Saturday, May 21, 2011

Rehab III: PT1

The first week of weight on the foot was rough.  As I described in the last post, my foot was acting criminally, shooting and stabbing, mostly below the outside ankle bone.  Advil helped significantly, but my home supply ran out and there never seemed to be a convenient drug store or I didn't remember to pick up a bottle, and with a new job (oh, yes, I started a new job this week!), I just did not have proper pharmaceuticals to ease the pain.  Day after, I hobbled with a crutch in my right arm pit, listing precariously to the right to ease the weight and the pain on the left foot, my lean exaggerated by the two-inch thick sole in my medical boot.  On and on this went without improvement and I looked forward to my first physical therapy appointment on May 18.

The appointment was with Wayne Diamond, whom I've known since his kids were to pre-school with Sophie.  He treated Jessica successfully for back and hip problems and I requested him specifically when the time came to make an appointment.  On the morning of the appointment, I took the last dose of Advil in the house, put on two tennis shoes, leaving the Big Black Boot at home, and headed to Kaiser.  After I waited for a brief period, Wayne came out and motioned me in.  I hobbled in on one crutch, noticing that Advil was working.  As we entered a long hallway, Wayne said: "Let me see you walk."  I tried walking and I wasn't bad at it.  Wayne was mildly impressed, but he also told me not to try so hard, as it was obvious I was hurting.  We came into the examining room and talked for quite a while about what hurt and where and what caused the pain.  I lay on the table and he started manipulating.  I was nervous: my range of motion was limited and, though I tried working on it, I expected a return to the Woyld of Hoyt.  But no.  Wayne bent my foot in directions I couldn't imagine it would be willing to move, yet it followed obediently and willingly.  There was a minor jolt of pain in the usual spot once, but that was the only time during the several minutes of work.

Wayne was pleased.  He thought the foot moved well and was encouraged by the absence of pain.  He gave me a exercises to do five times a day: seated calf raises for strength and child pose to increase for range of motion.  With passage of time, I'm to add resistance to calf raises by pressing down on my knee with both hands.  He told me to increase my daily water intake by one glass to help healing.  In theory this is great, but is difficult to implement in practice.  Walking to the water cooler involves walking and hurts.  Drinking more involves walking to the bathroom and hurts, so it's hard to motivate myself to drink more, but I'll have to.  Wayne also gave a compression sock to wear all day and told me to ice the ankle every evening.  Since I arrived wearing compression socks, I left his office wearing three of them.

I went to work and as I sat at my desk I did calf raises.  My desk has a center drawer and my knees nearly touch it when I sit, so I did two or three sets of resisted calf raises, pushing up with my knee against the bottom of he drawer.  Which is dusty, as I discovered when I saw a brown line on my pant leg, above the left knee.  The calf raises felt pretty good, though toward the end of each set my leg would begin to shake -- a reminder of its weakness and the work that lay ahead.  Nonetheless, I felt encouraged.

I arrived at home after work and, with a crutch in my arm pit, began climbing stairs up to the house.  For some bizarre reason, I stepped up with the left foot.  I cringed as soon as I realized what I'd done, expecting a bolt of pain, but it didn't come.  I stopped, flabbergasted.  It didn't hurt.  I processed that.  Then, I took another step up with the left foot and that felt OK.  It ached, but nothing worse than level 3.  Thrilled, I walked up the stairs like an uninjured person, alternating feet, and carrying the crutch in my right hand.  At the top of the stairs, I took a normal step and that didn't feel so good.  On flat ground, the foot has to flex.  On the stairs, a peg leg suffices.  And a peg leg is what I had.  But hey, a functioning peg leg on which I can climb stairs is a dramatic improvement over what I'd had for the week since I started putting weight on my foot and I couldn't be more excited about the improvement.

Wayne had written me an e-mail, summarizing what we'd discussed, explaining the exercise regimen, and cautioning that the next day would be painful because of all the manipulation the foot had undergone.  I responded excitedly with a description of my ascent.  "Wayne Diamond," I thought, "you are brilliant!"  A thrilled text message went to Jessica.  Ten minutes later, it was time to pick Sophie from school.  I tried walking down stairs and that was not happening.  Stepping down with the left foot produced unwelcome level 6-7 pain and I decided not to push it.  After returning home with Sophie, I demonstrated my recovered skill to her and she was as excited as I.

Wayne was right about one other thing, the next day was a bear.  I had such a hard time that I decided that it would be a two-crutch day.  I had to go to court first thing in the morning and it was 10:30 by the time I arrived at the office.  I helped myself to the office supply of Advil and settled in.  I kept my foot elevated as much as possible and used crutches.  As the day wore on, I felt better, but I remained cautious.  As with everything else, this would not be a linear progression toward improvement.


No comments: