Archive for May, 2013

Flash Back: Correcting The Toe Problem

1 Foot before
Dr. Roukis shared the following operating room pictures with me. I will share them with you. You will see the tools and how and where they were used.

They removed the Orbital Fixator. Then worked on my hammer toes. Since the second toe was so long, it was decided to shorten it. This would give a good contour allowing for my foot to fit into a shoe without rubbing the end of it causing an ulcer that could be problematic. After the removal of part of the toe bone, the skin was rolled down and stapled in place. I called it my Chinese Sharp-Pei toe, or “dog toe”.

2 Tools Used in surgery
From the looks of the pictures, the third toe was a lot of work and difficult to straighten. In fact it still isn’t straight and Dr. Roukis frowns at it each time he sees it.

Third toe

The big toe was beginning to turn in. Not sure what they did to 3 Stapled toesstraighten it, but I know they drilled holes using a small drill and a template in05AANNITorder to insert the staples. The little toe posed another problem. It had had an ulcer, but it turned into somewhat of a callus upon healing. It was decided to amputate that bulge so it would not be likely to form another ulcer.

I am amazed when I look at my feet now. It is difficult to believe all this work was done as scaring is nearly impossible to detect. Seeing the pictures of them using a hammer and chisel, all the clamps, staples and other little metal pieces to fuse my toes to my foot was certainly interesting and educational. I can wiggle my toes, but they are quite stiff and probably always will be. All the Wrapped up aftermetal and staples that were implanted will stay in my foot.

Now for the challenge of splint and plaster casts.

This weeks article was contributed Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

Don’t Stop Doing Things You Love

Prior to all the surgery, I had judged student art shows. I wasP8170033called to judge the student art work at our county fair I wasn’t sure I could in a wheel chair. Reviewing what needed to be done the decision was made that Max could help me. But, first we really needed to get my surgeons input. Fortunately, he was very supportive of my trying to do as many things I normally did as long as it didn’t interfere with the healing process. I was to use my head.

The judging took place less than 6 weeks after the surgery. I was still in the Orbital Fixator. It was awkward and I found it hard to allow others to place the award stickers where I wanted. I even went back to the fair to watch the reactions students and parents had to my judging. This actually gave me a great deal of confidence. I was tired after both experiences a good tired, however.

Being at the fair was a good experience as I was quite comfortable in crowds where I didn’t know people. The County fair was aP8270107different situation as I knew many of the people, vendors, exhibitors, entrants and attendees. While upstairs looking at the beautiful flowers and displays, one of my former student’s parents stopped me to find out what had happened to me. I explained Charcot Foot to her. She said that there was a vendor downstairs she thought had the same problem and told me where to find her. We went down to talk with her and sure enough she had Charcot also. She was in an electric wheel chair and basically unable to walk. Hopefully, she will tell her story here later.

One of my good friends wanted to give a surprise birthday party titlefor one of her young friends, but I couldn’t go up the stairs into her house for the party, so she decided to have it in my studio. We did much of the planning by phone. Max and I went shopping for the decorations and some party favors. Judy brought all the goodies. It was definitely a surprise. One of the guests was about two years old. We had great fun blowing bubbles. It was wonderful being a part of something that was such fun for everyone.

After my second surgery and all of the fun of the first surprise birthday party I decided to surprise Max for his 70th in September. Thank goodness for a phone. I called a local P9090006restaurant and arranged for our son to pick up the main meal, Judy brought a cake and balloons. Max walked in when we were setting up. He was shocked as he hadn’t heard anyone drive up to the house. He was even in the room next door. This was a chance for me to feel pretty independent even though I couldn’t walk. I found I could still get things accomplished.

Because we love the theater also, we were able to attend the local theater nearly all season and a theater in Seattle. Not many in wheel chairs attend, but they certainly can. The ushers were extremely well aware of my needs and were helpful as there was special seating for me. They took me to the elevator, or made parking available for us. We just needed to talk to someone in charge.

It is frustrating to be confined. If you are facing surgery or recovery, have a place you really like to stay. Surround yourself with things and people you enjoy. As soon as possible, start doing what you love even in moderation, or with the help of others. Maybe find something new, never tried before, you might be pleasantly surprised how beneficial it will be.

This weeks article was contributed Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

Wheelchair & Other Lessons Learned

By the time the second trip in the van had been completed most of the difficulties of getting Annita in and out of the vehicle had been corrected. However, this person began to wish there had been a short course on what to look-out-for when pushing someone places in a wheel chair. Since we had become disabled there were things associated with the prospect, like getting a display placard, so as to avoid a ticket for parking in disabled spot. This process is not that difficult. Parking is only the beginning. We were surprisedP6130005to find out how many disabled parking spots are a significant distance from the sidewalk or a ramp to get on the sidewalk. The next, pay attention to the ramp. Does it match with the sidewalk or the pavement. Either way can give your passenger an unpleasant surprise, like almost being dumped in the parking lot or traffic. This can sure play the devil with trust issues and being relaxed when riding on this platform. Sometimes one can wonder what the disability is when a large 4 wheel drive pickup has a disabled placard in the front window and one almost needs a ladder to climb into the seating area.

One day we saw two people quickly climb up into a large 4-wheelP6130010drive pickup with a placard in the window. That day the space beside the handicapped spot was open where I had parked. As I pushed Annita from around behind our van into view they both hurried up into the pickup and left without making eye contact. I can understand that someone who exhibits no problems walking, but needs oxygen from time to time is disabled. I am a little suspicious when it takes a climb to get into the vehicle and those entering seem to not have any physical problems.

Many doors have an automatic door opener, but there are some doors, as in bathroom doors, which require an able-bodied football player to open and hold open. The inside of the bathroom might be no better. Perhaps there is no handicapped stall with no stall doorway large enough to get the chair all the way in and of course, there are the full view mirrors to give everyone a thrill. There are even some handicapped bathrooms that when the handicapped stall is in use the door can not be opened and there is no entry or exit either for anyone. There was the time when the door to the women’s bathroom had no automatic opener and was very heavy, so I helped my wife to enter the bathroom. We got her in and the handicapped stall door closed so she could use of the space. OneP6100012customer used the bathroom while we were there. We thought that soon as she left we could exit unnoticed. We started to leave and suddenly the door opened. The woman just stood there with her mouth wide open. Peeking around from behind and to one side much like a raccoon, a friend of ours appeared. I said, “Boy am I glad to see you.!” She said, “We are going to have to quit meeting in strange places like this.” We left and I do not think the woman closed her mouth even then.

Some department stores are real obstacle courses. The store is trying to make the most of its selling floor space with a major sale. Woe to the wheel chair pair trying to go from one place to another in the clothing areas away from the main aisles through the store. Your passenger is either dodging clothes, furniture, toys, or small appliances. This is when the chair pusher becomes concerned about the welfare his passenger. The branch aisles are just three feet wide, maybe. I think state law states specifically how much space should be there.

Homes are not the only places that have thresholds hard to take a wheel chair across. With elevators it is wisest to pull the chair in through the doorway and not push as the ride is smoother and safer. The outside entry for some stores has a door stop across the threshold, also hard to cross. In all cases backing in is best.

For most of the two months the orbital fixator was attached to Annita, it was necessary for me to help her position her right leg. It took the better part of six weeks before she could successfully move it without a lot of help. The other factor was making sure there was enough space between that foot and any other solid object, such as a door or wall. Essentially we handled the foot and leg as if there were broken bones. There was a time or two when I did inadvertently bumped the leg. Although much of the above talks about being out in public, there was the process at home. To get off the bed and into the wheel chair required the following; Help Annita put on the left sock and shoe, then sit up. Next, gently lift the right leg and ease it down to the floor. Steady her while she stood up and turned. Move the wheel chair close to her and set the brakes. Help her sit down on the chair. Next depended upon what was next; bathroom call, eat a meal, or be up off the bed when that was allowed to happen. Getting back into bed was the reverse. Place chair in proper location and set the brakes. Help Annita stand and turn so she could sit on the bed. Move chair out of the way. Help her raise and position her leg on the pillows for proper height and comfort. Take the shoe and sock off if she wanted both off. Help her recover her self with sheet and blankets to stay warm and resume what ever activity she had been doing on the bed.

By now the reader must think this recovery was a piece of cake. It was not, that bad either. Besides Annita and her foot recovering, I needed to make a number of changes as well. The biggest of the lot was to develop patience. I had to consider my wife and her location and movements. It made no difference what the situation was I had to be patient. First of all remember my wife went from being an independent adult to one who literally had to be waited upon hand and foot. If Annita needed to go to the bathroom at 2:30 am, I got up was pleasant and helped her accomplish the task, even if I was a little groggy. She was concerned about awakening me, though I told her I had had that happen more than once onboard a submarine or ship when I was in the US Navy. She still voiced the same concern many times. One night she did not awaken me and we had a problem, fortunately nor a serious one. She fell after the second surgery on her right foot. I did not scold her I just asked her to awaken me in the future. Remember this we had talked a lot about the recovery prior to the operation. But talking about and living the event is a much different situation. You can do detail planning, however, there will be something missed. We elected not to do detailed planning, so that when a surprise happened it did not create serious worry. We had as good a time as possible and I did handle the situation much better than the naysayers early on were stating. In a way it was a little like a honeymoon and our learning more about one another.

Guest Author, Max Shaw the founders husband

Brought to you by Charcot Awareness Education Foundation

Out & About in Public

By the time the second trip in the van had been completed most of the difficulties of getting Annita into and out of the second row of seating in the vehicle had been corrected. However, this person began to wish there had been a short course on what to look-out-for when pushing someone in a wheel chair to one place, or another. Since we had become disabled, there were things associated with the prospect, like getting a display placard, so as to avoid a ticket for parking in a disabled spot. This process is not that difficult. Parking is only the beginning. We were surprised P6130005to find out how many disabled parking spots are a significant distance from the sidewalk or a ramp to get on the sidewalk, for that matter into a store or other organization. The next, was to pay attention to the ramp! Does the ramp evenly match the sidewalk, or the pavement. Either way can give your passenger an unpleasant surprise, like almost being dumped in the parking lot, or traffic coming off the sidewalk. When the ramp has not been properly placed street to sidewalk or the reverse, moving the person backwards so the larger wheels go over the misalignments first is the best method. If not, this can sure play the devil with trust issues and your passenger being relaxed when riding on this platform. Sometimes one can wonder what the disability was when a large 4 wheel drive pickup, raised up so high is parked in a disabled parking spot, one that driver and passengers have to climb up into it, and they have displayed a disabled placard in the front window of the pickup.

One day we saw two people quickly climb up into a large 4-wheel-driveP6130010pickup with a placard in the window. That day the space beside the handicapped spot was the only one open and is where I had parked. As I pushed Annita from around behind our van into view the people hurried up to and into the pickup and left without making eye contact. I can understand that someone who exhibits no problems walking, but has COPD and needs oxygen from time to time is disabled. I am a little suspicious when it takes a climb, to get into the vehicle and those entering seem to not have any physical problems.

Many businesses and organizations have doors with an automatic door opener, but there are some doors, such as in bathroom doors, which require an able-bodied football player to open and hold open. Being inside of the bathroom the wheel chair person might be no better off without help. Perhaps there is no handicapped stall, or a stall, or with no stall doorway large enough to get the chair all the way in and of course, there are the full view mirrors to give everyone a thrill. In Russia there are mirrors on the ceiling in a Moscow airport and I’ll leave that to your imagination.

There are even some handicapped bathrooms that when the handicapped stall is in use the door to the bathroom can not be opened and there is no other entry or exit either for anyone. There was the time when the door to the women’s bathroom had no automatic opener and was very heavy, so I helped my wife to enter the bathroom. We got her in and into the handicapped stall just closing the door so she could use of the space. One P6100012customer used the bathroom while we were there. We thought that soon as she left we could exit. We started to leave and suddenly the door opened. The woman just stood there with her mouth wide open. Peeking around from behind and to one side much like a raccoon, a friend of ours appeared. I said, “Boy am I glad to see you.!” She said, “We are going to have to quit meeting in strange places like this.” We left and I do not think the woman closed her mouth even then.

Some department stores are real obstacle courses. The store is trying to make the most of its selling floor space with a major sale. Woe to the wheel chair pair trying to go from one place to another in the clothing areas away from the main aisles through the store. Your passenger is either dodging clothes, furniture, toys, or small appliances. This is when the chair pusher becomes concerned about the welfare of his passenger. The branch aisles are just three feet wide, maybe. I think state law states specifically how much space should be in all aisles of the store. By state law in Washington state requires that all aisles be at least three feet wide. On the day of a sale this is sometimes forgotten about and the maze is created.

Homes are not the only places that have thresholds hard to take a wheel chair across. With elevators it is wisest to pull the chair in through the doorway and not push as the ride is smoother and safer as sometimes the threshold alignment between the car and the floor do not match very well. The outside entry for some stores has a door stop across the threshold, also hard to cross. In all cases backing across the threshold is best. The main thing one should remember, the front wheels are much smaller and do not go oveer gaps and bumps as well as the larger ones.

For most of the three months the orbital fixator was attached to Annita, it was necessary for me to help her position her right leg. It took the better part of six weeks before she could successfully move it without a lot of help. The other factor was making sure there was enough space between that foot and any other solid object, such as a door or wall. Essentially we handled the foot and leg as if there were broken bones. There was a time or two when I did inadvertently bumped the leg.

Although much of the above talks about being out in public, there was the process at home. To get off the bed and into the wheel chair required the following; Help Annita put on a sock and left shoe, then sit up. Next, gently lift the right leg and ease it down to the floor. Steady her while she stood up and turned. Move the wheel chair close to her and set the brakes. Help her sit down on the chair. Next depended upon what was next; bathroom call, eat a meal, or be up off the bed when that was allowed to happen. Getting back into bed was the reverse. Place chair in proper location and set the brakes. Help Annita stand and turn so she could sit on the bed. Move chair out of the way. Help her raise and position her right leg on the pillows for proper height and comfort. Take the shoe and sock off if she wanted both off. Help her recover her self to stay warm and resume what ever activity she had been doing from the bed.

By now the reader must think this recovery was a piece of cake. It was not that bad either. Besides Annita and her foot recovering, I needed to make a number of changes as well. The biggest of the lot was to develop patience. I had to consider my wife and her location and movements. It made no difference what the situation was I had to be patient. First of all remember my wife went from being an independent adult to one who literally had to be waited upon hand and foot. If Annita needed to go to the bathroom at 2:30 am, I got up was pleasant and helped her accomplish the task, even if I was a little groggy. She was concerned about awakening me, though I told her I had had that happen more than once onboard a submarine or ship when I was at sea when in the US Navy. She still voiced the same concern many times. One night she did not awaken me and we had a problem, fortunately not a serious one. She fell after the second surgery on her right foot. I did not scold her I just asked her to awaken me in the future. Remember this, we had talked a lot about the recovery prior to the operation. But talking about and living the event is a much different situation. You can do detail planning, however, there will be something missed. We elected not to do detailed planning, so that when a surprise happened it did not create serious worry. We had as good a time as possible and I did handle the situation much better than the naysayers early on were stating. In a way it was a little like a honeymoon and our learning more about one another.

This weeks article was contributed by Max Shaw, husband of the Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

Second Surgery: Orbital Fixator Removal & Hammer Toes Straightening

P8160028Just to give you an idea about Dr. Roukis’ sense of humor, when it came time to do the removal of the Orbital Fixator, we had to do the usual paper work connected with surgery. He just had to contemplate whether he should, or should not remove it. As if I didn’t need, or want this to happen.

Fortunately, I only had to wear it two months as the healing went well. My glucose had been well under control as a diabetic. This and all the positive things in my life, I contribute to the healing. The surgery was scheduled for August 29, 2007. Pre Op went fine. Dr. Roukis just wanted me to talk with the anesthetist and make sure they gave me something that would keep me from vomiting during surgery as had happened before. When I asked the anesthetist about the medication, he said I hadn’t had a problem. However, after he read the Doctor Roukis’s report he gave me some medication to take before coming in for surgery.

This was a day surgery and would not require staying in theP8220017hospital. The time came, this time, very early AM as we had to check in at 6 AM. We had about an hour & 15 min. drive to the hospital. Max had to load the wheel chair in the back of the van before we could leave. It was the last trip with the Fixator.

After checking in at Surgical Services, doing all the “stuff” they wanted, I was then sent to Operating Room (OR) Reception. One of the patients was a medic that I had seen in limb preservation. He recognized me saying, “Aren’t you one of Dr. Roukis’ patients?” With that we visited a bit. As we headed off to our surgeries we wished each other luck. Just one more thing that tugs at my heart strings.P8160023 copyOnce in my gown and robe, then to the bed and waiting area prior to surgery. Dr. Shade, Dr. Roukis’ assistant, came to sign my right leg with her initials VLS and the other leg NOT! We laughed. Dr. Roukis came in and went over everything with me that was to happen during surgery and after. When finished he excused himself to get the operating room ready.

The anesthesiologist did a great job, no bruises, and no vomiting in OR. They gave me a shot to “relax me” and left to check if they were ready for me. I watched as everyone was moved to their destination. There were eight of us. I was the only one left. Two guys came bouncing in, surprised to see me there. They said, “Did they forget you. There’s no one else here…..” Who knows what else they said as I went out like a light.

When I awoke, I was in recovery. I thought I was awake, but I couldn’t understand what was being said until they moved me to another location. I had a doozy of a sore throat. Max came in. They gave me ice chips for my sore throat and a couple of wrist bands to help control nausea. Because Internal Medicine was concerned about my “High Blood Pressure” I asked the nurse if my blood pressure was high. He said. ” Hardly” and proceeded to tell me my oxygen was 97-98% and blood pressure 104 over 45. Not bad. As soon as I could get up with my new splint cast, I hopped into the wheel chair. We then headed home.
This weeks article was contributed Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation