Wednesday, 26 October 2016

Oct 25 2016 - Pubic hair removal

09:30
I am battling with my current socket.
When I put it on first thing in the morning, it is great. But soon the stump goes farther and farther into the socket, and puts more force on the stump end. Inflating the bladders helps, but I feel I need many more bladders. Especially up high in the back of the stump. This is where I need to add stump socks a few times a day. Yesterday I had on 4 socks by the end of the day. That means 4 times during the day I have to take off pants, take off leg, add sock, then put leg back on and then get dressed again.
Around the house I only wear my underwear. It makes life a lot easier.

I wanted to find a more permanent solution to the problem of the silicone liner pulling my pubic hairs as I walk. I tried shaving, and that sort of works, but stubble is worse than hair, so I have to shave every day.

Yesterday I went shopping at the Pharmacy.
I went straight to the "wrist brace" department, and tried on different braces to make my cane walking easier. I wore it from then on, and bought the empty box.
I stopped a white lady in her 50s and asked her about removing pubic hairs. She advised hair removal creams, because the new hair that grows, is not a stubble, but new hairs.  I bought some.
Then I got my prescription drugs from my one legged buddy pharmacist. We chatted a bit.

When I got home I wanted to test the hair removal cream.
The box says to first test the cream on the inside of my elbow to see if there is any allergic reaction. The box also says to...
 "Leave the cream on from between 3, and 10 minutes. Don't guess at the time, use a watch to make the time accurate."
So, I used a watch to make sure I was precisely accurate between 3 and 10 minutes. :-)
There was no rash or pain, so I smeared some on my crotch hairs, and 5 minutes later wiped the brown, sticky, goo off. It seemed to work, and this morning I did not put on a pair of cut up pantyhose before the liner. I'll have to wait and see if it is a good thing or not.

--
Oct 26 - 03:40
I went to bed at 23:00, and woke up at 03:00. My stump itches, and I have a burning pain below where my left knee should be.
I don't know where this PLP came from, and the itching isn't from where I did the hair removal.

 Yesterday was an easy day. I drove to the mall where I had lunch with a friend. We then did a short walk to a knife store and a book store. Then back home.

Sometimes if there is a bit of glycerin or cream inside the silicone liner, there will form blisters. Where the skin and the silicone are stuck to each other, and where the skin slides next to the silicone will form blisters from the stretching of the skin between the two areas. I think that is what happened. There was no sign of discomfort as I walked today, but now there are blisters about half way up my stump on the outside of the stump. Why is nothing ever easy?

My buddy has high speed internet, and downloads financial news videos for me. I have a few Kaiser reports I can watch till I feel sleepy, or the pain quits. I did some drugs again. I thought the drug use was over. Not so.
--






Monday, 24 October 2016

Oct 24 2016 - PLP and can't sleep.

01:15
There are many reasons why I can't sleep.

I have been trying to increase my daily walking to get ready for another park run before I go to the states. This socket really hurts on my ischail bone, and I have blisters and a rubbed raw spot. The prosthesis place is making a new socket with air bladders inside it. I so hope it works well. The new socket should be ready by Thursday.
This next socket will probably be the one I go to the states with, so it better be good enough for 6 months. I seem to average about 3 weeks per socket. Needless to say I am concerned about that.

I walked about 1.5 km every day last week. Any farther is very painful. The whole air bladder thing is good because it allows me to change the fit of the socket. But with the increase flexibility come increase complexity. The best way for me to inflate the bladders is through the zipper in front of my shorts. It is a little shocking to other people. They see me unzip, play around inside there, then starts pumping a rubber pump.  They all have dirty minds. :-)

On Friday, I was walking back from the shops, and my Achilles tendon started hurting. I had that a few years ago, and had to wear a moon boot for a month to fix it. I don't think I could use a prosthetic leg AND a moon boot at the same time.

I walked slow and gentle the rest of the way to the house. I was almost to the front door, when I fell in the driveway. As usual, I don't know why. I was walking, then I was face down. I hurt my right wrist. I'm sure it is just sprained. It is swollen a bit and tender, but everything seems to work OK.
Now I can't use the cane or the crutches. Even the wheel chair is difficult. I have to use the wrist bone to push on the tire.
With blisters on my ischail, sitting in the wheel chair sucks a bit, add to that a sore wrist, and I decided to play computer games all day Sunday.
I had planned on buying food this Sunday, because I am so close to being on a forced diet. For real food, I only have eggs and Muesli. But getting around with this wrist means I couldn't shop.
I did find some old, unopened bran self raising flour, so I made some flat pan bread. Not healthy, but tastes good with enough peanut butter and jelly on it. Actually anything tastes good with enough peanut butter and jelly on it.   :-)  If my wrist doesn't get better soon, I may find out how eggs and peanut butter taste.
(and Muesli?)

I went to bed at about 22:30 and couldn't sleep. When I turn out the light, I start a one hour white noise generator. I have not heard it quit in a month. I am sound asleep by then. But tonight I was still awake when  it quit. I started it again.
For some reason I was having PLP. First time in a long time. My wrist also hurt when I moved in bed.

Having only one leg means it is harder to sit up in bed. I used to just hold both feet in the air, with my legs straight, and I could sit up. Now nothing happens when I do that. I now have to roll onto my side, then push up sideways with my arms, until I sit. I didn't think about my wrist, and I hurt it.

When the noise generator quit the second time, I just got up. I took some pain drugs for the first time in many weeks, and I am now waiting for them to kick in. I don't know if I took the drug for the wrist pain, or the PLP, or the ischail blisters. I guess it doesn't really matter.

---




Wednesday, 19 October 2016

Oct 19 2016 - Putting Force Sensors inside my prosthetic socket.

I have been building a sensor system to show the forces between my prosthetic socket and my stump.

I am using some force resistive pads as sensors. They change resistance as the force on them changes. They can measure from 0 to about 20 kilograms of force.
I sense the change in resistance with an Arduino computer, and then use the Arduino to vary the power to 3 LED lights.
The LED lights are two color ones. Red and Green. I am using Green to show that things are on and working, and the red to show the pressure.

It looks like this.


I put the 3 force sensors that I had, and their wiring,  in-between two pieces of thin hard, clear plastic. I put the wiring for the LED's, and the LED's  in similar plastic. I then connected the two pieces of plastic so that when the plastic with the sensors is inserted into the socket, the LED's will always be in the same spot on the outside of the socket, where the sensors are on the inside of the socket.

 I tested everything.



Then I slipped the sensors into the front of my socket. The lower sensor should be down by the end of my stump, and the top sensor at the top of my socket. The middle sensor is about where I have my inflatable air bladders.
Then I test if it all works, by standing in front of the mirror.

Then I inflated the air bladders.

All my walking with the sensors never lit the bottom LED. This means there was never any pressure on the lower part of my stump.  I don't know why I need lights to tell me that. Pain usually does that job. :-)

To be really effective, I would need about 50 sensors in the socket, and a way of recording the forces, so it could be played back and studied. Tomorrow I go to visit my prosthistist. I will show him my invention.
He and I need to talk lots about me going away for a few months to America. I fear it will be on my old Mauch Knee. :-(  I am spoiled from wearing the Total Knee 2000.

--


Saturday, 15 October 2016

Oct 15 2016 - Life getting Real.


I have just spent lots of money, and bought plane tickets to the USA.
 I leave South Africa in the middle of November, for Daytona Beach Florida. I should be back in South Africa by May-ish 2017.  I bought tickets that I can change the return date up until November 2017. That would be a whole year away.
If I feel that I can return to my old life style of 6 months SA and 6 month USA, then I would want to be in both places in summer, NOT winter. That means staying till November 2017 would put me back in the right cycle.

I have some Oncology tests next month, on the 9th Nov and the 10th Nov. Assuming these are OK, then by the following week, I'll be in Daytona Beach.
My Florida buddy says he will fetch me at the airport, and take me to the RV.
His House, and the RV both survived the Hurricane.
 Some guy on TV in South Carolina, was asked if his house was damaged by the strong wind from the Hurricane. He answered that there was no wind damage at all, because his whole house had been under water. :-)

I am very concerned about wearing my prosthetic leg for so long during the flight.  It will be 34 hours from my Pretoria house, to the RV in Florida. After about 5 hours, I usually want to take it off. :-)
I will need many stump socks to enlarge the stump as it shrinks.
I have spent a lot of time with Delta Airlines on the phone, trying to get a good seat, and arranging everything. They want to take the prosthesis and check it in as baggage. I definitely don't want that.
I will start wearing it longer and longer each day, to try to be ready for the trip. If I get a seat with plenty of room, then I will be able to take the prosthesis off and hold it in my lap. If I get a seat with very little room, then I will still take the prosthesis off and hold it in my lap. :-)

I haven't planned enough regarding my transport while I am in the USA. I'll never drive my car there again.  It has a manual transmission. I really like that car.  :-(
Maybe I can convert it to an electric car. :-)

I am debating just renting a car at the Daytona airport when I arrive, and having that problem solved for the first week. I will need to do shopping and probably buy parts for the RV. So much, depends on so much. I hate that.

I am actually quite nervous about this trip. I have done all I can to arrange wheelchairs and baggage trolleys at the various airports. All the airports say that wheelchairs are available on a first come first serve basis. That could screw me over during the Atlanta connection. That is one reason I am flying all flights Delta.

I am only taking clothes, toys, my prosthetic leg, and a cane. No crutches or wheel chair. I need to see what will be necessary for living in the RV. I may buy crutches, or maybe a wheelchair once I am there. Unfortunately, the time I'll need them most, is the first few days in the RV. I fear my poor stump will want a few days rest after the flight.
 I also am worried about the prosthetic leg while walking on the Florida property. Walking on uneven ground is a real bitch, and that ground is all uneven. Clumps of grass growing in sand. Moving around on the property may be easier with crutches.
I am excited about getting to see the bears again. They roam all over the Florida Property. I wonder which is best for running away from bears, crutches, or a prosthetic leg.
Here is a picture of a bear and cubs taken from inside my RV during my last Florida visit..


And here is a picture of my RV and a Bear with cubs.


The ranch in Texas will be better for walking, if I stay on the roads. I'll still be paranoid, because I'll be slow. Being slow, AND being in the food chain is a bad combination.

 Inside the RV will be problematic. The passage is to narrow for crutches or a wheelchair. I have racked my brain to try to figure out how to get into the bathroom in the RV. I am so dependent on grab bars everywhere. The grab bars I have in this house would rip the walls apart in the RV.  Here in Pretoria, I also have a very strong bar going across the ceiling in the bathroom.

 Wheelchair ramps are only useful for wheel chairs. They are counterproductive with a prosthetic leg. I am very concerned about the steps up into the RV.

 I am so worried about a thousand things. But that is what will make "everything" I do exciting. Maybe not pleasant, :-) but definitely not boring.

 The life I had a few years ago, was designed and built by me. It was how I wanted my life to play out. That has changed. Fate, did not listen to my desires.

 I still want to live on the cheap. But I may have to throw money at any problems like hotel, car rental, buying  wheelchair, crutches, or even a different RV if necessary. Spending money for non-toys gives me hives. I am allergic to it.

 I may have to ask my friends for help in hooking the RV up. Electricity, water, and sewage. So much depends on the health of my stump. I hate being totally dependent on something that is so variable and nebulous. I can not wrap my mind around hooking up the RV sewage pipes, while in a wheel chair, on sand while in Florida, or on rocky ground while in Texas.
 A sore on the stump may mean a month without a prosthesis. Only a wheelchair or crutches. Of course, if I would lower my life expectations, and be happy with just reading a book, and looking out a window, then it wouldn't matter as much.

 I need to visit my Brother in Washington..
 I would like to drive the RV to Texas, but I'll fly to visit Washington.
I think I'll spend a few months in Florida, with good friends, then drive the RV to Texas, and spend a few more months with good friends.
If I need help driving, I'll ask someone to drive with me. Something simple like a sore stump, and bad phantom pain would mean drugs and not driving till it gets better.
I could get stuck in someplace like NOLA indefinitely. (This is a good lead in, for a talk on suicide.) :-)

Another patient I knew from my chemo days has died. He had colon cancer. He was healthy on a three month check up, then dead before the next three month check up.
 I also am sort of stuck in South Africa because of my Medical Aid. I am so sad that I don't see me living in America. :-( I should be with bears, and coyotes. I understand them better than people.

I just noticed how almost every paragraph of this blog, starts with the word "I". That should tell you what the blog is all about. :-)
The word "I" is used 84 times. Please don't tell my Buddhist teacher.

 I have now expressed some of my fears and worries. (85)

Since being diagnosed with Angiosarcoma, and having my leg amputated, I have kept myself securely encased in my small world. A world of easy wheel chair movement, lots of grab bars, and everything in easy reach. Now I will experience real life. On it's terms, not mine. (87)
I feel like this is where all the "theory" of daily prosthetics use, gets real. (88)



Sunday, 9 October 2016

Oct 9 2016 - Donning, an Air Bladder Socket

My newest socket has air bladders in it It is great, but takes some getting used to. I designed and built the air bladder part myself.

I went to Bradley to see if he had any air bladders that I could put between the flexible liner, and the fiber glass socket. He had some cool air bladders. They are about 2 inches by 4 inches. (5 cm by 10 cm).
I got 2 of them. Each comes with a valve to trap the air pressure, and a pump.

Here is what the bladders look like.
The bladders are supposed to take 100 kg (220 pds) of force on them when full of air.
It is not easy to see on the picture, but the one end of each bladder is double the thickness of the other end.
I only have only one pump, but the pump attaches to the bladder with a quick fitting adapter, so I can carry the pump in my bag rather than on the leg.

During the construction and designing, I had many failures :-)
DON'T do it like this :-)



If you remember earlier this year, I was complaining about it taking 10 minutes to put my leg on. It now takes much, longer, and requires more parts and accessories. But it doesn't hurt. That is vital and SSOOOO important.

Here is my morning procedure:

1. Take off the stump compression sock that I sleep in.


2. Put on part of a lady's large pair of tights. I had to cut away most of them. Their purpose is to stop my pubic hairs from getting pulled by the silicone liner. I tried shaving, but the stubble was worse than the hair being pulled out.


3. Next I smear glycerin over the end of my stump. This is to ensure that the silicone liner does not pull the skin on the stump end. Any pressure or force on the stump end is painful.


4. Now I liberally spray a mixture of alcohol, glycerin, and distilled water into the inside out silicone liner. This makes it easier to roll the silicone liner onto the stump.

5. Gently roll the liner onto the stump. I have to be very careful doing this. Any time I pull the liner toward my hip it hurts.

6. Now the liner is on, and the top part is over a part of the tights. The liner has small silicone ridges around it, down the length. On my last few sockets, these would form a seal for the vacuum in the lower part of the socket. This socket with the variable volume, caused by the inflatable air bladders is unable to form a vacuum seal with these small ridges.


7. Put on a sealing ring.


8. Now I put on a thick wool stocking on the top part of my stump because the top part is not adjustable using the bladders. The bladders only are on the bottom part of the stump, but not near the end of the stump. I need a little more security at the top part, so I put on a thick sock. I make sure the vacuum seal will not be broken by the wool sock.


9. Now I inspect the hoses, valves, and bladders. The bladders need to be fully deflated. I have replaced the metal hose clamps with Velcro. The Velcro strap wraps around the socket 4 times.

10. I now tuck the hoses out of the way, and get the valves in a place where I can reach them when the socket is on the stump.


11. Now I inspect all the pieces of foam I have inserted between the flexible liner and the socket shell. These will put pressure where I can not put the air bladders. I use 3 types of foam. They are color coded by compress-ability. White, Red, and Blue.

12. Now I liberally spray the inside of the socket with the same spray I used to put the silicone liner on. With out lubrication, the sealing ring will not slide against the inner flexible socket liner.

13. Now spray the sealing ring, and the whole silicone liner to make it slide easily into the socket.

14. Put the stump into the socket.

15. Push, shove, and bounce to get the stump down as far as possible into the socket. This is the part that scares me most. Any friction causes the silicone liner to try to move up the stump, and forces against the end of the stump. This can be very painful. It is pushing HARD, but gently. Duh!



16.   When the stump is as far in as I can push it, it is still not in far enough. This is a bad time, because since the stump isn't far enough into the socket, the leg is way too long, and not steady or supported well. Walking is very difficult.

17. After about 30 minutes of bouncing and walking around the kitchen, the stump is far enough into the socket.


18.  I check by sticking my finger in the vacuum valve hole. This way I can feel exactly how far the stump is into the socket.



19. Now to attach the pump to the bladder and pump. The bladders push securely on the sides of my thigh, and hold the femur very tight. The Proprioception increases dramatically. I can feel every movement of the foot.

20. Now I struggle and battle, to get my shorts on. Then I wait for my Buddy to drive up and take me to lunch. :-)

--

One of my readers sent me the links to some interesting sites about bionics. Cool stuff.

http://www.cybathlon.ethz.ch/en/

https://www.youtube.com/channel/UCqGx-eUykZLDKjjrwRhfilQ/feed

Thanks for that. :-)

--

Friday, 7 October 2016

Oct 7 2016 - Hurricane and Air Bladders.

03:30
I can't sleep.
No special reason.
 Not cancer, or pain, or drugs.
 Just a normal, garden variety, can't sleep.

I don't think my mind ever completely rests. I woke up at 03:00 thinking a jumble of thoughts.
 My Florida friends and hurricane Mathew.
 Air bladders for my prosthesis socket.
 My poor solar batteries.
Getting my car through the roadworthy test.

All these thoughts flooding seconds apart, over and over. No one thought taking charge.

Some of my Florida friends have boarded up their houses, and some have fled to the West, and some have done both. Away from the East coast and the hurricane's path. Usually these friends either have hurricane parties while the wind and rain blows, or else they just work as normal. Not this time. The predictions must be real bad. I have these people in my thoughts.
The eye should pass right over one friends house. My poor neglected RV is only 16 miles from the center of the path. It will probably get damaged. :-( It is deep in a forest, so it is protected from the wind, but the roots of the trees are in sand, and often the wind blows the trees down.

--

I have always thought of having multiple air bladders inside the prosthesis socket, which would allow the varying of pressure at different points against the stump, as needed. But the mechanics of incorporating bladders into the socket design require much thought and design work. I have a medical boot that is mainly used for sprained ankles.
It has air bladders inside to control pressure at different parts of the foot to prevent the foot from moving around. I just opened mine up and removed two bladders. Now to put them somehow into my socket. I think between the soft socket liner, and the hard shell of the socket. Then when they are inflated, they will press the liner against my stump. Ideally there would be many many bladders, each individually controlled. I question the strength of the bladders.
A perfect fitting socket is every amputee's dream.

--

Last night while I was watching TV, using headphones, we had a power failure. My solar system batteries kicked in, and the inverter supplied power to my house just like it was supposed to, but I didn't hear the alarm. After 4 hours of using the lights, TV,  2 computers, and cooking supper, I only then realized the power had failed. I normally reduce the electricity usage as soon as the power fails. This time I didn't know. So when I headed for bed at 23:30 I noticed my poor batteries were way below the minimum I normally allow them. Discharging batteries to far hurts them. :-( Sorry batteries.
Right then, before I could reduce the usage, the mains power came back on, and started recharging the batteries. They have been on high charge for about 4 hours now.
I need to devise a fail safe alarm, not just a soft buzzer to warn of power failure.

--

I got the car brakes fixed. The one slave cylinder had leaked real bad. Now I need to take it through roadworthy before I can put it into my name from Maddie's name. The papers Maddie sent arrived yesterday. 14 days to get here from George.
At the brake repair place, I saw a notice for a company that waits in line for people at the motor vehicle department offices.
We-Q-4-U.
 In British colonies, the word "Que" means to stand in a line. These people take all my papers, and stand in line for hours in my place. It is a good employment of poor, uneducated, people. They mainly do vehicle registrations, and renewals.
They are offering a new service, where they take your car through the roadworthy inspection, then take it to mechanic to fix any defects, then back to roadworthy, and keep doing this until the car passes.
My car has non standard tires. South Africa law requires the tires to be manufacture recommended tires. My car has Mag wheels with bigger tires.
WE-Q-4-U says they will temporarily swap tires just to pass the test, then swap the tires back. This alone will save me R3000, that I was going to have to pay for new tires.
Then they take all the papers and complete the registration into my name.
We-Q-4-U charge a lot of money, but it will save me many hours of standing in lines, and dealing with people that I would rather do harm to, than smile at.
--
My hot milk drink is finished, and I am sleepy now.
I am hoping the humbling, hurricane doesn't hurt my friends.
--