April 2020 – Alex’s Foot Surgery

The weather is getting more springy here in Saint Paul. Heck, it has reached 70 both yesterday and today. This is a welcome achievement for all of us, despite the continued stay-at-home order. We can have windows open, and also spend more time outside. Though we still should not interact with those beyond our households, this does mean we can see neighbors, and interact with them from a safe distance. Quite a change from just a few weeks back.

At my last PT appointment I was given the task of taking one longer walk a day, weather permitting, outside. So far I’ve done this twice, one to each of the corners of our block. Yesterday I used my walker, but found that much more difficult due to the way sidewalks are built (the breaks between the concrete segments meant that I could not really just go without constant stopping to get over obstacles). The walking itself seemed easier than needing to maneuver with the walker, honestly. After that walk we experimented with what it would be like with the walking stick my uncle Christopher gave us for Christmas a few years ago on my left side, and Eric helping support my right side. This was far more successful, and also enables things like going on the grass to maintain 6 feet of separation from others when needed.

This morning I did my second of these endurance exercise walks using the walking stick and Eric (who would join me on the walk even if I didn’t need him at all, to keep me company and get outdoors himself). I managed to achieve a very close to normal walking gait at times, when not really thinking but just walking and enjoying the nice Saturday weather. I think that this is the way that I will do these walks from here on out. This also showed me a clearer path onwards to eventual full recovery, because I was walking far more normally than I ever have with the walker. It forced me to put weight on my right foot in a way that I’d need to be intentional about not weight bearing through my right arm when using the walker. The ultimate goals with these walks will be to be able to do such walks without relying on Eric, eventually without even relying on the walking stick, and somewhere in there increase the distance first to around the whole block, and then beyond. When we approached the house, Mary took the below video to show off my progress (and document that we’re actually using the walking stick for once):

Today I had a follow-up with Dr. Koop. Once we finally got x-rays, as that took far longer than it should have (even being one of just a handful of patients at the clinic, schedules have gotten all confused due to the pandemic, to the tune of an extra whole hour), we got to have a decent chat about my progress. The point I am at in bone healing is such that Dr. Koop has given me his blessing to begin walking on my right foot again. While this will take a lot of getting used to in the walker, which will be a lot of physical work on my part, between now and August when I next see him I may progress to not even using the walker the entire time when at home, we’ll see (that’ll be up in part to the PT over the next few months). Certainly, I expect to only get more confident in walking as time goes on. I have PT once every week or two until summer to help me with exercises and stretching that get me more used to walking on what in many ways is a brand new foot.

Now that I can walk on it, I’m also allowed to use stairs more normally. That is, going sideways with the railing, but not on my butt. So not entirely normally again, and not independently, yet, but closer to normal. Also not a ton less energy-intensive, but I’ve only just begun, so my strength should build up at this over time, especially if I use stairs one to three times daily moving forward. The idea is to lead with my left foot when fighting gravity on the way up, and letting gravity help my right foot when going down. This will expand my universe during what is increasingly a coronavirus quarantine rather than surgery quarantine to 3 floors of our house rather than just the second floor, a 200% increase in territory at a time when most people are feeling stuck in their houses. This will be nicer for the 5 of us living here as we all effectively are stuck at home for the foreseeable future during this pandemic. My brother, Nate, who has moved back for now to not be alone, will get his room back in the next day or so. More of a normal lifecycle for us all in this house will emerge again in the coming days. I think a more normal daily life that uses more of the house may increase my happiness, as well as sense of purpose, and sense of normalcy as I get into this next phase of the hard work of recovery.

As a side note, we should all be in the mindset that there is no, and never was, a “normal”. So though more of my life will hopefully be getting better over the next few days and weeks as some things go back to what they were before surgery, nothing will go back entirely to how they were, in large part due to this pandemic. January 1st, 2020 will be nothing like December 31st, 2020. We all need to be thinking like that, because otherwise we will stay in a depressed mindset even after these stay-at-home orders end and the global economy gets back on track.

As I continue to walk normally, and use stairs in a way where my legs are the main weight bearers, this will itself aid in the further bone knitting over the next few months. You have to stay more sedentary by way of the bones for a while to help the healing, but then it flips and the work of using the limb more actually is necessary for proper healing. I’ve now reached that tipping point, and so even if pressure is something I feel, the more usual movement will be helping the healing. The PT has also, as will I think be a constant, added more repetitions of the exercises I’m doing, as well as a few more things to pay attention while walking and standing around in the walker.

Dr. Koop also advised that I can start wearing my brace a little less. While the definite time to wear it is any weight bearing, for the next few months, I can pull back a little, here and there, from the 20 hours a day “like a cast” wearing I’ve done this past month. That should help with the sweating problems I’ve seen in the brace too, though we also had that department look at the brace, adjust it, and give me more hints. Every now and then I could even go a night without it, should I wish. Come the next round of x-rays and talking with Dr. Koop (in August, when hopefully we’re all at least a lot better and more used to living in the pandemic, although I highly doubt we’ll be anywhere near through it by then) I may progress closer to the wearing it more outside the house only, though that will all also be a matter of what I feel like.

So, though perhaps this next few months will be hard work, it should also be good feelings to be in a more normal lifestyle. But again, with coronavirus normal has been murdered, so actually everything will still be a bit weird, just a different weird than being stuck on one floor.