Saturday, March 7, 2015

Foot Problems and Stress Management

The most effective way I have found to manage stress, anxiety and depression is to get a lot of exercise. That's completely in line with what the cardiac rehab folks want you to do to get back you heart function, get rid of plaque buildup, tone the muscles and reduce your chances of a recurrence.

So a couple of weeks ago I was chugging along on the treadmill at cardiac rehab and it felt so good that I decided to try jogging a bit. Being able to hold myself up with my arms would make the impact more gentle on my feet. I did a couple of intervals of 1 minute on 1 minute off jogging. This evidently was the very repetitive minor trauma that can lead to Charcot Foot, "...most commonly due to diabetic neuropathy." Well, I have the neuropathy but not the diabetes. (Serum glucose 79). Although a lot of my symptoms present as diabetes, and each doc I see asks if I have ever been diagnosed with diabetes, I do not have diabetes.

When the podiatrist explained that not treating this could lead to amputation, I got to practice my "learned optimism," that we were going over in Stress Management. "I'm so glad you caught this early," I found myself saying. The X-rays did not show any evidence of neuropathic arthropathy.

The repetitive trauma opened up a lesion on my left sole where a callus had built up, and then the wound got infected. I went through a couple of courses of antibiotics, which cleared up the infection, but the wound did not heal. The podiatrist took a look, shaved off some excess callus, and put me in a boot.
It's a cumbersome thing with an air bag that you inflate to immobilize the foot but still allow some walking about. I thought I could row with it, but that was awkward. So I took an old Teva and hollowed out a relief so the wound would not be pressured.

Well, no. That's not a good idea. The podiatrist wants me in the boot exclusively. Only out to sleep and to shower. The doc fashioned a cushion with a cutout where the lesion would not press on the innersole of the boot, and some of the sole itself was removed to leave a pocket. The cushion has one sticky side, which he attached to my foot to prevent sliding. The doc gave me extra cushion material, so I assumed that I should change the cushion each time I showered and changed the bandage. The first time, however, some skin came off with the cushion and left a bloody cut. Linda is getting good at bandaging.

I'm trying to be positive about this, but 6-9 months in the boot is not pleasant to anticipate. Better than amputation, though. How to manage the stress of a long-term disability? That's what the stress management class is working on.

Here is a good summary of Martin Seligman's Learned Optimism

Each time a worrisome thought comes along, I think of something else and relax my shoulders. We are going to work on other stress reduction techniques next week.

It will be a challenge to find an exercise l can do with this boot.


Ron Manganiello said...

David - I'm sorry to hear about your setback. Sounds like you are doing everything you can with your body/mind to heal from this new challenge. I am routing for you!

BTW, I just returned from Oaxaca late last night. 5 hour Bike Recycle Vermont Board of Directors meeting today. I was worried that I'd have trouble focusing but it was great to see everyone after 3 months absence and I'm very excited about the new incarnation of BRV and Old Spokes Home.

All the best,

MBC said...

But think of the good news.

You got the infection cleared up.
You don't have diabetes (not that you did).
You've eliminated the business with the Teva
You can get around pretty well on that boot. I'm guessing that not so long ago you would have been "in plaster" (ATS) or laid up in bed. Also . . .
Daylight saving time starts tonight; the forsythia is out in Atlanta; daffodils, too. Despite it being 26 degrees a couple of days ago!

Call me up and ask me about my car.

Beth said...

Aaarrrgg! Been there, done that. I have complete and total empathy. Was in a boot and full leg brace for a few months with my broken leg/foot. Couldn't take the brace off for sleeping. Stacie was in a boot for weeks following foot surgery just a few months ago. So today we are gathering for Stevens 51st and we will raise a glass to your health and rapid recovery. Being a tad older, I get to say, patience and then take a breath and gather more patience. Love you so much my dear cuz, please take special good care of you. Kisses and hugs to you and your gorgeous darling Linda.

Liz West said...

Drat! That is discouraging. When I was having my radiation/chemo/surgery treatments, I decided that as long as I was stuck at home I might as well learn something. So I signed up for and took several photoshop courses. They have interesting courses on many topics, and you work at your own pace. That not only kept my mind occupied, but also left me with a great sense of satisfaction once I had my life back but realized that I also had several new skills.