I write this 36 days after my main orthopedic operation (what my consultant once referred to as 'just guddled around a bit and got lucky'). A number of people mentioned 'physio' in hushed and slightly strained tones. I knew it would be good for me - I knew I would have to do it - but somehow couldn't quite imagine what it would entail. In retrospect this was probably just as well...
The first 2 physios I met were in St Johns. The first ten minute session was to teach me how to walk on crutches - and the second entailed hopping up the stairs. No exercises were mentioned. I figured I had got off lightly. Three days later, having been discharged - I met my third physio - again at St Johns, but this time a foot specialist. My right foot had dropped a bit and we would need to work it to bring it back. I was issued with a blue strip of rubber and a handwritten sheet of exercises. These included the dreaded 'foot pull', the slightly less dreadful 'knee press' and the hideously hard 'leg lift' to work the thigh muscles.
Back in Pathhead, my carer and I tackled these with cautious gusto - 2 days later we had clearly overdone it - excruciating night pain meant 10 sleepless hours. I bleeped the physio the next morning and explained. 'You should have started with 5 repeats, not 10..'. she said So lesson learned - do not overdo the physio - we duly cut back - a couple of gentle pulls 2 or 3 times a day.
Two weeks later I get the appointment for the community physio - at 9am on a Monday. Ever tried to do exercise first thing in the morning - noted a certain stiffness in the muscles? Indeed - and this is why, when I perched on the treatment table, my leg wouldn't do a damn thing - and to add insult to injury - it hurt as well - so much that I nearly fainted. The physio was kind - said she would like to see me a couple of times a week but had a heavy case load so once a week might be all that was possible. Issued with a couple of new exercises I left, bitterly disappointed at my poor performance, but still not anxious about the physio.
In the meantime. I had obtained an extra appointment with the consultant to talk to him about pain management. I duly arrived at OPD 6 at the Royal Infirmary. According to the whiteboard, my consultant was to see 26 people that afternoon, including me. I joined the masses (after an arduous journey around the hospital trying to find a wheelchair. Apparently the wheelchairs are £600 each and there are simply not enough of them. There were none at the back entrance, the closest entrance to the car park. There was no signage to the door to OPD 6 which would have meant no wheelchair was required at all.)
My name was called. Off to another waiting area. My name called again - this time for an X Ray. A further 20 minutes and again my name called - wheeled almost into the consultant's room - but no - not allowed in because of my plaster cast. Would have to go to the plaster room. Another wait - and then we are in.
On the treatment bed a nurse advanced towards me with large blunt scissors and attacked the bandages. I blanched - 'keep away from the skin flap'. She continued 'I've done this a thousand times'. 'Not to me you haven't'. She relented and changed tack. The bandages and cast were removed and the consultant examined my foot. Then all hell broke loose. Apparently my foot had dropped far more than expected - he hauled it into what we now know to be the 'neutral position'. I wept. People gathered round - physios, nurses, a medical student, possibly a junior doctor although I was never introduced, and an othoist. Between them they examined and stretched and pulled at my foot. The pain was intense. But the planned conversation about the pain became a lower priority - my foot had to be sorted - we could worry about pain later.
The consultant decided I was to wear a moon boot. This instrument of torture (black velcro and plastic - a bit like a backless ski boot) was fitted by the orthoist. Similar to the concept of a brace for sorting out teeth the moonboot pushes the foot back into the neutral position through sheer brute force. I wanted to head home. No - off to the physio again. I was wheeled into a small office. The boot was to come off and I would have a few more stretches. 'No' I said - no more. They relented. Showed me a couple more exercises involving a towel, booked me in for several more appointments, and I was off.
The boot hurt - a lot. Pain killers didn't help, nor did my wimpering. But, with my carer (handily also a yoga teacher) we followed our instructions. On Christmas eve the next day, we were back for the final appointment before the holidays. I had the physio room all to myself - and 2 physios. To my astonishment, almost half of the session was spent massaging my leg - in an attempt to stop adhesions under the scars. The final foot exercises were uncomfortable, but free of tears - until the physio put my foot back into the moonboot - the pain in my calf was searing and sudden - but over in a minute. We left, almost jubilant.
Since then we have followed instructions to the letter. Four sessions a day, two involving the massage, all involving discomfort, and all requiring major input from my carer. We can see the progress. My foot is coming up towards neutral, the swelling has receded from the toes and (horrors - sorry folks) - the dead skin is falling of the sole- ably helped by litres of almond oil. Next week I have another three appointments, where the work will continue. And of course once my foot is in position, the next phase starts, working my foot beyond neutral - there is no end to this, simply more beginnings. And the toughest bit of all - not to accept pain from others (eg, the physiotherapist) but to inflict it on myself four times a day so that I can learn to walk again at some date yet not determined...
The first 2 physios I met were in St Johns. The first ten minute session was to teach me how to walk on crutches - and the second entailed hopping up the stairs. No exercises were mentioned. I figured I had got off lightly. Three days later, having been discharged - I met my third physio - again at St Johns, but this time a foot specialist. My right foot had dropped a bit and we would need to work it to bring it back. I was issued with a blue strip of rubber and a handwritten sheet of exercises. These included the dreaded 'foot pull', the slightly less dreadful 'knee press' and the hideously hard 'leg lift' to work the thigh muscles.
Back in Pathhead, my carer and I tackled these with cautious gusto - 2 days later we had clearly overdone it - excruciating night pain meant 10 sleepless hours. I bleeped the physio the next morning and explained. 'You should have started with 5 repeats, not 10..'. she said So lesson learned - do not overdo the physio - we duly cut back - a couple of gentle pulls 2 or 3 times a day.
Two weeks later I get the appointment for the community physio - at 9am on a Monday. Ever tried to do exercise first thing in the morning - noted a certain stiffness in the muscles? Indeed - and this is why, when I perched on the treatment table, my leg wouldn't do a damn thing - and to add insult to injury - it hurt as well - so much that I nearly fainted. The physio was kind - said she would like to see me a couple of times a week but had a heavy case load so once a week might be all that was possible. Issued with a couple of new exercises I left, bitterly disappointed at my poor performance, but still not anxious about the physio.
In the meantime. I had obtained an extra appointment with the consultant to talk to him about pain management. I duly arrived at OPD 6 at the Royal Infirmary. According to the whiteboard, my consultant was to see 26 people that afternoon, including me. I joined the masses (after an arduous journey around the hospital trying to find a wheelchair. Apparently the wheelchairs are £600 each and there are simply not enough of them. There were none at the back entrance, the closest entrance to the car park. There was no signage to the door to OPD 6 which would have meant no wheelchair was required at all.)
My name was called. Off to another waiting area. My name called again - this time for an X Ray. A further 20 minutes and again my name called - wheeled almost into the consultant's room - but no - not allowed in because of my plaster cast. Would have to go to the plaster room. Another wait - and then we are in.
On the treatment bed a nurse advanced towards me with large blunt scissors and attacked the bandages. I blanched - 'keep away from the skin flap'. She continued 'I've done this a thousand times'. 'Not to me you haven't'. She relented and changed tack. The bandages and cast were removed and the consultant examined my foot. Then all hell broke loose. Apparently my foot had dropped far more than expected - he hauled it into what we now know to be the 'neutral position'. I wept. People gathered round - physios, nurses, a medical student, possibly a junior doctor although I was never introduced, and an othoist. Between them they examined and stretched and pulled at my foot. The pain was intense. But the planned conversation about the pain became a lower priority - my foot had to be sorted - we could worry about pain later.
The consultant decided I was to wear a moon boot. This instrument of torture (black velcro and plastic - a bit like a backless ski boot) was fitted by the orthoist. Similar to the concept of a brace for sorting out teeth the moonboot pushes the foot back into the neutral position through sheer brute force. I wanted to head home. No - off to the physio again. I was wheeled into a small office. The boot was to come off and I would have a few more stretches. 'No' I said - no more. They relented. Showed me a couple more exercises involving a towel, booked me in for several more appointments, and I was off.
The boot hurt - a lot. Pain killers didn't help, nor did my wimpering. But, with my carer (handily also a yoga teacher) we followed our instructions. On Christmas eve the next day, we were back for the final appointment before the holidays. I had the physio room all to myself - and 2 physios. To my astonishment, almost half of the session was spent massaging my leg - in an attempt to stop adhesions under the scars. The final foot exercises were uncomfortable, but free of tears - until the physio put my foot back into the moonboot - the pain in my calf was searing and sudden - but over in a minute. We left, almost jubilant.
Since then we have followed instructions to the letter. Four sessions a day, two involving the massage, all involving discomfort, and all requiring major input from my carer. We can see the progress. My foot is coming up towards neutral, the swelling has receded from the toes and (horrors - sorry folks) - the dead skin is falling of the sole- ably helped by litres of almond oil. Next week I have another three appointments, where the work will continue. And of course once my foot is in position, the next phase starts, working my foot beyond neutral - there is no end to this, simply more beginnings. And the toughest bit of all - not to accept pain from others (eg, the physiotherapist) but to inflict it on myself four times a day so that I can learn to walk again at some date yet not determined...
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