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Old 02-19-2014, 11:46 PM   #106
Rex Nemo OP
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Damn, that looks like hell! Also rather familiar, sadly. I'm glad I didn't have to deal with a neck injury and a staph infection on top of my already-existing injury! Good thing we humans are so resilient.

The 3rd metatarsal seems to have moved back closer into line, and remained there. The surgeon today felt it and said, "Huh. Well, good!"

An ADVrider fella came over a little while ago, looked at the DR350 in the faint glow of my backyard lights, and kicked it over pretty easily. He rode it around and came back and handed me a wad of bills...and full of feelings of regret and relief and closure and uncertainty, I watched him ride away on the slick and shining streets in the rain. May they have excellent adventures together.

I took a rifle class at the local range this weekend, and was actually able to hobble up and down the range, transition from prone shooting position to sitting, kneeling and standing, even under time pressure--pretty proud about that. I was also faced with the realization that my ability to concentrate and my energy levels are greatly reduced from the levels they once occupied. This made the first day frustrating--my shooting was all over the place and I couldn't get a handle on what I was doing wrong. Fortunately things started to come together the second day and went much better. Resilience! It will take a while to work back to hyper-alert motorcyclist mode, nonetheless. Another goal to work towards.



Unfortunately I injured myself overdoing it in the lap pool yesterday. I tried a little water jogging and suddenly it felt as if hot knives were slicing through the butter of my foot. I got to the edge of the pool and got myself under control with some pain-breathing exercises and some help from my partner, but the damage was done. Went in to see the surgeon and the physical therapist today, and was told I likely injured my arch from overdoing exercise before the foot was fully stabilized. They think the tibialis anterior tendon is probably inflamed, and there is likely at least one large nerve that gets pinched by the screws in the foot.

Did not get reassurance; got serious faces and "hmm" and "I'm surprised there wasn't more nerve pain before now" and a prescription for rest, ice, elevation...and neurontin. They want to prevent a chronic pain cycle from beginning. Gah.

For now, it's back on the crutches.


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Old 02-26-2014, 09:44 PM   #107
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So sorry to hear about your set back. I went through much the same with a badly broken knee in 1968. Had it replaced in Feb. 2000. Went from 32 years of pain 24/7 to 0 after the recovery from the replacement.

Please keep us up dated, and good luck.
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Old 02-27-2014, 05:54 AM   #108
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I'm not overly familiar with foot anatomy, but I can tell you that compartment syndrome is no laughing matter. You could have easily lost your foot / toes from unrecognized compartment syndrome.

I've also witnessed a fasciotomy (How they relieve the pressure in the muscle compartment) in person .
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Old 03-05-2014, 10:04 AM   #109
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Yuuup--I had never heard of compartment syndrome til I nearly lost a limb. Yow. I was very grateful to the young intern who recognized it. I'm told that if a fasciotomy is not performed within 6 hours of developing compartment syndrome, limb/extremity use is severely reduced, permanently.

As for the pressure, well, the surgeon said that it was good they were wearing face shields when they performed the fasciotomy, because it was so built up in there that I squirted the hell out of the first person to insert her scalpel!

Fortunately my setback has been brief, I've been able to manage pain with ibuprofen instead of gabapentin, and I have been able to return to exercise gradually and carefully. Just a reminder to take it really slow and not get cocky.
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Old 05-29-2014, 09:16 AM   #110
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I have so much progress to report! For now, I'm a touch perversely proud of being a minor footnote in the annals of Science. Here's a poster presentation given on my case recently--glad I could help my surgeon and several interns advance their careers a little, and hopefully treat trauma patients a little more effectively in the future.

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Old 05-29-2014, 03:33 PM   #111
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Puns abound herein and warrant further lay treatment. For now I'll just say you've underwritten numerous student loans, car payments, mortgages, swimming pools etc. Would that the assessment, treatment and recovery process been so concise and clinical from your perspective. "Pain out of proportion" indeed.

Quote:
Originally Posted by Rex Nemo View Post
I have so much progress to report! For now, I'm a touch perversely proud of being a minor footnote in the annals of Science. Here's a poster presentation given on my case recently--glad I could help my surgeon and several interns advance their careers a little, and hopefully treat trauma patients a little more effectively in the future.
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Old 06-20-2014, 05:08 PM   #112
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After much struggle, pain, and surgeon-convincing, I have a surgery date coming up to remove the bone screws! I've been developing bony growths near the tips of the large 1st metatarsal screws, and they make it tough to wear firm shoes (like, oh, motorcycle boots), and walk long distances. One of my tendons has a pesky habit of snapping across one bony spot like a painful rubber band--really lights me up for a few minutes when that happens.

I'm not looking forward to the same old round of surgery, opiates, constipation, limited mobility, pain and recovery...I had never wanted to see the peg leg or the shower chair again. But what a relief to have those ouchy metal foreign objects out of my flesh and bone!

After topping out at the 5-mile hiking mark and having continued irritation I started to push the reluctant surgeon to take the dang screws out. First he wanted to try a corticosteroid injection...



it helped once the butchered injection site healed (they brought in a couple of really novice students to inject the stuff, and they bent the needle, got stuck, missed the right spot, pushed into the bone, you name it--while I laughed and grimaced). Still, the irritation remained, so at last the surgeon agreed that it was time to take those suckers out.

In the meanwhile I have been breathing deep and engaging with a little mild PTSD and RIDING.



No dirt yet, but commuting to work, easing down the twisty roads, and doing errands on the bike again is an intense experience. I get shivers of fear interspersed with overwhelming jolts of pure physical joy...while trying to just be cool and ride it all out. One mile at a time.
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Old 06-20-2014, 11:26 PM   #113
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had a few screws removed form my left foot after they began rubbing against other bones but they never turned my toe nails green like yours hope it all heals up well for ya - cortisone injections suck
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Old 07-08-2014, 11:25 PM   #114
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Yeah, I try to keep the local podiatry department entertained with my colorful toenail polish. The corticosteroid injection actually proved to be pretty helpful; over the course of a week I could feel an easing of pain travel from the main (peroneal) nerve along the top of my foot, and spread as the nerve splits into 5 and heads to each toe. Pretty cool.

Been doing well--more riding (even one little overnighter camping trip a couple of weeks ago!), and the PTSD symptoms are easing up. Bicycling, working out in the gym, working more, etc. Just wish I could get these darn bone screws out.

I was supposed to have surgery this Monday...but got a call from the surgeon's office on Friday: Your insurance company has declined to cover the hardware removal, surgery's cancelled.

The surgeon is appealing; we'll see what comes of it. I can live with things this way, but I'm pretty steamed about having my mobility level decided by faceless corporate functionaries.
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Old 09-28-2014, 12:15 AM   #115
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The insurance company ended up flatly denying my claim, but after several months of appeals, workarounds, and negotiation, another surgery date was set for the end of September. I've been riding my bicycle, hitting the gym consistently, worn out a pair of running shoes (while walking) and am on to the next, and have been GOING ON RIDES again.

After many hard months of sadistic, yet strangely helpful, physical therapy, Evil Yoda (my physical therapist) has cut me loose. "You're doing great. Nothing more I can do with you with those bone screws still in--you have hardware irritation. Come back when you get 'em out and we'll do some more."

This means I needed to do some more adaptation, beginning with a revamp of my footwear. Sadly, I was forced to admit that the Sidi Crossfires I'd bought while laid up were not going to work. I'd bought them, put them in my bedroom where I could look at them and dream of riding, and anticipated wearing them again; but when I climbed on the bike and rode, I discovered that the narrow fit of the Sidis just no longer matches my custom-widened left foot. Damhik.

My touring boots (Aerostich Combat Tourers) worked ok, but did hurt some during the little bike camping overnighter I did to Fort Ross back near the solstice. I tried to pour warm water into them and wear them around for a day, which made them marginally more comfortable and hurt my feet a good bit. Hmmm. Back to the drawing board. And in the meantime I was about to head off with my GF on my first real moto tour since the wreck, up to the Oregon coast...it was looking uncomfortable for our hero.

Fortunately, I popped into Scuderia West in SF to say hi to a friend...and ended up with new boots.



These are Forma Adventures (made in Croatia by an Italian company). They have a nice wide toe box and a slightly stubby fit, which happens to match my danger foot quite well. They're quite light, with a bit of the look and feel of a hiking boot and decent protection; they have hard malleolus cups, a stiff leather upper that rises to mid calf, and three-buckle closure. They're also supposedly waterproof, which if you know my luck, will soon be very well tested.



I'll continue to search for dirt boots that fit; in the meantime, these will make good street boots, I think. Yep, I did that inadvisable thing and headed off into the boonies with new gear. (It worked out just fine, amazingly--great boots. Waterproof, too.)

But can I tell you how exciting it was to be heading off again, with my love, onto the road, into the mountains and up the coast and into the forest? Oil changed, chains lubed, tire pressure set, charging systems evaluated, packed up...Oregon, here we come.
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Old 09-28-2014, 12:20 AM   #116
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Riding and hiking are two of my favorite ways to explore the world, and I've been quite giddy with delight at getting them back. I was stuck at the 6-mile mark, but still, just getting out of bed and walking through my own place on feet that work is delicious, let alone a stroll in the redwoods or an evening ride. Hard earned, all of it.

T and I even managed a ride (with the help of the new boots and the good old DR650s) to the Oregon Coast and back, after all. Crater Lake, the ocean, her family, the redwoods, fires, rivers, the whole world open to exploring again...yes.





I got to walk the mosaic stairs of SF with my sweetheart the other day, too. I admit that I was grateful to Evil Yoda the PT when I was able to trot up and down the hundreds of stairs with so little trouble.



In preparation for the surgery a couple of days ago, I walked and hiked as many miles as my foot could stand, and rode whenever I got the chance, even to the grocery store, the bank and every other errand I could arrange. The day before the surgery I set a personal record: 6.2 miles in Redwood Park; the GF and I watched the ladybugs congregate for the winter in their great cuddle-piles. One even landed on one of my scars...a good omen. The intensity of bay and redwood scent in the air was amazing, and we watched the storm front lazily swirling in.





Tomorrow, I mused to myself as I stayed up, sleepless, the needle hits the record. I was hoping be out of the hospital with a couple of bone screws and a story to tell, by late afternoon. Fingers crossed. Toes crossed.

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Old 09-28-2014, 12:29 AM   #117
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Surgery day! I figured that screw removal was going to be a relatively minor procedure, but after all the damage and endless slogs to the hospital and surgeries before, I was unduly jumpy about the prospect.

I got into the prep room early, and got a quick stick from the great nurse there, once I explained that we should run the IV immediately; I am an easy stick until I get dehydrated, then it's a rodeo in my vein. I did get disapproved at for keeping my cell phone on me into the operating room, but a woman needs tools. ;)





I had to paint my toes in sparkly gay colors for luck. Revealing them cracked up the OR staff, too, especially with the arrow of the left foot and the "NO" I'd sharpied on the other foot. You can't be too sure!





I managed to talk the surgeons and anesthesiologist into doing a nerve block instead of full anaesthesia. I had a bit of a fantasy of gritting my teeth in fascinated horror as they sliced me open and wrenched the screws out, but of course as soon as the first little trickle of sedation hit I was out like a light. It was a much gentler awakening than the fog, lost time, nausea and struggle for consciousness that general anaesthesia allows, though.

In any case, I was sent home in the afternoon, helped in my hightail from Highland by my GF, who took me out for celebratory pancakes and painkiller.





I'm hobbling around and back on my good ol' knee scooter for a few days, but the incisions are quite small, and healing seems to be going fine. There's an ache in the voids in the bone left by pulling the screws, but it's not bad at all. One of the surgeons assured me that cancellous (spongy) bone will fill in the gap left by the screw removal in just a few days; the stronger cortical bone, however, will take a good bit longer to form a callus and achieve full strength.
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Old 10-05-2014, 04:39 AM   #118
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Just found this Nemo, and it was quite a read.
Glad you seem to be doing better.
As an aside, I'm sure I know who your "evil Yoda" PT is. I had her for a severe AC separation and she's awesome.
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Old 10-05-2014, 08:43 AM   #119
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Wow, that is quite the adventure of a recovery. I wish you all the best in your continued road to full recovery.

You sure opened my eyes to the value of very good boots! And for that alone, I really thank you.

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Old 10-05-2014, 07:44 PM   #120
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Great to see those toe nail colours along with your foot are improving

A solid pair of boots is an absolute must for any motorcyclist - foot injuries are so frustrating and painful - I ended up with complex regional pain syndrome in mine which is permanent and I'm sure had I been wearing MX boots instead of cheap but comfortable "adventure" ones I'd have avoided that outcome....lesson learnt I only ride with tech 10 alpine stars now.
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