Monday 23 July 2012

Recovery at 12 Weeks

It's been a little over 12 weeks ... amazing how time goes so slowly yet still seems to fly by.

My physio guy continues to try to kill me twice a week, and I get myself into the gym another three days a week - mostly to do cardio-type stuff like walking on the treadmill and the elliptical.  When my back muscles went all spazzy I wasn't able to do any core exercises, so hopefully I'll be able to get back to that soon.

So what's the deal at 12 weeks.

Left leg still has the usual issues except I, for sure, have some temperature sensation in the sole of my left foot (but nowhere else).  It's a little more subtle than my right foot - my right foot has better sensitivity to the nuances of temperature, but the left foot seems to be coming along.  There is nothing higher up the leg ... today being a good example of that, having left the car parked in the sun in 31C + temperatures.  I sat down on the (black) seat in shorts and my right leg sure as heck registered HOT, HOT, HOT !!!   Left leg, quite comfortable thank you.

Right leg ... my walking balance went totally wacko for a couple of days last week ... all of a sudden I had issues.  Then I started to pay attention.  I spend most of my life now in bare feet, so I started paying attention to my feet as I was trying to walk.   When a quote-unquote normal person walks, their foot doesn't just strike heel-toe.  There is the heel strike, then a very subtle pronation/roll towards the outside sole of the foot, then the toe strike.  My left foot has always done this, but after I lost proprioception in my right leg, I lost that subtlety.  The best I was able to learn was a BAM-heel ... BAM-toe stike.  But late last week, that subtle pronation/roll returned - which was what was causing my balance issues.  I was so used to compensating for the incorrect foot strike that I had to adjust to the correction.  Now my right foot is doing the heel-pronate/roll-toe and my toes are engaged in the process.  VERY COOL !!   

But again very weird.  Why I would start to get things back in my feet when the nerves were cut in my spine, I have no idea.  Google isn't very helpful and the only person who might have an explanation would be someone well versed in neuroscience.  That would not be me.

So  ... I take what comes, and hope that over time there is healing in the rest of my legs.

Friday 13 July 2012

I Guess I'm Getting Stronger

It was re-assessment day at physio,  The goal ...  to answer the question "has there been any progess in the last four/five weeks".

Apparently, I rock!

Well, I'm not perfect, but everything showed improvement.  The strenght testing showed that my right leg is getting closer to the strength of my left leg, balance tests were still challenging, but improved, and my endurance test rocked.

LOL ... ah, how the definition of success has changed for my life.  Take the endurance test.  When I did it four weeks ago, I was able to walk 274 ft (83 meters) in two minutes.   Today I was able to walk 454 ft (138 meters) in two minutes.  That's still a 14 1/2 kilometer (or a 23 minute mile).  I try not to think of it that way because my "old" walking speed was so much faster.  I have to think in terms of a new baseline ... that 10 weeks ago, I couldn't walk at all.

For all that progress, were you to walk behind me (and ignore the canes) you'd think "hmmm, there's something wrong with her right leg".  It's got it's own funky stride ... it works for me for basic mobility, but I strive to retrain it to a more normal flow. With focus and concentration I can do it.  As soon as I stop concentrating it goes back to it's wild-thing routine. 

Balance testing showed some improvement ... I can stand on one foot (my good leg) for 15 seconds, no problem.  Right leg ... well, it's actually pretty hilarious.  With my arms doing the wild windmill thing I can balance on my right foot for about four seconds before I have to grab something or fall over.  This time, though, I was able to stand heel-to-toe for 30 seconds with either foot forward!!  Yay!  When I did this four weeks ago, I couldn't stand with my left heel touching my right toe (left foot in front ... sort of like slalom skiing).

I don't see the progress because I see myself every day, but when tested against a benchmark ... I'm learning.  I don't know how much actual nerve healing has happened, but at least I'm learning to cope with what I've got.

As an aside .... today's workout was about endurance and physio guy had me get on the treadmill for the first time (at physio).  He asked me ... "so, when was the last time you were on a treadmill".  I had to confess .. "um ... yesterday".  Okay, so I'm the queen of too much too soon, but I can't go to a gym and not get on a treadmill and try to do better than the time before.

Tuesday 10 July 2012

69 Days and I Think There's Something

Sunday afternoon when I was standing in bare feet on my friend's sun-heated patio, I thought I felt some heat in my left foot.  I brushed it off as fantasy as the pin prick test later in the evening didn't resolve anything (sharp pain and temperature are the same nerve, so if you have one, you have the other).

But today ... I went downstairs.  That in itself is an adventure because I don't have handrails on the stairs to the basement, but I was in dire need of clean clothes, so getting to the washer/dryer was essential.  My downstairs has a lot of tile ... cold ceramic tile. When I stepped onto it,  I swore I could feel some cold with my left foot ... maybe not as precisely as my right, but there was something.

So, the pop can test.  LOL ... I know, surely there is a more scientific way to test these things, but when a pop can is cold, it's pretty cold.  Grabbed one from the fridge.  Touched it to the sole of my right foot - yup, COLD ... sole of left foot .. OMG, it's cold!  Not as sharply cold as felt by the right foot, but definately cold.  I tested it all the way up and down and my left foot was registering the cold up to my ankle. Nothing up further yet.  I have no idea why my leg and foot would sense temperature from the bottom up, but hey ... I'll go with it !  If I need to regain sensation starting with my feet, I'll take it.

69 days ... and maybe, just maybe, I'm starting to see some nerve healing.  I'll try not to hold my breath, but I really want these nerves to heal so I can be one of the lucky ones and get to go back to the life I knew.

Keeping my fingers crossed.

Monday 9 July 2012

Recovery at 10 Weeks - the Triathlon Sports

I think I have phantom healing ... those times when my brain thinks that maybe there is some improvement. 

Like yesterday - standing on a hot patio in bare feet.  My right foot could sure feel the heat - but is that heat I feel in the left foot?  Yes? No? Maybe? I think yes!   Or not.  Objective testing later in the evening showed that no, there was no real change.   (It's kinda cool being able to jab a pin in your leg and not feel it, but also kind of worrisome.)

Like in physio on Friday when my ankle turned doing squats on a bosu ball.  Did I catch myself because I knew my ankle was starting to go (I wasn't looking at it)? or did I catch myself because of a general falling sensation.  Judging by my foot getting caught under the kitchen chair this weekend, I'm thinking I still have no proprioception.

But I am definately starting to get my energy back, and that's very cool.  Energy means the ability to do more - both out in the world and in physio.  I know from experience that more energy means more effort means more improvement - that exponential spiral of positive change.  YAHOO !!  Finally.  It took almost 10 weeks to start to feel human again.   That made for good physio homework yesterday at the gym. As an aside, I gotta tell you ... hobbling into the gym on two canes gets you TONS of sympathy .. people move out of the way, give you lots of space, and offer to get you stuff.  It also gets you very weird looks and the odd "shouuld you be here" comment. (Yes, some woman actually asked me that.  She was older, and definately concerned, so I didn't whack her with my cane, but I was tempted ... instead I just smiled and told her I was there on doctor's orders). 

Back to homework in the gym ... I was very pleased with myself.  13 minutes on a recline bike where I only jammed my heel into the bike twice (see, not paying attention means my right leg does strange things, including my foot twisting inwards when it's not supposed to).  I also upped the treadmill challenge - this thing will NOT beat me.  Cranked the speed to a whopping 2.2, aimed for longer strides and did a full kilometer (0.6 miles) in 16 minutes. (well, 16:47, but I'm counting that as 16).  I'm not sure how I avoided falling off the treadmill, and I made a beeline for a chair when I was done, but I did it.  I also accepted a friend's invitation to try out a swim in her pool.  I recommend private pool swimming - stairs to get in and out and no slippery decks.

No changes in nerve healing that I can objectively determine, but I was able to do all the triathlon sports yesterday.  Not well, not with swagger and not with speed, but I'm a far cry from eight weeks ago when I couldn't walk.

Thursday 5 July 2012

Water Can Kill You - Approach with Caution

There was some discussion around whether or not she would rescue me from drowning, but ultimately the thought of having to explain a dead body to the police was the deciding factor.

My S.O. is away on business for a couple of weeks, so I gladly accepted an invitation to a cottage for a couple of days. We're in the middle of 30C+ heat and lovely July humidity, so being out of the city is something to look forward to. 

Physio guy spent lots of time working with me on walking on uneven terrain (read: walking on the grass) so I could cope with the brief walk from car to cottage and from cottage to dock.  Fortunately a huge, solid dock so the risk of falling into the lake is pretty slim.  Thanks to physio's help and preparation, I have been able to successfully navigate the grass and very small hill.

But it's hot, and I am a strong swimmer.  Nothing Olympic worthy or record breaking, but I can hold my own in the water.  Every physio person has told me that swimming would be an excellent addition to my rehab, but (so far) pool decks are much too slippery for me .... not so much with a lake.

After some discussion around how to get in and out, exactly (and the resulting teasing of whether or not to haul me out or let me drown), I decided to go for it.  My initial instinct was to just jump off the dock ... how hard can it be to get in the water?  It's getting out that needs the effort.  I made several attempts to get in the water: there was some standing on the ladder before I decided that that wasn't going to work and there was more deliberation about just jumping in. Finally I took a floaty, wore my sandals, took my canes, and wobbled in from the shore.

You would think by now that nothing would surprise me.  I was shocked.  My legs were not behaving, and not only were they not behaving, they were almost dead weight.  Jumping in off the end of the dock would have been disastrous. A very high risk of panic, and things don't go well when you panic.  By "walking" in, I was able to float around for a few minutes and make a few feeble attempts at kicking my feet, but the experience was not even close to what I was expecting.

Fortunately I didn't come close to drowning and Lucy didn't have any 'splainin to do.

Monday 2 July 2012

Baseline

Yesterday I ventured onto the treadmill.  I have spent some time in physio on a modified elliptical ("some time" = maximum of 10 minutes), but since I own a treadmill, I decided to try it out.

I don't know whether it was a good idea or not.

My goal was one mile.  Got myself up onto the treadmill (thankful for handrails), turned it on and hit "quick start".  My treadmill defaults to a speed of 1.0 on quick start.  Yipes !   1.0 was faster than I thought it was going to be.  I was able to get going and have pretty good posture without falling off or falling over.

But then I did the math.  A speed of 1.0 equals one mile per hour.  ONE MILE IN AN HOUR.  If I wanted to go the full mile, I would be an hour on the treadmill, and I knew that wasn't possible.  Cranked the speed to 1.2 and revised my goal to 0.25 of a mile.

It took me 13:09 minutes to walk 0.25 miles.  One quarter of a mile.  That's one lap around a standard track.  That's 400 metres.

I used to run almost two miles in 13 minutes.  I used to walk a perfect 16 minute mile (I could walk an exact 16 minute mile, mile after mile after mile .. I know - I've done it).

As much as I aim for positive and remind myself that six weeks ago I couldn't even walk, or that without surgery, in another four months I'd be paralyzed, it doesn't really help.  I should look at the bright side, aim for that goal of one mile and use all of those old training techniques I have up my sleeve to get there.

But really, some days it's allowed to be just plain, ole, depressing. 

1/4 mile in 13:09.  And it was hard. I hate this.