Archive for the ‘Message from the Founder’ Category
Flash Back: Correcting The Toe Problem
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”.
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.
The big toe was beginning to turn in. Not sure what they did to 
straighten it, but I know they drilled holes using a small drill and a template in
order 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 
metal 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
5/23/13 7/1/2012
Prior to all the surgery, I had judged student art shows. I was
called 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 a
different 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 
for 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 
restaurant 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
Second Surgery: Orbital Fixator Removal & Hammer Toes Straightening
Just 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 the
hospital. 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.
Once 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
History Of and My Experience With The Orbital Fixator
When I decided to have foot surgery, an entirely new learning curve was about to take place. I was ready, but apprehensive. We had already checked my surgeon out and were impressed with his credentials even though he was only 36 years old (about the same age as our son). We were very comfortable with him. He was thorough, professional, knowledgeable, had a great sense of humor and explained things so we could understand them. In explaining what was to be expected, we were told he was going to use a device on my foot called the Orbital Fixator. This would
confine my foot so it couldn’t move at all during the first two to three months after surgery. This was to help the foot heal.
The wires criss crossed through my leg bones allowing no movement of my foot and leg. I was shown the device, but I don’t remember holding it. If I did, it didn’t sink in how heavy the device was. Nor, did they suggest I tie a 10 pound weight on my right foot and practice playing hop scotch for a few weeks before. surgery. I truly thought that would have helped once I was ready to try to move around and wasn’t able to do anything, but scoot, or try to hop on my left foot.The Orbital Fixator was awkward and very heavy. I didn’t have strength in my hip or leg enough to lift my foot. So, I often needed help. It was, actually, exciting when I was able to lift my foot on my own. This came about because of the exercises that were given to me before I left the hospital.
The history of the Orbital Fixator is fascinating. In 1921, in Caucasus, in the Soviet Union, Professor Gavril Ilizarov was born. He had no formal education until he was 11. His parents were illiterate. Yet, he quickly went through medical school practicing in the Kurgan region of Siberia. He was having to deal with orthopedic problems. Though he wasn’t trained as a surgeon, he was the only doctor in the region. In the 1950′s he developed and created a method for treating fractures, deformities and other bone defects. It was called the Circular External Fixator (Orbital Fixator). It is said he was riding in a wagon and started studying the hub and spokes on the wagon wheel. This gave him the insight to create the Circular External fixator to stabilize the leg. He worked quietly and basically unknown until 1967 when Olympic high jump champion Valery Brumel sustained a non-union fracture. He successfully treated this infected fracture.
His methods were brought to the west in 1981 by an Italian doctor. Professor Ilizarov was the only orthopedic surgeon ever elected to the prestigious Soviet Academy of Medicine. He headed the world’s largest orthopedic hospital in, Kurgan, All-Union Scientific Centre for Restorative Orthopedics and Traumatology which has 1700 beds. He continued working and lecturing world wide in this field for 41 years until his death in 1992 at age 71. Because of his work, he showed that controlled mechanically applied tension, stress that there could be regeneration of bone and soft tissue. Various names of his Circular External Fixator have come about, the Orbital Fixator, the External Fixator and in the past decade the Taylor Spatial Frame has been introduced. It has been determined the external fixation devices disrupt the soft tissue less in patients whose healing potential is compromised in the case of those with diabetes mellitus and Charcot disease.
This weeks article was contributed by Founder Annita Shaw
Brought to you by Charcot Awareness Education Foundation
Pressure Ulcers From Wheelchair Use
Bonnie, as you know, uses a wheelchair as she has Charcot in the right foot and cannot use it except for transfers. She has it in a clam shell boot to protect it. Because of this and her other foot being amputated, she is confined to a wheelchair most of the time. She has used her present chair a number of years and last summer, when we visited her, she was telling me she was experiencing pressure ulcers, commonly called bed sores, because the chair no longer fits her properly. These pressure sores come about 
because of friction, humidity, temperature, continence, medication, shearing forces, age and unrelieved pressure.
I , for one, had not taken into consideration that one in a wheelchair would experience sores of any kind. However, when you think of it, it is obvious.
Patients who use a wheelchair have a high risk of developing pressure sores on their: buttocks, tailbone, spine, shoulder blades, back of arms and back of legs. MNT (medicalnewstoday.com) is an excellent source on this topic.
Pressure ulcers (bed sores) develop when the skin and the tissue below it becomes damaged. In some cases the muscle and the bone can be damaged also. Sustained pressure can cut off circulation to vulnerable parts of – the body, especially the skin of the buttocks, hips and heels. The affected tissue dies if it does not receive an adequate flow of blood.
Any person who has difficulty changing position can develop ulcers. They can develop and progress rapidly and are frequently difficult to heal. Preventing them is a wise choice.
If a person doesn’t feel pain and may not know a pressure sore is developing. Someone with diabetes and vascular diseases that affect circulation may have problems with proper blood flow to certain tissues, resulting in higher risk of tissue damage. A person may not sense the symptom, yet someone may see a rash on them which might be a sign a pressure sore is starting.
Pressure sores are classified into four possible stages by the National Pressure Ulcer Advisory Panel, USA. Refer to MNT for more info. I will give a brief description.
Stage I – starts as a persistent area of red skin, which may be itchy, painful warm, spongy or firm when touched.
Stage II – skin loss has already taken place.
Stage III – there is now a deep wound, like a crater; the damage has gone below the skin.
Stage IV – most severe ulcer. Skin is severely damaged and there is tissue necrosis (surrounding tissue starts to die).
Bonnie will continue with her recent wheelchair acqusition next week. We are so lucky to have her experiences to share so others can benefit.
Brought to you by Charcot Awareness Education Foundation
The Reality of Recovery Isnt The Same For Everyone
Since we started the Charcot Awareness Education Foundation, we have learned a lot from others who have this devastating disease. I was very fortunate to have a very dedicated professional caring for me. Some have told us they worked with a doctor who merely turned them over to a foot surgeon who counseled with them briefly. I worked with my surgeon nearly two years before the surgery. I was well counseled and he was very sure of what I was going to be doing and who was caring for me after surgery. Others have said after the surgery they saw the surgeon before they left the hospital and maybe at the next appointment and never again. My surgeon saw me every appointment I had after surgery until he was satisfied that I could see him at three, or six month intervals. Even after he left this practice and moved out of state, his replacement, who knows my case well, sees me every six months for a regular check up even though I see my regular doctor and my podiatrist on a regular basis.
Each person, with Charcot has a unique problem. It upsets me when I speak of the disease and people say, ”Well, it’s not life threatening, like cancer. You can get along just fine.” After the past week, or so, I’m not so sure. I’ve always been concerned about one’s quality of life. Those living with a physical disability have many obstacles they must over come. Recently, I received an e-mail from a wife of a man who had Charcot and had surgery in June of 2011. They had put some external rods in his foot to stabilize it. The rods started shifting when he started to put weight on the foot. They then had to remove all the rods. Shortly thereafter they did a second surgery to repair the foot as his bones were shifting again putting the rods back in only to have them taken out again in September. Can you imagine the stress?
In October they learned that he had developed a blood clot in his leg. He was given coumadin for this to get in the therapeutic INR range. They never got there, as, he passed away early in the month of November of a pulmonary embolism.
Think about the healing, the pain, how you would feel about the adjustments, about you as a productive individual, how your body can deal with this constant, or at least it seems that way, invasion. Well, the next happening death. Yes, Death. Tell, him , his wife and me Charcot isn’t life threatening.
Maybe it shouldn’t be, but if our doctors aren’t competent, or knowledgeable, it certainly is. In a study the University of Washington did a few years ago, they stated one in every 700 diabetics have Charcot Foot and aren’t being diagnosed. Diabetes is only one of 24 diseases that makes Charcot worse.
His wife added this in her e-mail to me. “ I pray for all the people who have to deal with the sufferings of Charcot foot. Thank you very much for your website and God Bless you for making people aware of this!”
I will continue with other recovery situations next week.
Brought to you by Charcot Awareness Education Foundation
The Reality of Recovery
Passing time between appointments, healing, keeping busy, staying comfortable and learning to go out in public now my new goals. One really needs to set these goals before you have surgery. Plan with someone, a spouse, caregiver, professional, or a good friend that may be around a lot. Have a pretty good idea about the length of time you will need to get well, the type of care you will need, how mobile you will be. In my instance, I knew I would not be able to walk, climb stairs, move around, take a shower or bath, especially the first three to six months. Because of these limitations, it was suggested we consider a care facility. But after Max and I talked it over, we decided we had a space that would work for us, the studio in our home. Max could care for me there.
I really wanted to be as independent as possible. I soon learned I needed a lot of help. The hardest was waking up at night, having to go to the bathroom and having to wake my husband every time. Max had to put a shoe on my left foot and steady me, so I wouldn’t fall as I hopped on the foot. I couldn’t lift my right foot up, because of the Orbital Fixator, to even get back in bed. He had to. If I wanted to read a magazine, sort papers, watch TV, draw or write, we had to organize things in such a way that I could reach them on a small table by the bed, or have them placed on the bed. Other wise I would drive him crazy. He spent a great deal of his time in the computer room next door. This meant if I needed him, I could call on the phone, but he checked on me regularly, so I didn’t need to call very often.
There were times I just enjoyed looking outside. Since it was summer, 
we could leave the sliding glass doors open with the screen in place. I really enjoyed the deer bringing her twin fawns by, all the chipmunks, birds and especially the Pea Hen as she seemed to check on me. We would carry on quite a conversation at times. Our cats kept me company. They didn’t understand what was going on.
I was beginning to become uncomfortable. The mattress on the bed was really old. My legs were hurting, not to mention my behind. Max would have to see what he could do about the mattress. I was sleeping off and on all day. Some times at night I couldn’t sleep. One of my good friends would record movies and programs for me. I often watched them at night.
Bath time was a new experience. I began to appreciate those soldiers that were in the field with no facilities. I used disposable wash cloths that were heated in the microwave. I even had a shower cap that I could use to wash my hair. This took some getting used to until I could finally use a basin with real soap and water. Just try to keep the bed dry.
Our friends, neighbors and our son were great. They came to visit 
often and many times brought food and flowers. Get well cards came from every where. Soon, I was on the phone visiting with friends and relatives across the states. I also wanted to know more about
First Clinic Appointment After Surgery
I really didn’t know what to expect from the first visit to the clinic after being dismissed from the hospital other than the redressing would be done. I really wasn’t looking forward to the ride back to MAMC either. Getting into the van was an ordeal, but the ride was short as I slept most of it. The gate ID check at Fort Lewis was funny as the gate guard couldn’t find the second person. My Husband had to tell him I was behind him in amongst the pillows. He laughed and passed us on through.
Once in the wheel chair, we headed to the Limb Preservation Clinic. I checked in, waited for the medic to ask his usual questions, take my blood pressure and show me to the room to wait for Dr. Roukis. He never kept me waiting and always tried to keep a pleasant atmosphere. Since I hadn’t slept well the night before, Max and I had watched a Russian film “The Cranes Are Flying”. A love story based around war. It had a sad ending as the girl goes to meet her love who is coming home, but he wasn’t there. He had been killed. Dr. Roukis poo-poohed the love story. Dr. Schweinberger, Alice and I, then, shared a moment at his expense.
Now, for the serious part of the appointment. Since I hadn’t seen 
any of what had been done to my foot, Dr. Roukis gave me an option. I could watch the entire process, or I could lay back and not watch. Of course I elected to watch. Dr. Roukis had taken pictures during some of my appointments to record my foot problems. I had brought my camera today. I asked him if I could take pictures. He said, “Are you planning a law suit?” My response, “Do I need to?” He then said, “Go ahead and take pictures”. I am so glad he did. It helped me in so many ways. Hopefully, now educating many about Charcot Foot and the process to save the foot.Dr. Roukis took an hour to change the dressing, scrub the leg and foot, use the Betadine and repack the Orbital Fixator. His assistants did just that, assist by handing him betadine strips and anything else he needed. He used the strips to wrap the lower part of each 
wire, sliding the strip down the wire and pressing it firmly into the flesh. That was not comfortable and a bit painful. He wants NO INFECTION! In fact, he said, “You don’t even want an infection.”
Apparently, I must have had a strange look on my face as he asked me if I was okay? I was fine. I was fascinated with the wires going through my leg and foot and amazed at the lack of pain. The device was more awkward and heavy than painful. Dr. Roukis was pleased that there was very little swelling. These appointment were scheduled about two weeks apart. I would be in the Orbital Fixator for two to three months depending on the healing progress.
It was great to be able to leave the clinic feeling really positive.
Brought to you by Charcot Awarenes Education Foundation
Heading Home After Hospital Stay
Max, my husband, decided he would be my caregiver. I was happy about this as I wasn’t excited about going to a care facility. I had visited friends there for rehabilitation and they didn’t seen very happy. Since the RV and the van were here and I was now unable to drive, he went to Silverdale to bring our son back to transport me home.
It was good to see Justin. Friends in my water aerobics class loaned me a wheel chair. After lunch on Friday and caring good-byes with thumbs up from staff, I was wheeled to the elevator and to the front of the hospital. The new venture of getting into a van for the ride home began. Max put pillows for me to lean against behind the drivers seat. I sat down on the back seat and began the slide. Using my left foot to help and my hands to lift my bottom in order to scoot. Max had to hold my right foot up. Once in place, the foot had to be elevated with more pillows. The seat belt clasps were very uncomfortable. We soon learned we needed to cover them and my sitting on a pillow made the sliding easier.
We drove to the RV where we left Max and our two kitties to head home. Yes, our kitties came along. Justin drove me. Our drive was about an hour and a half. Once home, we began the reverse, getting me out of the back seat and into the wheel chair. I couldn’t go into the main part of the house because of the stairs. The studio has a ground level entry so that would be our destination. It was so good to see the peacock hen that had come to live with us and all the other wild life around. The only real problem was getting into the studio. It was easier to turn the chair around and take me in backward over the threshold.
The hospital had sent lots of things home with me to make Max’s and my life easier; ice packs, special wash cloths and even wash caps for my hair. This was to be about three months with the Orbital Fixator. When it was to be removed there would be surgery on the toes.
It was good to be home and in my own bed, though after a while it wasn’t comfortable either. It was a very old mattress and as I said before, I’m not a back sleeper. So I was dozing off and on all day. I must admit I wasn’t sleeping very well at night. Since I love to talk, the phone was busy except when Max was on the computer in the room next door. I then used the cell phone. I had a stack of news papers I needed to sort so that became a task. Friends brought magazines, crossword puzzles, recorded programs, movies and other things to keep me busy. Everyone was so wonderful. I really enjoyed the many visits from friends and especially my “Pool Buddy” group. Flowers from friends and neighbors brightened my attitude and all of this helped with the recovery.
loved looking outside watching the deer as mom brought her twin fawns to show us, various birds especially the pea hen. She would come to the window near my bed and cock her head. I would talk with her. She would cluck or squawk as if to respond. ViVi, our Manx, even brought a kangaroo mouse in to entertain me. We thought we were going to have to learn to play “Dodge Mouse”, but she soon tired of the event and ate the creature. Dusty, our Burmese cat, stayed near at hand not understanding this entire scene.
Now for the first apointment after surgery.
Hospital Room After Surgery
Waking in my room at 4:30 PM was a surprise as it was so late. It was really good to see Max. Prior to the surgery, we were told to expect a two week stay. Since I am a diabetic, there was a concern about healing and keeping the blood sugar under control.
My medication was stopped prior to surgery. It was explained to me that they could control high blood sugar easier than low blood sugar as they could use insulin during surgery. I understood this, but during the hospital stay, it became an issue in no time. I was on the diabetic diet. I have been pretty conscience of how my body reacted to various foods. This diet was quite limited, but tolerable. I ordered my evening meal. Shortly after eating it, they gave me my regular meds. Within a half hour, they came in and took my blood reading. It was high. A young intern entered the room to give me an insulin shot. I refused it. She was upset as I explained I had been given my regular meds and they hadn’t had time to work. She came back with a supervisor. I explained everything to her. She asked if they could take a reading later. I had no problem with that. They left.
Several hours later, the night nurse came in. He took my blood reading. It was a bit high. I said I would take the insulin. He said I didn’t need it. I was surprised. Next morning, I had my normal reading back. I was really happy. The doctor in charge of internal medicine came in and wanted to monitor me very closely because of the happenings the day before. The morning I was released she came back to compliment me for keeping my blood sugar so well under control and knowing what worked for me.
Saturday, Dr. Roukis came in to see me. He explained things and told me he was going to take my pain medication away. I about panicked and asked what I should do if I needed them. He said he wasn’t taking them away totally, but that I had to ask for them if I needed them. Having never needed pain medication, I asked when would I know if I needed it. He said, “When you are in tears.” Fortunately, that never happened. I never did need them
Every morning, I was awakened by Alice, an intern, who worked with Dr. Roukis and Dr. Sweinberger. She was delightful and will make a wonderful Doctor. The team really made the stay pleasant. Even those that took your blood were great. I loved hearing their stories. Many of them just back from Iraq. They always helped in any way they could.
On Wednesday, I began to vomit. No real reason for it, but I was promptly put on a clear liquid diet. Even the kitchen staff felt sorry for me when I called in my meal request. Talk about a limited diet. It was comprised, mainly, of clear broth and Sierra Mist Free. They did let me have a packet (table spoon size) of peanut butter handy if my blood sugar dropped too low.
My right foot and lower leg was in the Orbital Fixator. It was so 
heavy. I could hardly move. My left was warped in a contraption that simulated muscle movement. I’m not a back sleeper so this was tough. There was a small TV near my bed. I left it on all the time, sleeping or watching TV, off and on all night. I had lots of time to think. The window in my room was very large and I had the best view in the world of Mt. Rainier. It was beautiful when the sun came up. Some mornings the clouds were a gentle pink in the sun rise. It gave me hope and started my day off beautifully.
One thing I hadn’t expected was facing getting up out of bed and walking. When the physical therapist came in, he asked me to sit up, dangling my feet over the side of the bed. Not to bad. Then slide down putting my weight on my left foot and no weight on the right. WOW! What a sensation as the blood rushed creating a type of pain I had never experienced. The Orbital Fixator was heavy. My leg had been elevated the entire time and iced about every 20 minutes of an hour. I learned to hop on my left foot using a walker. He also gave me a number of exercises to do any time I could. These helped as I needed to build strength.
I was surprised when Dr. Roukis came in and told me I could go 
home Friday, nearly a week early. Everything was going well. I was excited about leaving, but at the same time sad, as I didn’t want to say good-bye to such a wonderful group of people. When I called for my Friday noon meal, I asked if I was still on the clear liquid diet. She told me no, and that I could have anything on the menu. I asked if I could have a tuna sandwich. She said, “of course”. When I got it, it was huge, filled with about 4 times more tuna than usual. It tasted soooo good.
Note the bone growth stimulator on my foot. (above the menu) This was to help my body accept the artificial bone in my foot.
Now for the ride home.
Annita Shaw authored this weeks article
Brought to you by Carcot Awareness Education Foundation