Today I got a new artificial leg.
It is hard to believe that it has been two years since I got my first permanent prosthesis. In that time, my leg has shrunk considerably, and I have gone through two other temporary legs. The size difference is remarkable.
I have written before about how these legs were made; in the following video, I show .
On February 1, I graduated to a sleek aluminum and carbon fiber prosthetic.
Most of you reading this weblog probably already know about "my new leg" since it took me forever to write about it. Sorry about that.
It fits much more snugly and is much more comfortable than my last temporary. The springier toe and more flexible ankle make it much easier to walk. I also think the woven black shell and curving ankle look a lot better. The prosthetist asked if I wanted to get it covered with fake flesh, but I told him I preferred the technical look.
On Monday I got a second cast made for what will likely be my permanent prosthetic. I took pictures of the process and added them to the text describing the first casting.
On the Monday before Thanksgiving I got word from my prosthetist that I could start walking unassisted. Immediately after hanging up the phone I walked across the parking lot to my surgeon's office. It felt great! I was beaming, but my surgeon was nonplussed. "Oh, I see you got your prosthetic. Good." He said.
Two days later I spent an evening with Michael, Elise, and Eric. I drove and had my magical handicap placard, so we parked in a handicap spot right next to some bicycle cops. One of them came around to my door and said, "excuse me, sir. We aren't traffic cops, but my boss is a real stickler for handicap spots..." Before he could finish the sentence I pulled up my pant leg to reveal my aluminum ankle. He swallowed and said, "we'll take that any day, sir. Have a good night."
My gait has gotten smoother since then, and passersby don't notice anything strange about my legs. It feels like my life is finally returning to (what passes for) normal. Last week I even went to the gym for the first time since July.
Update 12/12/07: I added pictures from the casting for my second prosthetic to illustrate the original text.
Two weeks ago I got a cast made for my first prosthetic leg. Last week I tried on the leg and walked (albeit assisted by crutches) for the first time in a month and a half. Since then, I have been proudly showing off my new foot.
To make the hard shell of the prosthetic into which the stump of my leg fits, it was necessary to make a cast of my leg starting from just above the knee. Making the cast was a multi-step and multi-layer process. First, my prosthetist wrapped the stump of my leg in a transparent silicone sleeve similar to the compression sleeve I had been wearing since the second appointment. Then, he left the room and returned with a four foot long, one foot wide latex balloon.
He pressed the top of the balloon against the end of my leg, and in one quick motion, opened the other end of the balloon and inverted the latex around the silicone wrapping as the air rushed out.
He smoothed out a few wrinkles, then outlined the knee joint, kneecap, tibia, and other important points with a blue marker. These were points where the technician would have to create bumps or dips in the hard shell of the prosthetic. The prosthetist noted that I appear to be slightly bowlegged, which was news to me. I suspect it is because I favored my left leg for so long.
I asked if he planned to stretch the latex over the final casting. That seemed strange, since he couldn't know that the markings were in the right places. No, he replied, the markings would transfer to the inside of the next layer, a fiberglass cast just like one gets to protect a broken bone.
He pulled over a tub of bright pink grease, a bucket of water, a thick rubber sleeve with a flexible tube sticking out of the bottom, and a mean-looking vacuum pump with valves and pipes sticking out of its gray surface.
He coated my leg with a thin layer of the grease to help it slip out of the hard casting once it set. Then, he dipped a roll of fiberglass casting material in the bucket of water and wrapped my leg from the top down.
The rubber sleeve went over that, with the tube running to the intake of the vacuum pump. He turned on the vacuum, which tightened the sleeve and casting material around my leg.
It did not take long for the casting material to set. The rubber sleeve came off as soon as he turned off the vacuum. Then came the cast. Inside I could see the mirror image of the blue markings he had made.
The latex sleeve rolled off like a surgical glove. As it snapped off the end of my leg, a plume of powder flew all over the prosthetist.
Last week I got the prosthetic.
My leg fit snugly in the plastic shell, but the prosthetist had to make a few adjustments to make it as supporting and comfortable as possible. He marked a few tight spots with the same blue marker as in the previous visit. He expanded the tight spots by heating the plastic in a back room.
To figure out the correct height, the prosthetist had me stand on foot-shaped sheets of varying thickness. I would stand on one then another while—just like an eye doctor—he asked, "Which is better... this one? ...or this one?"
When I decided on a height that felt comfortable, he removed the foot assembly with a metric hex wrench and cut the corresponding thickness off of the top of the pipe that forms the ankle using a C-shaped pipe cutter like any plumber would use. He noted my interest in the tools he was using and warned me not to try to disassemble the prosthetic myself. Darn!
With all the adjustments complete, I finally got a chance to walk! First, in the examination room using two parallel bars for support, then in the hallway using my crutches.
Dad and Sue came with me to the prosthetist's, and they were both beaming when they saw me stand on two feet again. It felt great to get some of the weight off of my hands when crutching. The prosthetic also helps my balance, and it looks completely normal when covered by my pants.
My prosthetist wants me to stay on crutches for at least another week to allow my leg to acclimate to the prosthetic. At that point, I will probably switch to using one crutch or a cane. Not long after that I can start walking normally. I can't wait!
Yesterday marked the end of the most recent stage of the cancer/surgery odyssey. I got the surgical staples removed, got a new leg dressing from my prosthetist, and made the trip back to Champaign. Today I rejoined academic life.
Dad accompanied me to the surgeon's office early in the morning. We placed bets on how many staples the nurse would have to remove. He guessed 50 and I, 40. I counted 35.
We met Sue at the prosthetist's office. She got a show-and-tell similar to the one Dad and I got on the last visit. The prosthetist gave me a that I will eventually use in the fake leg. Interestingly, I need to wash it every night with hand soap and disinfect it twice a week with unflavored mouthwash. It seems strange to clean an expensive engineered silicone medical implement with random bathroom products.
Since the last visit I have had painful in my missing leg. Sometimes it feels like the leg is trying to "wake up" from being asleep. Other times it feels like something is gouging the sole or heel of my foot. Really, my brain is trying to rewire itself to handle the missing or confusing signals from the remaining nerves in my leg. My prosthetist recommended patting the sides of the stump. My surgeon prescribed and suggested that hypnosis may help. I have not gotten to the point of trying hypnosis, but the other two approaches seem to help temporarily. The pain should decrease with time as my brain and nerves adjust.
After grabbing a quick lunch, the three of us departed for Champaign; Dad in his SUV and me riding with Sue in my car. They took me grocery shopping and helped me carry things up the two flights of stairs to my apartment. I am not looking forward to traveling up and down those stairs with crutches every day. Fortunately, I will get a temporary prosthetic in a month or two that should make the trip easier.
Today I attended classes. I kept up with homework while I was gone, so my transition back to academic life should be pretty easy.
Thanks to everyone who sent good wishes over the past two weeks.
It only took only a week for my doctors to diagnose the tumor in my ankle and decide to amputate below the knee. It seems appropriate that the surgery itself was just as rapid. I arrived at the hospital at 7 AM last Tuesday, entered the surgical room at 8:30, and was awake by 11. My surgeon said the operation took just 45 minutes.
I woke in a wood-paneled hospital room with what remained of my left leg wrapped in three inches of cotton gauze. Even with the heavy dressing, my leg was noticeably lighter. For the rest of the day I swam in and out of the morphine. A physical therapist arrived around 3:00 and asked me to crutch between the bed and a chair. He returned the next morning and had me travel around the recovery floor. It took me a while to get used to the asymmetric weight distribution.
My surgeon visited a little while later. I had decreased my morphine intake overnight, and he felt that pills could take care of any remaining pain. That meant I could go home if I wanted. By the time my parents arrived, I was already dressed, and the nurse was finishing the discharge papers. I was home by 3:00, just 30 hours after major surgery.
Pretty amazing.
Since then, I have monopolized my parents' recliner.
