Less than four weeks now to my surgery!
Since my last post, I've been spending quite a lot of time practising with both my crutches and my "hands-free" crutch (see previous post for more details), and also in the gym, so this post will concentrate mainly on those activities.
First, the two types of crutch. I think it's worth saying up-front that I, personally, have got on significantly better with my "hands-free" (peg-leg) crutch than with the "traditional" forearm crutches.
I have been using a (roughly) 1,000 yard route on a road outside my house to practice with the crutches, and also to try to get some valid comparisons between the two.
After about ten days practice with both, the first thing I note is that I find the arm crutches significantly harder work than the peg-leg over this distance - physically I find them harder (despite the gym work I have been doing specifically to strengthen myself for using arm crutches - see below), and I find that at the end of the route both my heart rate and my respiration rate are higher using the arm crutches than for the peg-leg. Despite this (and although speed per se is not a prime consideration), I have also found that I can cover my route using the peg-leg in about two-thirds of the time it takes on the arm crutches. I also, and perhaps a bit counter-intuitively, feel MORE stable on the peg-leg than I do on the arm crutches.
Add to that the fact that you do have your hands free and, on the face of it, the peg-leg seems to be first choice.
So, what might be any downsides to the peg-leg. Well, thinking ahead to use in practice, one of main (potential) drawbacks to the peg-leg is that it does take a few seconds to put it on and take it off. So, if you were moving a short distance around the house (say from one chair to another, or from bed to bathroom), then the ease of use of the peg-leg will, I think, be outweighed just by the time it takes to get it on and off. (Especially as it's really not feasible to sit down in a chair/armchair with it on).
The other major drawback to the peg-leg I can foresee relates to post-operative weight bearing. It is my understanding that, depending on the view of the surgeon, you will progress over time from totally non-weight-bearing to fully-weight-bearing, via one or more gradations of partial-weight-bearing. If you are only using the peg-leg, the choice is binary - either fully-weight-bearing, or fully non-weight-bearing, so if a transition through partial-weight-bearing is required, then it will be necessary to swap to the forearm crutches.
Over the next couple of or so weeks leading up to the operation, I shall be testing both alternatives in more "difficult" situations - e.g. up and down stairs, up and down inclines, getting in and out of a car etc., and will report back to you on my experiences. However, inevitably, the real "proof of the pudding" is going to be when I have a cast/boot on for real, and again you'll get a blow-by-blow account of what works and what doesn't!
Now to the gym; I was fortunate to find in my local gym one of the instructors who had had two episodes of being in lower-leg plaster himself for some time, and who used arm crutches, and who kindly put together for me a whole series of exercises designed to do two things - first to strengthen those parts of the body/muscles that would be called on when using crutches, and second to strengthen, in advance of surgery, those muscles that will inevitably tend to atrophy during the time I am in a cast/boot.
So, for the record, and as a potential help to anyone else coming up to a similar operation who wants to do a bit of advance preparation, here is a list of the exercises that I am doing, together with a note of the part of the body and the specific muscles involved. I typically do three sets of twelve of each of the exercises - starting weight will obviously vary by individual.
Seated Leg Extension - front of thigh (quadriceps)
Seated Leg Curl - back of thigh (hamstrings)
Lateral Dumbbell Raises - shoulder (anterior/medial deltoids)
Calf Raise - calves (gastrocnemius/soleus)
Lateral Pulldown - (middle) back (latissimus dorsi)
Seated Row - back (erector spinae/middle + lower trapezius/rhomboids/latissimus dorsi)
Back Extension - lower back (erector spinae)
Crunch - stomach (abdominals)
Seated Lever Fly - chest (pectorals)
Reverse Machine Fly (Rear Deltoid Machine Fly) - shoulders (deltoids)
Cable Pull/Twist/Pull - upper arms (biceps/triceps)
Triceps Cable Pulldown - upper arm (triceps)
Incline Fly (Dumbbells) - (upper) chest (pectorals major)
Knee Raise - pelvic area (gluteus maximus/rectus abdominis/hip flexors)
Reverse Bar Curl - upper arm (biceps)
Wrist Curl - forearm (extensors + flexors)
One Leg Band Stand - pelvic area + core (hip flexors/hamstrings/quadriceps/gluteus)
One Leg Romanian Dip - posterior chain (gluten/hamstring/abductor magnus)
Triceps Seated Push-up - upper arm (triceps)
Pullover Machine - upper back + arms (latissimus dorsi/pectoralis major/trapezius/ rhomboids/posteriod deltoids/triceps)
Plank- stomach/back/shoulders (erector spinae/rectus abdominis/trapezius/rhomboids/ deltoids/pectorals/glutes/quads/gastrocnemius)
Those of you who have read most/all of my posts will have noticed that I've concentrated mostly on the practical/physical side of preparing for my surgery, and that I've had relatively little to say about the "emotional"/mental side.
That's due, in large part, and as I indicated in my very first post, to the fact that I'm not a "wear your heart on your sleeve" individual.
However, a comment/question a couple of days ago from my wife did make me stop and think a little bit about the mental side of preparing for my op. She asked me whether I had had any second or third thoughts about going in for what is - in the end - an elective operation which does have some risks attached (and which I must say were carefully reinforced to me during my pre-op assessment). My answer was - "yes" - I had had occasional second thoughts - there are days when you have woken up without the ankle having disturbed your sleep, and where you've not been very active (so the ankle is only mildly painful), and someone drives you right to the door of a restaurant, and you start down the line of thought - "maybe I could live with this", especially knowing that there are both risks and no guarantees with the surgery.
But then you remember when the ankle has kept you awake half the night, and you've turned down another round of golf, and shied away from that job that needs doing on the stepladder) and you (or at least I) know that the decision to go ahead with surgery was the right one, based on a rational assessment of the potential gains against the risks.
Next time, more on the crutches, update on fighting the flab, and why I'm going to be a movie star!!
Look after yourselves.
David
Thursday 11 June 2015
Monday 1 June 2015
ANKLE SURGERY HERE WE COME - 35 DAYS TO SURGERY (S-35)
For those who remember their multiplication tables, that means exactly five weeks to surgery.
Sorry for the delay since my last post, but I had promised you some information on post-op non-weight-bearing aids that I am looking at, and I've spent the last few days getting some initial experience with two of them.
First, crutches. As I mentioned in an earlier post, quite early on I discarded the possible option of underarm crutches partly because they seem to give many people a lot of underarm pain, and also because they are very unwieldy.
So, I focused on forearm crutches, but again my research told me that many people had issues as a result of most of the weight being focused on the hands, resulting in callouses or worse. As part of the research, I cam across a new(ish) design of forearm crutch called "smartCRUTCH". Essentially these have an additional component in the forearm design, in the form of a "rest" or "platform" for the forearm, which can be rotated through almost ninety degrees. The theory is that you can start on these crutches with most of the weight being taken (conventionally) on the hands but, as you gain experience and confidence, you can rotate the forearm platform from near vertical gradually towards the horizontal, thus enabling you to take more and more weight distributed along the forearm rather than almost wholly on the hands.
I must say that getting used to using these crutches, even just in the conventional vertical position, has proved more challenging than I anticipated, especially in graduating to a decent "stride" length. I think I've finally got the hang of it, though this has taken much longer than I had assumed, so over the next few weeks I will start to take advantage of the unique design of these crutches and distribute my weight more evenly across my forearms.
The other aid that I have decided to try out is perhaps even less well known than the smartCRUTCH. It is a "handsfree" crutch, if that doesn't sound like an oxymoron. It's probably more accurately (or more understandably) described as a knee crutch, and essentially involves creating a peg-leg, a la Long John Silver.
The product is called the "iWALK2", and it's probably easier if you look at their website - http://www.peglegs.co.uk - to see a description and a diagram. Essentially you bend the knee of your affected foot at right angles and then strap on a false lower leg!
Even more than the smartCRUTCH, this product requires very careful assembly (good instructions in both cases) and, particularly, very careful fitting to tailor it exactly to you as an individual. I am quite methodical and meticulous, and so others might well beat the two hours I took over the assembly and fitting, but at the end I actually, despite the odd feeling and all the straps, felt quite comfortable that I had succeeded in achieving a very good fit.
I think that then translated into my surprisingly easy introduction to actually using my "peg" leg - as soon as I summoned the confidence to let go of the wall, I found I was able to walk comfortably and with a lot of security and stability within a very short space of time. Within fifteen minutes, I was walking almost naturally and with great confidence. My only reservation is that I suspect that comfort may become an issue once I start to use it for extended periods of time, but I'll let you know about that as I increase my practice distance for both the smartCRUTCH and the peg-leg over the next two or three weeks.
The third item I am intending to use post-op is a knee-scooter which is pretty much as its name suggests - you rest your operated leg (knee) on a four-wheeled scooter with a raised platform, and use the good leg to scoot yourself along. The scooter is expensive to purchase, so I shall be hiring one immediately after my surgery, so I won't be able to give you feedback on that until later, but my guess is that that will be the easiest of the three to use.
I suspect that each of these three methods is going to have its strengths and weaknesses in specific situations (e.g. I can't imagine wanting to strap on the peg leg just to use the bathroom in the middle of the night), so hopefully I can tell you about my own experiences with each of them, and perhaps nominate a "best buy" in the event that you decide, or have to, opt for just one.
In the next post I'll update you on progress with the crutches, and also give you a bit more detail on the gym (and other) work I'm doing to prepare for the operation and its aftermath.
I'll close this post by hinting that you may soon be able to see me in glorious technicolour!!
More will be revealed in posts to come, so make sure you keep reading the posts, and pleeaaassse give me some feedback on whether you're finding this useful, even if it's just by "liking" the post.
Thanks - see you soon.
David
Sorry for the delay since my last post, but I had promised you some information on post-op non-weight-bearing aids that I am looking at, and I've spent the last few days getting some initial experience with two of them.
First, crutches. As I mentioned in an earlier post, quite early on I discarded the possible option of underarm crutches partly because they seem to give many people a lot of underarm pain, and also because they are very unwieldy.
So, I focused on forearm crutches, but again my research told me that many people had issues as a result of most of the weight being focused on the hands, resulting in callouses or worse. As part of the research, I cam across a new(ish) design of forearm crutch called "smartCRUTCH". Essentially these have an additional component in the forearm design, in the form of a "rest" or "platform" for the forearm, which can be rotated through almost ninety degrees. The theory is that you can start on these crutches with most of the weight being taken (conventionally) on the hands but, as you gain experience and confidence, you can rotate the forearm platform from near vertical gradually towards the horizontal, thus enabling you to take more and more weight distributed along the forearm rather than almost wholly on the hands.
I must say that getting used to using these crutches, even just in the conventional vertical position, has proved more challenging than I anticipated, especially in graduating to a decent "stride" length. I think I've finally got the hang of it, though this has taken much longer than I had assumed, so over the next few weeks I will start to take advantage of the unique design of these crutches and distribute my weight more evenly across my forearms.
The other aid that I have decided to try out is perhaps even less well known than the smartCRUTCH. It is a "handsfree" crutch, if that doesn't sound like an oxymoron. It's probably more accurately (or more understandably) described as a knee crutch, and essentially involves creating a peg-leg, a la Long John Silver.
The product is called the "iWALK2", and it's probably easier if you look at their website - http://www.peglegs.co.uk - to see a description and a diagram. Essentially you bend the knee of your affected foot at right angles and then strap on a false lower leg!
Even more than the smartCRUTCH, this product requires very careful assembly (good instructions in both cases) and, particularly, very careful fitting to tailor it exactly to you as an individual. I am quite methodical and meticulous, and so others might well beat the two hours I took over the assembly and fitting, but at the end I actually, despite the odd feeling and all the straps, felt quite comfortable that I had succeeded in achieving a very good fit.
I think that then translated into my surprisingly easy introduction to actually using my "peg" leg - as soon as I summoned the confidence to let go of the wall, I found I was able to walk comfortably and with a lot of security and stability within a very short space of time. Within fifteen minutes, I was walking almost naturally and with great confidence. My only reservation is that I suspect that comfort may become an issue once I start to use it for extended periods of time, but I'll let you know about that as I increase my practice distance for both the smartCRUTCH and the peg-leg over the next two or three weeks.
The third item I am intending to use post-op is a knee-scooter which is pretty much as its name suggests - you rest your operated leg (knee) on a four-wheeled scooter with a raised platform, and use the good leg to scoot yourself along. The scooter is expensive to purchase, so I shall be hiring one immediately after my surgery, so I won't be able to give you feedback on that until later, but my guess is that that will be the easiest of the three to use.
I suspect that each of these three methods is going to have its strengths and weaknesses in specific situations (e.g. I can't imagine wanting to strap on the peg leg just to use the bathroom in the middle of the night), so hopefully I can tell you about my own experiences with each of them, and perhaps nominate a "best buy" in the event that you decide, or have to, opt for just one.
In the next post I'll update you on progress with the crutches, and also give you a bit more detail on the gym (and other) work I'm doing to prepare for the operation and its aftermath.
I'll close this post by hinting that you may soon be able to see me in glorious technicolour!!
More will be revealed in posts to come, so make sure you keep reading the posts, and pleeaaassse give me some feedback on whether you're finding this useful, even if it's just by "liking" the post.
Thanks - see you soon.
David
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