So What's Up?

It's been a while so I thought I'd bring you up to speed on what's been happening lately.

First, on the medical side, the last trip to the pain management docs yielded four things. I can keep weaning off the suboxone, I can start weaning off the lyrica, I can stop taking the tramadol, and apparently I have completely exhausted all their capabilities.

The suboxone and lyrica are both types of pain meds that they want me off of and I want off of. Besides, they were none too effective anyway. The tramadol is another pain med given to em for dealing with the pain created by physical therapy. It wasn't working at all.

After all this I told them my feet were in some level of pain all the time. The essentially told me that's just too damn bad because they had nothing else to offer me. You would think since they are pain specialists and there are an absurd number of medications out there that they would be able to figure out something to help me with my pain. Apparently not. I'm on my own from here on out.

On the physical therapy side of things, there have been a few changes of late.

The balancing exercise I told you about where I stand on a trampoline with my feet in various positions has been modified. They now through a ball to me while I stand on the trampoline. Talk about some hard work! My feet and knees feel like Jell-O after that one.

My time on the elliptical machine and the total gym have both been increased. I expect the elliptical will continue to be increased much as the treadmill was. That thing is quite the workout and I'm rather enjoying it even though sometimes it feels like I'm gonna fall off the thing.

My weights and/or reps keep getting bumped up on my platform and leg extension machine exercises. The platform work is cool, but I could not hate that machine any more if I tried. It is a booger to get in and out of, it is a booger to setup and use, and by the time I am done on it something about it makes my feet hurt so much I can barely stand up.

Finally, I think, they have modified my stationary bike. Until today I've been using a bike they had removed the seat from and I operated it by sitting in a chair behind it. Today they put me on one with a seat to increase my aerobic activity and to work my back and my balance a little more. That's all well and good except that the seat on that thing could not be any more uncomfortable if it were made of a block of old hickory. I swear my butt must be bruised like I just took a good old fashioned beating!

On the work front, I gave them an update on my situation and they could not be any more supportive. I am so very lucky in that regard. They continue to tell me to take all the time I need and even though they'd love to see me back, they would rather I do what I gotta do and take care of myself first. How great is that?

As for my walking, I am now using the straight cane almost exclusively. I think we've used the wheelchair once and the walker twice in the past week, and neither ever get used at home except when I use the walker in the middle of the night and in the morning to steady myself a bit when I first get out of bed.

That is not to say there are no consequences for all the walking. I need to walk as much as I can, but it is causing all kinds of extreme swelling from the tip of my toes all the way through my ankle. I also have a wide variety of aches and pains to go with the swelling, the worst being in the balls of my feet and in my ankles as everything gets used to being used again. And now that I'm getting off the lyrica, I should have a nice variety of pains come in as nerves reawaken and I have nothing to dull the effect.

It never ceases to amaze me that for the amount of damage that was done to my heels and the extensive surgery that was done to repair them, I have almost no pain in my heels. I do have one little spot on one heel and I'm still not used to walking on hard surfaces without shoes so that hurts them a good bit, but other than that, it's the rest of my feet and ankles that are causing me all the pain and discomfort. Weird.

That's all I can think of for now so I'll close with this little reminder....

Save the handicapped stalls for handicapped folks if at all possible. They don't have any other options and they often have other needs than just the basic business.

I know. That was kinda weird too, but trust me. It's important!

PT Update 17 July 08

Today got off to a rough start. I wasn't feeling very well to begin with, but to add insult to injury (no pun intended) I woke up with my feet almost as swollen as they are late in the evening. This is NOT a good thing!

But I am determined to not let anything get in the way of doing at least SOMETHING, we head off to PT and I hope for the best.

The best was not exactly what happened, but we did have a few changes.

First, as you can see in the pic above,they started me on a new machine today. The elliptical. For those not familiar with this particular little lovely piece of torture equipment, it essentially gives you the same physical and aerobic workout as running, but without the impact.

From what I could tell, the main adjustments on this thing is the level of resistance (I started at 1, of course) and how long you spend on it. Today I put 7 minutes on the thing and it wasn't too bad. In fact, I kinda liked it. Getting my gimpy self on and off it was a challenge, but it was kinda nice...for now.

The next big change is, since I'm using a friend's treadmill at home, we are dropping it from the routine at PT to give more time for other fun. Also, we are changing the emphasis on the treadmill from building time to keeping the time static at 30 minutes and working on form, gait, speed, and incline. In that order. So when you look at the treadmill log you'll see what looks like a dip in my progress, but it is planned that way. No big.

If you'll remember I told you some time ago about an exercise of standing with my feet in certain positions to work on balance. Well, for the last few sessions we've been doing that with a bit of a twist. I stand on pillows for more challenge. Today we ramped it up a bit more. I stand on a mini trampoline! Talk about a challenge!

To add to the fun we are now waiting to see if insurance will approve more sessions. You may have noticed that we only had 2 sessions this week. That's because we are only approved for a total of 25 sessions unless and until we can show the insurance company that I still need to keep going. Since we are quickly approaching that limitation, we're cutting back on the frequency a bit until we hear from the insurance company. It is obscene that some insurance company rep with no medical knowledge has such a powerful role in dictating medical care from their little cubicle. But that's a whole other rant.

So that's about it. More challenges, more work, and steady progress.

Bless you all.

Treadmill Log Update

I made a bit of a change in the log.

First, and most obvious, is I changed it to a plotted line area graph just to through some color in there.

The other change is not quite so obvious.

There is another line in there and it is defined as a "Progress Index." This is a value which is derived from all of the other values in the graph, but it also takes into account the incline of the treadmill. My hope is that this will give a more complete indication of the overall progress while still being able to see the individual exercise factors. Adding the incline itself into the graph skews the overall viewability of the graph, but this "Index" helps to show its effect on the overall exercise value.

I also just discovered that while the PT treadmill incline is based on degrees, the one I am using at home is based on percent. So, I need to go back and recalculate to equate the two so you'll see some strange fluctuations in the graph soon.

That's it. Short and sweet this time.

OK, So What Have You Done Lately?

Funny you should ask.

As of today, Scott decided I am doing well enough that it was time for a little bit of change.

I still use the wheelchair primarily when we are out and about, but he wants me to start using the walker more (under close supervision, of course).

But you know that thing about using the walker solo at home and we'll start learning to use a quad cane? Well, that's out the window.

I am now cleared to use a regular straight cane at home, without direct supervision, as much as I can tolerate! We completely skipped the quad cane! Woo-hoo!

Other than that, things went pretty much as expected except this was a late afternoon session. This meant my feet were already sore, stiff, and swollen by the time of our appointment. That made the session nothing but a sheer test of determination, will power, and endurance. Check out the Therapy and Treadmill logs and decide for yourself how I did.

The new leg machine is an adventure. Getting in it wasn't too bad although it is reminiscent of the Mercury astronauts getting into their space capsules. The exercises were a VERY good workout, even at only 10 lbs. My knees are still tired 5 hours later. Getting out of the darn thing was a nightmare. I thought I'd be stuck there and I'd be found later with my arm partly chewed off in a hopeless attempt at escape! OK. Maybe it wasn't quite THAT bad, but it was something I'm gonna have to work on. The exercise don't mean nuttin' if you can't stick the dismount! Ask any gymnast!

So that's about it for today. Praise The Lord and pass the ice packs!

PT Update

Well, another day, more changes.

I was expecting just another routine PT session, except going longer on the treadmill. Wrong.

I DID go longer on the treadmill (30 minutes). I also went a bit faster (1MPH) and, as it turns out, during the last 3 sessions the treadmill has been at a 2 degree incline. But that wasn't enough. They also threw a couple of new things at me.

First, you may recall I mentioned some new balancing exercises where I stand with my feet in certain positions and let go of my walker for 30 seconds. Well, I still do that, but now I stand on pillows. Once that looks good, I'll be standing on a trampoline!

Also as I've mentioned before, we've been talking about starting on working with a quad cane. That's those canes with four feet at the bottom. We may still do that, but Scott has his eye on pretty much skipping that and getting me to a straight cane!

For those of you not watching my Physical Therapy Progress Log, I am up to using 10 pound ankle weights (that's 10 pounds on each leg) when I do my platform leg exercises. Apparently this is not enough. Starting Wednesday, I will be using a new machine. It's the one Annie has me trying out in the picture above. Once I get used to it, we'll be jacking up the weight and reps some more, so watch for that new column being added to the PT Log.

Well, I guess that's it for today. If it's not, it should be!

Little Gains, But Good Ones

There haven't been a lot of big gains lately and no more are really expected for a while. However, there have been a few small ones that are really pretty cool.

As mentioned in a previous post, I can now get in the van. But now I don't need to use the walker to get into it. I can just step, turn, and sit. All I need is to hold onto the van during the transition for a little help with balance.

I am about to make the move away from the hospital bed! The past couple of nights I've been sleeping on a regular bed and that's been going pretty well. So some time this weekend we will probably rearrange things a bit, completing the move to "the big boy bed."

Next, as some of you saw, I had to use a 'sliding board' to heft myself from place to place. Well, I don't use it for anything any longer. I can just stand and step to what I need to move to. Like getting into the van, I still need to hold onto something for a little help with balance, but that's it.

Probably the biggest improvement is that I don't use my wheelchair in the house. At all. Ever. I now use my walker exclusively at home. Pretty soon we'll start trying to use it elsewhere as well, working towards getting out of the wheelchair altogether. Pretty soon, they're going to start working on teaching me how to use a cane of some sort instead of the walker.

I still have a long way to go. I'd like to take a regular shower. I want to drive my X. It'd be nice to be able to find caches myself. I'd REALLY like to walk without assistance or supervision. I could probably go on listing stuff all day, but there's really little point in that. It will all come in time. For now, I'll take all the small victories I can get!

Back on Track

After the previously reported setback, I had to take some time to let things settle down. My right achilles and the stuff that wraps around the heel is still very tender and is slowing me down in some ways, but things overall are coming along anyway.

As you can tell from my therapy log, my leg weights are now up to 10lbs (per leg) and I am racking up more time on the treadmill (Time on the treadmill is more important than speed. Speed will come on its own later.) and on the Total Gym.

Also, my step-ups have gotten easier and I've graduated from seated ankle rocking exercises to doing them while standing. That's a little hairy. I stand with both feet on a rocker board and rock back and forth on my ankles while trying to not fall on my...self.

I've also been given the OK to use my walker in the house without someone right next to me although I still have to have someone near. The objective here is to use my wheelchair as little as I can stand when in a semi-controlled environment. This will help with leg strengthening, swelling reduction, balance, nerve regeneration, and more.

I don't see any more huge leaps of progress like we were doing early on, but these little steps are just fine by me!