Heading South

The flight out to NYC from London Heathrow was smooth & on time, the foot was reasonably comfortable,able to be elevated for the entire time, due to the club seat/ beds. For some reason I was personally welcomed on board by the chief steward (?).

I had a wheelchair service at both of the airports which was really efficient & amazingly the Clexane syringes weren't even questioned. The scanner guy's comment on my hand luggage as it passed through the scanner was " Wow ! That's a lot of drugs." But everyone was kind & courteous, which made it much less of an embarrassment.

Swelling only became noticeably painful during the descent to landing in Newark.

So the weather was hot & sunny in Manhattan, around 78c on average. I spent most of Friday around Wall street, Seaport & Pier 17. Whilst sitting on the pier enjoying the sunshine, a couple of men who were engaged in slightly high pitched dialogue, were edging along towards me. One chap was moving backwards with the other a "Jackie Chan" lookalike moving towards him holding what looked like a flick knife. To start with I watched them with mild bemusement & wondered if they were acting out some sort of street theatre .......
People around me started to back away from them & move along the pier, getting their mobile phones & cameras out of their pockets etc while they did so.
As I looked at "Jackie Chan " I noticed his eyes were bulging & he had a deranged expression fixed on his face, the other guy was wearing an amiable smile, whilst speaking softly. He was big built but quite young I thought. Anyway, after watching these two dance around each other for a few moments,it became apparent to me that "Jackie Chan" clearly was wired, unhinged & serious ! I then noticed that I was the only person left sitting on the steps & considered to
myself how quickly I could move away from them on my crutches looking as inconspicuous as possible. I looked upwards & the upper levels were lined with crowds of people filming & taking photographs!
I got up slowly & inched my way along the pier sideways, crab like really, all the time
watching "Jackie Chan's" wild eyes but trying not to meet his gaze full on. Two lads ran past & then wrestled the Chinese guy unceremoniously to the deck in seconds. One of them sat on him while the other wrestled the suspected weapon from his grip. I looked at it, as it was thrown to the ground but i couldn't really make out what it was exactly other than it had a bright green plastic handle. Then the NYPD arrived, trussed up the little China man like a chicken ready for the oven & carried him away.
I mused for a while about the "what if's" & then headed to the Pacific grill for lunch which turned out to be a bit of a disappointment. The rest of my day was pretty uneventful after that, a bit of shopping, the Brooklyn bridge & a little bit of Little Italy & Chinatown.
We had dinner that night at The Waters Edge restaurant in Long Island, it has a complimentary water taxi service from the Skyport marina which provides stunning & romantic (take note Glenn) of the Manhattan skyline at night along with a complimentary glass of champagne The food is pretty good too !

Next morning the sun was shining high in the sky as we headed to Central Park. After a taxi ride we entered by the Lake & Boathouse & walked to them via Strawberry Field. I took the obligatory photograph of the Imagine mosaic & some great close ups of the bridge & staircase down to the fountain, before we hobbled around to the Loeb Boathouse. I couldn't believe our luck, we got a great table by the lake for lunch. The view was so beautiful, of people trying to row their boats around, of the sun glinting on the water & glowing through leaves on the trees. I ordered the Maine lobster roll & it was delectable, slightly sweet but not too chewy, delicious, the glass of bubbly complimented it perfectly too !

Afterwards another taxi ride, but this time to The Empire State building. Although I have been up it before (2005) I wanted to watch the sun set & hopefully capture a bit of it in some photographs .

We finished the day by heading to some bars just off of Broadway & the foot & I boogied to
Michael Jackson before heading back to the hotel.

Yesterday we drove over 700 miles (after getting lost) through West Virginia & along the Blue
Ridge to arrive in Greensboro NC. Lovely chappie has a two day course to attend before we can continue onwards to our next destination which is Cherokee.
Whilst chilling out & watching daytime tv in the hotel room I saw an advertisement for a male grooming gadget, it had a bright green plastic handle & looked very familiar ..

I'm hoping to be able o visit an Indian reservation & maybe have a pow wow with the Chief !

The foot is crossing the pond !

Good morning everyone,
Thank you for your comments, they were a lovely reminder that I'm not the only one dealing with these problems........

The news is, I've decided to go ahead with my trip. A distraction is what I need at the moment I've decided. After a few days of stewing, a few minor alterations to our plans, we are flying out of Heathrow T5 this evening!
My lovely chap (yes he did hang around,despite the foot)has booked me club class all the way to NYC. Which means the foot will travel in style & will be elevated the whole way.
I am back on the Clexane to hopefully fend off a possible DVT & we have organised wheelchair assistance through the airports on both sides of the pond.
We have cancelled both of our internal flights & now plan to drive from NYC to Greensboro NC before heading to Cherokee & the Smokies. The beauty of this is we can stop as often as the foot needs & run to our own schedule. We've even decided to include Philadelphia in our return journey back to NYC.

I brought a new DSLR a few months ago, so I will be snapping away & will try to post as often as I can. We plan to have dinner at The Waters Edge restaurant tomorrow evening (Birthday) which has stunning views from Long Island of the Manhattan skyline. We were there last November, on our 2nd date so it's sweet to be going back. I may try to watch the sunset from The Empire State building, I visited it in 2005 & perhaps a picnic in Central Park .......
I've also researched wheelchair hire companies, if it comes to it, I'll swallow a bit of pride & use one.
So for the next two weeks, it's not about the foot & what I can't do, it's about exploration, fun, adventure & me ;-)

Fractured forefoot

My consultant was quite concerned when I arrived this evening. The CT reported a fractured forefoot which apparently is the part from the bottom of my metatarsals to the tips of my toes.
I just need to fracture my ankle & I've done the full set !

Thankfully it's not displaced & my mid foot reconstruction is still intact with no misalignment. Therefore as long as it stays that way I won't require surgery. It just needs lots of TLC.
So I feel some sense of relief but am upset & frustrated to be back in the aircast boot & on crutches for the next six weeks. The Osteopaenia is partially to blame apparently making my bones more brittle than normal, but the good news is it doesn't slow down the bone recovery rate.
I developed Ostepaenia as a result of the time spent none weight bearing, it should resolve itself in time I've been told. I am continuing with the vitamin supplements & will try to eat a diet to encourage the mineral density in my bones to improve.
It hurts, but the drugs are good, it's very swollen too, ice packs & elevation here I come!

So, on Monday 3/10 it is the six month anniversary of my Lisfranc fracture & on Friday 7/10 it will be my birthday. On Thursday 6/10 I am supposed to be flying to NYC to celebrate :-(
My consultants advice was I could travel but he wouldn't if it was him in this situation. I will have a higher risk of developing DVT being pro coagulant at the moment due to the fracture. He did say he would put me back on the Clexane injections if I went ahead with my trip to try to prevent a possible DVT.
I'll need to restrict what I do in NYC though & will need to put my foot up as much as possible (De Ja Vu !). I will need to sit in the back of the car with my leg up for the road trip in the Smokies as well .........  However I don't think we can get a refund on the airline tickets now. So, I don't know what to do really. I was so looking forward to seeing the Smokies in the Autumn, I bet the colours are stunning this year. But I'll be able to do very little in NYC, my planned cycle ride in Central Park on my birthday can't go ahead.......... Hold on, do they have tandems ??? Hehe I could just sit on the back & get my chap to pedal.

Travel insurance could be a problem too, getting cover for the foot !

With this unlucky streak, I don't think it's worth my while buying any lottery tickets.

Yes......... I panicked !

Last weekend, after managing fairly well for 3 weeks without the boot & using my crutches less & less I had planned a sailing reunion with my crew down in Southampton. Unfortunately I hurt my foot! I stepped up with my good foot, wobbled backwards & lost balance with my entire weight dropping back onto the ball & toes of my injured foot. The pain was immediate & severe. I felt a horrible crunching in the base of my toes, followed by a searing pain through the bottom arch.
It swelled pretty much straight away, a band of swelling all the way across the bottom of my forefoot & base of my toes. The pain was scarily similar in sensations to the pain I'd experienced following my 1st surgery. I took a hefty dose of ibuprofen & hoped that it would settle down & that perhaps I'd just jarred the joints & ligaments or something. The fear, just kept rising up inside though, managing that whilst being with my sailing crew was difficult. A couple of times the fear & panic overwhelmed me to the point that I shed a few tears. Sure I felt run down due to the pain, but the panic & fear overtook.

48 Hrs later I gave in, walking was incredibly difficult, the ball of my foot & underneath the forefoot felt horribly tender, my 2nd & 3rd toes were pretty swollen too with some bluish bruising starting to materialise. So on Sunday evening I found myself in the A & E department of a nearby hospital. After waiting for a couple of hours I was seen & lateral & AP Xrays were taken. To my immense relief no significant fractures were evident on either Xray !
But the consultant was concerned enough about my inability to weight bear & the swelling to give me another pair of crutches (my 3rd !) & prescribe very strong pain killers before discharging me with strict instructions not to weight bear until I had visited my own consultant.

So I saw my own consultant last night & after reviewing the Xrays again he agreed there are no significant fractures evident & my midfoot reconstruction still looked intact which was great news. He was slightly concerned over the swelling & tenderness in my forefoot & toes, with my planned holiday to the US due to happen in a week he has requested a CT scan before confirming that I'm OK to travel.

So it's been a pretty eventful few days, & here I am waiting to go back to hospital this afternoon for the CT. I feel so relieved I can't tell you, the thoughts of having to go back into surgery or back into cast were enough to make my stomach lurch & my heart sink. So I'm keeping everything crossed & thinking positive thoughts that the scan results are good, I'll get them during my follow up with Mr Ritchie on Saturday. In the meantime resting the foot & only partial weight bearing with crutches allowed.

Breaking the silence .......

Well ! Where have I been ?
Apologies first of all, I know I've been a bit quiet, it's been a very tough couple of months........
So after my second operation on the 15th July, I got an infection in the wounds. Which set me back a few weeks. Innitially after the op I felt great. It turned out to be more complicated than planned, I needed some tendon repair & cleaning up which meant another 2 1/2 hrs under anaesthetic. But I felt good and after a couple of days & was looking forward to walking without my crutches relatively quickly. What actually happened was the two weeks planned holiday following the op were spent with me feeling quite ill & eventually not being able to walk at all.
It put me back,but all in all I got over it quite quickly,
What was harder was the walking & weaning out of the boot. I'm no wimp, but when I started to walk I couldn't believe how painful or difficult it was going to be, or was. I knew it wouldn't be straightforward but no body explained to me or prepared me for just how hard it would be. The initial disappointment was so hard..............
I tried to stand up, but I just couldn't. Taking the first few steps out of cast were petrifying. People just do not prepare you for it.
Dealing with my weakness, limp & the pain have been a huge problem. I suppose that maybe I've been hoping that when I came out of the boot I would walk normally. in fact I think I've been in some sort of denial for the last 5 months & was pinning my hopes on it all being fine once I got out of cast.
So when it happened, that is the failure & pain when trying to walk normally, I really struggled with facing up to just how serious this injury is. I didn't deal with it, I cried lots & pushed more & more, hoping for a breakthrough, it didn't happen.

Physiotherapy, shoes & all that follows Lisfranc Surgery

2 1/2 wks post op removal of compression plates, fixing screws & arthroscopy.

I saw my surgeon last night for my post op check & all things considered I didn't think the foot looked too bad .............. I now have one more incision, on the inside of my foot following the arthroscopy but he used the same scar for the metalwork removal & I have to say, I think he did a better job of closing it this time then after the original surgery. What was encouraging was the lack of significant swelling, this is a positive sign apparently & is as a result of all of the elevating & rest it has been given. So there we are, the Lisfranc mantra of "keep your foot up" obviously works !
I still have internal stitches which will dissolve in time, but I can go back to bathing with "my foot"- heaven ! I looked down after the dressings were removed & thought there were a couple of blonde hairs that were perhaps stuck to the sticky residue left behind, but after a gentle tug & a bit more scrutiny, I discovered that they were in fact attached ! They were the 'tails' for the internal stitches- LOL
I will start with an intensive moisturising regime & will buy some "Bio Oil" to rub into the scar. My surgeon says that this stuff really helps with scar healing.......... time will tell !


I explained how I'd tried to build up the weight bearing last week & the amount of pain that I experienced afterwards.............. After an examination, there was some tenderness around the 3rd & 4th metatarsals. My surgeon commented that it is possible the bones haven't fully fused yet, which would explain the discomfort. He was hoping that I would start full weight bearing in a shoe yesterday, but in view of the pain etc, he has asked me to continue with trying to build up the weight bearing whilst wearing the (now stinking !) boot & I will see him again in two weeks time for another examination & X ray. But the good news was I am now ready to meet with the physio terrorists as I fondly call them & they can now be let loose on "the foot".
I must say, my ankle & foot are so painful & stiff at the moment it is hard for me to believe that I will manage to walk in a shoe in a couple of weeks time, but I'm hopeful that along with targeted physiotherapy exercises & a focused effort from me, it can happen. I'm sitting at the moment on my sofa with my laptop on my knees & both feet flat on the floor. Not really weight bearing, but bending the ankle joint & flattening the foot on the floor. My ankle joint has been in a rather odd position pretty much since I had my accident & although I do try to bend the joint & rotate it from time to time, it still will not reach the 90 degree angle which is normal.The pain has been gradually building whilst I've been writing this post & I know I will have to elevate it again shortly.
It's all very well, but when does this need stop ? Does anyone know if this need to elevate gradually lessens & "the foot" will build up enough strength to become strong enough not to need it so often ? I'd be grateful for an indication of how long from where I am now this will begin to happen too.

I have been thinking that swimming would be a good thing to do, but there are no facilities close enough to me to be able to get to without a lift or taxi. Maybe I might just have to stomach the bills & overcome the diminished self confidence & just go ! Quite frankly I think I'd do anything at the moment to help reduce the pain & accelerate the recovery process if I could.

1 step forward......... 2 steps back

Well, I've kind of had the wind taken from my sails so to speak. It seems I didn't respect "the foot enough" this week & it let me know !
So 4/5 days ago, I started walking around just using one crutch more & more often, around the house to start with & then I did venture out. I brought myself a new DSLR recently & a friend offered to take me to the Pantiles last Sunday morning. It was such a beautiful day, I took my camera & really enjoyed hobbling around (in the boot), snapping pics as & when I saw them. It wasn't a long walk or particularly challenging, I took my time & used just one crutch. I was tired when I got home but that was about it. The foot was a little sore, but after a painkiller it settled down. On Monday, I was home all day, hobbling in the boot & sometimes using one crutch, sometimes none. Well that evening, the foot really started to hurt, in fact it did feel scarily similar to the pain I had a few weeks after my 1st op. I had sharp pains in the arch & under the ball of my big toe, along with lots of prickly spasmodic type pains across the bridge/top of my foot & some pain up the back of my leg. I took pain killers & elevated it. the strange thing was, my toes didn't look particularly swollen. A little puffy but they've been alot bigger ! The next morning, it seemed OK, no lasting pain carried over.

My dog was desperate for a walk on Tuesday, I had arranged for someone to come over & take her, but it fell through. So after deliberating, I decided I could possibly manage a gentle hobble (in the boot & with one crutch) around the block with her & gave it a go.
I didn't go anywhere else yesterday, just pottered around the house, sometimes using a crutch & sometimes not. Instead limping around in the boot & using props around the house to support myself on. Last night I really suffered for it. The pain was all of the day before, but much stronger & at times nauseating ! I even had a grinding ache all along the balls of all of my toes (underneath the bases). I'm not sure if that's the right term for that area, but hopefully you'll understand from this odd description which part I mean :) I got up to use the bathroom & hopped all the way on my good foot to it, each hop I took, made "the foot" hurt, a bruised type of pain.
It stopped me going to sleep last night, I couldn't get comfortable in bed at all & I was seriously worried. I lay in bed trying to work out if this was the tendons & nerves healing following the most recent op or if I had somehow managed to damage "the foot" again. I had to go back to elevating "the foot" on a cushion outside of the bedclothes again. So after worrying & feeling pretty sick, I had a poor nights sleep & decided that today, I would hardly weight bear at all, using two crutches if I did.
I've spent the entire day on the sofa pretty much, trying to work, taking pain killers & If I'm honest still worrying. The thing is I still have all of the bandages on, so I can't actually see my foot & I have no idea if the surgeon went back in through the old scars, or if he has made new incisions (I forgot to ask). Therefore I'm not sure if the rest of the foot swelled as a result of the weight bearing & that's what caused the pain, or if it is the tendons etc healing or what, really.
I feel a bit deflated, after feeling so positive & that it really wouldn't be much longer before I could drive (it's my right foot) my car & get back to the office perhaps around the end of August, I'm now not quite so confident. I was also hoping to sail in the last couple of races of the season which are in September. I had realised I couldn't do foredeck, but in this amount of pain, to do anything except sit in the cockpit would be difficult. Not too mention dangerous really. I don't know, frustration & anxiety probably sums up how I'm feeling this evening. Since resting all day, "the foot" has calmed down & isn't hurting me quite so much, although the spasmodic prickly twinges are still happening.............

Last night I was all set to ring the hospital today, but I decided against it & thought I'd try the rest treatment first. I'm really hoping that I've just overdone it & perhaps pushed for too much too soon. I have to go back to the hospital next Tuesday which is 6 days from now, I think I'll just continue to rest it as much as possible, & see if I can gently work back up to one crutch by then. If I can't then I'll just have to make notes on how the foot feels & tell the doc.

Removal of my compression plates & screws Day 103

On July 15th I was re admitted to hospital for the removal of one of the compression plates & five of the screws that were holding this plate in place & supporting the Lisfranc ligament.

I arrived at 12.30pm, in my boyfriends Porsche, with the roof down of course! Peter Gabriel's Solsbury Hill was blasting out from the stereo, the sun was shining beautifully & well, arriving in style seemed like fun. A sort of ironic celebration I guess, but either way it took my mind off of the surgery for a while & I arrived at the hospital in good spirits.
I met with my surgeon who talked me through the process, it didn't seem to be complicated, but I was advised to have another sciatic nerve block from the knee down in addition to the GA. This was instead of Morphine, which the anaesthetist thought I may need in post op recovery otherwise. So the waiting began................

After a few hours of flicking through the daytime TV, fiddling with my Ipad, photographing the foot pre op & planning a possible holiday in October my boyfriend & I were pretty fed up with waiting & were beginning to wonder if I'd be able to go home after the op as I'd wanted to.

Eventually, just before 6pm, the porters came & got me !
Although I was a little anxious, with sweaty palms, i was relieved to finally go. Everyone was really friendly, I cracked a few jokes about needing a glass of Merlot & celebrating the end of "the foot" which now felt like it's not too far away. My lovely anesthetist gave me a little something via my canula to make me feel fantastic (I have no idea what it was, but it worked!) I'd agreed to have the nerve block administered while I was conscious, so I was asked to roll over onto my belly, I watched them do it over my shoulder. My sciatic nerve looked like a ball of wool really, a white mass on the ultrasound screen, to numb it, they injected anaesthetic around the outside edge of it, through the back of my knee, at equal distances, like the 12, 3, 6 & 9 points on a clock face. After rolling back onto my back, I can't remember much more really, the GA was given but I think i may have drifted off before then...........

So what actually happened to "the foot" whilst I was under was, my surgeon removed the plate which was bridging my 1st cuneiform & 2nd metatarsal articulation & also the 2nd metatarsal joint. he discovered that these joints were stiff & some of my tendons had become attached to the plate. So he also carried out a formal arthroscopy (examination & flushing out/cleaning of the joint to re mobilise it) & then an open release of the extensor contracture ( releasing the large tendons from the surface of the plate by laser). It all went smoothly apparently & I had a 'smooth uneventful flight' according to my anaesthetist.

I woke up at about 8.30 in recovery, feeling pretty groggy but already relieved & happy. After some oxygen, I was taken back to my room, where lovely boyfriend was waiting with a gorgeous smile for me :)
I peered under the duvet, to see "the foot" well wrapped, looking almost ball like in shape, with the familiar Iodine staining on my toes & around my ankle.

So the deal was, I had to eat, pee & walk convincingly on my crutches in order to gain my release from the hospital that night by the "physioterrorists" ! After half an hour or so, I began to munch the sandwich proffered to me & drink the tea in earnest, so as to satisfy the release criteria- ha ha !
We tried at 9.30 pm, then again at 10.00pm, I was given one last attempt at 10.30pm.

I could feel nothing in the foot at all, it just flopped about, & my head felt strangely separate from my body, but after forcing the foot back into the aircast boot & a few deep breaths, Voila ! I achieved the necessary few steps around the room on the crutches & the tea had performed it's magic too. Home I went, much more appealing to sleep it all off in my own bed than stay another night in hospital. I took Co codamol & Diclofenac home, just in case.

Saturday night, I was determined to take out BF for dinner, to say thank you for all of his support & to celebrate ! So we did, I managed to put on a high heel (hitched my crutches up a notch) & a dress & off we went. It was lovely, Chinese with a bottle of bubbly, foot still numb & although I was still a bit tired it was worth it.
So the nerve block worked fantastically, it finally wore off about 3 am on the Sunday, over 30 hours after the op, I'd recommend having one to anyone, much nicer than the groggy mess that Morphine can you leave you in sometimes.

But on Sunday I paid for not obeying my body, I was sooo tired, sore & groggy I slept most of the day. I took the Diclofenac & a couple of doses of Co codamol to take the edge off. Monday was spent dozing on the sofa too.

It's now 4 days since the op & I don't feel too bad. the foot is still a bit sore, but that's too be expected, but the swelling isn't too bad & the pain is bearable. I've been told to try to start fully weight bearing in the boot over the next 2-3 weeks, building it up gradually, but stopping if "the foot" protests too much.
I'm back to see my surgeon on the 2nd August........

3 mths since my Lisfranc surgery .........

Tomorrow will be the 14 week anniversary of my Lisfranc fracture, I thought I'd update you all on how I'm doing. ....
I've been home alone for two weeks, just me, my foot & my dog rattling around in my flat & finding ways to overcome some of the obstacles I now face when trying to do some of the simplest tasks.
My dog, Hannah is almost completely blind now from degenerative retinal disease, so trying to negotiate around the flat on my crutches & avoid banging into her has been a challenge !
Hannah lives to eat, food is her greatest pleasure in life, so every time I got to the kitchen, so does she. Hannah has cunningly worked out that if she sits in between me & the kitchen work surface, then she's in a prime position to catch any food I drop, before I can stop her. Although this has worked well for her for food, the downside is she regularly nudges my crutches that are resting against the work surface & as such has received several bumps on the head from them as they clatter to the floor.  She walks hopefully alongside me with her head in the air, nose twitching, as I trundle slowly along on one crutch, whilst precariously balancing a plate of food in the other hand. My cutlery & anything else I need in one of my pockets. I do it this way because the only other alternative would be eating in the kitchen whilst standing. Hannah's also bumped into my crutches when trotting up to me for a stroke, the poor thing has had to try to adapt to her mistress's extra two legs by touch & smell only. I look at her & can't help but think that this must be very confusing for her. Walks only happen if someone visits who doesn't mind taking Hannah for a quick stroll around the block, the rest of the time she has to make do with the garden, but she never complains.................. treats & strokes work wonderfully.

So I've been continuing with my physiotherapy exercise since being home, the plus is I can now do them in the living room in front of the TV. I've worked out a way to do my laundry too. I have a big bag with a long strap. So upstairs in the bathroom, I load my laundry into the bag, then I put the bag on diagonally & swing it around to the front, like a kangaroo pouch. After bum shuffling down the stairs, I then use my downstairs crutches to get to the washing machine in the kitchen & unload. To dry it I do the same thing but in reverse & sit on the loo (lid down of course , it's just a handy place to sit!) whilst I unpack the bag & hang the laundry onto my clothes horse.
Thermos vacuum mugs have been a god send. I make a cup of tea, put the lid on & then manage to hobble back into the living room carrying it without slopping it all over the floor- fantastic !
I had a go at hoovering the living room last weekend. Mmmn not my most sensible idea. I worked out how I could use the hoover as one of my crutches & shuffle around the room, hoovering as I went. Balancing was tricky & I did overbalance onto 'the foot' several times......
I've discovered the power of home shopping too ! I place my orders for my food & groceries online, a very friendly chap delivers it & carries it into my kitchen for me. I can even order magazines, newspapers & alcohol :) The next delivery is tomorrow & I can't wait, I've ordered an Indian takeaway, the highlight of this weekend- hoho
My sofa is a huge corner style one, which has now become my main base. I have the TV remotes, my handbag, Blackberry, Iphone & all that I need set up in the corner seat. Lots of cushions to prop me up & both laptops to hand. This is where I currently rest, work & spend most of my time.
I've been working from home for the past couple of weeks which has been difficult to concentrate on. But perseverance will help I think, I mostly just answer emails, phone calls write reports & co ordinate the team in the office remotely. But after being in this very insular environment for so long, it's tough now to snap out of it & stay focused on any singular task for any length of time I find.

This week however I went to two day sales meeting & met with the rest of my team. It was the first time I'd seen them all since I'd had my accident. So I had one chair for me & one for 'the foot'. I sat at the end of the boardroom table & gave my presentation, to my surprise it was well received, I finished with the last slide being my X-rays with the caption "any questions?" & gave everyone a wry smile.
The hotel room booked for me was an accessible one, with a walk in shower. This was novel, I've been lifting myself in & out of the bath for three months. So in I hobbled on my crutches & switched it on, the shower head squirted water everywhere, not just on me, but up the walls, all over the wash basin, all over the towels & mirror. It was broken & there I was naked, on crutches & powerless to do anything other than watch the water spray uncontrollably anywhere it wanted to !
I gave up, washed as best I could & switched it off. the bathroom was a scene of soggy chaos !
I think I'll stick to baths.......


So I received a letter from my consultant yesterday, I am to go back into hospital on Friday (15th) for the operation to remove one of the plates & approx 6 screws from my 1st, 2nd & 3rd metatarsals. It may mean an overnight stay due to the general anaesthetic, I'm hoping this op won't be a big deal though. I'm sure I'll feel a little bit sore afterwards but I have plenty of pain killers left over which should see me through. I'm guessing that they'll go back in through the same scar from the previous op, pity as it's healed quite well.
I've put boyfriend on standby for some TLC & to ensure they'll let me out as quickly as possible (apparently they have rules about discharging people after GA without people to look after them) & I've warned work that I'll be uncontactable for a few days. But this op is another step forward, after I've recovered I should then be able to begin walking using all of 'the foot' albeit still in my boot & on crutches. The thing to look forward to though, is I'll be another step closer to SHOES- Yay !

Day 80 Weight bearing- Woohoo !!

I had a really good appointment at the hospital today, for the first time in this recovery process, I finally received some real positive news !
My AP & Lateral X rays looked as good as the consultant would expect at this stage, his words were "You're making a good process in line with what I would expect at this stage".  The fusion (with bone graft) of the 3rd TMT joint is healing well & the plate & screws that are also holding it & the 4th metatarsal will remain permanently in my foot. The 2nd metatarsal which was treated with an open reduction & fixation look like it's healing well, the screw that was put in in place will hopefully be removed along with the fixation plates & screws in the 1st metatarsal. If I continue to make progress at the same rate, I can expect this to happen in about 17 days (July 15th).
After examination of the foot, he was encouraged with the low level of swelling that it presented with.  He wasn't concerned by the swelling I described & the purple appearance "the foot" sometimes adopts he said it was quite normal to experience this after exertion at this stage & I should take it as a sign that I need to rest it whenever it happens. The swelling should always subside after resting, which mostly it does.
I explained to him the problems that I was having with the boot, it was loose & hung awkwardly on my foot rather than supporting or cushioning it. This was causing the bridge of my mid foot to become sore, pins & needles in my toes & irritation of the operation scar.  He explained that he was hoping to get me to start weight bearing using the boot, so we needed to resolve this other wise it would mean transferring back to a cast, which would be a slight regression. So we hopped along to the physiotherapists office to see what her verdict was. After having a look, she explained that the boot was far to loose, following the reduction in swelling over the past 3 weeks. I also still cannot get my ankle & heel to bend into the normal 90 degree position due to stiffness & swelling within the ankle joint. This is also affecting the positioning of my foot within the boot. The physio suggested that we try to inflate the air cushions more to hold my foot in a better position, although it would mean discomfort short term, the long term benefits would be important. After doing this, the boot was a lot tighter, all around my foot & calf, apparently this is how it should have been all along :( I also need to continue with the ankle exercises at home.
Then came the "moment"................. after another nurse was called in for support, I was asked to stand up slowly.............. on both feet ! After much coaching from the physio & lots of instructions I then began to walk, just putting 50% of my weight into my heel. Crikey it felt alien, completely abnormal ! I painstakingly slowly put my crutches out in front of me, then brought my bad foot through, parallel with my crutches, put my weight down into it's heel & then brought my good foot through to meet it. The smile on my face after the first couple of steps was immense ! I even felt emotional, my bottom lip wobbled a bit, I don't mind admitting. The relief was over whelming, at last a real tangible step forward in my recovery process. I also had a lesson in staircase techniques, so hopefully after a bit more practice, I may be able to leave the days of bum shuffling behind me- Yay !
I asked my consultant if I had actually displaced the Lisfranc alignment when I fractured all of the bones that I did, he confirmed that in deed I had & it was by a serious measurement. However If I continue to make the recovery that I currently am, he felt confident that the ligament & tarsometatarsals should heal well. I asked about my prognosis, he confirmed that subject to the good recovery continuing I stand a relatively low chance of developing a debilitating level of arthritis. The good news is that I stand no chance of developing arthritis in my 3rd TMT as I've already had the treatment by having it fused. If I were to present with painful arthritis in the future then he would treat it my fusing the rest of my TMT joints. I feel reassured that it would be treatable & actually if it came to this, well at least I'd still be able to stay relatively active. I have lost some feeling on the inside of my 3rd & 4th toes, my consultant said he couldn't say for sure if this would be permanent, but it shouldn't affect me too much. I also asked if I would be left with a permanent limp, he said that I would have a slightly displaced gait, but after 6 months or so I shouldn't have an obvious limp & should be able to walk relatively normally. It will take a full 12 months or so, before I will reach my full recovery. I should be able to sail again next year, OK so no pirouetting on the foredeck but I WILL be able to balance well enough on both feet to be able to sail.

So I can hopefully look towards the op in July, then around a month later walking in a normal shoe, a few weeks later discarding the crutches & being able to drive sometime in August.
Happy, happy, happy of Royal Tunbridge Wells !!!

Day 78.......... Home at last

Two days ago, on Friday 24th June I finally came home, back to my own split level flat. You may recall, I live in a Victorian conversion, on the second & third floors. So I have a flight of concrete steps to get up to my front door & then another flight of stairs inside to get up to the bathroom & bedrooms.
I went to the supermarket to stock up before my boyfriend left, this time I decided to avoid the wheelchair & opted instead to hop around on my crutches- big mistake ! After the KOL concert the day before, "The foot" complained bitterly about more hopping about & swelled impressively to let me know that I'd overdone it.
After my boyfriend had left, I found myself feeling quite down & isolated. In fact just really insecure about my ability to look after myself & to keep myself staying positive now that I'd be on my own mostly, without transport & that I'd need to look after my dog, Hannah who was due to arrive home the following day.

However, I've been wanting this for weeks & the need to regain some of my independence & for my own space was stronger than the fear. Ridiculous really, I've been living on my own for over 10 years now & am a really strong & resilient character normally. I find it strange that this injury has had this latest effect on me. If I'm honest I have struggled with the immobility & in the first few weeks, the anger & sense of grief that I felt was very strong, but to now feel uncertain about the simple things, such as cooking myself a meal, taking a bath etc on my own, is embarrassing. So on Friday evening, I grasped the bull by the horns & decided I'd attempt a bath. After much planning I managed it, to my relief !
OK it was awkward, having to lift myself in, using my good foot & then twisting around to be able to use my good foot again to support myself when I lifted myself out, but I did it ! Without hurting "The foot"- Yay ! You see, just to make it even more awkward, my bath is on a plinth, which is about 1 1/2 - 2 feet higher than the floor. So negotiating this successfully too was quite tricky.
Box number one- ticked !
Yesterday I managed to cook myself a pizza & today a stir fry, then I administered all of the dog's drugs to her successfully & in the right order :)
Boxes 2 & 3- ticked ! All of a sudden, my self esteem crept up a couple of notches & I now feel that I was right after all, I needed to come home & get on with it, OK so it's all hard work & requires planning & thought (not my strongest attributes) but I'm learning.

So I'm back to hospital on Tuesday, more x-rays & a consultation. I am a bit worried, the foot still swells whenever I hop around for any length of time, it goes purple/blue in the bath & I have had a couple of falls on my crutches recently (on wet surfaces, another hazard !) But it will be what it will be. I don't think I've done any damage, but will feel reassured after the X-rays.

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 !

K wire gone & Aircast boot fitted

Well I finally managed to see some x-rays, they are post surgery, actually the ones that were taken a few weeks back, but it helps to see what was actually inserted into my foot. Quite a clever bit of hi tech carpentry really, I thought it was incredible that they'd managed to fit so much into such a small area & fix them all to such small bones.
The K wire removal wasn't too bad, a couple of deep breaths, a good pull & it was done. The worst bit was looking at it afterwards (I wouldn't recommend you do this unless you have quite a strong stomach). So I then met with a physio, who fitted me with an aircast boot. I still can't weight bear apparently, but I do have some gentle ankle exercises to do, to try to improve the flexibility in my ankle & also to stretch the muscles & tendons in my heel & back of my leg. At the moment my heel doesn't sit down in the boot as the muscles & tendons have shrunk. But the physio assured me if I do the exercises on a daily basis this will help. I've also been doing some other exercises which a physio suggested to me after the operation. Although none weight bearing, I'm convinced that they've been quite crucial in slowing down the muscle wastage in my upper leg & bum ! I've been trying to do them most days & actually the bit of extra weight given by boots & casts has helped by providing a little extra resistance I think.
After a few days of adjusting to the aircast boot & changing the surgical dressings I feel quite positive. The scar doesn't appear to be as bad as I'd feared & in a few days I should actually be able to have a bath.... with my foot :)
 I've also recently started using my parents neighbour's multigym a few times a week, to tone & strengthen my upper body mainly. It's not exactly been an adrenaline pumping activity, but it's helped I'm sure. One of my biggest concerns about the amount of time I was going to be immobilised for, was the effect it might have on my body & posture. So just by stretching muscles & lying on the bed to exercise for a little while every day it looks as though, so far, there's not been any noticeable change. I can now wiggle all five toes too ( I know I've mentioned this previously but I am so genuinely relieved that they do !), there is a little bit of numbness still in some of my toes but the important thing is that they move. Oh & I weighed myself today & I weigh about the same as I did when I had the op, yippee ! I  didn't want the problem of additional weight to try to lose or make my poor foot bear after I've gone through this process. Small positives, but it all helps !

It was my step mother's 50th birthday recently, so to celebrate we held a Mardi Gras themed birthday party for her last weekend. Despite the weather it went well, all enjoyed the food & copious amounts of alcohol that were on offer. Chicken jambalya, vegetable gumbo, red beans & rice & king cake were on the menu. Everyone made a fantastic effort with their masks, god knows what the passers by must have thought. Their house is up a remote hill in the Forest of Dean you see & the entire garden & garage was decked out with purple, green & gold decorations, so this along with an assortment of masquerade mask wearing people in the front garden, I should think it caused a few second looks !
Despite the boot, after a few too many glasses of wine I even managed to boogie on down with my dad to a bit of reggae. On crutches of course & perhaps not entirely keeping to the rhythm but I had a go & it was a laugh !

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 ;)

No bad news..... No other news..... But that's good apparently

Sooo disappointed I didn't get a chance to see the x-ray again ! But I've managed to get my consultant to agree to send them to me. As soon as I get them of course I'll post them.
My cast was removed again, dressings off & the wounds were cleaned. This time my foot resembled a manky Cornish pasty, swollen, flaky skin, scabby wounds- yuk! So I didn't photograph it, sharing it with people just wouldn't have been polite ;)

The verdict was that it was positive that there were no negative signs on the x- rays, all metatarsals & the Lisfranc joint were still aligned. I was told that at this stage (5 wks post op) that was all I could expect. The consultant is still being none committal about the long term prognosis, it's very individual & each case is different, with different outcomes apparently. I did manage to get an indication of the plan for the next 8 wks or so though.

So in two weeks time I will return to hospital for another x-ray, provided all is OK I will have the K wire removed. I will also meet with a physio, who will fit me with an air walker boot. I should then be able to start putting a little weight on my heel whilst walking with crutches- yippee !
At around 12 weeks post op (1st week in July) I'll have another op to have some of the screws & one of the plates removed. Roughly a fortnight after this, I will be able to start walking with my weight on all of my foot (assisted by crutches). The next stage after this will be shoes ;) Still no idea on when I'll be able to drive or will start to walk without crutches though.....

I'm immensely relieved that the results were ok this time, no damage done by the couple of parties I've sneaked out to, or the few too many glasses of wine I've drunk! I try to be good, no smoking(stops bone growth apparently),minimal caffeine (robs bones apparently), taking vitamin supplements, drinking orange juice (vitamin C is good!) & doing 1/2 hr of none weight bearing exercise per day to try to retain some muscle in my upper leg & bum..... But I have to have some time off the recovery treadmill from time to time. I would advise anyone that's going through something similar to this, to do the same. For your sanity really, or you may find the days & weeks drag relentlessly..... & there's a lot of them!

Thank god for my IPad, Lovefilm, naff daytime tv & my family. The pain is getting better, mainly caused by the swelling these days, so it's more of an incentive to keep it elevated & rested. I'm also fortunate that I don't have to work at the moment, I do have good sick pay benefits with my employer, which has been a god send.

So I googled it !

Of course once home, I really needed to know more, in some ways it was reassuring that all of the pain I'd been feeling was for a good reason, but this new information had put a totally different spin on the situation it looked like I was in. So I googled & googled...................

Not all of the info available was pretty, nor was it easy reading, this Lisfranc joint has an important role in our mobility I was discovering. Some of the facts I discovered during my various searches, I've listed below. I decided that it was important for me to fully understand it, to then be able to accept the recovery period it looked like I was going to need.

• The Lisfranc fracture is a fracture of the foot in which one or all of the metatarsals are displaced from the tarsus.
• It is named after 18th- and 19th-century Napoleonic surgeon and gynecologist Jacques Lisfranc de St. Martin.
  Dr Jacques Lisfranc found a novel way of amputating the gangrenous soldiers feet between the mid foot and forefoot. They named the supportive ligament between the two bones in the foot after him, Lisfranc ligament. 
• This injury is usually seen in horse riders whose feet have been stuck in stirrups during a fall, or in people following a fall from height & sometimes in motorists who have been in an accident.
  This is an area of the foot is where you transverse arch is so it is typically very strong and rare to dislocate. 

• Apparently it accounts for 0.2% of all foot fractures.
• The lisfranc ligament is a ligament which connects the base of the medial cuneiform to the base of the 2nd metatarsal. It is injured or disrupted in the lisfranc fracture.
• There are two main forms of treatment, stabilisation & support using a cast followed by gradual mobilisation or surgery followed by immobilisation, & then stabilisation & support using a cast followed by gradual mobilisation

During surgery the location of the surgical incision is dictated by the location of the fracture and joints that are disrupted. If all five locations of the lisfranc joint are disrupted, then two incisions may need to be made on the top of the foot; one on the top inside and one on the top outside. If the first three tarsometatarsal joints are disrupted, then only one incision is made on the top inside aspect of the foot.

Once the disrupted tarsometatarsal joints are located, the dissection is carried down to the involved joints and the debris is cleaned out. The disrupted joints are then repositioned back to the position they were in prior to the injury.  The joints are then fixed with strong screws.  However, if the fragmentation is excessive, a plate may be required. One exception is a disruption of the 4th and 5th tarsometatarsal joints; in this case, the bone is provisionally fixed with wires.  The wires are then removed after about six weeks so that some movement of these joints can be encouraged.

A typical post surgery recovery timeline might be as follows;

• 0-6 (or 8) weeks Post-Surgery.

The patient is non-weight bearing to allow for adequate healing. Not only do the bones need adequate healing, but the disrupted ligaments as well.  The ligaments actually require a longer time to heal.

• 6 (or 8) – 10 (or 14) weeks Post-Surgery.

The patient can being weight bear as tolerated provided the foot is protected in a walking boot, such as a CAM walker.  This boot (characterized by a rigid sole and a rocker-bottom contour) serves to disperse the force away from the middle of the foot and up the leg.

• 10 (or 14) + Post-Surgery.

At the 10-14 week mark, the patient can then transition into a stiff soled shoe.

A displaced injury takes a number of months to recover.  For most Lisfranc injuries about 70% of the recovery occurs in the first 6 months, but it is often a year or more before a patient has reached their point of maximal improvement following a significant Lisfranc injury.

Websites I used & have quoted from here are : www.footeducation.com & Wikepedia.

Thursday 7th April

The next three days had been painful & awkward but luckily I was well supported by new boyfriend, my dad & my grandad who had all visited me & helped me out with cooking & general day to day stuff, eating takeaways, watching movies etc etc :)
So I attended fracture clinic on Thursday 7th April & after having my cast removed, the registrar looked concerned. The location of the bruising & the amount of swelling were atypical to a Lisfranc, I later found out.After having my back slab plaster removed, I went for X-ray & also attempted a weight bearing X-ray, returning to Fracture clinic to meet again with the registrar.....
An orthopaedic consultant appeared along with the registrar & with a grave expression on his face proceeded to explain that he thought it was highly likely I had in fact broken more than one bone along with injuring the Lisfranc joint. At this point I'd never heard of the Lisfranc joint, but the consultant then proceeded to explain I would need surgery, but this wouldn't be possible until the swelling had subsided. I was referred for a CT scan & fitted with a walking boot, although told strictly no weight bearing & to keep the foot elevated at all times to reduce the swelling as quickly as possible. A possible 3 month recovery period was mentioned & after now realising the potential seriousness of the injury I booked a private appointment to follow up the CT scan results with the consultant on Saturday 9th April...............

One bloody metatarsal cannot hurt this much ???

As I held onto the sink in my kitchen, big hot tears formed in my eyes & 9 hours after breaking my foot, I cried. My shoulders shook as I gulped back the sobs, eventually letting out a hopeless wail, my injured foot now bound up in plaster of paris hung down from my knee, bent to prevent it touching the floor. I remembered I had a few cigarettes left in my sailing bag (I've enjoyed a love/hate relationship with cigarettes since I was 17 & although I'd given up last January a few social & post race cigarettes had crept back into my life recently, normally accompanied by a lovely glass of red wine). I inched my way around my kitchen, hopping & pulling my self from the sink to the cupboard, to the cooker until I reached the kitchen drawer that I kept a lighter in. After hopping & pulling myself back round to where the crutches were I made my way to the living room, sat down & lit the cigarette. Inhaling deeply, it didn't taste great, nor did it help with the pain but somehow it comforted me just to smoke it, whilst I tried to comprehend how much impact this injury might have on my life.
I work as a technical sales person for a connector company within the defence & aerospace industries, lots of blue chip customers & I normally drive on average 800-1000 miles per week. I reasoned with myself that one fractured metatarsal should only mean 6 weeks or so in plaster, perhaps a week off sick, then a few more working from home, I could get someone to drive me into the office for a week or so, yes this isn't too bad I concluded. Far from ideal but not a total disaster, Internet shopping for a while & maybe someone to help me walk my lovely cocker spaniel. I sent a text on my blackberry to my boss & emailed my dad & my gorgeous new boyfriend to let them know that I wasn't contactable on my Iphone as I realised that this had been left behind in Southampton. New boyfriend I guessed had probably been trying to contact me, to see how my day had gone with the new crew & might be worried that he hadn't received a reply.
I took a couple more co codamol & decided to try & get to bed, yep it was a struggle, the crutches felt alien & unco-operative as i tried to get upstairs, my foot dangled precariously in mid air as I limped, dragged & hopped my way up the stairs to bed.

I must have slept, but can't really remember going to sleep as such. It was 2.45 am when I looked at my bedside clock, the pain was excruciating. The bottom arch of my foot felt like it was on fire, with a hard knuckle or ball being driven into it. The top of my foot throbbed, pins & needles shot up & down my calf & shins. My toes were swollen unrecognisably & a sensation of hot stabbing pins intermittently affected the tips of them. I tried elevating my foot & lower leg on pillows, but this just seemed to increase the strength of the pain, nausea swept over me & I writhed around in bed just trying to somehow find a position that offered some relief. I can honestly say even after experiencing childbirth, a childhood kidney complaint that frequently caused renal infections, a horse riding accident that caused a badly broken arm & significant muscle damage I have never known pain like this !

Sweating profusely & absolutely at the point of despair with the pain, I pulled myself out of bed, grabbed the crutches & made my way down stairs. I stood at the top of the stairs pondering the safest & most painless way to get myself & the cumbersome crutches down them. Eventually I decided, sitting down & bum shuffling was the way to go. Once down, I again hobbled into the kitchen in search of a cigarette, I noticed the co codamol on the side & after reading the dosage instructions, took one more, hoping that this just might take the edge off of it. I held on to the sink, smoked the cigarette whilst tears again rolled down my face. All the while my mind was questioning the diagnosis at A & E, how on earth could just one fractured metatarsal cause me to be in this much pain ?

After I'd calmed down a bit, I made my way back into the living room, switched on the TV & aimlessly flicked through the channels to find something to distract me from the pain. I persevered for another hour or so but it was hopeless, back I went to the kitchen, another cigarette I lit, it tasted foul, it made my head spin, it did nothing for the pain but feeling as wretched as i did, I smoked it anyway. Again another  wave of nausea & cold nerve tingling pins & needles came, this is no good I thought to myself, ring the hospital, this can't be normal. Anxiety & fear was creeping in at this point, it was nearly 4 am & I was on my own.

After a short time I was put through to the A&E sister on duty, I tried to explain to her what the pain was like & where it was, I also shamefully admitted I'd taken 3 co codamol within the last 3 1/2 hours, tears again rolled down my face in desperation & just bloody agony. She sounded tired & rather annoyed, she proceeded to lecture me about only taking prescribed pain killers as directed & then stated that the fracture I had was notoriously painful & I just had to bear it. So I did.

Good old NHS

With an icepack on my foot & it supported by the crew members coats, Peter the skipper drove me the 2 hr journey back to the local A & E in Tunbridge Wells, I found a seat & still in Musto & Dubarry's along with my bag of foulies & sailing gear I began to wait.....
After a while I hopped over to the reception desk & enquired if I should sign in or something ? The receptionist beckoned to a seat in front of her & began to take down my details, the foot was growing nicely at this point, along with the throbbing. After completing a few basic questions, nature of problem, name address etc, she then informed me I'd need to make my way to the minor injuries unit, which was a five minute walk or so through a few corridors. I politely asked if there was a wheelchair available, "no, sorry we're short of those today" she replied, so I picked up my bag & began to hop whilst holding on to whatever secure props along the way i could reach. Luckily, a rather nice chap saw the size of my now rather colourful & odd shaped foot & offered me his arm. On arrival in the MIU, he also found me a wheel chair & sat me down, passing the paperwork I'd been given to the reception desk, by now it was around 3 1/2 hrs since I'd done the deed.
After about another hour or so, I was feeling pretty sick with the pain, a Dutch woman (who was there with her daughter who'd fallen from her horse & had suspected concussion) noticed my discomfort & highlighted this to the medical staff. Along came a young doctor who after enquiring about allergies etc, gave me a couple of co codamol, all the while still no one had looked at or examined said foot !
Eventually after a takeaway from Wagamamas (also kindly provided by the Dutch lady) I was taken through for assessment, by now it was almost 10pm, 4 hrs after I'd arrived ! After X-ray lovely young doc, confirmed I'd broken a metatarsal & prescribed a back slab plaster, some co codamol & an outpatients appt at the fracture clinic in 4 days time.
Shortly after this, I was greeted by the lovely smiling face of a chap from the Phillipines, "Hi I'm Johnathan & I'm your plasterer" was his opening line, I resisted the urge to respond with a quip about his screeding skills. After a brief discussion about the size of the cast, I explained that the sailing trousers I was wearing were new & I was reluctant to lose them due to them not being able to be removed, Johnathan scratched his head for a while & looked a little embarrassed. A flash of inspiration then led me to explain to the lovely Johnathan that I had my very baggy foulie trousers (heavy duty sailing waterproofs) in my bag & suggested that if I removed the ones I was wearing until he had finished his 'plastering' I could then put these foulie's on to go home in !
Johnathan left me in the cubicle, I proceeded to squirm around on the hospital bed, whilst trying to wriggle my trousers down until they fell off of my feet. I then grabbed the hospital gown that had been left to spare my blushes, wrapped it around my waist & waited........
When Johnathan reappeared he looked a little embarrassed & explained that he needed me to lie face down on the bed, with the offending foot hanging over the end. Again I squirmed myself into position & found myself face down, with the hospital gown covering my bum & thighs & one leg bent up at the knee with Johnathan now sitting at the end of the bed with his bucket of water & plaster of Paris at the ready to begin his sculpture. Up to now, my foot had been permanently in a pointed toe position that would make most ballet dancers proud, Johnathan did his best to bend it back into a normal angle/alignment with my ankle & proceeded to slab the plaster around the back & heel to hold it in place. I grimaced & gulped, blushing red with embarrassment, becoming tearful & emotional with the pain in front of everyone was not an option, I'd already decided.
Plastering finished, I then pulled my foulies out of the bag, bright red dungarees with the grey all weather bum & knee patches, normal for sailing but obviously not really Tunbridge Wells fashion, there was no choice I concluded as I pulled them on, again squirming, a few grunts escaped as I managed to wriggle into them & sat upright. Armed with crutches I then wobbled precariously out of the cubicle, fully appreciating every pound of the 9 3/4 stones I weighed. How on earth am I supposed to be able to support myself & be mobile I wondered to myself as my biceps throbbed & shook in protest !
Dutch lady had become quite concerned about me & so kindly offered to take me home once my cast had set. Home is a maisonette contained within a three floor converted Victorian building, requiring a steep flight of stairs to get to the front door & then further conquering of another staircase to get to the loo...........
After getting me inside, Dutch lady left me with her contact details, along with a bar of Galaxy chocolate (emergency provisions) & departed. I was indeed deeply grateful for the kindness this lady who had in fact been a total stranger up until a few hours earlier, had shown me. Thank god for the good Samaritans on this planet !