First weeks of Phase 4

OK I don't know why I numbered the phases the way I did, but Phase 4 is now, leg unsupported and in principle able to recover without further intervention.

To recap, the other phases have been: Phase 1 - external fixation post discharge (August - December 2010); Phase 2 - leg in cast post frame removal (December 2010 - March 2012); Phase 3 - leg rebroken and in external fixation again (March - November 2012). So I guess Phase 0 was June - August 2010 when I was in hospital in the beginning.

Deep breath - Anyway, the frame was removed, and honestly, I couldn't have hoped for it to feel this good this quickly. Of course, there's still a way to go until I can use it without thinking, until I'm completely off crutches etc., but it does feel pretty good! I realise now how much pain I've been in the last couple of months, because it's relatively painless now - I still get sharp twinges, especially if I'm putting weight through it, but it doesn't hurt hardly at all now when I bend my leg - so that pain was definitely due to the frame. I should've remembered this from December 2010 when they removed the first fixator, because it was similar with my knee back then, but I think you don't dare hope it'll not hurt, so, when it doesn't, it's a nice surprise.

I also thought there would be much more of a psychological issue about putting weight through it without the frame - even though I knew for the last few months the frame wasn't supporting my leg (struts unlocked) I thought there would be some effect. Well, apart from the first day or half-day, I've not had a problem with that! Maybe I'm just too sick of hobbling around and I don't care anymore? In any case I've been fine with it, just one-crutching around like before. It really just feels the same without the frame as with, stability-wise. I think this completely vindicates erring on the side of caution re. taking the frame off. I think it probably would have been OK to remove it two months ago, but this is much better - worth the extra months of difficulty to not have to go in a cast for an undetermined amount of time. I feel good about not begging for it to be removed as soon as possible. 10 points to me :)

A few days after frame removal, looks a bit less swollen? 

The itching bandage too much, I took it off, here's what was underneath.

The pin sites healed quickly - the small ones where the wires were had healed up the first time I took the bandages off. The bigger pin sites took a few more days before they dried up but it didn't take long. What a difference compared to last time! No infection in bone, no MRSA (I guess). Big difference. So I could have a bath again :) Crikey I missed having a bath. I've had one every other day since I could - still not had enough. I've not been able to wash my left leg properly since March, so there was a lot of dead skin and mank to soak off of it (nice if you're eating your tea, I know). Most of that has gone now and it looks clean again, kind of.

The first close look, the pin sites mostly healed up.

Swelling, yes, still quite a lot. Last time, being in the cast no doubt helped to reduce the swelling because of the pressure. I think I'll ask my consultant if there's some kind of strapping I can get to speed it up this time. It definitely looks different in the morning when I wake up to when I go to bed at night. It's still a bit unsightly, and of course it'll never look normal, but it seems to work. That was always supposed to be the deal.

A few days, and a few baths later, looking much better :)

Clothes - I had all my jeans and trousers out which I haven't worn for 29 months. The intersection of the set of trousers I can get over my leg with the set I can fasten around my (now much bigger) waist contains but one member, and even that pair is on the tight side. So, I either need some bigger, looser pairs or I need to slim and get the swelling down quickly.

These, the only pair of jeans I can get over my leg and around my waist!

Which brings me on to exercise. Last Friday I had my first physiotherapy appointment since the frame removal, and I was looking forwards to it because I've known for some time that physio would only start properly when my leg was unsupported - which it hasn't been at any point since the accident - until now. So, I expected to be able to do a few more exercises than before. I wasn't disappointed! Of course I have a lot of stretching to do to try to free my ankle a bit because it still doesn't move very much. I probably have just about enough dorsiflexion (that's moving your foot towards you) to walk, but obviously more would make it easier and more natural. I have more plantar flexion (moving foot away from you). I've got some exercises to do with a step - stepping up and wdown in all possible combinations of which leg first forwards and backwards - and also lowering (well, trying to) my ankles over the edge of the step. The hardest is stepping up onto the step backwards leading with my left leg. At the moment I can do it if I first do it a few times holding on to something. I think that must just be a case of trusting my leg. I also can't walk downstairs without holding on to something - that is going to take a long time I think! Stretching is also tough because my ankle is really really stiff. I'm supposed to bend my knee towards a wall from a stretch position with my foot flat on the floor. Of course I can bend my knee freely, but seemingly not at all with my foot flat on the ground. Hmmm. Work needed, patience too I suspect.

Next, I have to try to drop down to only using one crutch, all the time, because using two now will hold me back - I think I was expecting this, so my physio confiscated one of my crutches and I left the appointment with just one. That will be a struggle for a while, but the idea is I will walk again without crutches, so my strength and stamina for that has to be built up. My crutches have become crutches, it seems :) Of course I do have more crutches at home in case I really need two at any time.

BUT by far the best news since they told me they could reconstruct my leg and not have to amputate it, is that I have now been given the green light to go swimming and, wait for it, to ride my bike outside. I wasn't really expecting to be allowed that yet, but my physio said "why not?" when I asked him meekly. "You need to reclaim your life." Yes I do. That was last Friday, today is Wednesday. So far I haven't been outside on my bike. Hold on, hold on, I hear you cry - you've been waiting for this for two and a half years, what's wrong with you! Yes that's right, I say, but I also say, I've waited 29 months, so I can wait a few more days until I get my head around the idea and feel comfortable about doing it.

Rebecca grabbed this cheeky picture of me suffering.
First time on a bike for 29 months.

On Sunday I rode my road bike on the trainer properly for the first time. I set a target of 10 minutes. 2 minutes in, I was knackered, thighs burning, heart rate at maximum. Maybe I should have just turned the pedals for 10 minutes, but that's not really my style, so I pushed it, and pushed through the 10 minutes. It was so hard, but it felt so good to be able to feel the burn again. It was a bit tricky for my left foot to stay in position on the pedal, so I have reattached my clipless pedals to fix that little niggle. I posted my 'ride' on the Strava site - something I've been dying to use. The trainer is not a good measure really for a number of reasons but mainly (I feel) because you can't really have a rest and free-wheel like you would on a descent on the road. And you don't have fresh air and scenery to keep you happy. But it is good for pushing you :) Needless to say, however much I try to convince anyone otherwise, or however much they try to convince me, I am hopelessly unfit. But, I have a data point now, for the progression back to where I was. Joy of joys, that process can start.

Yesterday I sorted out my road bike so I can take it outside. This wasn't the original plan - that was to use my old mountain bike, but I found to my dismay that the fork has rusted :( Maybe if I take it out and batter it a bit it will come loose again, but I don't really want to 'batter' it at the moment in case I batter my leg in the process. So, road bike it is. It took me a little while to check and clean and everything but I think it's good to go now. I'd have gone yesterday afternoon if the weather had been better, but it's November now and rainy season appears to have started in High Peak. But it's ready, when time and weather permit.

I have, however, decided on a route to do first of all, to put down a proper marker. I looked back in my ride log from before the accident, and found a loop I did once around here, which is not very long (11.7 miles) and which contains a long, reasonably hard climb about halfway round. I think this is perfect. Of course, the first time, I will be horrified at how hard it is and how slow I am (won't I?), but it will mean I can see exactly where I am with respect to where I was, with the added bonus that it was in February 2009, fully a year before I reached my 'peak' in Spring 2010. Naturally I have other rides I can compare with later on, but they're all further and harder and I want (need) to start small. I probably need another 10 mile route, 2 x 5-mile routes and a 25 mile route too, to break up the training a bit more properly. I am so pleased to discover that my enthusiasm for training and testing and riding has not diminished. I didn't seriously think it would have, if anything, it would get stronger, but you never know. This experience could have killed it completely. It hasn't.

Last night I spent some time on the internet looking for a new helmet, the only thing I really need before I can go out. I will also replace my nutrition products which I had to bin because they went out of date in 2011 :( And I found some new overshoes for the weather and probably I need a second pair of long-legged bib shorts too. Ah, you see how it goes! I love this stuff :)

The best thing: 2012 will not be 0 bike miles :)