Simple Joys: Shoes!

After nursing this foot injury and exercising every last muscle of patience in my body for six months, I finally had my breakthrough step yesterday: no crutches, scooter, wheelchair, or boot; two sneakered feet hitting the pavement. I was shocked, and slightly disheartened, by how strange and difficult it felt to freely move both ankles and walk unencumbered by a big, heavy, rigid plastic boot. I felt wobbly and unsteady, and yet so light. I told Ben the feeling could be modeled by making a stick figure out of uncooked spaghetti and then just dipping the ankles in boiling water, turning them into wiggly noodles. But that model would fail to capture the deepness and endurance of my smile. Like a baby, my whole body beamed while I walked. Although I can probably count the number of times I have cried from happiness on one hand (it’s just not a reaction I get with that emotion), tears of joy welled up as pain-free steps took me further down my road. It took nearly ten minutes of a slow, steady, somewhat braced gait to gain confidence in my stability and ability to walk without any accoutrements, and I didn’t want to overdo it, but by the time I had completed my loop and was back in the driveway, my body felt more like a graceful gazelle (or at least a well-adjusted deer) than a newborn fawn. My mind, however, retained all of the qualities of the newly birthed animal, full of wonder, thrill, pride, and elation. I lifted my arm triumphantly upon my arrival back inside, like when I would win something as a child.

And that’s exactly how I felt: like I won. I beat my mental demons telling me I’d never walk again without at least a boot, I beat the pessimistic prognosis from negative doctors, and I beat the intense anxiety I had preventing me from lacing up the shoes and trying for the past week or so, too afraid the pain would still be there or I’d set myself way back again on the road to healing. My smile lingered until bedtime and it cropped up a few times in the night too, when pain-free steps carried me to the bathroom. I feel good this morning as well; it doesn’t feel like yesterday’s short excursion see me back!

Image may contain: shoes

I’m not out of the woods yet and I still have a long way to go towards full recovery, but these literal steps were a huge figurative one. At physical therapy the other day, we measured the atrophy in my calf. We compared it bilaterally (to my right leg) and also to my measurements back in February when I first went, before the orthopedist told me I needed to be fully non-weight-bearing. Compared to its original circumference, my calf has shrunk almost 3 centimeters, which is more than an inch. It’s also about an inch smaller than the healthy right leg. Most striking was the change in ankle size (and corresponding strength and stability). Compounded with my SPD-induced poor proprioception and balance and my connective tissue disorder-related joint wobbliness and instability, I have a lot of work to do to rehabilitate this ankle and restore safety and function. Yesterday, I finally got to start. Since I wasn’t cleared to do any single-leg work on that side, I haven’t been able to even attempt many strengthening exercises, let alone stabilizing ones. It’ll be a slow process, with bumps and setbacks along the way I’m sure, but this hurdle I’ve cleared fills me with so much more hope, confidence, and genuine happiness that I think it restored my bone-dry patience tank enough that I’ve got the mindset and mental fortitude to be positive and patient, the two critical ingredients to get me where I want to be as quickly and healthfully as possible.

 

Face-Planting

I face-planted today. I was at physical therapy trying to walk with an iWalk, and I literally toppled prone onto the floor like a stiff board. (I probably should have been in the parallel bars while testing it, right?)

Let me back up. I recently broke my foot and I’m to be non-weight bearing for 8 weeks while it heals. I’m on day 3. As an avid runner and someone whose coping mechanisms involve movement, this is not a brief nor welcome prognosis. I’m already falling off the rails a bit. Because of physical issues, I get injured a lot, but this is different because the world becomes much more limiting on crutches. So, the doctor suggested an iWalk. As I mentioned, I clam up and become nonverbal in appointments, so I was unable to ask any questions about this device. While I can certainly see how it would be a useful ambulation aid for most healthy adults who are able to balance, it could not be a more mismatched tool for my safe mobility. The Amber-iWalk incompatibility stems from three six crucial issues (all of which could have been addressed had I advocated for my needs and asked questions at my appointment!):

  1. Balance: you have to have normal to good balance to use this thing. Essentially, it’s like a prosthetic lower leg that sits on a small foot with a platform for the injured foot to remain perpendicular to the ground. Since the base of support is smaller than one’s normal foot, it’s hard to control. As I mentioned, one of the primary issues with sensory processing disorder (SPD) is significant difficulty with balance.
  2. Size: it’s meant for adults 4’10”-6’5″. While I do fall within this range, albeit close to the minimum, it’s still too big for me. We were unable to tighten the straps sufficiently around my leg without maxing out their available adjustments. The therapist tried sticking a towel in there to bulk up my dimensions, but the thing still kept rotating around my leg. That doesn’t work when you’re trying to control an artificial leg. Take it from me: I spent two years earning my MS in prosthetics & orthotics, a degree that I don’t use for my vocation, so I might as well apply it to my own life situations! Prostheses need to have as intimate of a fit as possibly for control and comfort. This loose fit resulted in a device that was neither comfortable nor well-controllable!
  3. Body control, kinesthetic awareness, and coordination: sensory processing disorder issues manifest in poor coordination, and proprioception, body control. I’m somewhere between a pinball and a snowball rolling down a big hill. The laws of inertia do not necessarily seem to apply to my movements. I tend to go faster and faster with unintentional reckless abandon once I get moving and I can’t seem to control the movement of my limbs or coordinate limbs and trunk. The one exception is running. Running seems to iron out my kinks and turn me into a relatively graceful, well-oiled, unified machine. It’s always been my magic.
  4. Lack of interoception: (so, I guess there’s another reason; this is now #6). I mentioned in my first post that I have difficulty with detecting and processing internal body signals like hunger, temperature regulation, and when I have to use the bathroom. Females, or anyone wanting to sit when using the bathroom, can’t really have the iWalk on. It doesn’t allow you to comfortably flex your knee and hip appropriately to squat down. It’s also not that easy or quick to remove. Therein lies the problem. The operating window of time that I usually have between realizing I need to use the bathroom and when I will start peeing hovers around 90 seconds to 2-minutes. This works well for someone who is home and can ambulated normally, but strap on a device that’s stubborn to remove, a broken foot, and a big open physical therapy gym with a long walk to the bathroom and you’ve got yourself a free two-minute slapstick comedy show. While everyone watched the panicked and desperate struggle of two PTAs and a tech careen my awkward gait like a baby giraffe, all the patients at their respective tables or exercise stations stopped and watched. Once inside the stall I yelled, “I made it!” Ah…why do I exacerbate mortifying situations? I hate when I get anxious and blurt stuff out.

After I face-planted trying to walk with the iWalk, I lay silently on the ground thinking to myself: Wow, can this be any harder?! I have all these challenges and pains and now my foot kills, I can’t run, I can’t even walk, and more and more is taken away from me like I’m on some sort of slippery slope to doom. Thankfully, the pity party of one lasted less than two seconds. I rolled onto my side and got up using my arms and my good leg in a strong single-leg squat before the PT was even able to catch up with me.

“I was going to help you up!” She exclaimed.

“I know, thanks. But when I fall, I get back up.”

And I do, and I will.

The iWalk is getting returned. Some tools are just not suited for a particular job. You wouldn’t use a staple gun to saw a board! It turns out my insurance immediately agreed that a knee scooter was medically necessary, given my risk factors with using the other standard devices and my injury. I’m sure that’ll be another adventure, but I’m up for it.

Just like the strong callus that forms over the fracture line of a healed broken bone, strengthening the new bone beyond that of the original bone, I become stronger where I was weakest. I fall and I rise up braver, tougher, wiser, and more determined. Sometimes it takes just a second or two; other times it has taken a couple of years, but I commit to myself that whatever is thrown at me, I will face, I will fight, and I will overcome.