Stump Flexing #NSFT

Don't worry, I was just tired.  This isn't the result of too much Percocet.
I told a friend of mine I'd put together a video displaying how my reattached lower leg muscles now work in the residual limb.  While Brooke and I were changing the dressing and cleaning the limb, I put together this video to show off my stump flexing.  If you'd like to see another recent amputee's similar video, check out my friend Christina's stump flexing video here.
Stump Flexing Video
The video may or may not end abruptly because I was tired and in a rush to wash the limb. 
The phantom pain continues to improve every day.  I'm really liking the 600 mg of Gabapentin.
Yesterday was my first time to get out of prison the apartment for something that wasn't a visit with Dr. Attinger or Elliot.  It was awesome!  We spent most of our time celebrating America outside grilling by the pool.  I was worried about a few things, like sweating too much, not being able to keep my limb elevated, and offroading with the crutches, but it all ended up being absolutely fine.

To feel like I was a part of the team and joining in on the festivities, I had a few non-alcoholic beers.  O'Douls website cracks me up.  You still have to be over 21 to enter.  It also plays music.  No one on the Internet finds that annoying.

At 6'3", I guess I'm a little taller than most people.  My buddy Matt is a hobbit and also does not know how to use my awesome Millennial Medical crutches correctly.  They're backwards, Matt.  Backwards.

Troy snapped this picture with my GoPro and caught me with my legs crossed.  I've discovered that it can be done with a stump, but it's just not the same.  I miss my ankle leg crossing.
Below are the pictures we took of the wound last night.

Shrinker, Sedation, and a Sidekick

Elliot vs. Stump Shrinker

This morning we met with my prosthetist, Elliot, at Orthotic Prosthetic Center in Fairfax to get my stump shrinker.  It was a simple and easy visit.  

Elliot was impressed with how the residual limb looked.  He also made use of the word, "textbook," to describe how happy he was with the progress.  The limb, with respect to its shape and volume, is very close to being ready for a prosthesis.  Elliot was expecting the leg to be much bigger.

I took some pictures below to demonstrate how to put a shrinker on.

The shrinker is very similar to a sock.  It's lined with hundreds of rubber bands to help constrict and shape whatever goes in it.  It's open at both ends.  I explained on Monday why this thing is necessary.

One end goes on over the stump.  I no longer have to wear an Ace bandage wrap.  I can put this right over the cotton wrap for the wound dressing.

I have to pull it up snugly all the way over the knee.

Once that's done, I pull that ring down as close as I can to the bottom of the stump.

Then I pull the remaining part of the shrinker back over itself.

Here's what the bottom of the shrinker ends up looking like.  You have to be careful that the two ends of the shrinker aren't too close together.  Otherwise that could create an uncomfortable tight spot.  I will wear this constantly to keep the limb size down.

Because the residual limb looks good and is close to its final shape, Elliot scheduled me to see him again just a few hours after we see Dr. Attinger for our four week follow-up.  Given everyone's excitement at how quickly it's healing, I'm hopeful that I'll return to walking in July instead of August.  Elliot's plan is to begin the process of taking a mold of my leg for a test socket that same day I see Dr. Attinger.  

I could be walking on a test socket that week, two weeks ahead of schedule!  Whether or not that happens depends on me not falling and whether Dr. Attinger releases me to Elliot for good.

So that's some good news for today.  We also heard a funny story from the surgery from Elliot since he was invited to help measure the cut (measure twice cut once).

Apparently I'm a hard guy to knock out.  At the time I was a very anxious and highly strung 6'3" and 198 lbs dude.  The patient anesthesia team, through tremendous effort, could not knock me out and struggled to get the epidural to work.  At one point, when it looked like they'd finally given me enough medication to knock me unconscious, I sat up on the operating table and started cracking jokes again.  This led Dr. Attinger to proclaim they'd all be there until midnight.  The wonderful anesthesia team eventually got all the bugs worked out.

They said I wouldn't feel my butt for weeks.

I thought that was hilarious but also not unusual.  It took multiple attempts to consciously sedate me right after my accident in Breckenridge in order to remove my boot from my dangling leg.

On final thing I'd like to point out before concluding this post.  Notice in the first picture of this post above that Brooke is sitting in a chair against the wall waiting patiently.  She's been the most awesome, loving, caring, and patient sidekick a guy could ever ask for!

I went back through some old photos of our ankle battles and found very similar images.

I know I keep ending these posts with how awesome my wife is, but holy crap she's awesome.  I love that woman!

Recent Awesome Tweets

You might remember Meg from one of my earlier posts.  She's a fellow ankle arthritis sufferer and used to enjoy jumping five stories to break, like, basically every bone in her body.  And by enjoy, I mean she did not enjoy it.  She's very lucky to be alive!

And I'm lucky she found me and the blog.  Meg's been a big supporter.  Us ankle pain sufferers need to stick together.  She's currently seeing the same orthopedic center up at Mercy that I saw when I was working with Dr. Jeng.

Earlier today she had her external fixator removed at Mercy in Baltimore.  She sent me some awesome tweets that just made my day!  In case you don't follow me on Twitter (what are you, crazy?), here they are.

Sometimes I'm just amazed at how special and amazing nurses and professional caregivers can be.  But then again, I married a nurse, and I see how awesome they are every day.  It was really cool of Meg to update them on my status (though, seriously, they need to keep up to date on the blog!).

Thanks, Meg!

I also got an awesome Tweet from another person I admire.  Amy Purdy.  She's a bilateral below-knee amputee snowboarder, motivation speaker, and top ranked world adaptive snowboarder.  I'm sure she knows the Original Gimp.  I couldn't believe I hadn't heard about her in all these years trying to fix my ankle and get back to snowboarding.

Anyway, a few days ago, after reading her story, I sent her a Tweet to let her know I was a big admirer.  She sent me this Tweet earlier this evening.

Of course Brooke and I would love to!  However, while I was in the hospital, I also sent these Tweets to Zach Anner.  For those of you that don't know Zach, he's a TV and Internet comedian with cerebral palsy, the sexiest of the palsy's as Zach would remind you.  The guy is hilarious and I'm a huge fan.

In case you're wondering if my initial Tweet was tasteless, his profile said he's back on the Internet and more disabled than ever.  I was really pumped he reached out to me.

Just between you and me, I hope Amy and Zach aren't just being nice to me on Twitter and humoring me.  Brooke and I would love to get a chance to meet these inspiring individuals and hang out with them and our friends on our first return trip back to snowboarding.

I broke the news to Amy and let her know that I've been seeing other people on Twitter.

Hope she's cool with it!

We should seriously start thinking about turning my first trip back to snowboarding into an event that helps others somehow.  Not sure how yet.  Going to need to brainstorm on that one.

In the meantime, I need to keep healing!  Tomorrow we get a stump shrinker to shrink this stump!

Snowboarder vs. Tweezers

No suture removal today.  Just a cleaning.  Like going to the dentist.

Good news and bad news.  The good news is Dr. Attinger, nurse Katherine, and our NP, Margaret, all thought the limb, incision, and recovery was going excellent.  They said it looked "textbook."  I'm on board with that.  I love books.

The bad news is we didn't get pictures from the operation.  The anticipation is driving me nuts!  I can't wait to see them.  According to Dr. Attinger, they're "still under development."  He's a busy dude, so it was understandable.  Hopefully in two weeks we can get our hands on those precious files.

His team takes almost as many pictures as I do.  In this picture you can see that the nurse tech placed a clear and sticky ruler on my leg to provide a sense of scale to the image later.  She also used the blue backside of a wound dressing mat to get a better picture, "on Dr. Attinger's orders."

We'll have the sutures removed in two more weeks.  Dr. Attinger's team likes to play it safe and keep the sutures in as the wound continues to heal.  If for some reason the incision broke open and dehisced, I'd be in a bad situation without them.

You only want to take sutures out once.

We handed Dr. Attinger our thank you card for him and his team.  When he saw the picture he burst out laughing and thought it was a great picture.  That's high praise.  The dude's an awesome photographer.  Seriously, check out his pictures on that link.  They're displayed all over the hospital.

Dr. Attinger took the thank you card and taped it to the front of his office door to show it off to everyone.  I need to remember to get a picture with him and Brooke.  We love this guy!

Now that things look good, I'm allowed to starting wearing a stump shrinker.  This will help reduce the size of my residual limb and get it close to its final shape and volume.  Without a shrinker, my limb would be like a water balloon with two bones in it.  As the day goes on, the amount of water in that balloon changes, which makes it difficult to fit snuggly into a prosthetic socket.  With significant changes in limb volume, I'd end up wearing several layers of stump socks just to fit snuggly into a prosthesis.

So the smaller your limb, the smaller the fluctuations in the volume of the limb throughout the day.  That makes for a better fit and a happy amputee.  I see Elliot on Wednesday to pick one up.

I asked if I could start doing quadricep exercises on the stump by placing stretch bands over the front of the tibia.  They were cool with it as long as we don't put any pressure on the bottom of the stump.  I was happy to hear that.

Before we saw Dr. Attinger, we ran into Tricia.  She had her amputation about two weeks before me and has been a great source of information for me.  I've asked her a lot of questions to see what's on the horizon for the recovery.

We increased my Gabapentin (Neurontin) dosage from 300mg to 600mg three times a day.  I was happy about that, too.  It definitely helps with my phantom pain.  Charlie Crone dropped in, too.  That was awesome since he's not my prosthetist.  He recommended I massage my good foot when I run into phantom pain.  

It's all about tricking the mind.

I also met with Rebecca Dean, the coordinator for the amputee support group at Dr. Attinger's center.  They offer educational and motivational speakers at monthly meetings.  I'm really looking forward to getting involved with that group.

Still a weird, but awesome sight.

Appointment with Dr. Attinger Tomorrow

Amputee thank you cookies!

Tomorrow morning is our first follow-up appointment with Dr. Attinger and his team at Georgetown University Hospital.  The objective?  Look at the stump.  We'll likely get x-rays, remove a couple of sutures (which I will record, of course), and determine whether I'm still on target for that August 1st inaugural walk with a new leg.

One thing I'm really looking forward to is finally getting my hands on the pictures that were taken at key moments during my amputation.  One of Dr. Attinger's residents was equally pumped about the shots he got when he described them to us during one of our dressing changes at the hospital.  The blog post with these pictures will more than likely not be safe for Troy (#NSFT).  

If all goes well, I'll get these pictures, along with detailed descriptions, on the blog tomorrow evening.

Brooke ran in the rain and then got her bake on.  She rocks.

Since this is our first return trip to the hospital, Brooke and I are working on a gift basket for the nurses and other awesome caretakers.  We're using the one-legged cookie cutter we got from the leg's going away party to bake some cookies for the small group that took care of me during my stay.

It's become a tradition that after each surgery I create Thank You cards for everyone that's provided awesome support to us during the recovery.  The rest of my evening will be spent writing notes to the nurses, doctors, nurse techs and aides.

The Sixteen Things, Part One

This ends in a brain freeze or a melted mess.

We're two weeks out from my below-knee amputation.  It's supposed to be a life changing event.  But up to this point it's felt more like a routine tonsillectomy without all the ice cream — seriously, where is all of the amputation ice cream?

Since we've said our goodbyes and cut my leg off, I've had an opportunity to contemplate, ruminate, and other words that mean think about the permanent changes you get with the loss of a limb (I could have also gone with brainstorm, ponder, or even muse).

I enjoy brainstorming while taking opiates.  And I also enjoy lists.  I've classified my amputation pondering — my amputee ponders — into four categories.  

The four categories are as follows:

• Things I'm Going To Miss
• Things I'm Loving
• Things I'm Hating
• Things I Cannot Wait To Do

As I was writing down my musings, I realized how ambitious this thing had become.  I'm a slow methodical writer and even slower meticulous editor.  To buy me some time (I started writing this eight hours ago), I've broken this whole concept up into a four part series — a first for this blog.  Four parts for each of the four lists.

But don't allow yourself to think I'm planning ahead here.  I walked several blocks into this post before I realized I was lost.  Here's part one.

Five Things I'm Going To Miss

In the last few weeks I've been longing for some things that I'll never do for the rest of my life (a phrase I now find myself using a lot).  Walking in sand may have shown up here if it wasn't for our good friends bringing us a box of sand to the leg's going away party.  Here are five things I'll miss.

1. Quick Showers

I no longer stand in the shower.  With my previous surgeries, we Amazon.com'ed a temporary shower chair and threw it away once one of my external fixators was removed.  But our last purchase was not temporary.  If I really wanted to stand with a below-knee amputation, there are expensive shower legs, but hygiene is an issue.  My residual limb must stay clean and infection free.  Shower legs cover it up.  And insurance has a hard time seeing these special purpose legs as medically necessary — another phrase I'll end up using a lot for the rest of my life.

Travelling is also complicated.  Specifically, hotels (or motels, if you're my Mom).  According to the Americans with Disabilities Act, hotels built after 1993 are required to provide a small percentage of rooms with roll-in showers.  The roll-ins provide handheld showerheads but may or may not have a bench.  

One leg, plus no shower chair, plus no handheld showerhead adds up to a bad idea.  The days of convenient travel or waking up late for work and jumping in the shower are gone. 

2. Laziness and Eating Bad/Awesome Food

There's nothing I loved more than a lazy Sunday.  Sitting on the couch.  Interneting and ESPN-ing.  Somewhere between the end of the second and beginning of the third Sports Center I'd decide to investigate the refrigerator situation for some Chinese food, a leftover reminder of a detour I'd taken while returning home from last night's bad decisions.

With my amputation, I cannot afford lazy Sundays.  And let's be honest, I couldn't afford to spend almost every night of my life as if it were a lazy Sunday.  This cost me days living on Earth.  That's slightly more expensive than leftover Chinese food or a good burger.

This is a dramatization, of course.  Before you get upset, Mom and Dad, I didn't actually live like this (after around 2008).  What I'm trying to say is I ate poorly and I rarely exercised.

Moments of clarity: Aaron Hernandez is on my keeper league team.

Like everyone else, I've had moments of clarity before.  They never lasted long.  Laziness is easy.  But earlier this year, I had one of these moments, and it wasn't just a realize-and-forget-it moment.  I acted.  Along with my awesome wife, we revamped our diet.  After I lost some weight, I added regular gym visits.  Over five months I dropped 27 lbs — 225 to 198.  

I've told this story a few times already.  And I don't want to wear it out by repeating it.  But I've never told you why I really changed my life five months before my amputation.

It was a test.

I wanted to prove to myself I was serious about my decision to remove my right leg below the knee for the rest of my life.  If I couldn't make such a small change to become healthy, then I clearly wasn't ready for the hard work, pain, and emotional challenges shipped with an amputation package.

I never doubted my decision.  I just doubted whether I'd be responsible for my decision.

3. Dominating the Dance Floor

I love weddings.  The artisan dinner menu, assigned seating, the nuptials — the pomp and circumstance of it all, really — it's all butterflies and warm fuzziness.  But after the newlyweds dance, and Mom and Dad finish warming up the dance floor with their son and daughter, it's time for this snowboarder to shred in his suit and dress shoes.  This is why I love weddings.

Granted, most of my moves these days are above the waist, though I did whip out an awesome push-up move at my most recent booking.  I used to rely heavily on my elbows, but my moves have matured.  I've got the lasso, the elaborate two-shooters-blow-the-smoke-and-holster move (something I've featured on not one, but two different stadium jumbotrons), and a bow and arrow.  While that sounds like a complete repertoire, I used to have more in my satchel.

My accident and amputation may very well put an end to my razzle/dazzle days.

Fortunately some of the epicness has been recorded for all of history to remember on YouTube.  A talented friend of mine, Jonathan Pierce, choreographed an intricate Riverdance-style caper where I exhibited my moves as one of the three main dancers — all for a football pep rally.  At the 18 second mark you'll see a picture of me on the right.  That's me as we march out to the center of the court.  Jonathan's impossible to miss.  He's the main event.

We worked hard on this dance for several weeks.  I remember wearing ankle braces on both feet after a few days just to keep up with Jonathan.  That man is a machine.  But in all seriousness, I'm not going to miss dancing.  I just wanted to show you this video.

4. Crossing My Legs

Just one of many leg crossing techniques.

This one is very simple but so satisfying.  Do me a favor.  During a typical day, count how many times you cross your legs.  I did it all the time, usually when I was trying to relax and take it easy.  I'd even cross my legs at my ankles in bed when falling asleep.

Right over left.  It was a huge source of comfort for me.

5. The Last Three Years

I had my accident in February 2010, a few days before my 28th birthday.  Much of the last three years was spent recovering, crutching around in a bear trap, or walking in pain.  It was difficult to be a good friend and a good husband.  My ankle kept me anchored at home on my butt.

I stopped going to several annual trips with some good friends.  I stopped answering text messages and phone calls because I was tired of having to decline on account of my arthritis.  I ended up missing out on many opportunities to enjoy my awesome friendships.  This was a big contributing factor to my decision to get an amputation.

And while I'll always miss those chances to be with friends and loved ones, I still wouldn't change anything.  Snowboarding into a tree ended up strengthening my marriage with my amazing wife, Brooke.  It happened only two years after we got married and added additional stress to our relationship.  It obviously continues to do so, I depend on her for so much right now.  But we somehow ended up in a better place because of all of this.

I owe Brooke so much.  Like, at least 40 bucks.

Phantom Pain and #NSFT Pictures

A week after my amputation, I began to experience uncomfortable nerve pain in my residual limb.  It started off as a steady and continuous tingling sensation over my entire stump — as if the limb was a funny bone that had just been smacked.  Only without any of the associated pain from hitting your funny bone.  

Over the following day or two the nerve pain escalated.  I began to realize it was phantom limb pain.  It's difficult to describe how it feels.  It's occasional but quick burning, electric, stabbing pain.  It's like going from zero to 100 mph in a split second.  Then it's as if nothing happened.

Today the nerve pain quieted down, making it a little easier to describe.  Every few minutes I feel like my big toe is crushed or the right side and bottom of heel is being burned and electrocuted.  And again, it comes and goes very quickly.

The good news is this pain is expected to diminish once I get into a prosthetic limb.  And even if it didn't, I'd trade this pain for what I had before my amputation in a heartbeat.

It's weird but fascinating.  I'm looking forward to spending more time describing this sensation.  But in the meantime, here are the pictures of the limb from yesterday.