Happy New Year 2014 !

Gosh, 2014 already & in April it will be the third anniversary of my injury. I have been seeing posts from other Lisfranc victims via the Facebook page; www.facebook.com/LisfrancFractureClub & I often see questions & enquiries from newly injured people on long term pain, shoes etc. This got me thinking about how my situation has progressed & I remember only too well the uncertainty I felt & misery of the constant pain during the recovery process. I also remember the despondency that I felt when even 18 months later I still experienced severe pain after walking or being on my feet for a period of time. The doctors were reluctant to speculate on my prognosis, I think that this is probably something that most Lisfranc sufferers experience at some point from their medical team. I have had to work quite hard in the gym, with physiotherapists & personal trainers to rebuild the muscle & tendon strength etc lost during the none & partial weight bearing period of recovery. At times this has been embarrassing, frustrating & quite frankly slightly depressing, but interestingly the by product of this work has definitely been a significant reduction in the pain.
I still have the pins & a plate in my mid foot & I had a cuneiform fusion, whilst I do sometimes experience tenderness in my 3rd & 4th metatarsal joints I can confidently state that I am pain free most days. If I know that I will be on my feet for a long time then I prepare with perhaps taking with me a second pair of shoes & some Ibuprofen as I know I'll need to manage my foot. However the period of time involved has lengthened considerably from around an hour or so 18 months ago to 3-4 hours now. To be clear this is normally standing or walking in a court shoe on a hard floor surface, or walking quite vigorously. In thicker soled footwear or on softer surfaces I can be pain free for longer. I walk at a normal pace again these days & can even run if I want to. I won't be entering any marathons anytime soon though :-) Not that I wanted to run a marathon even before the foot !
I would advise anyone with this injury to seek expert help & advice on the physical rehabilitation as it will help you to get the best results possible. I am planning to go skiing again in a couple of weeks, this time for a whole week. I recently purchased my own ski boots with a custom fit boot liner so that should help too. I have had 19 sessions with a personal trainer to help me prepare for skiing. We have focused on weight bearing strength, lower back strength, hip, knee & ankle flexibility as well as upper body. At one stage I was leg pressing 120 kilos ! It has been hard, I have had to step outside my comfort zone & push myself to beyond it.
I can also wear high heels again, a two inch heel to work for most of the day is quite comfortable now anything higher is for special occasions only ! Stilettos are tricky, wedges or thicker heels work better I find as there is more support incorporated within the shoe design. The happy feet insoles I previously mentioned are also worth a try, the good thing about those is that you can insert them into any shoe & improve your comfort pretty much instantly.
Anyway this update may help I hope, don't give up it does get better !

Special shoes ! Not bad for a girl with a broken foot :-)

Looking forward & enjoying it !

It's been a busy time here in Blighty with the 2012 Olympic fever which has been gripping the nation !

I can't tell you how wonderful it is to finally be able to blog about how happy I am & how well I feel.
I did lose my job as I feared I would. In fact just a few days after my last posting I was notified of my probable redundancy. It was a shock when it was confirmed even though I'd had my own fears for a few months. Of course I sought legal advice etc, but after a difficult few months deliberating over what to do I have decided not to look back !

I have been attending hydrotherapy now for 2 1/2 months & it has helped me immensely, god I wish I'd done this a while ago. I was referred after my last relapse in April & I seem to have gone from strength to strength in the past couple of months. I am still only able to wear flat supportive shoes but I am not utilising the metatarsal bar & appear to be coping very well without it. I have focused much more on the foot recently, taking notice when I am in pain & developing an awareness of the amount of time I spend on it etc. Resting it when it needs it & accepting that pushing it beyond it's limits (I.E ignoring the pain) is detrimental to my long term recovery. I realise that all of these points may seem obvious to anyone reading this, but I am a strong willed, stubborn & determined personality, accepting the restrictions that having a serious injury bring has not been easy for me to do.
The positive of being made redundant has been that I have been able to take a couple of months out to rehabilitate the foot with my focused attention. I have not had to drive 7-800 miles per week & rely on Ibuprofen to get me through the day. I have also registered & got a rehabilitative programme organised with the local gym. At the moment it is all sedentary stuff & not too demanding. But it's a start & I'm grateful to finally be at this point after so many setbacks !
I have been swimming & took a holiday to Bermuda last month. I spent all of my time in flip flops & swimming or snorkelling. The freedom of movement I experienced was so uplifting, I think it gave me a sneek preview into what my life could be like without pain & with improved mobility which has spurred me on to work harder at getting fit :-)
I returned home in love with Bermuda, such a beautiful island with friendly people & a wonderful climate.............. I will return :-)

I visited Weymouth at the start of the Olympics to take in some of the sailing action (spectator only) & stayed in a holiday park nearby which had a dry ski slope. I decided to take this opportunity to see If I could get the foot into a ski boot & to attempt a couple of very gentle runs down the nursery slope. The good news was that I could get the boot on, my confidence was low & I struggled with the reduced muscle in my right leg. But this was also a positive experience, as it left me with a clear understanding of what work I would need to do to be able to enjoy skiing again, importantly I feel that I can now allow myself to look forward to being able to do it again one day.
I walked for a couple of miles & some of it was quite uneven & tricky, even involving a little bit of climbing during the visit to Duurdle door, but the sense of achievement on reaching the top was exhilarating !
I've also purchased a second hand bike for myself & have been out on a two mile bike ride. Not exactly a marathon, but again a start & an important step in the direction that I have wanted to go for so long.
 I still require Ibuprofen most days, but only maybe one or two doses, I'm no longer dependant on it to be able to do things.
In October I am going on a trip to Hawaii & I'm determined to be fitter & stronger than I am now, what I can achieve will depend on what I can do & my commitment to getting fitter I know but I certainly am looking forward to being able to be mobile & strong enough to enjoy this trip to its maximum. I also want to try to go on a ski trip next Feb perhaps, so I will set that as a goal to work towards whilst I'm at the gym.
Maybe it's the whole Olympic fever surrounding the Team GB successes or just that I've finally reached a turning point in my recovery, but what's really great these days is how much more positive I feel in myself, I am now allowing myself to look forward & dare I say it -to a life beyond Lisfranc !

Transfer metatarsalgia ?

I subsequently underwent two MRI scan examinations in the end, the first didn't include enough detail on my forefoot to accurately determine if it was fractured or not......
I visited my consultant to receive the verdict & much to my surprise no fractures were seen, stress or otherwise. My consultant expressed his surprise at this result, stating that he was as sure as I was that a stress fracture would be the culprit of this latest bout of pain. My consultant involved another specialist when reviewing my MRI images & after discussions & a diagnosis elimination the consensus of opinion appears to be that I am suffering from transfer metatarsalgia............

This is believed to be the result of the mid foot fusion that I underwent as part of my Lisfranc surgery, essentially my 2nd, 3rd & possible 4th metatarsals are now too long. The bio dynamics of my foot have altered following the surgery apparently & this has resulted in a change to how my weight is distributed within my foot & how my foot manages this. Additional length in my metatarsals will cause them to weight bear beyond the amount they should, this also causes the metatarsal heads to become inflamed thus causing significant pain & discomfort like I have been experiencing within my toes. So the prescribed course of action is to first wean the foot back out of the boot & into my MBT's (Fitflop). When I can walk relatively comfortably I will then meet with a physio who will fit a metatarsal bar into my shoes. This should relieve the pressure in my toes. The metatarsal bar will get my foot back into proper alignment when I stand or walk, it simply takes the weight off of the metatarsal bones which should relieve my pain instantly.
Failing this then a metatarsal osteotomy would be required to permanently shorten my toes- Eeek !

It has now been 17 days since I put the boot back on so I decided to try a day without it yesterday, the result was quite a bit of building discomfort in my mid foot, particular increase in acute pain when my foot was positioned with the weight into the heel & lower than my fore & mid foot. The foot was quite red & puffy afterwards, although this settled down after a couple of hours. The building pain is significant enough however to prevent me from walking for any length of time at the moment. The feeling in my mid foot is quite bizarre, more of a nerve sensation, similar to when you have burnt yourself & the area affected projects that tingly slightly numb sensation. When I touch it it feels like this too, so I am wondering if the real problem lies within the mid foot area. but I am not a doctor so I feel obliged to follow the advise given & hope for some improvement. I am back in the boot today to give it a rest & will try again to hobble about without it for a few hours this afternoon.
It is a worry as I have had to take time off from work again & even now I am working from home, this cannot be a long term arrangement as my role requires me to visit customers on site & to travel significant distances. My company will not support me indefinitely I don't think & let's face it at the moment I am not able to fulfil the role I was employed for :-(

But I realise that I must focus on my long term health & recovery as my family & friends advise me to, if I need to change employment due to this injury then I will, there is very little that I can do about that except heed advice & try to recover as best as I can, the foot is in the driving seat at the moment, well that's what it feels like anyway !

Day 76......... KOL

I'd booked the Tickets to see the Kings of Leon play at Hyde Park before "The foot" happened. So after having to cancel all of this years sailing, holidays, exhibitions abroad I was rather determined that this would be one event that I'd manage to get to.
I had to purchase another two tickets on top of my original two, to allow me to be able to sit within the accessible arena due to Ticket master's refusal to give me a refund, but this was still better than missing out !
So off I went on my big adventure yesterday morning, after a long drive to London, we parked the car in Park avenue underground & we began the hike to Marble Arch. Typically inconvenient, I became in need of the loo ! This is a nightmare, after all concentrating on the ground so as to avoid any slippery obstacles with your crutches, doesn't enable you to hop at any speed :(
I plodded on slow & steadily, as the panic set in, my palms began to sweat- brilliant on plastic crutch handles ! Eventually, after about 25 minutes, we made it to Marble Arch & asked a policeman where the nearest loo was. He suggested we try to cross the road (a major junction in central London !) & use one, in one of the shops. After a bit of crowd dodging & 3 pedestrian crossings were successfully conquered we made it to KFC. Only to find the loos were up 2 huge flights of stairs ! So I gamely began to hop up them, by now my hair is stuck to my head with the sheer exhaustion & panic sweat, & my now very sweaty palms were slipping around precariously on my crutch handles, not a great position to be in !
I got to the top- hurrah !
Bugger !!!!
A long queue for the ladies !
By now even my boyfriend was concerned & sweetly offered to act as bouncer whilst I used the gents.......... just as thought I was about to lose yet another shred of dignity courtesy of the foot I spied a KFC worker out of the corner of my eye.
"Excuse me" i asked in the calmest voice I could muster, " please can you tell me where your disabled toilet is ?" The KFC worker, was a small but impatient oriental lady who carefully surveyed me up & down, looking intently at the perspiration on my forehead, my crutches & of course the foot ! She muttered something that I couldn't understand & gestured downstairs ;(
So I picked my way back down the two flights of stairs & followed her to the back of the restaurant where she did, after one more scrutiny of the foot, unlock the disabled loo- Bingo !!!!

So normality resumed, I was now pretty tired, shoulders hurt, foot was swelling, protesting at the hike & bumping around, so we made our way back to Marble Arch, where I sat & recharged my flagging arms. We were waiting for two friends to join us, one of which was a Canadian, with a knack for hunting down Knights in Shining armour I discovered later.

Our friends arrived & we started to make our way into Hyde Park, after about 20 minutes, my left palm began to hurt, I stopped & looked, not only had I developed an impressive blister, it had just burst ! I carried on a few minutes longer, my friends by now were getting a little concerned. The pain from the blister was beginning to cause a problem all of its own- off setting my balance ! Our Canadian friend decided, action was what was required & set off stridently across the park in search of a St Johns ambulance. She struck gold ! We found a couple of policemen in a patrol van who were only too happy to unpack their first aid kit & bandage up the offending blister with enough wadding to ensure I'd not only be protected, but look like I'd done something far greater to it than the hard earned blister. The care & attention they were taking over the task in hand did make me feel just a little bit special- haha !
Whilst the policemen were concentrating on my hand, our Canadian friend decided more help was need & once again strode off purposefully across the park...................

I couldn't believe it ! She'd pulled it off again !
As she walked towards me I could see she was being followed............ by "Pablo" a park keeper, who was driving a golf buggy !
Pablo kindly piled me, the foot, the hand & my crutches into his golf buggy & after telling my friends he would look after me until they caught us up, he put his foot to the floor, heading in the direction of the gate to the disabled access area.
Great fun!
By now, yes I did have to concede slightly that having "the Foot" sometimes had a few advantages.

Friends caught up, we entered the gate & wow ! The disabled area was not only seated with plenty of room for me & the foot to have our own chairs, it had it's own disabled loos ! No lengthy muddy queues for me- Wahoo ! It also was on a staged area, not too far from the stage & above the crowds. Drawback was, only one friend could accompany me in as a carer :)
I had a great evening, in relative comfort & worth the struggle. It was by far the best evening I've had in 76 days !

Foot still protesting today with swelling & of course the inevitable pain that goes with it, but it was soooo worth it :)

Two heads or invisible ?

I was genuinely quite surprised at other people's behaviour  during my first couple of weeks on crutches....
I found most, don't give way to you (I'm not saying that they should have to, but ?), in fact on more than one occasion I've found myself actually hobbling around them. They push past, to get past me, or worse then are the ones who race up behind you & then huff & puff irritably because you aren't going quickly enough.
Then there's the doors when you go into places, a few have seen me coming & held them open for me, but the majority don't. I have struggled & wobbled precariously to get doors open & then get through them, whilst people just watch or stare ! Or I've been following someone into the loo or shop & the person in front has just left the door to swing shut, without looking to see who is coming behind them. I've become a bit of a dab hand using my crutches like a door stop over the past couple of months after narrowly missing a broken nose !

My theory is somehow, when you are out & about on your crutches it's like you've put on an invisibility cloak or something. You do quite literally become invisible to some people I think.

The other funny thing was, I recently used a wheel chair to get around a supermarket with my step mum & the way that other people behaved then was hilarious. They stopped & stared at me, quite openly & brazenly, like I had two heads or something ! But did any of them care about how embarrassed they were making me feel, no of course they didn't. It was almost as though because I had something wrong that warranted me having to be in that wheelchair, it gave them a license to do it !
Did they speak to me ? No of course not.  You don't have a voice if you're in a wheelchair I found my self thinking. When I got to the checkout with my step mum, the cashier actually ignored my attempts to pay her using my debit card! It was like she couldn't see me, but she could & I knew that she could.

I really couldn't believe in this day & age there are still so many prejudiced people walking around.
I also thought to myself how glad I was that this wasn't a permanent state that I was in, I felt lucky because eventually I will be able to walk around, the poor souls who are disabled permanently can't. They have to face this kind of stuff every single day of their lives I suspect. I was always brought up not to stare at people, my dad always told me off in fact if he caught me !
I think an experience like this type of injury really gives you an insight into how much more challenging life becomes with a disability.

So after 10 weeks of staying with my parents & having quite a bit of help from them, I am going home later this week, to try to give it a go on my own & in my own home. It's a little daunting, my house is far from accessible & I'll need to change a few things around. It's not going to be easy physically, that I know. But I think what is more daunting is the prospect of spending so much time on my own, after the pretty much constant company I've been having. Of course people will come & visit me, but not every day or each weekend. I'm going to be spending a lot more time by myself & before 'the foot' I was happy enough in my own company, but it was my choice then. If I wanted company I'd simply go out & get in the car & go & find some. When I return home this time, I can't. So I will be entirely reliant on other peoples timetables & their choice of when/if to come & see me.
Although I live in a town, walking into the centre on my own & on crutches is a terrifying prospect. Before 'the foot' I always walked the mile or so into town. I can't see me managing it at the moment. I know I can get cabs to the hospital & can use the home delivery services that most major supermarkets offer for food shopping, but I'll be quite reliant on prepared 'ready meals' I think. I'll need to get a home help or cleaner I've realised, my house is quite small & certainly not palatial, but I won't be able to use the washing machine on my own, hang my laundry out, hoover my carpets, wash my floors, iron my clothes etc. Then there's things like putting my dustbin's out on bin day, impossible at the moment !
The list goes on in my mind at the moment.
There's also my lovely dog, Hannah. I can't walk her whilst I'm still on crutches. I have a little tiny bit of a garden at home, but it's down steep concrete steps, she has cataracts so her vision is quite impaired & just letting her out there to go to the loo won't work. I can't clean up after her whilst I'm on crutches & certainly won't be confident about going down the steps to call her in at night. I wouldn't be able to help her at all should she take a tumble down the stairs, which worries me. So I'm hoping that my parents might keep hold of her for another few weeks, perhaps until I can at least weight bear.


I know that I've still got at least a couple more months of being on crutches & still quite a lengthy recovery beyond those, so I just think it's about time I got myself home & got on with looking after myself, with the foot !

Around & around .....................

It's 7.00 am & I've been awake since 5.30am. No particular reason, just awoke with a busy mind, so many thoughts jostling for attention inside of my brain...

Yesterday I woke up feeling down, actually quite tearful & wobbly..... It was the first time in a couple of weeks, I felt disheartened by it  & like I'd stepped backwards in the whole "dealing with it" part of the recovery process. I don't really know why I felt so down yesterday, I had no particular reason, no triggering factor, just a wave of emotion that left me feeling angry, frustrated, bored & tearful.......
I'd got up & it was a beautiful day, I'd let my dog out & stood outside my parents cottage. Beautiful blue skies, golden sunshine, lovely warm air, but no wind I thought to myself. There is no wind, sailing would be tough today, most probably a day of bobbing around. It was there before I knew it, before I'd even had a chance to control it. A stomach churning familiar realisation that I wouldn't experience sailing for months to come, maybe not even this year & what about when all of this was over ? Fear set in, what about if my foot didn't fully recover ? What if I couldn't jump about the foredeck like I used to ? What if I couldn't balance on the boat like I used to ? What if, what if & what if ?
I was told by a nurse at the hospital at one of my appointments that there is a grieving process attached to dealing with this sort of injury, it's to be expected apparently. My experience is that there is a cycle of it actually. It's like being on an emotional roundabout. Yesterday to my dismay I felt like I'd gone all the way around & was back at the beginning.

In the beginning I remember after the initial diagnosis by the consultant at the fracture clinic, it was definite shock that I felt, followed rapidly by total denial. Then following the CT scan appointment I dealt with it by asking my stepmum to stop by the local supermarket on our way home & in I went to purchase copious amounts of red wine & cigarettes. We ordered an Indian takeaway, that evening I ate my favourite food, drank far too much red wine & smoked way too many cigaretttes. I completely displaced the situation i was in at the time. I pushed away all of the fears & panic completely to one side. It was almost sheer refusal to accept that this was happening. They must have got it wrong & even if they haven't, well I'm just not going to let this happen to me ! When the red wine got a hold of me, I cried & said things as & when they came into my mind......... Like I'll never run again, well not to get anywhere anyway. I won't be able to wear high heels anymore, how on earth will I look sexy in "special shoes" ? There is no way my boyfriend will fancy me now. The bright & funny intelligent sailing buddy I'd been when I'd met him, was going to disappear. I'd wanted to climb Mt Kilamanjaro for my 40th birthday & now I wouldn't be able to. All of my staple "emotional crutches" were applied that evening. I threw everything at 'it'. From a medical point of view, a big red cross against what I'd done & yes the next morning the guilt crept in. But did I feel any better ? Well I felt relieved for taking the cork out of the bottle so to speak........

I look back on it now & I think all of those worries & reactions I'd initially had were relevant, but were superficial really. Just scraping the surface. The real worries that I should have had like, my job security, ability to do my job long term, walking normally, learning to walk again, looking after myself during the lengthy recovery period, looking after my dog, dealing with the operation didn't even enter my mind at the time. The job situation, I have thought about since, but have I dealt with it ? No I haven't, I've just "shelved" it, along with walking normally & facing up to the possibility that my life will change permanantly following this incident. Denial again possibly or maybe it's just my body's way of preventing overload ? After all how can I face up to & comprehend any of this when I still do not know how much of an impact "the foot" will have, once it has completed it's healing process. Although it may reach a finite level of physical recovery achieved by the surgery, there may be exercises I can do & improvements I can achieve with will power & determination, People overcome greater disabilities all around us with amazing results everyday !
I have accepted that it is beyond my control, what ever permanent injury I may be left with has already happened, it's there at the end of my leg, I just don't know about it yet. It will be, what it will be & when the time comes for my consultant to be able to confirm it, I will then have a tangible situation to work with & will deal with it then.

Yesterday, I pondered on why, after having a couple of good weeks emotionally was I feeling the "old" feelings again. maybe it's because the clock has continued to tick & time has moved on. The end of the initial recovery period is getting nearer. I've spent 54 days in plaster so far & reckon I'm about half way through. The fear of what level of recovery I'm going to make is a real & constant concern. It doesn't go away, it just manifests itself in different guises I think. The worries I had in the beginning are still there. But my dog is being well looked after, along with me. I have managed to look after myself so far, with a few breaks from the healthy regime along the way of course, but none the less I've managed to avoid weight gain with a careful diet. I've been managing to do some exercise. the muscle waste age is happening to my injured leg, but I'm managing it. My toes are now able to move, all of them & my job is secure, for now at least. The swelling has improved & the pain is less. My boyfriend is still around, sure this situation has had an effect on our relationship, but despite my efforts to push him away, he's still here.

So although I did feel lousy yesterday after thinking it all through, I can now see that I have made progress both physically & mentally, but it just takes time. It is a gradual process & you can't hurry through it ticking boxes along the way. It's individual, some people work differently to others & this is just the way that I'm doing it ;)