Two Steps Forward, One Step Back

Why Do I Post These Updates?

Before I get to the topic mentioned above, I thought I’d give some of the rationale on why I post these detailed insights into my current medical situation.

I’m not doing it for personal glory, nor to try to shock you with all the details of what I’m going through. Rather, I recognize that we all encounter new things/challenges in our lives and we need to adapt to these changing circumstances. It’s important to remember that God is in control of all things. So we can rely on Him to help us. Thus, rather than be upset that we are not in control ourselves, we don’t have to be upset, but can learn from these new/changing circumstances.

 

New Steps Forward

The past several weeks have been a bit of a wild ride. First, about two weeks at home not feeling great because of COVID, then two and a half weeks in the hospital, then two weeks in a rehab facility, and finally a few days at home. I’ve known for quite a while that getting my right big toe amputated was a possibility, but it was a bit of a shock when the doctor determined that I needed a trans metatarsal amputation, i.e., the entire front of my foot. But I dealt with it with little difficulty and took the opportunity to minister to others in the rehab center.

There have been two really positive “side effects” that I’d like to share:

First, probably because of the CCD (Constant Carb Diet) that I was on in the hospital and the rehab center, my weight has been dropping. As of my latest stepping on the scale at home (which I’ve used before, so I know it’s pretty accurate), my weight is down 20 pounds compared to a few months ago. I’m now at the lowest that I’ve been going back at least several decades. I’m now in the “older normal” range. Now my challenge is to keep it off. My wife is trying to replicate the same CCD types of meals, but that’s not been easy, as she doesn’t know the portion sizes that they were using.

Second, and also related to that same diet, my average blood glucose is holding fairly consistently in the range that I’ve been shooting for over the last few years since I met with a nurse who started me on insulin, i.e. 100-130 target. My A1C the last few times it was measured was about 6.8-6.9, indicating a glucose level of about 140. But my average over the last 30 days is only 115, indicating an A1C of 5.4. Not sure if I’ll be able to keep it there, but if I can keep it below 130, that would be great! (This morning I was at 113, so this new diet appears to be working!)

 

One Step Back

However, I have had one setback….

It was great last Friday to have the wrap on my foot removed, the stitches taken out (after less than two weeks post-op), and come home. But then I had to figure out how to adapt the getting around on my knee scooter, going up the few steps into the house, and to make the various transitions to recliner, to bed, etc.

When I went into my den and wanted to get off the scooter into my recliner the alignment of the scooter to the chair was on the wrong side of the scooter, and there was not enough space to turn around. (I’ve now changed to getting off on the futon first, then making a second transition from the futon to the chair, but this was my first time and I hadn't figured that out yet.) Even with the assistance of my wife and daughter it was awkward. In the process I began losing my balance and I set down my right foot to stabilize myself. While I caught myself, I twisted my right ankle and heard an audible “pop” and felt a pain in the back of my right heel.

While neither my wife nor my daughter had heard the “pop”, I believed that it was like my Achilles tendon. It was late enough in the day that the orthopedic surgeon’s office was closed, but I contacted his office and left a message about what had happened and asked for an appointment on Monday. On Monday morning I heard from his office and we scheduled a short visit for early afternoon.

He quickly determined that I was correct in my analysis. He did not seem overly concerned as part of the eventual plan was to lengthen that tendon to compensate for the lost dexterity in my now shortened foot. But in the meantime, I needed to have it splinted to give it time to heal without any further damage.

[Splinted Foot]

 

The above picture shows the size of my splinted right foot compared to my still-normal left foot. You can see the size of the combined splint and wrap. The splint has several layers: gauze against the skin to prevent irritation; a sock to hold the gauze and give a slippery base; a splint (material that is wet to activate, then the water squeezed out, then shaped from beyond the front of the foot, around the heel, and up to just below the back of the knee where it hardens in a minute or so); a wide tape of elastic material. I covered it with bag-like black sock that my daughter got for me that keeps it all clean and doesn’t look quite so clinical.

So now my foot is immobilized and I can’t bend my ankle for the next two weeks. Just one more adaption!

 

Movement and Transfers

The process of moving around and transferring to various seats has been a shifting landscape. In the hospital I was confined to bed and only allowed up to sit on a commode right next to it. The bed was alarmed if I tried to get up, so I had to call the staff then stand and pivot on my left foot. In rahab I started out on a wheelchair with a right leg support and had to get cleared by the therapist to demonstrate that I could transition to the toilet before they would let me go unattended. Then I got a knee scooter but had a belt around my middle that they could hold to ensure that I did not fall – eventually cleared to use that unattended as well. Finally got training on a stair-climbing cane to show that I could go up/down the few steps at home.

At home I started using the knee scooter, but it requires space to turn and so it was very awkward for things like going to the bathroom as there was no turning space. I’ve now transitioned to using crutches in the house and using the knee walker when I go out (so far only to doctor visits and church). This also facilitates any transitions (to recliner, to bed, to kitchen chair for supper) as the knee scooter only allows exit on the left side where my left leg is. I’m also using a urinal so I don’t have to make the trek to the bathroom if I wake up at night. Every change creates a new learning experience!

 

What’s Next?

If all goes well, then the splint on my leg will be removed in two weeks. Then I can make an appointment with a local company that will make a prosthetic insert that will attach to the front of my foot and enable me to use a regular shoe. I’ll then be cleared to drive and be somewhat back to normal. Not sure when I’ll need additional surgery on my ruptured Achilles tendon to give me the needed flexibility.

I’m continuing to learn new things – new things about my body, new ways to get around, new adaptions needed to transition, etc. But in all this, God is in control. Psalm 46 says, “God is our refuge and strength, a very present help in trouble. Therefore we will not fear…” I will continue to rely upon Him!