Hey There, It's Yoga Bear!

Did you miss me?

I've taken a couple of months off from the blog in order to get back into the swing of real life. I've gone back to work, which at first was a bit daunting since nearly everything I was selling before the surgery had been discontinued in favor of new models. The nomenclature of home technology normally requires a glossary of terms to understand, but when you've been away from it for several months a Rosetta Stone would be more appropriate. I felt like I was floating in a sea of  indecipherable vocabulary, occasionally having a shark come up and nudge my leg, reaching out for a lifeboat that keeps moving just out of my reach.

And then it all made sense again.

On the foot front things are progressing as they should be. The wounds have now pretty much closed up. The last to go was the largest one on the left side of the foot, the source of all gauze related discomfort at one time. Now it has neatly scabbed over and per the instructions of, well, everyone I am not picking at the scab. However any time someone mentions not to pick at the scab the only thing I want to do is pick at the scab. Otherwise I never think about it. And if I blink or yawn, you will blink or yawn as well.

Yesterday as I was driving up to The City for another physical therapy appointment I grumbled to myself that this was going to be the last one. For two months I've been going there, riding the bike, making circles with my foot, tracing the alphabet with my foot, bending my foot back and forth, and occasionally having someone twist and turn my foot in one direction or another. Save for the last bit, everything else I could do at home. I didn't need to drive through traffic twice a week, struggle to find parking, and put up with a smelly old gym (yes, the gym's charms wore off a few weeks ago). I was going to go to this last appointment, tell them I'd call about the next one, and quietly slip off into that wormhole of customers who never return.

My resolve to do that only strengthened when my PT assistant of the day turned out to be a kid I have nicknamed Caspar Milquetoast. I'm sure he's a nice kid but as a physical therapist he leaves a lot to be desired, mostly because he refuses to put any strength into the only thing I really need a therapist for -- the resistance work. Whereas all the other guys really force me to push against them, Caspar retreats like a friendly ghost, offering little if any resistance. Having him was just another nail in the coffin of physical therapy as far as I could see.

I'm riding the bike and Caspar asks when was the last time I saw Mr. Miyagi, the actual physical therapist. Not in a couple of months I reply, so off he goes to fetch the elusive Miyagi. I must have turned my head or closed my eyes for the briefest of moments, but suddenly he appeared next to me asking how everything was and had all the wounds healed. When I said they had, he clapped his hands together like a miniature Oliver Hardy and exclaimed that it was now time to really start working on my foot. He turned to Caspar, told him to do ultra sound therapy all the way up to my knee and then a deep massage on my calf and ankle. Mr. Miyagi would then come back and do some resistance work.  Okay, I thought, let's see where this goes.

The ultra sound went fine and then I prepared myself for what I assumed would be the worst leg massage I've ever had.

A BRIEF INTERLUDE: Years ago Betsey and I went up to Calistoga  for mud baths and massage at Doc Wilkinson's Spa. When asked what type of massage I wanted I opted for the Shiatsu massage because I had never had one. After half an hour of having elbows pile driven into my muscles and fingers literally wrap themselves around various tendons and ligaments, I swore I would never have one again. That was until yesterday.

Caspar Milquetoast turned into the Incredible Hulk ("Hulk like to smash things"). I have never felt pain like I was feeling then. My calf muscles were on fire. I suddenly understood that I could never stand up to torture. If I have the secret codes you will get them with little effort on your part. I swear I thought at one point he was going to ask me if it was safe. I have never in my life asked a masseuse to stop because it hurt too much but I found myself just on the edge of crying out for Caspar to cease when, in fact, he stopped. I'm laying on the table completely drenched in sweat, completely spent, and all I've been doing is nothing.

But damn my leg and foot felt GREAT!

Once again Mr. Miyagi appeared at my side asking me this time if I had ever done yoga. Other than in college when I did it in order to ogle the girls and one time at a Club Med when I was dared to do it, I had not. Then we will start slow he said and guided me down to the floor and onto a yoga mat. This will be for the stretch of your foot he told me and had me kneel down and place my feet under my butt. Then he had me lean back and apply pressure to my calves and feet. You will do this for ten seconds he commanded and we will build up to one minute. In my mind Mr. Snark came out to play. Ten seconds? Really? We gotta build up to.....

OH MY DEAR GOD THE PAIN!!!!

I was cursing every sugary snack I ever ate in life, every time I went back for seconds at the buffet, every time I laughed at my dancer friends who warmed up while I sat there making fun of them. A minute, are you insane?! My knees will pop out and my thigh muscles will explode if I do a minute.

And it was when I was doing that last one, the one lasting a minute, that Mr. Miyagi bent down and asked, "When will we see you again?"

"Next Wednesday", I croaked.

Life in the Scooter Lane

Say hello to my little friend.

The one basic rule of my post operative care is to never let my left foot touch the ground. No pressure can be applied, lest the healing bones shatter and I return to where I started. Years ago this would have meant not getting out of bed for six months. New surgical treatments (those screws you've seen in the X-Ray) have made it so I can get up and around, but I still have to keep my leg from touching the ground. There are two ways to accomplish this, crutches or the knee scooter. I will be the first to admit that my upper body strength is not what it used to be, if it ever was at all, so crutches were out of the question. That left the knee scooter. 

Betsey, being the half of our marriage who is actually capable of thinking ahead, rented a scooter a couple of days before the surgery. Now we could have bought one, in fact we could have bought one pretty cheap on Craigslist, but our feeling was that it was going to be better to just turn in the damn thing when it was no longer needed than to have it taking up space in our small garage till we finally had the time and inclination to go on Craigslist ourselves and sell it. Besides, the ones on Craigslist all came with admissions like "steering doesn't work well"  or "our six year old decided to decorate it for daddy".  Renting the scooter also gave us the option to return it for another one should something go wrong or I decided I really needed the schoolgirl's bike basket accessory to hang off the handles. This is embarrassing enough. And all talk of a bike horn or bell was quickly sent to the dead letter office by the scowl on my face when it was brought up. 

What's it like to perambulate with one leg on a scooter? Well imagine if every time you wanted to do anything, like  get a glass of water, you had to get into your car, back up out of your driveway, then made a three point turn before heading out straight. Once you arrive at your destination, which was only a few feet away, you now have to parallel park between two cars that, while you do have enough space, you don't really have a lot of space. Oh, and no cup holders here, so the return trip means you have to do all the same things only now with a glass of water in one hand. 

All this does mean that I need to be very specific about what the objective of the movement is. If I need to get from the living room to the bedroom I better remember to take everything I have in the living room that I want in the bedroom with me. Failure to do so means frustration and and a self inflicted dope slap to my forehead. It also means I have to bury my natural inclination to want to get things done quickly. Believe me, there is no quick on a knee scooter. Oh I just need to grab something off my desk, oops, don't put that left foot on the floor, get the scooter over here, swing the leg over, okay back up, make the turns, ah now I can get that pad of paper. 

But it's not the obtaining of objects where the greatest hurdles must be overcome. Surprisingly the toilet, while it does take some knowledge of advanced geometry to align oneself properly, is not the biggest problem. It's bathing where ingenuity must be employed. Remember, no pressure on the left leg of any kind and I can't get the cast wet. What it comes down to is I  put all my weight on the bad leg's knee, which is planted firmly on the scooter so my foot has no pressure on it and then I swing the good leg into the tub. From there I turn on the shower and get as much of my body wet as I can, soap it, and get as much of the soap off with the spray from the shower head as I can. What soap I can't get the spray to I simply dry off with a towel. 

Still there are limitations. Stairs? Forget it. Even the single step up from the driveway to the pathway leading to the front door I can't negotiate myself. In fact, any surface that's not perfectly even has me afraid of going head first over the handlebars. Activities outside the house have to be scrutinized for how I could deal with it. I am disheartened that I will not be able see my nephew in his high school play this weekend because sitting in an aisle seat (which it would have to be) with my leg straight out, unable to get up to allow others to pass, just isn't going to work. 

Yet I have to remind myself this is ultimately a temporary situation. Once healed I'll be able walk, run, chase frisbees (all right maybe not the latter). I won't be perpetually seven steps behind because of my limp or screaming in agony after being too long on my feet. 

And that's what this is all for. 

17 Days Later....

Traffic was a bear getting into San Francisco today. Who thought it was a good idea to schedule a follow-up appointment at 9 AM on a Tuesday morning? We're in the middle of commute traffic. Fortunately we were able to play a good game of "Spot the Techie Bus" along the way. Google still won, but Facebook, Yahoo, and Genentech all came pretty close. Passing a decrepit passenger van, I opined "that's the MySpace bus". 

Arrived at the CPMC campus just in time to make the appointment. Into an exam room we went, ushered in by David, Dr. Knee's new assistant. At least I think that was his name, he kinda mumbled an introduction. I would say I hopped up onto the table, but then again unless I'm one knee on the scooter, I have to hop in order to get anywhere. So in this rather small exam room there was Betsey, me, the assistant whose name I think is David, the knee scooter, the table, a chair for Betsey, a rolling chair and not much room for anything else.  David (let's call him that for the sake of brevity) took my vitals and brought out....the saw.

Having never had a cast before and therefore having never had a cast removed before, the saw was a bit intimidating. The fact that it came in a hard plastic case similar to what a jigsaw from Home Depot comes in and looked like the Dremel electric router I acquired somewhere along the line didn't help either. He placed it reverently on the floor next to the table. I swear it hissed at me, it's snake like tail plugged into an outlet and ready to rumble.

Dr. Knee poked her head in with a cheery "Hi kids, how we doin'?". Opening the door knocked David into the scooter which decided  to make a break for itself but was quickly grabbed and set back in place. David took a powder at that point and Dr. Knee got down to the business of removing the cast. I'm sure she thought of it as completely routine. I thought of it as this:

Do you expect me to talk Dr. Knee?

But moments later the cast was off. Strangely enough over the past two weeks I had thought that the first thing I'd do after getting the cast off was reach down and scratch away like a mad man. Instead, I had no desire to scratch at all. However looking down, what I saw concerned me. My foot was puffed up and swollen and in a distinct shade of orange which nicely set off the black of the stitches. So as to prevent young or sensitive eyes from having to get a close up view, you can take a look at a picture here. But Dr. Knee was oohing and ahhing about how good it looked, how the swelling was less than she expected and how well the stitches held up.

"Umm, but what about the orange tint?", I asked.

She laughed. "That's the sterilization liquid from the operation. You know, like iodine before we had to stop using iodine." 

And it was at that point that I realized I hadn't washed my foot in seventeen days; of course that stuff was still going to be on it. And that I didn't know they don't use iodine anymore.  I breathed a sigh of relief and relaxed. She wrapped my foot in an ace bandage and sent me off to X-Ray for pictures. Here's what they found:

This apparently is a good thing.

Back in the office again it was time to get the stitches out. While Dr. Knee was going over the x-rays, David came in and announced he was going to take out the stitches. Oh, I thought, so the doctor doesn't do that? The ambiguously hipster twenty-something does that? And why do I have a feeling mine might be the first time he's not practicing on his mom's Sunday roast beef? With a combination of  feeling "someone's got to be the first", wanting to get this over with, and knowing that the doctor was only steps away should it come to that, I let him loose. 

"So howya think the Giants will do this year?"

Other than his running out of the room to find out if it was normal for there to be as much blood as there was (it is), it all went fine. A snip, a tug, and soon the table was covered in little bits of black thread. For the after picture click here. Dr. Knee came back in and put a new cast on. Two weeks with this cast and we'll see if the bones are strong enough to actually be able to put weight on the foot. If so then I get a walking cast. Once that cast comes off, she'll send me to these guys for them to stretch and manipulate the ligaments, tendons, bones, and nerves:

"We're going to stretch your little girly-man foot"

Sigh. It's a process.

Top Ten Things I've Learned So Far As An Invalid

1. The cat really does sleep all day long.

2. You don't need as much coffee if you're just going to sit around all day.

3. The predominant commercials on daytime television all seem to be for law firms soliciting clients for personal injury cases or class action suits against pharmaceutical or medical device companies. 

4. On  a gray cloudy day like today, with rain but a moment away, it is better to be sitting in a comfortable leather chair while wrapped in a thick green sweater than taking a tour group out to Alcatraz.

5. Though the body may be bound, the mind can always run free.

6. Previously simple everyday chores become triumphs of the spirit when accomplished on a knee scooter.

7. Naps can never be overrated.

8. I'm seriously considering getting a pair of binoculars and going all Jimmy Stewart in REAR WINDOW on my neighbors.

9. When your wardrobe choices are limited to sweatpants and t shirts, getting dressed in the morning is a breeze.

10.If one forgets there is a cast on one's foot and crosses that leg over the ankle of one's good leg, the pain subsequently inflicted is one's own damn fault.  

The Pictures Don't Lie

Contrary to popular belief, in the immediate aftermath of my surgery I was NOT put into a cast. Rather I was put into a splint to allow the swelling to recede and any residual bleeding to ooze out. 

Oops, hope you weren't eating dinner while reading that.

So today I got my first outing since the surgery. I got to get in the car and drive up to San Francisco for my first follow up appointment with the surgeon and if everything looked good I would have a cast put on. The surgeon's name by the way is Alicia Knee. This is a picture of her:

In the movie of this experience she would be played by my friend Tamara Zook due to the fact they were obviously separated at birth. Also they share a personality.  When I first met her it seemed strange to have the woman who stood comically toe to toe with Robin Williams and Billy Crystal and gave as good as she got (see FATHER'S DAY)  telling me how she was going to re-sculpt my foot, but a few jabs in the ribs from Betsey reminded me that Tamara was not in fact going to be doing the surgery and in fact was on the road with (shudder) I LOVE LUCY LIVE ON STAGE. 

But I digress. 

It felt so good to get out of the house. I don't think I've ever spent this much time cooped up in one location. I was so happy I wanted to put my head outside the window and feel the wind on my face. I wanted to let my tongue loll out and put a giant smile on my face. Betsey said that was not socially acceptable. I acquiesced as she had a rolled up magazine in her hand when she said it.  

It was a beautiful day for a drive and everything was going right. We sailed into the city with little traffic hassle and even found a legal parking space right out in front of the California Pacific Medical Center. I even discovered that the knee scooter and San Francisco hills could produce some fun activities that I doubt I would have tried without being under the influence of heavy pain medications. I scored an 8.7 from the Russian judge but the French judge only gave me a 6.3 so I finished just outside the medals. 

At last we made it into the office. I was excited to see what was underneath all the bandages that had weighed like a cement shoe on my foot for the past four days. I wanted to see the miracle of modern medicine that would have me walking proud and proper in just a matter of days. Here is a picture of what I saw. I link to it rather than show it just in case you are still eating dinner.

It was fascinating to see though. My foot might look like something Dr. Frankenstein would have cobbled together, but Dr. Knee said it was all normal. I finally got to hear just exactly what had gone on in the OR during the surgery. I know that she had told me while I was in the recovery room, but I also apparently was singing quite loudly at that time so anything she might have told me I honestly don't recall. Apparently when the tendon snapped into place with a giant PLOP, the surgical nurse announced "That's the sound of freedom". I thought that was rather poetic till I was informed that the surgical staff is made up of former military medicos who were more than likely referencing that it sounded like a gunshot. Oh. Well. Never mind. 

Since everything looked good on the outside it was off to X-Ray to snap a few 8x10s just to double check the inside. Here's what they showed (and if you're still eating dinner, jeez finish up already):

It may be modern medicine and the miracles associated with it, but what I see is a couple of wood screws in my heel and a metal plate on the top of my foot that has me thinking TSA is going to give me a good going over the next time I fly. But according to the experts it all is good and so at last I got my cast. Dr. Knee made me promise I wouldn't Beadazzle it, which I guess is a problem with her younger female clients. I said at most it would be sporting a SF Giants logo when I see her in two weeks. 

Welcome to The Coloring Book

Today is my birthday, the 56th anniversary of my birth. On most birthdays I'd be either working or spending the day having an adventure my wife planned out. She's very good at planning out adventures.

Instead this birthday I'm the one planning. Planning on having my left foot re-sculpted so I can once again walk like a normal human biped. Actually strike that. A successful operation will mean I'll walk like a normal person, perhaps for the first time in my life. Currently my foot is such that I walk on the side of it, my big toe riding high and the left side of my foot callused, the tendon stretched into uselessness. As you might imagine, it's quite painful. Amazing thing about the human body though, once you've had the pain long enough, you get used to it. That is until I place my foot wrong, or walk on an uneven surface, or walk for a long period of time. Then the pain shoots up to my eyes, hot daggers dragged mercilessly up the back of my leg till I beg for a moment to avail myself of the opiate of deep breathing and visualization of my "happy place". And a hit of Advil always helps too.

Once upon a time I went to an orthopedist who prescribed an orthodic "device" to insert into my shoes. It was supposed to force the left side of my foot up and the big toe back down. Like a comic book super villain pestered by the futility of mere bullets to harm him, my foot would grind down the device till it cried uncle. After several versions over the course of several years and way too many hours of physical therapy provided no relief, I gave myself over to the idea of a surgical repair. .

I had nothing better to do for three months anyway.

Yes, that's three months of recovery. Half will be with no weight allowed on the foot at all, then half with very limited weight bearing. Basically bed ridden.

There aren't enough books, movies, and music to make that bearable.

When I was little, if I needed to go to the doctor I would be rewarded with a pretzel, an egg cream, and a coloring book. While the pretzel and the egg cream were greatly appreciated, it was the coloring book that made all the difference. It was what took my mind off the pain of the shot, or the fever, or the stomach ache. And yes, I was one of those kids who colored inside the lines.

But I did like making the sky green and the trees orange and the boy white and the girl black.

This blog will serve as my adult version of a coloring book. 90 days from Friday I  hope to be back at work with a new spring in my step and a song in my heart.

Here we go.