Return of the boot !

Ello, ello, ello,

Yes it's been a while hasn't it ?
I was so astonished to see that I'd had over 4000 hits when I logged on last night !
Thanks to all of you that have read my woeful tale :-) I have been quite miserable in some of the posts I've made ,I noticed, but then It's been a crap year for me ! A Lisfranc fracture is not funny & I'm not superstitious but I do find myself being careful around mirrors & ladders these days !
It has been probably the most difficult & challenging year of my life, not just because of the foot....
Where shall I start to bring you all up to date?
I think where I last left you will probably make the most sense....

Sadly I haven't been away pirouetting on the foredeck, or trekking up Mount Kilimanjaro :-(

When I returned from my road trip to the US last October, I learnt that my dear Grandfather Pete was seriously ill, so ill in fact he died just three weeks later. This event was devastating to me, more so than the consultation with Mr Ritchie last April when I learnt the full extent of the damage to my right foot.

We were best friends you see, really true best friends.
When together we were always in cahoots, giggling together about the silly daft things that our mutual sense of humours connected on, often hiding away together when I was a young child in his woodworking shed from my quite strict Gran when she was on the war path !
In fact I think my Grandfather gave me my love of the sea & all things salty ! As soon as I was old enough to walk he got me a life jacket & took me sea fishing with him off of the coast of Hastings in East Sussex. This was the way I would spend most of my summer holidays with him right up until the age of 13 or 14. My grandfather taught me all of the essential things that a young lady should know, like how to thread lugworm onto a fishing hook, how to cast a decent line, how to tell the difference between a Flatty & a Plaice (fish!) & of course how to tell a decent pint of beer from a wrong 'un', although not this lesson until I was of the legal age to consume alcohol of course :-)
I experienced my first man overboard with him on Emma 1 (of course it was me) & my first rescue by the RNLI when the new radio he'd installed on Emma 2 failed when we were out at sea. My grandfather found this event most exciting & whilst I was being uplifted from the boat by the RNLI, he got his camera out to photograph the entire proceedings- LOL

So it all came as a huge shock to me, to lose him so quickly & unexpectedly, the foot actually became second priority to my grief for the best part of six months. He'd appointed me as his executor in his will as my Gran had died 14 years previously. I carried out all of his wishes as best as I could & then after much soul searching I decided to leave my birth place- Tunbridge Wells for a fresh start. I found a house in Addlestone, Surrey, closer to my work, my son, the rest of my family & my man. Yes, my man did hang around (see earlier posts about my worry & self doubt) & he has proven himself to be my rock during this difficult period. I often wonder at his unwavering support & faith in me as he'd only known me for a few months before my life was turned upside down.
I moved to Addlestone on April the 4th, the house is lovely but a project. It needs extensive redecoration & repair as well as having a garden that needs designing from scratch. So I spent the first three weeks in April decorating & cleaning the house with my man in earnest & we travelled to London on April 22nd to watch a great friend of mine compete in the London marathon. The foot was behaving well, a little tender at the end of the day but that was about it. I discussed climbing Mt Snowdon with my friends that evening, I planned to join the local gym the following week & my man had just booked me a trip to Hawaii in October this year to celebrate my 40th birthday.

Then on April 27th after a few days of feeling a little more tender than usual I got out of bed & upon standing I experienced acute pain through my 2nd & 3rd toes. I presumed that I'd just overdone it, I took some Ibuprofen (Aadvil to all you Americans ) & continued with my day hoping for the best.  On the Monday evening (30th) I caved in & drove myself to the local hospital casualty department, by now walking was extremely difficult, I couldn't bend my big toe at all & the pain wasn't responding to the Ibuprofen. I had a standard X-Ray & it didn't show any fractures (neither did the one I had last September) but the doctor decided to refer me to the fracture clinic the following Friday as a precaution in view of my history. I declined the offer of Tramadol & decided to persevere with the Co Codamol & Ibuprofen that I had stocked up at home.
After driving some 700 miles for work over the next three days I arrived at the Fracture clinic sore & feeling slightly unwell. I met Mr Monk- an Orthopaedic & Trauma consultant who browsed my X-Rays with considerable interest & read the letters I'd taken with me that detailed the details of my original injuries, previous surgery & then the second fracture in September. He informed me that he was very experienced in Lisfranc injuries & expressed sympathy at my latest predicament. He recommended an MRI examination & a referral to his private clinic as the current waiting list for the NHS service was around six weeks. Luckily my health insurance provider approved this & it was arranged for the following Tuesday (8th May). Mr Monk also strapped my foot back into an Aircast boot & presented me with another pair of crutches, precautionary but essential as was the ban on driving he explained :-)
Oh the irony wasn't lost on my either, the date ? Well it was the 4th May, exactly 13 mths since my original injury..........
So I had the MRI & met with Mr Monk this evening for the results, the good news, no fractures detected, the not so good news was that the radiologist omitted my toes from the scan ! Mr Monk puzzled over my symptoms, he commented that I was a mystery as both he & the expert radiologist he'd asked to interpret & report on the MRI were convinced as was I that I'd developed a stress fracture in either my 2nd, 3rd or 4th metatarsal. A second MRI of the front of my foot has now been booked for next Monday (14th May) with a further follow up consultation booked for the 15th with Mr Monk.  Morton's Neuroma was also mentioned by Mr Monk as a possible diagnosis;

Morton's neuroma is a condition that affects the nerve between the toes. The nerve becomes irritated and compressed, which results in severe pain on the ball of the foot and at the base of the toes.
Morton's neuroma usually affects the nerve between the third and fourth toes. It is rare for more than one nerve or foot to be affected apparently.

So A further week of minimum weight bearing, in the Aircast & no driving awaits me now. I have limited Internet access at home due to no WiFi as yet so I re subscribed to SKY TV today just to relieve some of the boredom. I will have to sit on my hands to stop myself from getting up & grabbing a paintbrush or doing any more of the various DIY jobs that are outstanding in the house. I must admit I'm now doubting myself, I pondered on the way home if the pain really was that bad or was it just me being nervous about the foot ? When I got home I removed the boot & tried to walk around the house, yes the pain is still there, between my 1st & 2nd metatarsal, maybe not as acute as it was but enough to prevent me from walking normally. So I will just have to await the verdict on Tuesday.

I also received the results from my bone densitometry scan (DEXA) that my GP referred me for a month ago this week. It appears that I do have signs of Osteopaenia in my lower spine so it's a lifestyle change for me, from now on a careful diet & a lifetime's supply of Acal D3 (Prescription Strength Calcium & Vit D)! When my time comes to enter the Menopause then I will need a rescan & possibly more of the Alendronic Acid that I had following the fracture last September (Oh the joy !).

The positives; Well it's an Olympic year here in Blighty, Oh & we have the Queens Diamond Jubilee to look forward to ! Yay !!!!!!!!!!!!!

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.