If Your Veterinarian is Not Available, Go to Vet Depot

The other night my husband had to take our dog to the Emergency Vet in the neighborhood.

An issue which came up had to do with the relationship of a high calcium level, anal gland problems and cancer.

We will be taking our dog back to our veterinarian for a follow-up visit, and will inquire about checking his calcium levels.

Going on the internet to research the issue brought me to a blog called Vet Depot.  I was able to get a great deal of information about anal glands, calcium and cancer right away.  There are so many topics covered on this blog that I now have it bookmarked and will continue to read it.

Where to read the blog:  blog.vetdepot.com

Using Crutches Take Practice

Now that I have spent 3 months on crutches, I have finally figured out how to manage.

I have fallen numerous times, slipped, gone forward too quickly losing my balance or landed the crutch on someone's foot.  Ouch!!!

While in the hospital I did get a lesson on how to use crutches.  You always go up or forward with your "good" foot.  Going down the stairs has your "bad" foot going first.  So up with the good and down with the bad.  Easy enough to follow.

I was also told to keep the crutches on an angle out from your body vs directly at your side.  This does help and may affect which height you keep your crutches at. 

I feel that a comfortable height for your crutches is a personal choice.  Keeping the crutch on the hole for my height was not working for me, so I went up an inch.  Don't be afraid to experiment.


Watch out for your pets.  My dogs are always under foot and you can't imagine how easily you can trip over them.

There have been some door thresholds where there is a raised piece such as weather stripping or a metal bar which have caught my crutch many times so raise those crutches as high as you can.

Let's talk about water.  Anytime the ground is wet, please be careful.  The rubber tip of the crutch will come out from under you and you then go flying...sometimes into a wall, sometimes landing on the "bad" foot, so now you are dealing with even more pain.  Any floor surface which is slippery to begin with becomes your worst nightmare when it is wet.   I even slipped on wet blue stone since there was some mildew on the stone. Take small steps whenever the ground is wet and try not to put as much weight on the crutch until you know the surface isn't slippery.

Doors are another problem.  Once I pushed open a metal door I assumed was going to be heavy and before I knew it, the door flew open because it was not the heavy door I imagined it to be. And again I went flying forward.  Then the real heavy doors take good maneuvering because you have to push them way open and get through ASAP before it closes on you.

I learned to carry a cup of coffee in a travel mug so the lid keeps it from spilling on the floors or rugs.  Carrying a bowl of food could be tricky unless the bowl or plate has a good lip for you to hold onto while keeping a finger or two on the crutch.

For carrying laundry I use a shopping bag.  I carry my computer from room to room in a backpack.  Actually the backpack has many functions and has become very useful over time.

Wearing clothes with pockets also helps.

I found that using a folding chair in the shower worked wonders.  You can always order something for the shower, but for the three months I needed it, the folding chair worked really well.

There are cushioning products to help with the pain you will experience under your arms which tend to get very sore.  I have had numbness in one finger as a result of pressure from under my arms because a nerve was being affected.

Needless to say I am looking forward to being able to walk on both feet.  I will not be sad to see those crutches go into storage!

Where to shop for products:  http://www.crutcheze.com, www.juvoproducts.com/designer-crutch-covers-pages-48.php

Do You Know How Visiting Nurse Service Works?

I do now, but it took having surgery to find out.

While in the hospital, a representative from Visiting Nurse Service came to see me.  We spoke briefly and she said someone will get in touch with me once I was back home.

I was released on a Sunday and sure enough, Monday I received a call from a nurse who would come to see me for an initial evaluation.

What an exciting Monday - the nurse ordered supplies for me, noted the type of assistance I needed, took my vitals, checked my wounds and left.  Needless to say, he was mesmerized by the frame and rods running through my foot.  He had never seen it before.

The next day I received a call from the coordinator at VNS.  I was offered a home aide a few times a week for 4 hours each visit. As far as my insurance was concerned, I had unlimited (approved) visits as long as I pay the co-pay.

This was so helpful to me.  I now had someone to help me shower, get upstairs, heat up some food for me and even do my personal laundry.

There also had to be a visit from a nurse each week to establish my need for continued home care.

And there lies the rub!

Apparently it didn't matter that I could not manage to take a shower alone, cook for myself, or do much at all without help.  What only mattered was the fact that the nurse had to justify my having help based on a medical need only.  So if I had a skin infection where the pins and rods went into my leg and foot, that would justify having a home aide.

And for each week I had a home aide, I had to have a visit from a nurse, who was actually my case manager.  If she could not find a medical condition then I could not qualify for the home aide.

I could not understand this because a home aide is not allowed to do anything "medical" for me anyway.  They cannot help with wound care, for example.  I was on my own for that.  Where I needed assistance was of no concern to how this system works.

Had I not had the skin infections, which were the result from having all these foreign object inserted into my foot and leg, I would not have qualified for the home aide.  I cannot imagine how I would have managed alone for that first month at home.

More than likely, I would have had to privately hire my own home aide.

And now a word about the organization which partners with VNS, supplying the home aides:  what a mess!  At first I was told that I live in an area where there is no public transportation so it would be difficult for them to get me an aide. Not everyone has a car. Try finding that information in any of their brochures.

The first aide they sent to me was not someone I wanted around.  I never even saw her wash her hands! Then different aides kept coming.  All of a sudden, there were aides with cars.

There was no consistency of who came and when they arrived.  I had such little energy and was in pain, but I had to spend my time showing each new aide what I wanted, where things were, how to help me get upstairs, etc.  It was just complicating things.  One day an aide showed up but no one had even called me to tell me anyone was coming.

This is not a fault of the aides.  They came to do their job.  It was the coordination which needed much improvement.  After many frustrating calls to the aide coordinator, I instead worked things out with the VNS representative who called me with updates each day to let me know who was coming and when. This person deserves high praise for all her help.

I did eventually get "discharged" by the nurse because I no longer had a medical necessity to justify an aide.  Thank goodness I am now able to manage many things myself, using my ingenuity and determination.

My advice is to be prepared when you are in a situation where you may need a home aide after surgery.  Look into hiring someone on your own so you will have someone to call upon if you don't qualify for the medical necessity clause!

What A Pain This Foot Has Become

One week has passed since surgery and I am finding things to be a little more difficult than I thought.

All went according to plan and then some.  When I was wheeled into the operating room, all I saw were tables filled with nuts, bolts, pins, rods and frames.  Not your typical surgical supplies.

The nurses and I joked because I had requested a black color frame.  It goes with everything, they all agreed.  The surgeon told me afterwards that he was going to give me a pink frame, thinking who in their right mind wanted black.  At least the nurses knew what I wanted since I was under sedation and couldn't speak for myself.

Surgery lasted 3-1/2 hours.  The surgeon had to go into one joint and do major scraping since the arthritis was so bad, so now I also have a huge cut on my foot along with stitches.  

During my stay at the Hospital For Special Surgery, I was so pleased by the professionalism and attentiveness the nurses and aides exhibited.  I had great care and knew it even though I had to be on a good amount of pain meds, which I took willingly.

It was two days before they removed the wrap on my foot for me to see my new companion for the next 12 weeks.

Sunday was my discharge day.  So happy to be going home, or so I thought.  You don't realize how much you are taken care of while in the hospital.  Your meals and meds are brought to  you.  The aides help bathe you.  Your vitals are taken all the time and most importantly, I was able to get coffee anytime I wanted!

Trying to make a cup of coffee at home and then carrying the cup while using crutches just doesn't work.  I came to the realization that I could barely do anything by myself.

So here I am, learning that I can't be the independent person I have always been for at least the next 11 weeks. 

The most wonderful thing about all this is seeing how terrific my friends and family are and how caring and helpful they have been. All way beyond anything I could have imagined!

For Surgery:  www.hss.edu/limblengthening.asp 

Hello Surgery, Goodbye Arthritis!

The day is finally coming.  I go in for surgery on Wednesday.  Thanks to Dr. S. Robert Rozbruch and his staff at the Institute for Limb Lengthening and Reconstruction at The Hospital For Special Surgery, I will emerge from surgery looking as if I am part robot.

My saga began when I broke my ankle in 1990.  I was fine, although as the years passed I was having trouble running on the tennis court.  After many MRIs,  I found that arthritis was the culprit for all my pain.  There is no cartilage left between my joints in my ankle and foot. 

Getting steroid injections helped temporarily but at the risk of destroying any good bone I had, it was necessary to limit these to when I was absolutely desperate.

Limping became a way of walking for me.  The pain was increasing. I was limited to a few shoes which did not make my foot feel worse.  Some days I could barely put my foot into a shoe.

Time passed.  Out of desperation I contacted many orthopedists.  After each visit, I was told the same thing:  I needed a foot fusion.  I even had a well known orthopedist in LA look at my MRI and had the same conclusion.  Then there was the orthopedist who had taken care of some famous ballerinas.  He said the same thing.

I was lost, out of options.  Then one day I was at the physical therapist at Access Physical Therapy and Wellness in Armonk, NY discussing my pain.  He mentioned Dr. Rozbruch and suggested that I had nothing to lose by calling him.  I emailed the doctor and in five minutes he responded and told me to come see him.

Months later and I am about to enter into a fairly new surgical procedure where I wear a frame with pins, rods and screws for 12 weeks waiting for magic to happen. This is how the surgery is described: A right ankle distraction arthroplasty; application of an SBI RAD frame, Right illac crest bone marrow aspirate and distraction of the hindfoot. 

The joints are opened, holes drilled in the bone to bleed and form scar tissue, then my stem cells are injected into the joints and we hope that cartilage will grow.  Apparently when the joint is forced open that action may prompt the body to start growing cartilage.  I am hoping that all goes according to plan but nothing is guaranteed.

The frame then gets removed after the 12 weeks and then I spend the next 3-6 months doing physical therapy.

And I can't drive those first 12 weeks.  I will be at the mercy of those who call to offer an escape plan.

I will be writing updates for anyone else considering this surgery.

Wish me luck!

Where to see more info:  www.LimbLengthening.com

Where to go for Physical Therapy:  www.AccessPTW.com

To Run Barefoot Or Not: That Is The Question!

The newest way to run seems to be without our shoes.  There are articles published touting the fact that all sneaker companies are redesigning their shoes to give the runner an experience closer to running barefoot.

You use your foot differently when you run without shoes and that alone takes an adjustment.  

Many months ago on TV we saw Luke Russet walking in those shoes which look like gloves for the feet.  Now you can find those "shoes" on people in place of their regular footwear.

From the Vibram FiveFingers website, www.vibramfivefingers.com:

Our revolutionary design makes feet healthier by allowing them to move more naturally and freely.
The typical human foot is an anatomical marvel of evolution with 26 bones, 33 joints, 20 muscles and hundreds of sensory receptors, tendons and ligaments. Like the rest of the body, to keep our feet healthy, they need to be stimulated and exercised.


I came across this article by Dr. Andrew Weil which offers insight to the debate as well as a link to a website from Harvard University, discussing this subject.

Thought it made good reading: 


http://www.drweil.com/drw/u/QAA400991/Better-to-Run-Barefoot.html

I do think that we need to be selective on what is on or not on our feet.  I cannot imagine walking barefoot in NYC, yet the beach would work although you could cut your foot on a cracked shell.

I myself have yet not tried these shoes, but when I do, I will be happy to review them.
 
No matter what we are wearing on our feet, the most important thing is that we are moving!

For Coffee Drinkers, It's Dean's Beans or No Beans

While shopping at Cronig's Healthy Additions Store in Martha's Vineyard, www.cronigsmarket.com, I ventured to the coffee area looking for something interesting.

What first got my attention was this dark green bag with a colorful label.  Picked it up and started reading about the coffee.

The coffee comes from Dean's Beans Organic Coffee Company, www.deansbeans.com and they are out of Orange, MA.  All their coffee is certified USDA Organic by Quality Assurance International.

"No hype or spin, just great coffee and fair dealings all around."

"We only buy beans from democratic cooperatives and small farms, and we know the farmers personally.  In partnership with the growers, we also design and fund People-Centered Development projects to contribute to the well-being of the coffee lands."

Now a word about the coffee:  I have not had a better tasting cup of coffee since I was on a coffee plantation in Costa Rica.  And I have made the coffee using various methods:  drip, press and with an espresso maker, all producing a great cup of coffee.

One of my favorite coffees is called "Ring of Fire" which is a "dark, smokin' blend of high mountain beans from the active volcanic soils of Indonesia, Timor and Papua-New Guinea. Eye-opening!"  As of this writing, it is not showing up on the website but will be available after 9/06/11.

There is also an interesting selection of decaf beans, which I have not yet tried but will be ordering as soon as I can add "Ring of Fire" to my shopping cart.

Check out their website, www.deansbeans.com for other products such as organic sugar and cocoa.

On their site you will find a link to see where you can buy their coffee.  I did some research and even though I can get it,  it's possible that some merchants may not carry all the varieties.  You can shop locally and try one of the varieties the store does carry to see how you like it.

Dean's Beans ships UPS and will deliver next day in the Northeast, excluding Saturdays and major holidays. Although it may be a bit costly, the coffee is fairly priced and you will have your beans right away instead of having them sit on a truck.  You can choose to have it shipped USPS Priority Mail or for orders less than 5 pounds, USPS Flat Rate Box.

The aroma of my freshly brewed coffee is in the air, so off I go to enjoy it.  Have a good day.

Where to shop:  www.deansbeans.com