgery was when I first met my current therapist.  So much has happened between then and now.  Months of therapy, another surgery, and more therapy.  I told my therapist this and he was equally shocked of how long we have come in this journey.  It really is true that time flies.

When I walked into the treatment area, the summer high school volunteers were absolutely shocked to see me walking.  It was pretty funny to see their reaction.  My therapist was like, "You do realize that patients get better, right?"  Their reaction was similar to the reaction of my students when I finally started walking upright.  They didn't realize how tall I was.

For therapy, I started with riding the bike for 8 minutes.  This was my first time on the bike with my new shoe gear.  It certainly felt strange.  It was much easier to pedal while my foot was in the boot.  I have trouble with the down stroke.  It is at the edge of my flexibility with the calf and achilles lengthening.  Not painful, just uncomfortable.  After, we did a short massage/ROM session and then I was off to do exercises.  Pretty much the same as I have been doing, just in the tennis shoe instead of a boot.  I talked to my therapist about the thoughts I was having yesterday.  He obviously has worked with athletes before and their struggle to return to their sport after a major injury.  I really wanted to know how he thinks I can get back to training.  First, he said that I should't even consider "training" for a long time.  Of course in my mind, my only motivation to work out is to train for something.  I don't just go to the gym and do some random bout of physical activity for my health.  I have to be reaching for a goal, so I never call it working out, I call it training.  He went further and said that I shouldn't use my therapy as training when I move, that I should just focus on rehabbing my foot without any races on the calendar and without following a specific training program.   He told me that I basically have to become an awesome power walker before I can think about running again.  He wants me to gradually increase my speed, distance, and tolerance for walking.  He recommends that I be able to walk for an hour at an aggressive treadmill speed pain-free before starting to run. And of course, just keep taking everything one day at a time.

With these surgeries, I have done a lot of "cognitive reframing," which is the psychological term for changing your perspective.  Basically, changing the way you think about something in your life.  I could open my own custom frame shop at this point.  Doing therapy and working out to get better without training is something that will take me a little bit to digest.  When I went through my first surgery, I wanted to keep as much fitness as possible so that I could literally return to training as soon as my foot was cleared.  I was doing all kinds of functional training and preparatory exercises to be ready for my return to tris.   I had my heart set on doing a tri this month, before I moved.  I think that if it were only my left foot in the conversation that I could have been ready.  With this surgery, I haven't been able to do much because I didn't want to jeopardize my new left foot.  Now that my right foot is better, I am inclined to want to train again, to pick a goal race, put it on the calendar, and follow the necessary training plan to be ready for it.  I have to change my way of thinking and just be "ok" with following through with my recovery without the treat of racing as motivation.

My foot took well to rehab today.  It was sore when I finished, but nothing the GameReady couldn't handle.

When I got home, I continued packing, and then I had my farewell dinner with some of my closest friends.  By the end of the night, my right foot was ridiculously swollen.  I wore the boot to dinner so that I wouldn't have to bring any assistive devices with me, so it should have been fine.  I am not sure if the swelling was from pushing it hard at PT, or being seated at the restaurant without it elevated for a while, or even the sodium in the food.  It may have been a combination of all three, but it was swollen the worst it has been in quite a while.  So much so that I couldn't get it to go all the way flat.

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Reflection

1) I am making great progress.

2) I know that I still have quite a long road ahead of me and that I need to shift away from being so goal oriented and just go with the flow in my recovery.

3) My feet have their limits and they will continue to cramp my lifestyle until they are fully recovered.  They are happier when I follow their rules and just sit at home and ice and elevate them all day, but I am happier when I follow my own rules.  I wanted to enjoy my farewell dinner and that I did.  I will be paying for it the next couple of days, but that is how my life is now.

4) I have to continue to believe in my medical team and stick with my PT exercises if I want to change my circumstances.

Day 49 (189): 7/27 week update

*Right: 7 week surgery anniversary*

*Left: 27 week surgery anniversary*

Made it 7 weeks!  Today, I was inspired to look back at my blog and see where I was with the first surgery at this point.

Day 48:

First Surgery (1): 1st PT session, barely PWB in a boot with the walker

Second Surgery (2): 6th PT session, FWB in a boot

Day 49:

1) Teaching meltdown, painful PWB in a boot with the walker

2) Packing in my tennis shoes with my ankle brace on my right foot, pain free.

Day 50:

1) 2nd PT session and my first time meeting my current therapist, barely doing ROM exercises in therapy, PWB in boot with walker

2) I will have my 7th PT session, FWB in tennis shoe with ankle brace

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New PT Clinic

I also got set up with my new PT clinic for when I move.  The new clinic has entirely different staffs for different injury classifications/needs of the patients (general orthopedics therapy, hand therapy, neurorehabilitation therapy, pediatric therapy, spine therapy, and sports therapy).  I will be going to their sports therapy clinic.  My new therapist is a competitive runner who is highly requested.  Luckily, I was able to work my way onto his schedule.  My first appointment is next Wednesday (July 31st), which means that I will only "miss" one appointment by not having therapy on the Monday directly after my move.  After that, I will be going on Wednesdays and Fridays for the next few weeks at 8:15 am!!!  Those were the only days and times he had available.  I don't mind because I am extremely lucky to even be able to work with him right away on such short notice.  I am interested to see how their clinic runs compared to my current clinic.  I also wonder if I will like my new therapist's treatment style.

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Reflection

I am really far ahead of where I was last time.  For that I am happy.  What disturbs me is the thoughts I had today, when I walked a few blocks from my apartment to get some takeout.  On my way back, I was hit with physical exhaustion.  I was out of breath.  I thought to myself, this is so uncomfortable.  It is so much easier being lazy.  What would make anyone want to be so active like I was before?  Will I ever have the will to train like that again?  Will I be able to get over the psychological hurdles (trusting my feet, getting over my fear of re-injuring myself) to allow me to return to high impact activities?

As an exercise physiologist who specializes in obesity prevention and health promotion research, it is literally my job to encourage people to lead active, healthy lifestyles.  I never understood, until now, how someone could be so unmotivated to change their behaviors to improve their own health.  It has been difficult for me to find meaning in everything I am going through.  All the time, I ask myself, "why me?" and "how did this happen?"  Now I know that what I have gained is perspective.  I have had the fortunate/unfortunate opportunity to experience this world not only as an elitely fit and extremely capable person, but as as a disabled person, as a physically inactive person, and as a person apathetic about their health.  Fortunately, I know that the thoughts and feelings I am having now are just a phase, and I will get over this as I have everything else.

Day 48 (188): Weekend Recap + PT Session #6

This past weekend was the last full weekend that I have living here before I move on Friday.  I stuck to my PT exercises two times per day.  I also took care of closing out a lot of my personal affairs and started packing.  I can get around pretty well in the boot, but I have only been able to pack a couple boxes at a time.  It is so physically exhausting for me at this point.  I really think that all of my body's energy is going to repairing these lovely feet of mine, so I have none left over for anything else.  Luckily, my parents come on Thursday to help me with the move.  I am normally super prepared for moves with all of my stuff perfectly packed in labeled boxes.  This time, my stuff is still literally everywhere.  It doesn't even look like I am moving, and I have less than a week to go.

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PT Session #6

Good news: My therapist is back! Yay!

Bad news: Only 3 sessions left in Miami with him :(

I told my therapist about how the other two therapists kicked my butt while he was gone.  In my head, I kept thinking, "While you were on vacation, they made me work hard for the money!" Haha.  He was really happy to hear about how much I had been able to do.  As such, we only did about 10 mins of massage and ROM compared to the usual ~30 mins of that.  After that he had me on the fitness floor doing similar exercises to the ones I did on Friday.  The only thing extra we did was weighted leg abduction/adduction and knee raises.  By the time I finished everything, we talked about our strategy for the remaining appointments.  Since I only have two left and I want to be walking and driving by the time I leave, we decided that I will try to transition to the tennis shoe and ankle brace a little bit early and try it at my appointment on Wednesday.  I have had no pain FWB in the boot, so I don't think it will be an issue.  With the first surgery, my therapist had to beg me to make the transitions.  It was so hard for me because with every transition, my pain level would go up and I would have to basically start from scratch again to learn how to get around.  This time, I have been begging him and my doctor to let me progress.  I really am the best one to gauge the transitions with this surgery, since I have personally been through this all before.  I have none of that nagging heel pain or the feeling that my heel is scraping on concrete with every step from the calcaneal osteotomy this time.  My foot feels good, a lot more stable than with the first surgery, and I have already been walking around my apartment without my boot for days now. (Don't tell anyone, haha!)

After therapy...back to packing.

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Reflection

More hard work, but also more progress...which means I am a happy camper :)

Day 45 (185): PT Session #5

Another day at the PT clinic.  Since my therapist is still out of town, I worked with one of the therapists that I worked with during my first surgery recovery.  This was good because he already knows my story in detail and what it was like to work with my other foot.  He was as impressed as everyone is with how fast my right foot is recovering.  Since I didn't have too much soreness or discomfort with doing weighted exercises on Wednesday, we did a round of exercises more similar to a FWB routine.

We started with massage and ROM as usual, and then...

15 mins Pike's Peak bike program
4 x 10 Front and Lateral step-ups on the lowest step, and then the same exercises one level up
4 x 10 Leg extension
4 x 10 Leg Press
4 x 10 Leg curl
4 x 10 wall squats with exercise ball
10 more mins on the bike

When I finished, I was completely exhausted.  It was a clear slap in the face of how out of shape I am and how much more work I have to do before I can get to a reasonable fitness level.  To make matters worse, there were no tables available for me to ice on.  It was really busy at the clinic.  My therapist told me that I could ride the bike for a few more minutes while I was waiting, and I said, "No Way!"  I was so tired.  I barely made it through 10 mins on the bike after that workout.  Luckily, moments later, someone got up and I was able to use their table.  After icing and almost 2.5 hrs at the clinic, I was on a wing and a prayer to make it home without passing out.  As soon as I got home, I showered and got right back into my bed.  I am so useless these days.

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Reflection

If I keep up with my therapy exercises, I will get better and I won't feel so terrible doing such basic things.  Luckily, there is almost no pain with any of my exercises, I am just simply out of shape.  All weekend I must do my at home exercises twice per day.

Day 43 (183): PT Session #4

My regular therapist is on vacation for the rest of the week, so I worked with another therapist today.  I know him pretty well from being treated at the clinic for so long, so it wasn't an entirely foreign experience to work with him today.  I told him the whole story of my feet and how they came to be in this situation while he was working on my ROM.  I also told him that the feeling of my left foot in my lace-up brace is so eerie because mentally it feels exactly how I remember that my pre-injured foot used to feel.  I really do feel like I could run with the left with this brace on.  He cautioned me not to wear it too much, because then my foot  will weaken to the point that it will rely on the brace.  I am primarily wearing it at this stage to preserve my left foot while it still has to do the majority of the weight bearing.  I will stop wearing it as soon as my right foot starts tolerating more weight.  He taught me a new exercise, "arch crunches."  That is where you try to raise the arch of your foot off the ground by crunching your foot together, while not relying on your toes.  It should strengthen the muscles of my arch.

After the seated stuff, he had me put my boot and shoe back on and do some exercises with the equipment on their fitness floor.  I can tolerate limited FWB in the boot, so I didn't need to use any assistive devices around the clinic.  I started with 15 mins on the hill program on the bike.  This was much harder than anything I had done before.  I then did leg press, single leg press with each leg, calf raises with the leg press machine, and leg extension.  This was really my first time doing any weighted strengthening exercises, so by the end of the appointment I was worn out.  We did double GameReady as usual to finish.

When I got home, I literally passed out while sitting up on my couch (with my legs elevated, of course).  This session in combination with the residual exhaustion from my defense yesterday took all of my energy.

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Reflection

Another day closer to my goal...

Day 42 (182): 6/26 week update + D-day

*Right: 6 week surgery anniversary*

*Left: 26 week surgery anniversary*

Today is the day.  The day that my entire academic career has culminated to.  I woke up really early to get all of my stuff together and to get in one final practice of my presentation.  I felt at peace and confident that I was going to nail my defense.  I chose to wear a short-sleeved blouse that epitomizes my personality (hot pink lace fabric with a jeweled neckline and a bow at the back) with a pair of black dress pants.  I wore a neon pink and orange zebra striped sock under my boot on my right foot and a neon pink sock under my lace-up ankle brace on my left foot.  Of course I also had my neon pink and orange tennis shoe on my left foot also.  My dress pants oh so nicely draped over my boot and my tennis shoe, so the audience had no idea that I had all that neon going on under my clothes.

My friend picked me up, because I am of course that girl that couldn't even drive herself to her own dissertation defense.  Anyways, I arrived an hour early and got everything set up.  My defense went, in my opinion, flawlessly.  I spoke even and confidently.  I was able to stand for the entire 45 min presentation, with only occasionally leaning on my walker.  Of course my feet were on fire at around the 30 min point, but I wasn't going to let them stop me.  My slides directly correlated to my oral presentation.  I fielded questions from the audience and my committee with no problems.  I knew the literature and my study so thoroughly that there was no question in anyone's mind that I was going to pass my defense...and that I did.  I PASSED MY DISSERTATION DEFENSE!!!  

Afterwards, I went to lunch with my friends to celebrate and then home to rest, ice, and elevate my feet.  I didn't leave my bed for the rest of the day!

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Reflection

It has been a long and arduous road to get to this point.  So many sacrifices...just so many sacrifices.  I doubted myself at times and questioned why I was doing this to myself, but I absolutely never gave up.  Today, I stand proud of what I have accomplished.  I am trying to enjoy the moment, since I really have accomplished this major life goal.  However, again, in the context of my life at the moment, me getting a PhD is nowhere near as important to me as it used to be, and doesn't even compare to my quest of being able to lead a normal life again.  I am mentally abled and at the top of my game, but physically disabled as an expert in a field exclusively reserved for abled bodied people.  The quote for today is perfect to capture the end point of my PhD, because now I get to live the rest of my life as a doctor, but it is also a source of inspiration to continue my struggle to rehab these feet of mine and get back to an active lifestyle.  I will be nothing but a champion if I ever get to run a race again.

Day 41 (181): Post-op #2/4 + PT Session #3 + Final Defense Prep

Today is August 2nd.  I have been really bad with posting these last few weeks because of my dissertation defense, preparing to move, and then moving.  I have been taking notes along the way of the last few weeks, so I am going to fill in the days up to present. It is a lot of work keeping a blog up to date, much more than I expected.

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Post-op #2/4 (6 week/6 month check-up)

My second post-op appointment for my right and my fourth for my left was the morning of the day before my dissertation defense.  I had hoped to defend a week earlier, but things didn't work out that way.  From the time I woke up, I knew that it was going to be a really busy day.

I was more than prepared for my appointment.  I wasn't nervous and I didn't really make my list of questions that I normally do.  I just wanted to get it over with.  All of the support staff (registration people, cast/brace guys, x-ray people, athletic trainers, physician assistants) and the doctors of the practice recognized and greeted me today.  It is a good feeling to be so welcomed, but at the same time it is a slap in the face of, "oh by the way, that is the girl that had to get both of her ankles reconstructed and we see her here all the time."  I really never thought I would be a "regular" at a surgical practice.  Well...let's not start that train of thinking of what I never thought my life would be at this point.

After being taken back to a room and giving the AT a brief report, I was off to get X-rays.   We only took them of the right foot.  Afterwards, my doctor and his PA came in to speak with me.  It is kind of funny that they don't even knock anymore when they come into my room.  They just walk right in because I am here so frequently.   I gave them a brief report of where I am at with each foot, and then I asked some questions, as usual.

Questions:

1) What is the timeline for my transition from PWB to FWB in boot to FWB in tennis shoe/ankle brace?  Let's use the last surgery as a guide but keep in mind that the recovery will go a little faster for this foot since we didn't do the tendon transfer.  I told him that I was already PWB pretty comfortably in the boot and that I didn't think that I needed much longer before transitioning to a tennis shoe.  We agreed on 2 more weeks in the boot of weight bearing as tolerated (WBAT) and then moving on to the tennis shoe with an ankle brace.

2) When can I start returning to activity (swimming, biking, and high impact activities/running)?  Swimming and Biking: 4 weeks, high impact/running: 3 months minimum.  These estimates were not unexpected, but it was hard to hear that I had another month before swimming and biking (outside) and another 3 months before learning to run again.  That puts me at mid-october before I can even think about high impact activities.  I don't mind waiting after everything that I have been through, but I really do hope that with my right progressing so quickly that I will be able to return to moderate-vigorous physical activity sooner.  I am really getting tired of all of this low level physical activity.

3) Are there any limitations on my ROM at this point?  No.  You can work on eversion and inversion right away this time since we didn't do the tendon transfer.

4) At the last post-op appointment, I noticed an extra pin on my X-ray, what is it there for?  The head of the guide pin that we use to place the screw broke off, so we couldn't remove it when we went to put the screw in.  It is all the way inside your bone and not across any joints, so it won't bother you.  It is just an extra piece of metal.  (Like I need anymore in me at this point.)

Overall, my doctor is really happy with both of my feet and where they are.  He says they are progressing well, and that I just need to keep up with all of my PT exercises to get the best possible outcome.  My left is still bothersome, especially at the tendon transfer point, and at the calf and achilles lengthening point, but he said these issues should work themselves out with time.  I also have issues at the other two incisions where the bone work was done.  They literally feel like they are burning when I walk.  He told me that that feeling is the nerves coming back, so I just have to give that time too.  Not much to report with my right since it is so early in its recovery.

Before leaving, I got a new PT prescription for my move to a new clinic, new braces for my feet (a lace-up brace for my left and a new air cast ankle brace for my right), and made my 3-month appointment.

Here are two pics comparing the bone work incisions (lateral column lengthening and calcaneal osteotomies).  My right foot incisions are looking really good for only being 6 weeks out.

Right Foot (~6 weeks)

 Left foot (~6.5 months)

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Meeting with my Advisor

Right after my appointment, I rushed over to school to meet with my advisor.  We went through my entire defense presentation to make sure I was on target.  He wants me to adjust a few slides, but all in all, both he and I feel good about it.  We also practiced the media set up for my presentation in the conference room.  The worst thing that can happen for a big presentation like this is to have something with your computer set-up go array.  I was so carried away with getting these final details together, that I didn't look down at my watch until my PT appointment was only 15 mins away.  Both the hospital/surgical clinic and PT clinic are right across from my university.  They are not at the same place but they are "walkable" from anywhere on campus.  I knew that I wouldn't have time to catch a shuttle, so I quickly packed my stuff up, and my walker and I went on a speedy adventure.

__________________________

PT Session #3

I made it to the clinic just in time for my appointment.  I was dripping in sweat and hadn't even eaten lunch yet.  My therapist was surprised by how disheveled I was, and then I told him the story.  Another therapist at the clinic overheard about it being the day before my defense, and he was like, "What are you doing here?"  I responded that I have realized that walking/your health is more important than any piece of paper will ever be.  Ultimately, that is all a PhD is, another degree, another piece of paper.  I used to think that it meant more, but these surgeries have seriously changed my value system.

While my therapist was massaging and stretching my foot, I ate the PB&J sandwich that I packed just in case of an emergency.  Thank goodness for that sandwich!  For the rest of the appointment we focused on progressing my ROM with harder exercises and I did some standing knee raises and leg abduction/adduction while b
alancing on my right (booted) foot, and leaning on the table to support myself.  These are to get ready for FWB in the boot.  After, I rode the bike for the first time, for a grand total of 10 mins!  The tour de france was on the tv in front of me, so it was perfect motivation.

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Final Defense Prep

When I got home from this busy day, I had to fix my defense presentation slides, practice, and get everything else together that I needed for my defense.  I stayed up until just after midnight, but I got everything done.

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Reflection

Feet are doing well, defense prep is done, which means it is GO TIME!  Tomorrow is the big day.

Day 40 (180): Edits and Defense Presentation DONE :)

After gathering myself on Friday, I spent the rest of the weekend working around the clock to finish the final edits to my dissertation manuscript and my defense presentation.   I am so happy to be done with those.  Less than 2 days until my defense!

Around doing my work, I made sure to do my at home PT exercises twice per day.  I have less than 2 weeks left before I move, and I want to be as close to walking and driving as possible.

I have my second post-op appointment with my doctor in the morning.  I am excited to hear what he thinks about my right foot and how quickly it has progressed compared to the left.

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Reflection

I am so proud of the work I have done to get to this point, mentally and physically in terms of my PhD, and my surgery recoveries.  You really can accomplish anything if you have the right motivation, are determined, and are willing to persevere through the bad days.

Day 38 (178): PT Session #2

After going out last night, my feet were a little swollen when I woke up.  Fortunately, they weren't really painful.

At PT, we did the usual stretching and ankle ROM exercises.  Since I am just barely PWB, there is not much that we can do at this point.  My ankle took really well to everything, and has much more motion at this stage than my left did.

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When I got home, as usual, I had a lot to do to prepare for my defense.  Looking at what I had left to do was so overwhelming that I didn't end up doing anything.  Every now and then, I reach that kind of mental block.  It doesn't happen often, but when it does, my best bet is to just take the time to calm down and make a plan to tackle what I have to do.

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Reflection

Note to self:  Relax and get the job done.

Day 37 (177): A day off

After having such a draining day yesterday, I took today off.  I stepped away from my dissertation edits and preparing for my defense.  Instead, I did a thorough cleaning and reorganization of my apartment and went out to happy hour and dinner with some friends.  This was my first time going out since I had the second surgery.  My foot has transitioned really well to partial weight bearing in the boot.  I used my walker to help me get around. When I got home, my foot was a little swollen, but nothing that a round of icing and elevating couldn't fix.

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Reflection

Sometimes...you just need a break.  I have so much work to do and am under tremendous pressure to finish up my PhD, prepare for my move, and for my new job, but I just had to escape it for one day.

Day 36 (176): A day of meltdowns + First PT session!

6:45 am: Alarm

8:20 am: Left my apartment 20 mins behind schedule.  It is so tough to get myself together with my stupid feet.  Gear: Left ankle brace/tennis shoe, right foot in boot, walker.

8:35 am: Caught the train to school.

8:40 am: It started to rain while I was still on the train.  Panic started to set in.

8:50 am: Arrived at school and realized that with the rain and relying on the campus shuttles that I wouldn't make my 9 am meeting with dissertation committee member #1 on time.  I frantically sent an email hoping that she would understand.  I needed her signature on my paperwork that was due a week ago, and I was going to miss her, since she said she was leaving her office at 9.  I decided to try anyways.

8:55 am: The shuttle arrived at the stop.  One person got on and the bus driver closed the door without even seeing me.  I knocked on the door, she opened it, and said that the lift was broken.  I was staring in the face of 4 steep stairs and not a hope to get up them.  A rider lifted my walker up the stairs while I had to rely on my left foot to jump myself up the stairs one by one...

When I finally got myself on the shuttle, I sighed from the struggle, and tears started to stream down my face...MELTDOWN #1.

9:05 am: Arrived at the shuttle stop closest to where I needed to meet my professor.  It was still raining.  I had to crab walk down the stairs to get off the shuttle.  Then, I pushed myself to cut through two building parking lots to get to the building I needed to go to.

9:10 am: My professor was still in her office!  I collected the signatures I needed and picked up the rest of my paperwork from the office assistant.

9:30 am: Made it back to the shuttle stop.  While I was waiting to catch it, I was trying to figure out a way to get to the building I needed to go to that doesn't have a stop anywhere near it.  After making that same trek on Friday, I knew that I would be paying for it for days if I did it on my own.  I called the campus parking and transportation department.  They said they don't provide any services to help disabled people get around campus where the shuttles don't run.  Tears started to fall.  I was so frustrated.  The next call I made was to the office of disability services.  She said that they expect disabled people to have their own wheelchair or motorized devices and they don't provide any transportation assistance...MELTDOWN #2.  I am disabled enough to need assistance beyond my assistive devices to get long distances, but I am not disabled enough to have an electronic scooter or actually be proficient at using a wheelchair.  Besides, I wouldn't be able to get on a shuttle with STAIRS with either of those!

9:50 am: Got off the shuttle at the stop closest to where I needed to go.  I told my other committee member that I needed to meet with that I would meet him around 10 am.  I had 10 mins to get a quarter mile.  I had to take it one sidewalk square at a time to make progress.  I literally had to give myself a pep talk every 10 seconds.

10:05 am:  Arrived at committee member #2's building.  I stopped at the bathroom before going to his office.  I looked at myself and I looked absolutely exhausted and like I had been thrown away.  I splashed some water on my face, straightened my clothes, and sprayed myself with body splash. I gave myself a pep talk and walked to his office.

10:10-10:50 am:  Listened to committee member #2 pick at the "threads" of my dissertation.  The whole time I had to smile, keep a positive attitude, and promise him that I would address his concerns before my defense.  At the end of the meeting I collected his signatures on the forms that I needed.

10:50 am- 11:15 am:  Trek to my department's main building to our lab to meet committee member #3.  This is probably the longest segment I have gone on the walker yet.  I was supposed to meet with her at 11:00, but I couldn't get there any faster without the help of shuttles.  By the time I arrived, I was dripping in sweat, even more exhausted than I was at stop #2.

11:15 am- 1:05 pm:  Listened to committee member #3 put my dissertation in a blender and select the highest speed.  By the end of the meeting, it was beyond recognition.  There were more marks on the paper than text.  I smiled right through the whole thing while inside I felt like my guts were being ripped out.  The hardest thing for me to hear was how my dissertation proposal was so good, that it had flawless writing, that it was so focused, that I have such a high GRE score, that I was the one that landed a prestigious outside fellowship...and this is what you turned in???  Guess what...the girl that wrote that proposal and the girl that collected all those pre-grad school accolades is not this girl.  NEWS FLASH.  When I landed that killer GRE score and doctoral fellowship, I didn't have a care in the world.  I focused solely on enjoying my senior year and setting up my future.  When I wrote the proposal, that was a year ago.  I was in a boot with my initial running injury but had no idea the next year of my life would include two ankle reconstructions...MELTDOWN #3.  Why did she have to compare my current self to my former self?  If that wasn't enough, then she had to bring up my feet and ask me why I had to get the second surgery.  She said, "You know, it was really bad timing."  In my head: DO YOU HONESTLY THINK THAT I PLANNED ANY OF THIS?!?!?!  I had two choices, (1) go forward with my life not being able to walk without pain and having difficulty with activities of daily living as a 25 year old, or (2) get another surgery and hope that my future situation will be better than the present one.  And really, all of this drama with my dissertation is because I have been caught between all of my committee members not agreeing on what they want from me.  I am 6 days away from my defense, and now they want to stir up all of these "concerns" over my manuscript?!?!?!?!  At least she signed the approval form to officially schedule my defense.

1:30-2:00 pm:  Ran into another doctoral student that I haven't seen all summer.  It was nice to catch up, but hard to suck up all the emotions that I had already been through today to focus on our conversation.

2:00-2:30 pm:  Printed and signed my lease for my new apartment.  Our lab secretary is a notary, so she notarized it for me.  I scanned it in and emailed it to my new landlord. The last thing I have to do is go into their online system and pay my deposit.

2:30 pm: Got told that my advisor won't be coming in to sign the form that I needed to turn in today!  I had spent the whole day collecting signatures from my other three committee members, and now he won't be in to sign it????? Seriously????  I called the office secretary that I needed to turn it in to, and luckily since he already sent a copy of the form with just his signature on it earlier in the week, she would accept the form I had with three signatures and attach it to that one.  Crisis averted.

3:00 pm: Started making the trek to the other side of campus via the shuttle system to turn my form in.  I realized that I hadn't eaten anything all day, not since I ate breakfast around 8:30 am.  This morning, I packed a PB & J, just in case I found myself in this situation.  I was so hungry at that point that the sandwich literally disappeared in my mouth.

3:20 pm: Arrived at my shuttle stop for the same building that I started out in today.  I had to again trek through two parking lots to get to the building I needed.  I turned in all of my paperwork to the office worker, and she said that I am all set for my defense and that my doctoral program of study is all in order, except for one small thing that I can fix by filling out a form.  I think this was just about the only good news I got today.  Graduation still on track.

3:30 pm:  I had to get back to the shuttle stop and catch it to the stop closest to my PT clinic, which is conveniently located right across the street from my school.  Of course it was the shuttle with the stairs again.  This time there weren't any friendly riders to help me.  The driver had to begrudgingly get out and help me.  Like that wasn't humiliating.  I hate feeling like I am a nuisance.  I just can't help that I am disabled right now and I need assistance.

3:50 pm: Arrived at the shuttle stop across the street from my PT clinic.  I had to cross a 6 lane highway and had just under 30 seconds to make it safely across in the crosswalk time.  I pushed my walker with my right knee on it as fast as I could and I made it with 5 seconds to spare.

3:57 pm:  I ran into a woman with a boot in a wheelchair and her husband holding her walker coming out of the PT clinic.  They had tons of questions for me and we swapped surgery stories and compared X-ray pictures.  That was the second ray of sunshine to come into my day.

4:00 pm:  I arrived to the PT clinic 30 mins before my appointment so that I could fill out some paperwork.  I was anxious, scared, and excited all mixed into one to be walking into the PT clinic again.  With the tough day I have had, it was just one more reminder that I am disabled and that I need professional help to get me back to normal activities of daily living.  On the other hand, it was another new beginning for me.  Once I started PT last time, my recovery sped up exponentially.  It will be no different this time, as long as I commit to it and do the work.  PT is useless if you don't do the exercises they tell you to do at home.  Consistency is the key.

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4:30 pm: PT SESSION #1

It was really nice seeing my therapist again.  I am working with the same one as last time, well only for the next 3 weeks, until I move.  I am really trying to ignore how I feel about not being able to finish my full recovery with him.  In a few weeks, I will be with some new foreign therapist in my new city.  I will have to exhaustively fill this person in on the last 7 months of surgeries and their recoveries, and of course take them all the way back to my original injury over a year ago for the person to understand my history.  Can you tell I am not looking forward to that?  This person is going to be like a head coach that inherits another person's team and wins a national championship with them in their first year.  They are going to get to see me FINALLY get back to walking normally with both feet, get to do high impact activities...and eventually, get back to running.  So not fair, considering all the work my therapist has put in on my recovery.  And you know what, it won't mean nearly as much to them because they won't fully understand everything that I have been through.  It also won't be fair for the new therapist, because the whole time, I will be like the annoying kid in the classroom that says, "My old teacher used to do this...and say that..."  In my head I will always be comparing this new therapist to my current one.  Good luck new therapist...this is your warning!

Back to my session today.  My therapist and I have been on such a long journey together and the next chapter began today.  We first had to do the evaluation.  He started by asking me about the history of this injury and wrote down the surgery procedures.  Then, I took off all my feet contraptions and socks so that he could get some measurements.  He was measuring for swelling and ROM between my left and right foot.  All in all, my right foot wasn't too bad and ahead of schedule than my left was when I started PT at week 7...and this is only week 5!  After the eval, he stretched my foot and we did a few exercises.  I had to move my foot up and down trying to max out my range of motion in those directions.  Then I had to move my foot slowly in circles clockwise and counterclockwise, alternating sets of 10 in each direction.  After that, my old friend...a yellow thera band returned to my life.  I had to do some plantar flexion reps with the band.  Those are the only exercises I can remember doing.  Then it was GameReady time.  I wondered how my foot would take to ice with compression, but it was just fine.

Just like my first PT session last time, it was really uncomfortable.  My right foot has been fairly untouched for the last 5 weeks and my therapist was all over it.  With every transition, pain comes back into play.  The next session should be better because it is in the morning and I won't have been at school all day.  My feet were already irritated before PT, which made it hard to tolerate more irritation.  

My therapist gave me some home exercises that I am supposed to do at least twice a day.  I will do them, because I have 2.5 weeks to get back to some semblance of walking and being able to drive before I move.

5:45 pm: Caught the train back home.

6:15 pm: Home sweet home.  Shower.  Eat.  Ice.  Elevate.

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Reflection

I am continuing to realize that I am getting some of my old resiliency back.  I used to be able to take struggle and defeat and brush it off without it affecting me too much.  Today, I had THREE meltdowns, yet I kept moving forward with everything that I needed to do.  Tomorrow, I will keep making corrections to my dissertation and continue preparing for my defense.  No use in taking my committee's comments personal, I just need to make the corrections they want and get on out of here!

Day 35 (175): 5/25 week update

*Right: 5 week surgery anniversary*

*Left: 25 week surgery anniversary*

Today marks 5 weeks since my second surgery, which means...I only have one more week of non-weight bearing!!!

Over the last week, I have been doing a lot of planning: (1) prepping for my dissertation defense, (2) preparing to move and for the start of my new job, and (3) getting ready for my upcoming surgery recovery transition.

Dissertation Defense

My defense is scheduled for next Tuesday, exactly 26 weeks (6.5 months) after my first surgery and 6 weeks after my second surgery.  Tuesdays mean more to me than they used to, so I am really happy that my defense will also be on a Tuesday.  As they say, "Only on Tuesdays."  This week, I have been working on the corrections that my committee has requested to my manuscript, getting all the paperwork signed and together, and creating my defense presentation.  I have one more week to finish it all up for the big day!

Move

After my family visited my new apartment options for me last week, I finally decided on a place.  I received the lease for my new apartment today.  I have to get it signed and notarized, and then I will be all set to take up residence in my new city at the end of this month.  My hiring paperwork at my new university is also almost complete.  On this end, my move out day and time, and the moving truck is reserved.  I still have to work on scheduling my utilities to end here and to start up at my new place.  I also have to PACK!!! AHHHHH!

Surgery Recovery Transition

Since I am coming up to the 6 week mark, I have been calling since last week to get my PT prescription sent over to the PT clinic.  I called again yesterday morning.  By yesterday evening, a scheduler at the PT clinic called to tell me that they received my prescription and that my therapist wants me to start this week!  I was like, wait...what?  So...yeah...much to my surprise, my first day of PT is TOMORROW!!!!!  With the last surgery, it took until week 7 for me to get all set up to start PT.  This time, I am starting at week 5.  Since I didn't get the tendon transfer this time, my foot is actually much more advanced at this point than at week 5 with the first surgery.  I can tell that the bones are healed, so I have started putting just a little weight on it.  I am so glad I get to start PT earlier, because I am moving in less than 3 weeks.  By the time I move, I need to be full weight bearing in the boot, or really close to it, and have enough strength and flexibility in my right foot to drive again.  I am catching a flight from here, but once I get on the other end, I need to be able to drive.  I've already selected a PT clinic in my new city, but I'll need to set up a transfer of all of my info and get a prescription for them.

Feet Update

On Friday, I had to make the journey to school to get some paperwork taken care of and to meet with a writing tutor to go over my dissertation manuscript.  I took the public transportation train from my apartment that has a stop at my university.  Getting to the train, riding it, and getting off were fine.  The problem was that the Writing Center is located in the middle of my campus where no shuttles go.  I had to trek to there and away from there while scooting with my knee on my walker.  When I got home, I decided to stop by the grocery store, since I haven't been in over two weeks, not since my dad left.  Since I had nowhere to put my walker, I ended up pushing a basket through the store with it, instead of riding a motorized scooter.  Then, I had to go a few blocks to get back home.  By the end of it, I estimate that I went 1-1.5 miles with the walker.  It was tough at the time, but I didn't really pay the consequences until Saturday and Sunday.  My back and neck were so tight, my palms and wrists hurt from putting so much of my body weight on them through the handles, and my left foot hasn't been the same since.  I broke down and took a Tylenol 3 on Saturday night, and have taken a Percocet each night since then.

Today, I had to take another trip, a few blocks from my apartment to the business center to print some paperwork.  I also stopped at the grocery store for a few items and returned back home.  This time I wore my ankle brace on my left side and my boot on my right side.  I really think that the extra stability helped my left foot.  I have another hard journey at school tomorrow with multiple meetings before I go to PT.  I will definitely be wearing my ankle brace to preserve my left as best as I can.

All of my incisions are closed and I peeled off the remaining steri-strips.  Over the last couple of weeks, I have really had trouble with one of my incisions, the one where they inserted the bone wedge.  Luckily it finally closed up this weekend.  I peeled all the steri-strips off because it has already been several weeks and I wanted to take them off before my skin grew into them too much.  I was instructed to peel them off by my doctor at 6 weeks when I got my cast removed with my first surgery.  I lost a lot of my newly repaired skin with them.  I didn't want that to happen this time.  My incisions didn't really scab up this time, since I have been able to wash them daily.  It really just looks like there is some dead skin that needs to fall off.

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Reflection

With all I have to take care of in the next few weeks before I move, on top of taking my surgery recovery seriously, I just have to stay focused and keep going.