Sunday, November 30, 2014

Three Years

Earlier in the day I had to write a check, and when I asked what the date was, it dawned on me.....Wow, today is the third year anniversary of my accident.   I think it is a good thing that this particular date did not loom
Red Rock Canyon with friends, Nov 30, 2012
over me as it had the first year (I had to plan a trip to NV for that one to keep occupied...and it was great.)   Still, November 30th marks an important life change, and I am honoring that today.

What. a. whirlwind.   Seriously.   I think I have only come to realize recently that I no longer feel like a "patient" (as I had for over two years).   Planning for and recovering from multiple surgeries can really wear on a person and a family.  Not that prosthetic adjustments aren't a drag, but the experience is much different....with the added perks of decreased pain when walking, and support from the amputee community.

Scott and I frequently comment on the increased amount of gray in his hair and sense of tiredness we both feel.  Some of that has to do with having kids as "middle-agers", but a great deal of the fatigue also has to do with lingering issues from my accident.  It can be tempting to long for the pre- accident body (okay, I do every day), but I try to focus more on what I have gained. 

A great sense of community.   Nothing quite brings people together like sharing struggles and triumphs.    And just as I curse a bad leg day or high back pain day, I am reminded of the others who I have met throughout the past three years who are also great warriors in the physical healing journey.   We are a tattered bunch, but I've met so many folks who really rock!

A better handle on priorities.   I used to sweat the small stuff.  A lot.   The things that used to drag me down don't have the grip that they used to.  That is an awesome thing.   Life is too short to worry about stupid shit.

A different focus.   Kind of like savoring a good meal, I'm trying to savor life experiences.   It is a focus on enjoying the journey, with less emphasis on the destination than the rich experience of getting there.    This pertains to parenting as well as all kinds of goals, and is a major shift in thinking.    (It also feels pretty counter-cultural.)

Appreciation.  For my family, friends, and the health of my loved ones.   For new relationships gained.  For the seasons and nature.   For my pets (yes, snuggling with a purring kitty is so therapeutic!).  For the fact that I live in a place where I don't need to worry about war or where my next meal will come from.  For the kindness of people.

Cool Opportunities.   Because being active, for me, is like breathing, it has been super cool to bring my passion for adventure and climbing to others with physical disabilities.   I am enjoying the relationships I am making, and watching the possibilities unfold!

I saw this a while ago, and it seems pretty simple, but it is very true......

 
 

Monday, October 6, 2014

Keepin' it Real

I've been doing a lot of thinking lately about how tempting it can be to view folks with disabilities or physical challenges as victorious, or having somehow "arrived" at a great place despite their struggles and challenges.   While I soooo understand this tendency from a personal perspective, I have come to understand that truly, there is another reality that most of us do not see or fully comprehend, which is understandable.  We don't want to see pain.  We don't want to see struggle.  We want the Hollywood version which makes us feel better......... So, the main intention of this post is to stress the importance of keeping it real.  

Let me start by sharing what an incredible summer we had.  It was active, and full....and challenging.   In many ways I look at how it felt "victorious", but know that it was also very hard.   Dealing with a new reality IS hard  .....and it is something that I know I am not alone in.  

Behind the smiles, great scenery, and hands in the air, here's what you need to see:   I'm tired and sore.  I miss the old body.  Wearing a prosthetic liner in the summer sucks (I had to literally pour the sweat out more times than I can count.), Crabby kids and hurtin' mommy is not an optimal combination.   A "good leg day" is not always guaranteed, and neither is a day without back pain (on a typical day).   Trying to enjoy the process of finding the "new normal" is easier said than done.......but we try.  We keep plugging on, and try to grab a strong hold of the moments of gratitude we find along the way.


 It is a PRACTICE....cultivating gratitude.   The love and kindness of people and the beauty of nature are great strongholds.   They help to pull us through and give us fuel to keep going, thank god.  

I was asked to write about my experience in the Trauma Survivor's Network, Fall Newsletter, and you can read that here.   I've had the pleasure of helping to create a peer-support program at Froedtert Hospital and am delighted that it is going well.  We have some great volunteers...other survivors who understand what it is like to keep going, despite difficulty.   Recently we've received some great feedback from staff and patients there!  This always helps to validate the importance of sharing how it is.....and keeping on, keeping on.     


As is usually the case at this time of the year (when the weather starts to turn, and I begin to become more reflective), I found that it would be a good time to put together a gratitude collage.   This is by no means, exhaustive.....and it will be growing.    There are times when I think about how awesome it would be to return to the "old" (pre-accident) me.   Then I think about all of the great relationships that have resulted, the amazing people I have met, and the profound experiences I have had....AS A RESULT of my accident.   I would not take those back.   

    High-five my warrior-friends...and as always......CLIMB ON! 

    Chris  

Thursday, June 19, 2014

The Cool Folks You Meet...

A few weeks ago, my daughter asked:  "Mommy, is it fun being an amputee?"   After chuckling for a moment with a raised eyebrow in utter disbelief that she'd ask such a question, I gathered my thoughts and replied:  "Um...I wouldn't exactly call it fun.  But I guess there are parts that are:  You get to pick out the kind of foot you want, you can pick out cool patterns to laminate into your socket, and oh....we get to meet so many really interesting people."    "Yeah....that's what I mean."  Jade said... "It's neat to meet all kinds of cool people who do such amazing things."   

So I have pondered that comment frequently......and, when I'm in a space where I'm frustrated for some reason (which happens a lot, believe me)  I think about all of the awesome relationships and experiences I am collecting.   Pretty damn cool.  

DWTS' and snowboarding paralympian, Amy Purdy,
Accomplished para- climber, Ronnie Dickson, and moi.at
Prosthetic and Orthotic Associates
I am down at Prosthetic and Orthotic Associates this week for a new socket (I am the "incredible shrinking woman"....at least in my prosthetic socket.).  It just so-happened that Amy Purdy (from Dancing With the Stars) was also here yesterday and today having some adjustments done.   We ended up having some cool discussions about keeping a positive attitude, how to walk around on the toes of a swim-foot, and expectations with limb-shrinkage as a BK amputee.   She really is quite the lady, with lots of interesting developments on the horizon....one of them, writing a book.   The casual atmosphere at POA is great for just sitting around and chatting about all kinds of things, which is really important.
 
Ronnie Dickson works at POA as a prosthetist, and is also an awesome climber.   He's an AK (above-knee) amputee who I had connected with initially when looking for information about climbing in a prosthesis.  As I began to share my various prosthetic frustrations with him, he encouraged me to come to POA because of the incredible work they do in an expedited fashion, as well as their great track-record with highly active and tough-to-fit amputees.    When I got to POA and began to meet all of the people, the energy was palpable.    Dozens of amputees, all with amazing stories.....some with prosthetics, some crutching or wheeling around, hanging out in the same space just getting to know each other.   A "bonus" is the fact that a lot of the prosthetists at POA are themselves, amputees....so they get it.  A healthy, good-natured banter abounds, and folks are constantly sharing about how they love their jobs.    It's the atmosphere their CEO, Stan has created and fostered....and really works.
 
It has been very neat to see a lot of the researching and efforts I put time into while recovering, finally coming to fruition (I was the research-demon on the net while on bedrest!  I guess while my body was laid-up, the brain worked overtime).   The Trauma Survivor's Network has partnered with Froedtert Hospital, and a peer support visitation / support program is being implemented.  We currently have four very cool survivors of trauma on-board (me being one of them) who will finish up training this summer and launch the program within the month.   Pretty exciting!   We are starting up a climbing program in partnership with Adventure Rock and Adaptive Adventures, and will have a climbing wall at the Milwaukee Adaptive Sports and Recreation Expo on July 26th.  I've connected up with the folks at Paradox Sports in CO for some good advice on starting a climbing program in our area as well.   We are lucky to have the support of the Director of Clinical Services in the Physical Therapy Dept. at Carroll University, who has decided to weave-in the idea of educating her students in the power of using adaptive sports and recreation as part of the rehabilitation process (I had the pleasure of sharing [through the lens of understanding recovery to be a "mind/body/spirit" experience] with her graduate class last month, and will again in the fall.)  Luckily, these students will learn first-hand the power of connecting through physical activity and adventure sports. 
 
In all of these experiences I have met the most interesting, colorful, fascinating people, and the experience has been so enriching.   
 
So, when I grumble about how frustrating it is to have undergone 2+ years of atrophy and various levels of deconditioning, how I miss the ease at which I used to get out of bed in the morning, or how I hate to pour sweat out of my liner (which happens in the summer....pretty gross), I pause to remember that I'm part of an awesome group of soulful survivors, which is pretty cool.     

 


Saturday, May 31, 2014

Kinda like....another kid

We had reason to recall recently, the scared shitless slightly comical situation whereby I had a positive pregnancy test result on the morning of my amputation surgery (pregnancy testing is routine / mandatory for women of child-bearing age prior to surgeries).   Thankfully, the test turned out to be a false-positive, but for about an hour....while waiting for confirmation of the blood test....we spoke of mother nature's sick sense of humor.    Frequently when asked how we'd feel to be "blessed" with another child, my standard response has been "Our two are kind of a handful...more than enough work for a gimpy mom and two ADHD-inclined parents.  So, no thank you.  We're good."

Oddly, over the last couple of weeks  it has occurred to me just how much my leg situation IS very
much like having another child.  Yes....a very consuming, energy-draining, high-maintenance and often colicky little turd that acts up at the most inopportune times.   

Take for example, schlepping around the eternal diaper bag.   Yup....carrying what I call my leg stash (a bag containing: prosthetic ointment [eg. Desitin], spray bottle of water/alcohol [for donning / doffing the liner], allen wrench [on-the-go foot adjustments], an array of various ply's of socks [volume fluctuations throughout the day...socks are necessary], pieces of moleskin to help with occasional socket trouble-spots, a cloth, and rubber gloves [ointment gets slimy and messy at times, and hand-washing facilities are not always nearby.].)  What do we do when our colicky little one needs a changing?   Find a bathroom, inconspicuous corner, or out-of-the-way place to take care of business....preferably with the least amount of attention possible.    Let's face it, no one likes to witness a foul-smelling diaper change or a leg-ointment application. 

Every morning....the dreaded routines (bottles, formula, diaper changes, etc.) take some time.....and it is time where you wish you could be doing something else, right?   The whole leg thing is similar....and while the leg does "mature" (relatively speaking), it will never outgrow this morning / evening ritual or become fully self-sufficient.  

We like to look back on our "pre-children" days, and will frequently comment that we used to be the kind of folks who were punctual.   Either we would be a couple minutes early, right on-time, or "fashionably late."  Everyone knows that children throw a monkey wrench into the deal, but a colicky stump is something most folks would have no idea about.   (....things like sweat, dietary and temperature changes will do it, as well as over-doing it, which I am prone to doing.  Guess I'm stubborn.).   It is not uncommon for the fam to wait because "mommy has to sock-up" or adjust a fit. 

The oldest child is typically the one to help out with the responsibilities of the new baby in the family, right?   Well, I guess Jade has lived up to that one too, as she'll often yell to me from another room, "Mommy, do you want me to bring you your leg?"  Luckily we laugh about these oddities.  I mean, what kind of parent asks their kids to fetch their body parts anyway?  

While all of these issues amount to being a pain-in-the-arsh at worst,   At best, I'm able to walk around, hike, swim, climb and enjoy a much better quality of life.  (Running is a longer-term goal)  I
knew that there would be frustrations at the outset and that I should expect a 6-month to one year adjustment period.   Thankfully, I think I'm ahead of the curve on this one....which is great.   It is nice to know I'm done with medical stuff and moving on with a new normal.  
 
Yes, I'm nursing this infant-limb which is going through all kids of changes, but life is good.   We're moving ahead! 


Monday, April 21, 2014

The AIT (Amputee in Training) Experience

We are entering our second week in Florida as part of our dual purpose trip:  Family vacation, and expedited custom leg fitting.   It has been an odd balancing act for sure.  

In regard to my prosthetic fitting, I knew that I would be in for a frustrating six months to one year, as all of the amputees I have talked with warned me that it would be an adjustment with fits and starts, peppered with a whole lot of adjustment and increasing doses of patience.   I'm not quite sure why I've got this tendency to always believe that through my sheer force of will I will be the exception to those expectations.   I can work my butt off, find the right resources, or gut through the difficult transitions more quickly and somehow be spared the ugly realities of the amputee experience.   

Don't get me wrong, for the most part my leg / ankle is pain-free. I have no problems with phantom pain, which can be bothersome and disabling.   I have every reason to believe that eventually I will be back to enjoying the active life I love.   However honestly, all sugar-coating aside.....the experience has been tough at times.


 It is Amputee Awareness Month, so I figured why not air some of the dirt that we as amputees experience.    Here goes: 
  • Insurance hassles.   It's pretty obvious that folks need working limbs, right?   Well, unfortunately prosthetic coverage is one of the areas which falls through the cracks in terms of medical coverage.    The Amputee Coalition of America has initiated the Prosthetic Parity Bill, which aims to require fair health insurance access for amputees and provide a standard of care for prosthetic coverage.  It would be way cool to sign the petition asking senators and government reps to support this legislation.  Click HERE to support this effort, and if you do sign it, I'm sending a cyber-hug from the bottom of my heart on behalf amputees everywhere. This issue is huge.)  If you're interested in more advocacy, here's another petition:   Insurance Fairness Act for Amputees.
  • Socket-fitting issues.   Probably one of the most challenging issues for a new amputee, if not THE biggest frustration.  I've learned that there is both an art and a science to prosthetic design, and it is critical to have a prosthetic provider which embodies the best practice possible in that regard.  The "right touch" combined with dedication and passion are critical in the relationship between patient and prosthetist, and folks are known to travel wherever necessary for that combination of attributes.   
  • Shrinkage.  (No Seinfeld references here!) Within the first year all amputees undergo volume changes to their residual limb, which makes the fitting process a challenge (as well as continued documentation to insurance companies for those changes....see above.)
  • Skin issues.   Like today.  I've got itchy red bumps on the back of my knee, likely due to a combination of having shaven earlier in the week and sweating under my liner.   They suck.  And its best to air out the leg to avoid aggravating the problem for a day or two, lest we complicate the problem.  Usually we hope to figure out the source of the problem (like shaving probably, in my case) and hope that this is part of the "leg adjustment" phase.
  • Hairy Legs, baby!   Yup.... even in best-case scenarios, the little hair follicles scream "help me....I'm suffocating" under the silicone prosthetic liner.   So obviously, taking a razor to emerging hairs becomes even more problematic.   At some point I may attempt laser hair removal, but for now I get to be part Sasquatsch.  Oooo...sexy, hey?
  • Sweat happens....and under the prosthetic liner, sweat becomes trapped.  Now consider that I am a 45 year old woman who is on the brink of menopause.....you get the idea.   After doing eight miles on the stationary bike a few weeks ago, I was able to gross out my entire family by pouring what appeared to be at least a tablespoon of sweat from my liner.  There are some solutions to consider (prescription deodorant, botox, and a specialized absorbent prosthetic sock), but for now I'm trying to see if my limb will just get used to it.
  • The need to carry a stash of supplies (allen-wrench for the necessary emergency foot adjustments, extra prosthetic socks, prosthetic ointment and alcohol wipes, rag and other sundries)  at all times.  Ah....and don't forget the crutches for "bad leg days."  
  • A subtle, creeping guilt complex about all that I'm not able to do, the excess crabbiness which comes from pent up ongoing frustration AND the inability to parent my kids in a more active fashion.  We're coming up on 2 1/2 years of  "wait and see", so this feeling is not unfamiliar.   I just want to feel like a fun, not-so-crabby mom again.  I would imagine that these are common feelings among parents who are caught in a similar situation.
Luckily, this AIT experience is not without its positive aspects!  Truthfully, it has been said over and over again that becoming an "amp" is like becoming part of a family.  Folks with limb loss obviously "get" one another, and share the experience on a deep level.  They can also offer support, guidance, practical tips, and understanding.....often with a twist of good natured humor.  (the only problem with the amputee family is that it is expensive....it'll cost an arm and a leg to get in.)  


Ali, Rebecca and I had a great time entertaining folks at Jimmy Johns,
obviously blending in with the crowd.  We drew no attention whatsoever!  ;)
It was awesome to connect with these gals to share laughs as well as
helpful advice.  While Ali and Rebecca are both AK (above-knee) amputees,
I learned a lot tips from them as the "new amp on the block."


I met Rebecca through a mutual friend in the blogosphere over a year
ago, and was totally surprised to meet her at Prosthetic and Orthotic Associates
in Orlando.  A very cool chance meeting!   Rebecca lives in Philadelphia
and blogs at:: A Thousand Miles .  Check it out...she's got an amazing story!
 The experience of peer-support and sharing is really important.   I found that it was incredibly uplifting to be able to share experiences, questions, challenges, and concerns....as well as our stories.  I am continually amazed by the people I meet with the most amazing stories.  (I plan to do another post on this later....so stay tuned!)  

All of the folks at Prosthetic and Orthotic Associates have a passion for their work, as well as helping amputees regain an active lifestyle.   Folks from all over the world come to POA because of their custom fabrication and incredible team approach to solving prosthetic challenges, which many of us face.   The family-like atmosphere and team approach works really well, because "many eyes" looking at a prosthetic fitting issue are better than only one set.   What is also very cool is that a lot of folks working at POA are amputees themselves, which have an intimate understanding of the experience. .


I first learned about POA from Ronnie Dickson (pictured here working on my leg.)
Ronnie is an amazing climber, prosthetist, and above-knee amputee who shares
a passion for adaptive climbing.   He's also an awesome, caring guy with a very cool dog.
You can learn more about Ronnie here:  http://xt-9.com/ronnie_dickson.html.  Ronnie is
also heading up the National Paraclimbing Competition coming up in July in Atlanta, GA,
which sounds very exciting.
  
Part of my rehab includes gait training on the Alter-G...
an anti-gravity treadmill.  It felt great to be walking with a pretty normal gait
at 75 percent of my body-weight, and it was cool to be able to watch
my stride on the monitor.


POA works with lots of kiddos.  Here, Jade and Kai pose for a pic with
Bella (second from right) and her family.  Bella was adopted from the same
province Kai is from.....and as you can see, she's super-cute!
We are hoping to move ahead to create my definitive socket within the next couple of days.  I have been wearing a series of check-sockets (see-through plastic sockets which are modified through the fitting process to ensure the best fit), and am looking forward to receiving my lighter, carbon-fiber permanent socket once the proper fit has been achieved.   I anticipate continued changes throughout the months ahead as my limb matures, but we are definitely off to a great start.  

Sunday, March 16, 2014

Road Blocks

I never quite know what to say when folks tell me that I am a strong person or that I am an inspiration.  Truthfully, I've known myself for my whole life and do not find myself uniquely strong or inspiring.  Conversely, I tend to find myself more as just plain stubborn and determined, with the necessary thrust of human connection, peppered with a lot of grit and some occasional self-pity (okay, a lot of self-pity lately).  

Yeah, this week has been a rough one.  While I was forewarned to expect a year of frustration after my amputation, I did not expect that I would be this frustrated, confused and down about the whole thing.    It has been challenging to say the least.  

I was really psyched at the beginning of the week to finally be getting my prosthesis....for my "walking day," as it's generally called in the amputee community.   While I knew I would encounter some discomfort and mixed feelings,  I did NOT know that I would be forced to confront the fallout of my multiple traumatic injuries, as well as how they still impact the way in which my body continues to respond.   

One of the symptoms resulting from my pelvic fracture was a peroneal nerve injury.   The peroneal nerve originates at the base of the sacoiliac joint (as part of the sciatic nerve) and runs down the outside of the leg, around the edge of the fibula (outer leg bone), and over the foot, where it ends
between the first and second toe. (see pic at the right).  When I still had my foot, I could touch between my toes and it would be numb there...which was really no big deal, as I got used to it and it really did not affect me much.   I also had, and continue to experience a lingering numbness along the outside of my thigh, which turns into a tingling sensation when I press on the top side of my calf-muscle.   Again, no big deal......that is, unless you're trying to fit a prosthetic socket. 

Earlier this week while my prosthetist and I were trying to work on getting a comfortable fit in my socket, I felt a shooting pain across the outside of my shin.  I pointed to a small lump which seemed to be the culprit.....and was informed that what I have is called a neuroma.     Neuromas can present quite a challenge when fitting a prosthetic socket, as the pressure put upon them when bearing weight can cause significant pain and cramping.   Needless to say, my hopes to be up-and-walking came to a standstill, because at this point the socket is too painful to wear.   On Monday we  are going to start over with a new check-socket and see if it is possible to make a few adjustments to accommodate the neuroma.  If it still continues to be problematic despite multiple attempts at socket corrections, steroid injections can be attempted, as well as surgery to transect and bury the neuroma deeper into the muscle tissue closer to the bone.    Obviously, the last thing I want is another surgery.....so fingers are crossed that we find a better solution.  

I guess that  this is where I am humbled and reminded that the human body has its own logic, and no sheer force of will can change that.  I have been pretty concerned and worried....as I've obviously been looking forward to getting my life back.   It is sometimes hard to trust when one experiences setback after setback, or to catastrophize and think that I'll never be walking again.   So I try to get scrappy and educate myself about all of my options, as well as connect with others who share similar struggles.   Still, there are days where it is just plain hard. 

Still Searching for "Normal"

I think the most difficult part of this experience is the length of time it is taking to regain some sense of normalcy.   I want so much to be in a good head-space for my kids and family, but find myself feeling sad as I sit back and watch them participating in the fun stuff I would love to be doing.   I also find that my patience is lacking, as well as the joy I used to feel on a regular basis as a very active person.  I guess my energy tank is running on low, and the long hard winter has compounded the arduousness of the journey.    Usually at this time of the year we would be making plans to camp, hike and travel....as the snow melts away and we prepare for increased time spent outdoors.  Unfortunately at this juncture we are unable to plan with much certainty, which is tough.    Luckily, my tough German temperament pushes me onward....as I kick myself in the butt to stay as active as I can be, and surrounded by good people.  I try to find joy in the small things, such as richness of conversation with friends, holding my kids on my lap, watching the birds come to our feeder, getting in a good swim, or listening to my cat purr as I scratch him under the chin.  (I do this to my husband too sometimes, but he doesn't purr....).

Somewhere in the back of my mind I know that this will not last forever.  And I look around to see all that I have been blessed with.  I am thankful that through all of this, my children are learning how to be helpful, how to be compassionate, and how to press on through difficulty.   Of course, they are also learning new skills, such as how to throw their snow-covered clothes into the dryer and how to empty the dishwasher!   I look forward to some exciting goals on the horizon.....and try to embrace the understanding that these things happen in their own time, which may be outside of my
control.  (I can be so impatient!)

....and we continue taking things one. day. at. a. time.    

Wednesday, March 12, 2014

Live Woman Walkin' (well, sort of)

Today I received my check socket and took my first steps in a prosthesis.   All of the amputees I've talked to have mentioned the fitting process as being the most frustrating part of the experience.   We spent three hours working on trying to get the fit right.....and this process is likely to continue for several months.
 
At this point I am able to walk for a very short while, and still have some pain in the anterior part of my tibia (bottom of my shin bone).  We will continue to work on this (ie., I will communicate my experience w/ my prosthetist and he will make needed changes).

  video

(The video above was taken after some modifications, including a change-out of the foot.)
I guess this is how it goes....one step at a time.  

 
Patience grasshopper.............


Monday, March 10, 2014

A Day In The Life: Update #4

Haven't updated in a while.....seems I've had a case of good old-fashion writer's block.  There's probably a good reason behind that.   I've been doing a lot of hanging out and waiting, which honestly has been pretty boring.   Admittedly, life has been quite different being Madame Gimpsalot...sans leg until hopefully later this week....

...Hence, I thought I'd write about a typical "day in the life."  

As I am awakened at 7:00, I am lucky to have my Prince Charming bring a cup of coffee to my bedside.   Interestingly, I still dream that I've got all limbs intact and am running around like a kid, so the first brief moments after awakening can be somewhat of a reality-check.   It takes a good fifteen minutes for my coffee to kick-in which is pretty necessary as my morning jump-start.   Unfortunately I can't hop around with my hot coffee in-hand, so after I slurp it down, I ask one of my little hoodlums to bring my cup down to the kitchen...where I get on my knee scooter to ready the kids for school while gulping down cup #2.

While the knee scooter is better than crutches, it is still a pain.  I've run over my cats' tails more than once, as well as my kids' backpacks, jackets and mittens as they lay scattered across the kitchen floor.   And forget about doing anything quickly.....something as easy as last-minute homework folder retrieval from the living room couch can be quite an ordeal.  

Initially I used crutches up and down the stairs, but now I four-wheel it.  Much quicker, although I've earned a seemingly permanent rug burn on my right knee as a result.   Getting around in this way is strangely akin to climbing, believe it or not, as I continuously scan my environment for "holds" to grab on to to transition from standing to kneeling or sitting, and vice-versa. 

Maybe no one will notice???
I need to admit it is very tempting to avoid going out in public sans-leg.    The attention is weird and I prefer to avoid it.  However, those who know me well know how much I abhor being inactive.   I've needed to swallow my pride, suck-it-up and get my gimpy butt to the gym...regardless of how much I hate the gawking.  Without fail, I always feel so much more alive after pushing myself and getting in a good swim (...and I'm slowly figuring out how not to swim in circles!  :) ).       

Of course, people are very curious and full of questions. The hardest ones to answer are probably the questions where folks don't know my history but are really curious.   Those obviously take a longer time to answer and I need to do a fair amount of educating.   Heck, I never knew that some fractured bones don't heal well, so how would other people know?   Most of us believe that bones heal by simply slapping on a cast for a while....and suddenly voila, all better, right? 

....And while I'm okay with this amputation thing (really...it is so much easier than hauling around a painful, useless ankle), I find a lot of people are sad and perplexed about it.  Oddly, I need to do a fair amount of consoling to those who don't understand how a person would "choose" amputation.....and usually this is done by raving about the advances in the prosthetic industry.  Pointing to examples of accomplished amputee athletes usually does the trick.   

Speaking of prosthetics, my fingers are crossed that this Wednesday will be my "walking day."  I was casted last Friday for the fabrication of my check-socket (a temporary socket which can be modified as my limb changes shape and / or atrophies).  I have a fair amount of volume in my residual limb (the PC version of "stump," although most amputees are quite comfortable w/ the word.   I find "stump" to be a tad masculine sounding, and prefer to use stumpette.  Lol...  :) ).   The remaining musculature in the distal end tends to be larger than is typical, making"doffing" (taking off of) the prosthesis a potential challenge.  We will know on Wednesday if this is an issue or not.  If it is, my prosthetist has an idea or two.....but that might delay things a bit. 
 
I've known from the advice of other amputees to expect lots of frustrations and challenges, so this is not surprising.   Of course, we always hope to be surprised that things go more smoothly than planned, don't we?    
 
I continue keep in mind that this experience beats additional trial-and-error surgeries, and that I am still much closer to being able to run around with my kids than I would have been, had I continued to keep trying to fix the dang thing.   With the weather steadily improving, I am still hopeful that I'll be up and walking by the end of the month.  (I'll need to put running off for a bit....just trying to be realistic.)
 
About a year ago I read the book Daring Greatly, by Brene' Brown, which is based on the following quote from Theodore Roosevelt's speech:
 
THE MAN IN THE ARENA Exerpt from "Citizenship In A Republic" delivered at the Sorbonne, in Paris, France on April 23, 1910. 
It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better.  
The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again,  
because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions;  
who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly.
In truth, it has felt like nearly 2 1/2 years of daring greatly, with a rollercoaster of surgeries and recoveries behind me.   It has been so tempting to look for excuses (It's too cold, I don't want people to stare,  I'm too tired, etc.), but I have tried to keep my head held high and continue forging on...sometimes, while gritting my teeth or ending the day in a lump of exhaustion. 

At present, I'm feeling oddly like a penned-up horse waiting for the gates to open.   It has been a very, very long time since I have walked or run without significant pain and effort.   I am excited to move into this next chapter, as the snow melts away and we begin to embrace growth and new life......   I'm more than ready.

BRING IT ON!

Thursday, February 13, 2014

S0....what do they DO with the limb? (more interesting little-known facts)

Believe it or not, folks in my type of situation (undergoing what is typically called "delayed" or "elective" amputation) have the luxury and freedom of exercising some ownership over what happens with our amputated body part(s).   Conversely, when people undergo amputation after initial trauma (when timing is of-the-essence), where there is an infection or suspicion of contamination, the protocol is to send the entire limb directly to pathology before it goes to the incinerator.

I never really thought about it....(where amputated limbs go) until looking into this whole ordeal myself.  Trust me, it is a very strange experience.

At first I asked my little piggies which market they would like to go to, but none of them could agree on the same place.   Of course, the biggest one wanted to go to the market, but, as typical second siblings can be, the next really wanted to stay home.   After much deliberation I eventually came to an executive decision for all of them...but this required a lot of research on my part.  I tended to side with piggie #2 initially, but unfortunately, the prospects for bringing them home were not optimal..  
Our needing to travel was probably the biggest hurdle in attempting to come to a good plan for keeping the pigs, and I did believe it was pretty important for them to stay together.   (they're very connected and have always been extremely close....sometimes needing to endure extreme conditions that stunk, literally.)  Still, I learned that bringing them home would be a challenge...sigh.

Option #1: Crematamous de Parte
I did know of two women who decided to have their limbs cremated after their amputations.   This required some leg-work beforehand (no pun intended), eg., hooking up with a crematorium, settling on a cost, having the limb delivered, picking out a receptacle / vase, etc.  One woman shared that she needed to do some haggling over the cost, as a basic "human body" cremation typically runs around $2000.   Eventually the haggling came down to weight in lbs., and an amount was settled upon based on the weight of a 12 lb pet (coming to about $285).    Still, running (or limping) around haggling with funeral-dudes did not thrill me.  Neither did the prospect of keeping a vase of foot ashes on my dresser or the mantle.   

Option #2:  PediMortis vs. Appendigeous Insectus
 In discussion with the office staff prior to my surgery, I learned that there have been times when folks were given their amputated bones back.....completely intact after the soft-tissues were gotten off somehow (I wasn't sure how this was done.)   Really??  I asked....."So I can take my leg/foot home with me, bones and all?  From a curiosity perspective that would be really cool."   Yup....sure enough, I was told that I would basically need to inform the medical team of my desire to have the bones back, and that there would be some paperwork to fill out after the surgery.   I became excited about this possibility, mainly to see just how messed up my ankle was from a three-dimensional perspective (and it sounded more attractive than cremation).  

So on the morning of my surgery I brought this up ....and the Physician Assistant affirmed that lots of folks have taken home their amputated limbs.   "You can take the whole thing home if you want." She said.  "What?"  I asked... " Really...the whole ankle/foot....with the skin, bones, and all?  You're serious? What do people do with them?"  "They mainly store them in the freezer and stuff."  She answered.  "Wow...." I replied, "I bet that would totally freak out the airport security folks when they check my suitcase!   Mmmm, probably not the best idea." We agreed.    Although  frequently I stop to wonder if we might have had a total blast with the idea of flying my decomposing leg home in a suitcase. (My Criminal Minds / CSI friends will appreciate this sentiment). 

 I then mentioned the comment from the office staff, and asked about the possibility of getting my
bones back.  The PA said "Oh yeah....we have a place called Skulls Unlimited which can do that for you if you'd like.  I've even seen one guy have his foot mounted."   "Mounted?"  I asked....as in taxidermy mounted?"   "Yup....." (I pictured my Uncle Bob's deer heads hanging on the wall, but with a foot hanging there instead.)  "Uh....I wouldn't want to mount my foot....that's just strange.  Maybe I'll just keep it as the skeletal foot."   We then obtained the paperwork and website address to Skulls Unlimited, and called them to obtain more information.

In the phone call, my dear hubby learned all kinds of interesting things.  These people really love their work and go to great lengths to discuss what they do.   Apparently, the process we had been considering for my limb would entail the unleashing of flesh-eating, Dermestid Beetles  (no relation to the guys from Liverpool) in a tank of some sort where the little insects would go to town devouring the flesh of my foot for a week or so.   From what I hear they do a damn good job cleaning straight down to the bone.  (For more info about these little critters, click here.)   For the small price of $800 we could have my bright and shiny, insect-cleaned, bleached, and reassembled bones shipped right to our home within a two week time frame.   Such a deal, hey?     

Option # 3:  Limbis Incineramous
Suffice to say, the thought of millions of insects chomping away at my detached limb did not leave me with a good mental image.   I've spent many-a-summer avoiding bugs of all types....my piggies were way too ticklish.    $800 was a bit steep as well, especially just to entertain my curiosity.

So in the end we just took the easiest measure.....to incinerate the sucker.  To simply leave it up to the good doc and medical folks to send it on its way.   

Before putting our cat Dylan to sleep several years ago, the vet suggested that we could do a fur clipping in memoriam / as a reminder of him (I still have that little baggie in the bottom drawer of my jewelry box.).  For a half-second I thought that might just-as-well clip a few toenails from my right foot to keep in there too.....until I realized that this was getting just plain ridiculous.  

Sometimes the best option is the easiest......to do nothing.   In the end we knew that this limb-o-mine would literally need to bite-the-dust....and functionally, it already had.   I now literally have one foot-in-the-grave..... 

.....and my piggies have gone off to the market for good.  

Friday, January 31, 2014

Update #3

Today marks Three weeks since my amputation, and seriously....this is the first day I have sat down in my home and done absolutely nothing.   I figured, why not a blog post?    The topic:   

Interesting little-known facts and info (from my vantage point):

  •  My toes get cold....yes, the ones that are not there!  Truthfully, it does feel as if the toes on my right foot are still there, sharing the love of our cold winters with the toes of my left, intact foot.  AND, since there is less surgical pain now, I am starting to wiggle those invisible toes of mine.
  •  Phantom pain....happens.   This has decreased significantly since the first week post-amputation, when I felt as if someone was squeezing my pinky toe with a pliers.  Other sensations would include feeling as if a lighter is burning under my toes, and having an itch on the sole of my foot that I can't scratch.  Luckily, these sensations have been short in duration (usually lasting fewer than 20 seconds.)  Now the most common sensation tends to be a buzzing feeling in my foot which can get annoying, but is not painful.  I continue to sleep well and symptoms usually do not keep me awake (this can be a problem for some amputees.)
  • People DO stare.  And that is okay.  I know people are curious.....and I would be curious too if I were them.  While we were grocery shopping the other day my daughter noticed that people were staring (I was oblivious).   I asked her if she was embarrassed....she said "No.  It's kinda fun actually."  (Jade had fun pushing me in the wheelchair....which we take when we travel outside of the house.  Too much snow and ice here in WI to take chances with crutches!) 
  • I kind of like my stumpy little limb.   That might sound really weird, but from a  [body] system perspective, it is like the part that requires a little extra TLC.....a massage several times a day, special attention to acknowledge when to rest, etc. Quirky....I know.  I guess you could say that we're getting to know each other.
  • Not all amputations are created equal.    Every amputee's experience is different.  It is tempting to lump all amputees into the same category, but truthfully there are HUGE differences based on surgery technique, levels of amputation, and folks' unique situations.    I never realized this until I began to talk with other amputees, and lemme tell ya....the amputee world is full of folks with amazing stories!   
  • The new prosthetics are amazing.....but one does not cover all desired activity.  Insurance will only cover a single "every day" prosthesis, and other (deemed) "non-necessary" prosthetics usually have to be paid for out-of-pocket.  Insurance expects that that one prosthesis should last for three years, and (not unlike healthcare) bureaucracy is hard to deal with.  So, realistically do you know what this means?   It means that while most folks look forward to getting a new car every few years or saving for a really cool vacation, we'll be looking forward to getting a new leg so I can continue to run around with my kids.   Yes....running prosthetics do run about the same cost as a new car.  (While I plan to apply for a grant, these are not guaranteed.)  So when you see us driving around in our 2002 rusted out SUV, remember this. 
  • The KNEE.....VERY important.    Recently someone inquired about my situation, and in the conversation, made the comment:  "Wow....and I thought my knee replacement was hard."  I responded by acknowledging that the knee is a crucial joint, and not being able to use it is much harder than having an ankle injury.    If you haven't had any knee issues, envision not being able to kneel or bend that joint when climbing stairs.  It's hard.  I'm lucky to have a good knee on my injured leg.....which is awesome.   Now I just need to protect the knee on my sound side (it is tempting to hop and overcompensation injuries are common.)    Furthermore, I have come to know folks who are above-knee amputees......a much more challenging situation in many respects (this touches upon how "not all amputations are created equal.")
  • The amputee community is awesome.    I learned this early on as I began to research my options.   I would venture to guess that what makes the amputee community pretty cool is the visible nature of the disability.....and the absolute need for peer support.    There are countless "issues" which arise with amputation, ranging from socket fit, to skin issues, to choice of prosthetic componentry, to coping with limb loss.   Whatever a person's concern might be, there is always plentiful information to be found from others who have "been there."   A HUGE BONUS is the fact that amputee humor rocks!!
  • This list is by no means exhaustive.    And I would invite others to share their "little known facts!"  


Friday, January 24, 2014

Update #2

It has been two hazy-headed weeks since my amputation surgery.....thought an update was in-order.  

Yesterday I had my two-week follow-up appointment with a recommended orthopedic surgeon.    He is an older, seasoned fellow who got his start as an orthopedic surgeon working in Vietnam.   He took a special interest in my case, since he has seen and performed a lot of amputations in his lifetime.  Much to my surprise, as he perused my before and after BKA x-ray images, he shared that he was happy to see that I'd chosen to end the limb-salvage two-year purgatory experience.   He noted: "You know, a lot of surgeons view amputation as a kind of failure.  I've seen so many people become fixated on saving the limb that they lose sight of its purpose of function-ability...many times it had been lost long ago, but for some reason they don't want to amputate.   The prosthetics out there today are amazing....good for you that you found this out early without going through years and years of heartache."   I thanked him for his professional opinion, and explained that my experience had taken me to consult with lots of medical  folks....some of whom did not share his same impression.    He smiled and commented about how medicine has changed over the years, making these decisions much more complicated because of the new technology available.  

The Upshot:  Everything looks good.    I developed a small hematoma (bruise) on the medial side of my incision shortly after the surgery, where my gastrocnemius muscle was pulled under and reattached.    Apparently this is quite typical and nothing to worry about (it is just a little red and


My x-ray:  Note bone bridge between tibia and fibula with
bone-graft material, and muscle padding at the end.
inflamed).   The incision looks good and has mostly closed/healed....although the good doc prefers to wait until the hematoma has cleared, as disturbing the tissue could open up an area where infection could set in.   

I've got another appointment in a little over a week
to have the stitches removed.  This will mark three weeks post-surgery.   Generally if all goes well, folks begin prosthetic fitting with a temporary socket / prosthesis between 6-8 weeks after amputation.  (Timing to receive the permanent / definitive prosthesis varies and is greatly dependent upon changes in the residual limb.   Obtaining the right fit is critical and it is always best to take plenty of time making sure all of the tweaking is done prior to getting the definitive socket.)

While leaving my appointment with the orthopedic surgeon, he brimmed like an excited little boy who was proud of something he had learned as he said to his nurse in the hallway , "Hey, I've seen an ertl done by Dr. Ertl.   I studied the Ertl procedure a long time ago and had used the technique, but I've never actually seen the outcome of one of these done by one of the guys in the Ertl family."  I commented that after talking with a lot of folks,  I wanted to be as convinced as possible of the finality of the limb-salvage trial-and-error experience, and in the ability to move on and get my life back.

Recovery
Recovering at home has been about as pleasant as one could hope for.   Lots of good pain meds, family providing lots of comic relief,  wonderful, caring people dropping by and calling, and loving meals prepared and brought over  by so many thoughtful, compassionate folks.   I have been overwhelmed by all of the support and encouragement that has poured into our home.   

Pain-wise, I've had some post-surgical pain and cramping, as well as some phantom pain....although that has diminished  substantially within the past week.  (Phantom pain has consisted of feeling like a pinching of my [nonexistent] pinky toe, burning of the front of my [nonexistent] toes, and itching of the bottom of my [nonexistent] foot.)   Often I will feel a sort of transitory "buzzing" feeling in what used to be my foot which is a little weird.   The most noteworthy sensation in terms of my transition experience (from right limbed person to amputee) has been in my daily typical fingers-to-toes morning stretch.   Imagine what happens when you try to point your toes that are no longer there with newly transected, surgically reattached muscle.   Yeah....Owwww!   I now try to do my morning stretch in a 3/4 body-fashion, in order to avoid major crampage and calf pain.  (Dr. Ertl did mention this is also common and that it obviously hurts.) 

I am deeply thankful for all of the encouragement I have received from people as I've shared this journey.   Believe it or not, that encouragement helps to fill my tank and keep me going.   I hope to be up-and-about by the time the snow melts.  (Although here in Wisconsin, that could be as late as May.)    Keep sending good energy!

Wednesday, January 15, 2014

The Survivor Tree

Ever have one of those moments where you're overwhelmed by something that speaks to what I call your rightness in the universe?   I know....it sounds very Shirley McClain, but as I begin to slow down and pay attention to the richness of moments, I begin to notice things I may have not noticed before.   Today, at our visit to the Oklahoma City Memorial, I was seized by one of such moments.

Being a survivor of trauma, and visiting a place which embodies the meaning of trauma, I was overcome by emotion as I sat below the  Survivor Tree.   After withstanding  the blast of the bombing in 1995 and burning for several days, this tree still stands as a symbol of human resilience, hope, and rebirth.   Despite the 4,000 lb. bomb which killed 168 people and injured hundreds, the tree continued to struggle for survival.  With the help of the community, the health of the tree began to improve.  Seeds were taken and seedlings were grown.  The Survivor Tree has re-birthed hundreds of offspring which serve as reminders of the undeniable life force within us.  

The tree continues to thrive....

  As I began to think of a theme for this blog, I scoured the Internet for images depicting hope and resilience, with a particular focus on the limb, as this has been an element of my grieving and my striving for acceptance.  Sadly, no image emerged which seemed to fit.    Today as I sat below the tree and looked up, I found it. 


There is life after loss.   The life-force within us propels us to press on and to nurture each other as we grow.

Survivors of all types....we know this.  The moving on is bittersweet, but it is ripe with possibility.  Having risen from the ashes, like this tree, we just keep going.....reaching for the sky

As I move forward in my journey with limb loss, I look toward a future of possibility, and a chance to share my passion for adventure with others with disabilities.   When faced with significant life-challenges, we can shrink back from life, wither away, or embrace our challenges as unique opportunities for connection.   Herein lies my passion.....harnessing hope and connection, and finding meaning in shared life-enhancing experience.  How cool is that?

(NOTE:  I will do an update on my medical stuff soon!  Just needed to get this post out first....the timing was right.)
  

Friday, January 10, 2014

Update #1

Attempting to do my first update on the blog.....head is a little fuzzy but we'll give it a good ol' try. 

Yesterday I underwent an osteomyoplastic trans-tibial amputation.   With the exception of a potential pregnancy scare (false positive in the urine test) the procedure and recovery was uneventful.  Looking back I find that pregnancy scare quite comical....I mean, really?  A 45 year old lady in for an amputation...pregnant?!?   

How did it feel to wake up and see the leg gone?   Surprisingly, very good.    The day before was spent meeting w/ Dr. Ertl and the rehab team to discuss my goals and expectations, and they're all of the mindset that amputation is the beginning of an exciting rehabilitation journey.  A journey which will hopefully lead to getting me back to doing the things I love.  

Through talking with the team, I learned that Dr. Ertl actually developed and fine-tuned his surgical approach in consultation with a fine prosthetist, Jonathan Day.   It is important to realize that not many surgeons do that kind of thing.   They generally make their decisions through the protocols which they know and are comfortable with.  So when a surgeon takes the opportunity to learn from another professional (say....is humble enough to consult), and work collaboratively, good things happen. 

Physiatrist, Dr. Carol Dionne is also on the team, and her job is to consider the "whole person" in her approach to recovery.   Dr. Dionne has a specialization in spinal injuries, so she was quick to bring up my SI joint fusion, and how this next step will be very beneficial for me to  equal out my limb-length discrepancy.   The entire team talked about the importance of a good prosthetic leg as it relates to my other orthopedic injuries.   

What impressed me the most was the sense of camaraderie among the team, and attitude of excitement for my being active again in ways that I haven't been able to be in over two years.
Post-op with Dr. Ertl.  He left a nice, 10 in below knee residual limb.
Physically, the experience has not been a walk-in-the-park.   I have an epidural right now which helps tremendously with post-op pain.   I don't like this epidural, but it is better for pain relief than anything else.    I've had a few occasions of breakthrough pain, and have been given a PCA (patient controlled analgesic) pump with dilaudid for those times.   

Our hope is to remove the epidural sometime tomorrow and switch to oral, longer lasting pain medication.  Fingers are crossed that goes well!

What was particularly cool was the fact that the third doctor I had sent my medical records to (at Georgetown University Hospital), called about a half-an-hour before my pre-op assessment.  He was happy to hear that I had moved ahead w/ the BKA, and in fact, was recommending that I have the Ertl amputation procedure.   (Said he wants to see pics of me "doing my thing" once I'm in a prosthesis.  

Thankfully we were able to Skype with the kiddos and Uncle Matt....so far the house is still standing!

 
Thanks so much for everyone's support and encouragement!    It means SO much!  

Wednesday, January 8, 2014

New Chapter...

There's a huge relief in the act of letting go, especially for a tough-ol' pit-bull type of woman like me.  It is an odd mixture of emotions, I'd say.....somewhere between admitting defeat and ease of being okay with the world.   And as I really ponder, I am struck by the fact while that this "okay-ness" has something to do with the knowledge gained with research, confidence in my treatment team, and the resignation which comes from just being plain tired, a greater part of this "okay-ness" comes from the strength and energy I have received from others.

 It has been a gift, really....something I never would have imagined needing, as I'd always prided myself in being a strong, independent type.   It is tough to admit "dis-ability." I think somehow, our
 culture has morphed the concept into a dreaded lot-in-life to be avoided at all cost, as to admit it would equate with throwing-in-the-towel.   

The truth I have found however in coming to embrace this new life I'll be facing, is that the inner drive to overcome, and that drive to keep on, keeping on is amazing.  It is a STRENGTH.  As I have shared my struggle and this journey, I feel honored to have met so many others overcoming obstacles of all types.  There is really something quite sacred about joining together in this space....something which is deeper and more real than anything I have ever experienced in my lifetime until this point. 

 

It is with a grateful heart that I'm moving forward with this huge life-change.  I am grateful for all those who have also shared how they have risen from the ashes, and have shown me the view from the other side.  
 
I know there's a long road ahead, but this is the beginning of a new life, and I've found some great fellow-travelers.  I'll be looking for more....there's a lot of life out there to explore!

Friday, January 3, 2014

How DO you say "goodbye" to a limb?

They say that the experience of losing a limb is similar to that of losing a family member.   When I heard that initially, I was somewhat skeptical, as I wondered just how the comparison could be made between a living, breathing, talking person and a physical extremity / body part.   The closer I get to this loss however, the more I understand the comment.
 
The longer I think about it, I realize that for me, losing this limb is kind of like losing an estranged spouse.   
 
I'm hesitant to pull the genetics card (since my kiddos are adopted), but in my pondering recently it has occurred to me that I have sort-of inherited an athletic legacy.  My dad is, and was a legend in my hometown for his sports capabilities, and folks will commonly recall that I'm "Randy's daughter".... the guy known for his home-runs, high school football and basketball involvement, and "hall of
famer" in the city's softball history.  In his 70's, the guy still has a mean golf-drive and is the envy of the guys on the golf course.   So....I guess I realized at an early age, intuitively, that my body and I had a good relationship going.   My legs were obviously part of the deal.

In high school, I did well in track and diving...participating and placing in the state meets.  I was fast and could jump....and I had an awesome toe point (something you don't usually think about much unless you're a diver or gymnast, and obviously, when you think about the things you'll lose when you lose a limb.)

When I met Scott, we shared an interest in sports and the outdoors.  We enjoyed being active together and had dreams of being an active family.    It was fun coaching my daughter's little tyke
 soccer team and teaching swim lessons at the YMCA.  When Kai came along, we began rock climbing as a family (I found it taught our children patience, tenacity, and how to use their bodies to reach a goal.  It was / is a particularly good discipline  for our son who tends to want to "check out" mentally, as it keeps him focused and in the moment.)     Kids are naturally little monkeys and love exploring, so these interests naturally became a big part of our family's activities.   We love, love, love the outdoors!

Since my accident, we have done our best to continue this lust-for-life and adventure.....although watching my family participate in many things without me has torn at my heart.  It is amazing how you can really miss an ability once an injury has taken it from you, and sitting on the sidelines is incredibly depressing.   Until the last two years, I had really taken for granted all of these abilities, and have come to appreciate some of the smallest, such as walking, the most.

In less than a week, I will be saying farewell to my right foot.  Damn that's hard.   But in doing this, I
know that I'll be able to regain a lot of what I have been missing, and I'll gain a huge, important part of my life back.  

What are the things we say as we begin to part with something / someone who is a big part of who we are?  

In my case,  looking at this cobbled-together ankle/foot....I say "You're not who you used to be."   Truthfully, it has been very much like going through a divorce!   :)   To this limb, I've said:  "You're causing me too much pain.   You're holding me back from being the person I know I am and can be.  You've changed....and you're never going to be what you were. You WERE awesome!  We had a good thing going, you and I."  

But the closest thing I can get to the "me" I know and love...the active "me", is to let go of this bad relationship.    It is the equivalent of having spouse who wants to lay around all day and be a couch potato (pain and limited function will do that to a person.)   Functionally, prosthetics will offer a huge improvement.  That said......

There are things I know that I will absolutely miss.  I grew up playing on the shores of  Lake Michigan, spending the day in my swimsuit and jumping over the waves.   While there are a lot of cool prosthetics that function in awesome ways, (running, climbing, etc.) none can offer the kind of foot that can feel the sand between your toes or run and jump over the waves....yet (I've thought about this a lot, actually....but then realize that realistically I don't do this often anymore anyway.)  

My sister used to give me a hard time about my ugly feet, and my family would laugh about my talented, flexible toes as I'd hold a spoon between them and feed myself  (I know...we're a strange family.)    Because I'm right-side dominant, my right foot was obviously considered the more talented one.  If I had to fall and crush my tibia again, I'd pick the left one.  Ah well.  

As one begins to realize any relationship is a total drain, still, the process of moving on is hard.  It is not really possible to just "cut it off" and not have that person with you in your heart forever.    STILL, sometimes we need to make that cut so we can move on.   (Aren't you lovin' the awesome metaphors!?

To say "goodbye" to this limb is bittesweet.   I think folks who suffer a traumatic amputation are usually left shaken and painfully robbed of a very important part of them...similar to losing a loved one very suddenly.  And I assume that that grieving is done very intensely at the time their loss is realized.  But for folks like me, this ankle has been more like a painful, aching tumor....and while hope was given throughout the long treatment period through lots of surgeries, hopes, and broken promises,  there has also been a prolonged grieving period.  A feeling of: " hey, I've already lost it....she's not coming back."  (the function-ability of my leg, that is....not my mind!)  

Sudden or gradual.....loss is not easy.   
 
....but there is life after loss.   I've met dozens and dozens of amazing amputees....all with incredible stories.  They're all back to DOING WHAT THEY LOVE...   I want thatI'm psyched to get that....back!    So is my Family....
 

 
....I guess, this is the best way to say farewell....