The Blackburn Digest

Sometimes, I get the wicked urge to make an appointment with my former podiatrist. To just tell the scheduling clerk something banal like “I’m having trouble with callouses”, and then watch the podiatrist’s face when I unveil my new feet. O.K. - they’re not “new”. They are officially almost 15 months old, but the urge to use them as a “teaching tool” grows ever stronger!

It’s not the podiatrist’s fault. When years of Rheumatoid Arthritis had dislocated my toes and set them all at weird angles that shoes could no longer encase without severe pain, I sought her out. She was the daughter of a trusted physician, newly set up in practice with her surgery-schooled husband. I received sympathy, custom orthotics to ease my stride (which they didn’t) and, eventually, braces attached to both shoes with knee-cuffs to minimise my spectacular falls (which they did). Pain and mobility were still issues, however, so I kept pushing the young pair for a better fix. At my last visit to their office, I was told that the only solution was “drastic surgery” that “shouldn’t be considered until I was older”. That made little sense to me at the time (it was 2004 or 2005); if it was drastic surgery, shouldn’t we do it when I was younger and better able to recover? They wouldn’t answer that, so I didn’t visit them anymore!

I now have one less doctor on my “With whom/when?” appointment list. I wasn’t thrilled at the need for trekking across a fair amount of the city this morning to attend the post-op visit with my foot surgeon; the weather has turned freakin’ cold and WET the past few days. Wet is good. . . .wet is great, actually, as the Edwards Aquifer levels have been dropping near water-use restriction levels recently. In San Antonio, however, rain is best dealt with inside the safety of one’s own domicile. Our drivers seem blissfully unaware that a speeding car does not stop as quickly on rain-slick streets, nor does said car perform right-angle turns as obediently as it might in dry conditions. Coincidentally, they also are unaware that their cars (especially white & light blue ones) are much more visible in a heavy downpour if they Turn On Their Headlights. Sigh - with thunder rumbling and rain striking the roof, I was not happy to leave the house!

DH has been making frequent trips to the market for necessities since Oct. 30th, but we haven’t done a full food shopping since????? The pantry and refrigerator were looking quite bare, and DS will be here tomorrow for Thanksgiving dinner; it was definitely time to go to the market with a long list! My poor, much-loved Camaro hasn’t moved out of the driveway in nearly a month, so I asked DH if I could try driving to the store. . . .we needed its carrying capacity, and I could easily pull over and let him take the wheel if it hurt too much. I had an absolute blast! I’m not wearing shoes yet (that has to wait on additional healing plus the prosthetics), but I have my comfy/colorful socks and the protective post-op shoes/boots are comfortable. My feet are still tender, but accelerating and braking were just uncomfortable, not painful, and the feeling of regained freedom was exquisite. I used an electric cart to chase DH around the store, grinning like a fool the entire time. (Confession time - I bumped two stacked displays while trying to make the tight turns to transition from one aisle to the next - but only knocked one box off. I also ran right into DH’s butt once! LOL!)

Generally, I’m pretty tough; I was awake for the surgery and didn’t freak out when I heard the bone saw (probably fitted with a grinding disc, actually) start up, after all! Still, I know my limits. While monitoring the healing process (and trying to get adjusted to my “goose feet”), I’ve noticed a few facts about the stitches which were due to be removed today. Most obvious was the sheer number of them…..removal was going to take awhile. Also, they were very, very tight…someone (as it turned out, it was a nurse whom I like very much) was going to have to pull up rather firmly on each of them before they could cut them. The visible portion of many of the stitches was only barely-visible, being embedded in scabbing along the incision line…….hmm, that wasn’t going to feel good, either! OK - Tough, yes. . . .stupid, no - - -since DH was doing the driving and I’m still using the wheelchair when away from Casa Blackburn, I arrived at the doctor’s office fortified with pain medication, a muscle relaxant and a tranquilizer! It was still a thoroughly nasty procedure!

When I had my post-op checkup, the surgeon told me to go see the orthotics/prosthetics group and have them fabricate toe fillers & carbon fiber shanks for me. Uh oh! The toe fillers (prosthetic toes) will prevent the front part of whatever shoes I wear from curling up like Persian slippers in short order. O.K. - preventing curling is a good thing, but the alarm bells went off.

I have been visiting the wonderful, caring staff at HK Orthotics & Prosthetics for several years now. They are a terrific bunch, and I like them immensely. However, I delayed for two days before calling for an appointment because I knew what they would have to do! When I whined about it at home. . . .”They’re going to have to take molds of my feet. They’re going to press down on the stitches (and the rest of my feet) to get a clear mold in semi-rigid foam!”, I was met with ‘comforting disbelief’ by family members. “Maybe not.”, “You don’t know that.”, “I don’t think so; this is different.”, etc.

The surgical bandages have been on my feet since October 30th. I got a very brief peek at the surgeon’s work late that afternoon, when both incisions sprung a leak and the PA had to redo the dressings, but it hasn’t helped me to answer the standard questions which have popped up over the past two weeks; questions like. . . .”Why does it hurt way up there?”, “Is that a staple poking at me?”, “Are they healing well?” and “What do they Look Like!?”

Today was “answer day” (and my first time out of the house since Nov. 1st!) - time for the big reveal and answers to the questions. In short: 1) It hurts there because the incisions are longer than I envisioned (about 23 stitches in one foot & 22 stitches in the other). 2) Despite the fact the surgeon said “staples” while briefing DH after surgery, no staples were used. 3) Despite the surgeon’s conviction that I was a very bad candidate for proper healing (because of the Enbrel therapy), I am healing very well, thank-you-very-much! He was surprised, and I sort of had to rub it in a bit

I knew “Dr. P” (my Rheumatologist) was going to be less than pleased to see me in a ‘walking boot’, but that didn’t half cover his mood when I discussed my upcoming appointment with the orthopedic surgeon!

The rest of the “maintenance visit” went fine; we’re both delighted that I have responded quickly (again) to the Enbrel therapy, the Dexa scan (bone density test) read rather well for an old broad and he was impressed at how well the ‘attempted amputation’ had healed.

Then I told him I was scheduled to see Dr. B. on August 13th, to discuss surgery on both feet - that is when he began to growl! I understand (and agree); we’re both expecting the proposal to be joint fusion, and that’s a very bad idea on so many levels!

We’ll see:)