The Last Pedicure and Follow Me on Twitter

Only a few more hours to go.  I'm excited.  I don't have any more anxiety than the previous five surgeries.  Maybe less, actually.  I've been thinking about this for so long that it seems routine at this point.

Today was pretty low key.  One of our awesome friends took some pictures of me and Brooke.  I got this ridiculous pedicure.  And I went to a going away happy hour for a friend before picking up the parents at the airport.

Tonight's game plan is to drink a ton of water since I'm not going to have a drop after I wake up.  This is actually one of the worst parts about surgery.

As you can see, the five toes are ready to go out in style.  The University of Tulsa colors, of course.  I only had the right foot painted.  I wanted to make every effort to distinguish which leg needs to be amputated tomorrow afternoon.

I've never had a pedicure before.  I'm not sure I'm a fan.  I got a lot of stares.  By the point I was getting my nails done I wanted out.  So I didn't end up with sparkles, leopard print, or other fancy designs.

This part killed me.  The bottom of my foot is extremely ticklish.  This is the last time I'll ever be tickled under my right foot!  Because after tomorrow, I won't have a leg to stand on.

I'm sorry, I know.  Puns are the lowest form of humor.

I plan on live blogging the surgery tomorrow (before the surgery at 1PM EST and after I wake up and get access to my phone) on my Twitter account, @snowboardvstree.  I'll post something on the blog when I wake up, but it's going to be easier for me tomorrow and Saturday to use Twitter.

Thank you to everyone for the well wishes, prayers, and happy thoughts.  I've been waiting for the opportunity to get my life back since I snowboarded into the tree in February 2010.

It's finally here.

X Marks The Spot

Only one more day until the blog gets funny again.  One more!

Earlier this morning I had an appointment with Elliot to mark the exact location he'd like Dr. Attinger to make the cut on Friday.  I felt like a 2x4 getting ready for its date with a circular saw.  

It was good to see Elliot again.  The guy just flat out exudes confidence.  I'm looking forward to you getting to know him.  Today he provided some anecdotes of amputees that are able to do more than most people with two legs.  He also reassured me that phantom pain usually becomes manageable once you start using a prosthetic regularly.

Elliot brought out what looked like an Ossur Unity foot without a pump to explain how he takes the measurements.

While the prosthetic is about eight inches tall, there are several additional layers of other attachments that sit on top of the prosthetic before hitting the bottom of the socket.  So you need to make the cut fairly high to leave clearance for the whole package.  

One great thing about being 6'3" is my leg is long enough to provide plenty of room for a prosthetic while leaving enough limb for excellent leverage while walking.

The cut is going to be about 8.5 inches below the patella tendon.  For those of you at home, if you want to know where you'd get your below-the-knee amputation, just take a tape measure and go up about 11 inches from the bottom of your foot.  That's where the circular saw will come down.

These prosthetics are just incredible works of art and craftsmanship.  And yet it's so simple.

The split down the middle of the foot allows for better weight distribution over side-to-side movements of the legs.  I'm sure once I get my actual prosthetic I will go into crazy detail about how these things work.

I wanted to leave you with an awesome story.  Last week, while we were still waiting on word from my insurance company about whether they would approve Friday's amputation, my wife and I were at our local grocery store.  While we were there we saw this little girl sprinting through an aisle with a below-knee prosthetic leg.  She was booking it as if she had two perfectly normal legs.

I leaned over to Brooke and said, "that's the reason I'm doing this."  The places you get inspiration from will surprise you.  All I want is to be able to move around as freely as that little girl was -- though I don't expect to run up and down the pasta aisle.

While I was visiting with Elliot I saw a young girl walk by with a below-knee amputation.  It reminded me of this story, so I told Elliot about what had happened at Harris Teeter a few days ago and how it had kept me inspired for Friday's amputation.  He threw on this huge grin and said that the little girl that had just walked by lives near me and that her prosthetic leg was only one of five ever made.  I had seen the exact same prosthetic leg in Harris Teeter.

Sure enough, it turned out to be the exact same girl!  How crazy is that?  I told her Mom that her daughter was a huge inspiration to me and my wife.

Mom's response?  She looked at her daughter and scolded her, "so you were running through the grocery store, were you?"

What a small world.

A Leg's Going Away Party

A one-legged gingerbread man!  Yes, they make one-legged cookie cutters.

Sunday afternoon was my leg's going away party.  It marked perhaps one of the first pre-amputation celebrations in the history of medical leg removals.  It's only a matter of time before Evite has an amputee theme.

It was great to share the send off with friends over brunch and drinks.  These are the people that have lived with my injury for the past three years and know exactly how excited we are to finally put this all behind us and get our active lifestyles back.

I got up early to make a sun-dried tomato and bacon egg roulade (here is the recipe).  It was simple to make but took a toll on the ankle early in the day with all of the standing at the kitchen counter.

A reminder of why I've decided to get an amputation.

One of our friends went to the beer store and asked for amputation-themed beers.  After reassuring the staff that this was actually a good thing, they recommended Antigoon, a belgian pale ale, and Heavy Seas Peg Leg, a russian imperial stout.

You should see a doctor about that.

The stout was not bad.

What other amputation appropriate beers are out there?  Does it count if the taste of PBR makes me feel like cutting off my tongue?  Maybe the draftnotes.com blog can help us find some others.

During the party we set out some sharpies and let people sign the leg if they wanted to share a goodbye message.

Some people signed their name.  The top incision scar was prime real estate.

I left an apology to my ankle.  My bad on causing the injury.  Your bad on being terrible.

Canada gave its official seal of approval by donning the leg with the friendliest flag in the world, The Maple Leaf.  The finished drawing is shown below.  Our awesome and quite impressive friends from Canada also brought the one-legged gingerbread men.

Some took the opportunity to just state some facts.

"Not resistant to trees."  Our only live testing we've been able to do so far shows that my ankle has little to no resistance to trees.

"Defective product: Return for disposal."  Another accurate statement.

Scott's signature ended up being difficult to read in the picture.  It said, "If found please return to owner."  It's a little known fact that the US Postal Service will mail feet back to their owners free of charge.

Crystal and Megatron (Crystal's unborn child) left a sentimental note.

They make a good point.  The foot and toes really have been handed a bad deal.  The ankle committed the crime, but the foot and "little piggies," because they're all an accomplice -- they all do the time.

The most elaborate signature of the night belonged to a two-person team from Hawaii (an artist and her creative director and mother).  They designed an entire diorama using a box of sand Crystal and Troy brought us as a gift.

By the way, how awesome of an idea was it to bring sand so that I could feel it under my foot one last time?  Amazing idea and something I will remember for the rest of my life.

Here's team Hawaii's diorama, complete with a palm tree and three coconuts made out of an incision scar, a dancing hula girl, and sand from exotic British Virgin Islands Home Depot.

It was a memorable night and a great way to mark an end of the last three years.

Ankle Scars

I read yesterday that amputees mourn the loss of a limb as if it were a spouse.  That surprised me.  But now that I think about it, as much as this ankle has hurt me over the last three years, not having it after 31 years of life is going to be a shock to the system.  After all, it wasn't my ankle's fault that it got crushed with a head-on collision with a tree.  It was my awesome snowboarding skills that did that.

My bad, ankle.

I decided that with the seven days I have left with this ankle, I should try to do my best to remember it by documenting it with my camera.  I recently borrowed a macro lense from a friend to get some close-up shots of the ankle scars.  Here are a few up-close photos of the ankle landscape.

The scar at the bottom is from this wound from 2010.  There are actually three scars in this photo.  There's another one above the huge dimple.  The one on the bottom right of the picture is from the fracture blister right after the accident.

This scar is from two incisions in the same spot.  Here's the first one a few days after the surgery in March 2010.

You can't tell from this picture, but the malleolus is full of cracks and valleys.

This is The Friendship Scar, named after the fact that I went on a snowboarding trip to Breckenridge without inviting some old ski buddies.  In other words, I deserved this!

It's weird to say it, but in a way I'm going to miss this ankle.  Primarily because I'm used to it being there.  This morning I drove into work using my left foot on the gas and brake pedals.  I've been practicing this for the last month.  Halfway there I got tired of reaching over with my left foot so I decided to switch back to the right.  After next week, I won't have the luxury of switching back to normal after getting uncomfortable.  I'll be permanently stuck with my left foot for the rest of my life.

That's very surreal to write.

Where Does My Leg Go?

Today started with a simple question: what happens to my right leg after it's amputated?  Of course, there have been a lot of ideas on what should happen:

• Turn it into a leg lamp.  We'd need to be careful in case it's fra-gee-lay.
• Hire a taxidermist to mount it on my wall.  Because that's not weird.
• Toe shot.  Yes, this is a real thing.
• Bury it.
• Donate it to science.
• Get a tattoo before my amputation (not exactly the same category, but worth mentioning).

While scheduling another pre-op appointment with Elliot to get some measurements on where he'd like Dr. Attinger to try and make the cut, I got an opportunity to ask him what happens.

The answer?

Apparently they turn them all into leg lamps.  I know, I wasn't expecting that either.  Good to know my leg will illuminate some creepy dude's basement man cave.

Okay, no.  This is not what Elliot told me.  I promise the jokes get better when I start taking the pain medication next week.

The hospital most likely will place the leg into a bag and incinerate it to reduce it down to a small and economical volume.  This also minimizes the risk of spreading infectious diseases.  Once converted into ash it will be deposited into local landfill where it will join all of my Chipotle wrappers.

Given a choice, I prefer to donate the leg to the cadaver lab so medical students and researchers have access to the limb.  Most amputated legs are likely gangrenous and nasty, so this could be a good opportunity to kick out some sweet science.  I'll look into this option and if it's available this is what we'll most likely do.  I'm sure after the science is completed the leg will still end up in an incinerator.

The tattoo idea was my favorite one by far.  I'd totally get one if it didn't prevent me from having a surgery next week due to the elevated risk of infection.

Game On!

This scene from Wayne's World was going through my head all day.

The amputation was approved this morning by my insurance company.  We're cutting the leg off next Friday.  GAME ON!

What an anxious month May turned out to be!  I apologize for my radio silence, but I had no idea if the amputation was going down or not.  And I try to avoid writing when I'm anxious or pessimistic.  

Elliot told me insurance fights will be the most frustrating part of my life as an amputee.  I thought I was prepared for the stress of an insurance battle.  I was not.  I waited for one person to decide my fate.  I will never meet this person.  I will never talk to this person.  I have no idea who this person is or what his medical background is.  I waited for him to decide whether he thinks amputation will get my life back.

Fortunately, it all worked out.  The medical director agreed, so my insurance agreed.  And we're going to be minus one leg in two weeks.

As it turns out, the denial by my insurance was in all likelihood just a formality.  Because Dr. Attinger didn't have my entire medical history, he didn't ask for the pre-determination of the amputation with sufficient documentation.  After his peer-to-peer conversation with the medical director, Dr. Attinger agreed that we needed more documentation before my insurance could approve the operation.

 

The insurance approval process was a distraction from the surreal thought that I've had a right leg for 31 years and won't in two weeks.  I'll spend the next two weeks trying to write about how I'm preparing for the surgery and dealing with the anxiety.  We got a new camera (Nikon D5200) to help document the whole process, which will probably go into 2014.  I'm really excited and nervous!  Can't wait to get started.

Surgery Update

I realize it's been a few weeks since my last post.  It was intentional.  Not long after my last post I received a phone call at work from Dr. Attinger.  A medical director with my insurance company, also a doctor, reached out to Dr. Attinger on the phone after we submitting the approval for the amputation.

My insurance company, through the medical director, will not approve the amputation until more documentation is received on five areas:

1. Document loss of range of motion
2. Document loss of functionality
3. Document visits with multidisciplinary teams
4. Document the five surgeries and the results
5. Document emotional health and well-being 

Dr. Attinger reassured me on the phone that he 100% agreed with my decision and that we'd get this done, but that he agreed that this information needed to be documented.  

Fortunately, I've recorded all of this information on the blog!  I was able to pull together all of this information and send it over to Dr. Attinger's office.  I was hoping to update the blog after we received approval, but I think that's still several days away.

In the meantime, I saw my family physician, Dr. Kabatsi, last week for a physical and to update him on my plan.  After discussing with him my decision, he told me that he completely agreed.  The combination of poor bone quality and history of non-union combined with my family history of heart disease and high cholesterol indicate that amputation is the best possible solution.  He told me he sees several patients with ankle fusions who continue to suffer from pain and undergo revision surgeries.

He also told me that he's never heard of anyone choosing amputation over fusion or replacement.  Most patients go through with a fusion or replacement only to discover later in life that amputation is the best option.

So that's the latest.  I will keep you all updated once I hear any news.  Everyone seems to be optimistic that the approval will go through.

I should also tell you that I've found a prosthetist!  Elliot Weintrob at Orthotic Prosthetic Center in Fairfax.  It was awesome meeting with him and even more awesome that one of the amputees that commented on my post showed up for my meeting!  We got to sit down and talk for about 20 minutes.

I'm starting to find out that the amputee community is amazingly supportive.

Finally, I was recently reunited with my snowboard during a trip to Oklahoma.  It was the first time I'd seen it since I snowboarded into the tree on February 13th, 2010.  I expected the reunion to provoke anxiety and fear, but surprisingly, I was really excited and energized.

My helmet was still in the patient belongings bag from the park emergency room.

I was able to push my right foot into the boot and stand in it, but I couldn't bring myself to lacing up the boot.  I was afraid it'd start hurting.

There's basically no damage to the board.  There are a few bumps under the right binding where I hit the tree.  The park Ski Patrol told us "boards never break, only humans."  That is an accurate statement.