Archive for August, 2013

Physical Therapy Begins

Soon within a few days, I was able to go back to Madigan. My biggest complaint was being poked by one of the screws near my knee. They determined one of the screws was a bit long and may be giving me trouble. All in all things looked good and were healing nicely. They decided I would need physical therapy. Because I lived in Silverdale, I should do it at the Naval Hospital, but the Navy sent me to a Silverdale location. Madigan doctors also said I could go back to the pool on a limited basis.

This was very different for me as there was no therapy with the Charcot Foot surgery. Because of this, my therapist was a bit hesitant as she didn’t want to create any PB170019problem for my feet. When I first arrived, I was in the wheel chair. I learned to work out on the bike, walk using the railings, stepping up and down using the railings and walking the grape vine. I spent quite a bit of time with jell and heat trying to get a better range of motion for the knee. I worked with her three days a week for several months. My time on the bike increased and other exercises were added. My range of motion increased making everyone happy.
Those at the base gave me some exercises to do in deep water that would help.

I was sent to the Naval hospital for a DEXA (Hip / spine) bone scan. The news wasn’t great. I was told I had Osteoporosis. Obviously, I was given a prescription of calcium and vitamin D. I will have another scan by the end of the year. Unfortunately, the exercises needed for Osteoporosis are weight bearing and not good for the Charcot feet. Not yet anyway.

At the end of therapy, I was walking without help. Since I had fallen before, I was much more causious. Walking up and down stairs is still difficult. Some days are PB170023better than others as I seem to have more confidence. Everyone has helped a great deal whether helping build my self confidence or helping me build strength through the many types of exercises needed.

It was decided that the screw in the knee was creating some of my problem. However, a year had to go by before it could be removed. That was done. I can now move my knee without pain and sleep without a pillow between my knees. It has also made walking easier.

This has been a long process, but in the end well worth it. It is great being able to walk nearly normally and not having to use the wheel chair, or the electric carts in the stores. They are there. Yes, but only if I need them.

This weeks article was contributed by Founder Annita ShawBrought to you by Charcot Awareness Education Foundation

The Challenging Ride Home

Though I was well cared for in the hospital in Gallup, I really wanted to get on the road PA170044home. It hadn’t been cleared for me to go back to Madigan. That was a concern for me. The time finally came to leave the hospital. Walking out was not an option, nor was riding out in a wheel chair. I was placed on a gurney and wheeled to the front of the hospital where the RV was parked. I am sure this was not a common event. In fact, I teased, saying that they put out an all call that they were going to load a lady into an RV. If they weren’t busy, anyone who was able could come watch. I was amazed how many were there to see me off. ( Maybe they were just glad to see me leave.) My nurses, friends and a whole lot of other people were there. I was shocked at how many were inside the RV when I was placed on the couch, my location for the remainder of the trip.

I was confined to the couch. I thought I would be able to at least get up and sit on the potty chair, but I couldn’t get up. I think the main reason was that the couch was too low. I couldn’t get enough leverage to sit up. My position was as if I were sitting on a lawn chair. In order to look out of the windows and enjoy some the sights I had to scooch up which was difficult and not very comfortable. It was still a nice change when not sleeping and I did a lot of that.
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Once home, I couldn’t get out of the RV. I was still stuck on the couch. We were hoping I would be able to go to Madigan where they could take me out. After the check up there, I would be able to get in the wheel chair and transfer to the car as I had done in the past. Unfortunately, I was going to have to stay in the RV for nearly a week longer. I am slightly claustrophobic and the “four walls” were beginning to close in on me. Nearly to the breaking point, Max decided he could drive me to the local hospital and they could take me out.

PA200089Max drove the RV to the emergency entrance. Unfortunately, when he drove under he wiped out our air conditioners and their over head sprinkler system. They didn’t have a low clearance sign. Max was really stressed and so was I. He explained our situation to the attendants as the water poured over the RV. They quickly removed me and headed me in to the examination room. One of the men asked me if my husband was all right. I said I didn’t think so, as he was really upset and stressed. They said he just drove off. I said he had planned to go home and get the van to take me home. They went on with my check up and x-rays. All was okay. Max returned and they told him not to worry about the sprinklers, but wanted to know how he was. He kept saying he was okay, but no one believed him.

PA230094Once they released me, I slid into the wheel chair. They followed me to the van and were quite surprised I was able to get in as I had done the past year. I had had plenty of practice. It was great being able to get back into the studio and my routine. The next day the hospital called, not to find out how I was, but to check on Max as they were really worried about him. I thought that was wonderful of them.

This weeks article was contributed by Founder Annita ShawBrought to you by Charcot Awareness Education Foundation

Whoops!: Watch That Step

I was really doing well, in fact, I was doing some walking after surgery on both feet. I was even doing some short distances without assistance. No walker, or wheel chair. Max was at my side to make sure I was stable and didn’t fall. I was gaining confidence and enjoyed showing my independence. Maybe, just a bit too much confidence too soon. We had been at our farm in Nebraska and were on our way to California. We stopped to see a friend in Gallup, New Mexico. We had spent several days there and were going to leave on Monday. We went to church with her on Sunday. After church, we went into the fellowship room to visit with everyone.

I decided I needed to go to the bathroom which I saw to my right and down the hall. Max said he would take me there. Unfortunately on the way, he dropped some things and he stopped to pick them up. Independent me decided I could do this on my own. I went ahead of him. One problem, I didn’t see a step leading up to a stairway. I only

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saw a short cut to the bathroom. My right foot hit the step. I fell forward. My right leg hit the edge of the step just above my knee. Laying in a crumpled heap, I looked up into the doorway. A man said, “Did you break anything?” I replied, “Yes, my leg. I can’t move it.” He said, ” I know. I’m an orthopedic surgeon and I heard it break. I have already called the ambulance. They will be here in a few minutes. ”

The really cold slab of concrete felt really good. I was fortunate that I didn’t hit my head. In just a few minutes The paramedics were swarming

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around me. They slid a large plastic sheet, what made me think of as a spatula, under me and put me on the gurney. I was rushed to the ambulance and they whisk me away across the bumpy parking lot and back street to the hospital only a couple blocks away.

Now for the wait. Unable to move and the pain was beginning to start in. Of course all the x-rays and impossible positions they put you in didn’t help. I was so glad Max was there to comfort me though there were times, I’m sure, he felt nothing

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helped. My friends were with me also I appreciated them though I was in misery. The surgeon came in and told us I wouldn’t have surgery until Monday afternoon as the hardware necessary to repair my leg would have to come in from Albuquerque.

My night was a blur, maybe a good thing. Monday was the longest day of my life. I don’t remember much other than wondering when I was going in for surgery. even when we went in to the room to wait my turn it seemed to take for ever, In fact it was after 5 P.M. before I did go in. I remember waking up in my room.

The day following surgery, I was given a blanket some of the women in the area had made. It was so welcoming and comforting even though

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the room was hot and the weather outside was also hot. I stayed there until Friday. Meanwhile they tried to put me through physical therapy. My problem two feet that didn’t handle weight well because of my precious surgeries. This was hard to get them to understand. Max ended up helping me get out of bed and set in a chair and back to bed. The week was also long even though I had lots of company, my friends and many people I really didn’t know. The doctors said I would be released on Friday.

That meant, Max needed to call our son and have him fly to Albuquerque on Thursday evening to help him drive back home.

This weeks article was contributed Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation

INFECTION: A SILENT DESTROYER

In re reading Bonnie’s last posting where the suture had been left in her first amputation, a sore developed into an infection requiring amputation of another 6 inches of her leg which caused me to do further research concerning infection.

My surgeon was very concerned about infection. I had a very minor one after surgery to correct Charcot in my left foot. He aggressively treated it and it was soon gone. There were signs around the hospital warning people about MRSA.

Recently, I was watching a popular TV program that had a guest doctor and the topic was Sepsis. I had no idea what it was, and was shocked when they said more people die from this than diabetes and cancer. It was infection.

I then began to talk with health care professionals and having my husband search the web. There is a lot of information for you to read so I will break down some of the information for you.

You have probably heard of Necrotizing Faciitis (NF), but more commonly called Flesh-Eating Bacteria. This is really scary to me. It can destroy skin, fat, and tissue covering the muscles within a very short time. Fortunately this infection is very rare, but deadly if you contract it. In fact 1 in 4 that get this infection dies.

Higher Risk Group
• Have a weak immune system
• Have chronic health problems such as
diabetes, cancer, or liver or kidney disease
• Have cuts on your skin, including surgical wounds.
• Recently had chicken pox or other viral infections that cause a rash.
• Use steroid medicines, which can lower the body’s resistance to infection.

Symptoms
• Skin the is red, swollen, and hot to the touch.
• A fever and chills.
• Nausea and vomiting.
• Diarrhea.

These usually happen after an injury with pain worse than expected for the size of the injury. In fact it may feel fine and a day or so later it suddenly gets worse. You could go into shock. The bacteria destroys the soft tissue and fascia, which quickly becomes gangrenous (dead) This tissue must be surgically removed to save the life of the patient. NF can cause excruciating pain, dangerously low blood pressure, confusion, high fever, and severe dehydration due to the toxins poisoning the body. It can also occur under the skin resulting in a misdiagnosis.

If it occurs in the muscle or bone, major limb amputation is necessary. Death from this condition is not uncommon. Aside from tissue decay, the bacteria causes the rest of the body’s organs to go into systemic shock.

NF is not a recurring condition. Once treated the bacteria is eradicated from the body. (A good thing) However, this is a very fast moving infection, so time is the most important factor in survival.

For further information on Necrotizing Faciitis use your favorite search engine. Much of this was based on NNFF’s information from Dr. Steven Triesenberg, MD (Infectious Disease Specialist) in Grand Rapids, Michigan.

This weeks article was contributed by Founder Annita ShawBrought to you by Charcot Awareness Education Foundation

Infection: Don’t Take It Lightly

Until I had the incident with an infection and saw how concerned my doctor was, I really didn’t realize the effects it could have. Foot ulcers in the diabetic is problematic. It is easy to injure the foot and not know it. Years ago, my husband and I went to Las Vegas. I was wearing socks and sandals on my feet. I was not a diabetic at the time. It was a very hot day. We walked a long distance taking in the sights, malls and casinos, then worked our way back to the RV Park where we were staying. I looked down at my feet as I stepped up into the RV only to discover my bloody feet. I had worn blisters on them. They had broken and bled. I should have gone to a doctor, but didn’t, as we were in a strange place and didn’t know any one. We used a home remedy for over a week. I stayed off of my feet and took really good care of them. They healed and I didn’t get an infection. I think back now and believe I had the neuropathy then. Unfortunately, many don’t check their feet. They may even believe the ulcer, or wound will heal on its own. It may be under a callus and become infected. Infection compounds the problem.

What is infection? It is a bacterial invasion that under favorable conditions multiplies and produces injurious effects.

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What does it look like? (Symptoms) It could be sore, red, warm, or tender to the touch, swollen, and could even weep with a fluid, or pus. These could be ulcers and could turn into calluses anywhere on the bottom, side or toes of the foot. If ignored and nothing done to heal these, amputation could be the end result.

Where should I look for infection? Infection can be anywhere on the body, but with Charcot Foot one should be most concerned with the feet. Examine your feet often. Check for wounds, blisters, bruise and cuts. If the heels are cracked or areas are showing evidence of increased pressure, one needs to moisturize the skin and possibly be fitted for orthotics by a professional to cushion the foot.

Is infection easily missed? If one has Nueropathy some of the symptoms will not be evident. We have the tendency to think it will just go away, or heal on its own. One needs to check the area often, both morning and night. If it is not healed in a couple of days, one should seek medical attention.

Since MRSA has become a very serious concern, I would like to share this poster which was on display at the hospital.

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This weeks article was contributed by Founder Annita Shaw

Brought to you by Charcot Awareness Education Foundation