May 25 2018 - Prosthetic Accessory Test

It has been a month since my last blog. Not much has happened, but what has happened has been depressing, and exciting.
Friday 4 May 2018
My socket had been bothering me, so I visited my Prosthetist. He had a bunch of new "Toys" for me to try out for my prosthetic leg.  :-)
Toy1 - A rotation adaptor is a device that fits between the socket and the knee that allows the lower leg to rotate. While sitting, this allows the lower leg to be twisted 360 degrees. I can rotate at the knee and put the foot right in front of my face.

This guy is using a rotation adapter

I personally could not find any use for it, other than as a party trick.

Toy2 - A screw that replaces the normal pylon, so I can lengthen and shorted the pylon. This looks like something I could really use.

During the ParkRuns, I battle when the terrain slopes down from left to right. My left prosthetic leg is always way to long, and that makes walking very difficult. If I could shorten and lengthen the leg easily it would help me lots.

Toy3 - An ankle device made for ladies that change their heel height often. If the heel is thicker/taller, then the toe will not have pressure on it to break the knee loose as I walk. High heel shoes mean the prosthetic knee will remain stiff. This problem is also evident when walking down a hill. My weight never transfers to the toe as I go downhills, so the knee never bends.

This device changes allowable heel height (actually the angle of the foot) with the push of a button.

This is my old fixed ankle.

Heel height Variable Ankle.

You can see the big white button on the side. Pushing it releases the foot, so the angle can be changed. It only is variable for about 10 degrees, I wish it did more.

Toy4 - An extension assist. This is a spring and cable assembly added to the inside of the knee to help push the knee into the straight extended position.

It takes pliers and about 5 minutes to install. There are three different strength springs. 

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On the ParkRun I was doing that Saturday, there is a 1 km section where shortening the left leg 1.5 cm would help, and a 1.5 km section where a 3 cm shorter leg would be nice. On the rest of the run, a normal length would be best.

The fancy screw pylon would only add or subtract about 1 cm to the length of the leg. My prosthetist suggested that maybe I could just lossen the bolt, and slide the pylon out of the ankle or out of the knee, then tighten it back up. I tried that and found I could safely lengthen and shorten the leg by a total of 3 cm. :-)

I Cut the pylon shorter, then marked the pylon with lines to indicate the different lengths I would require for the different parts of the run.

I decided to not use any of the new "Toys" on the Park Run because I had not practised with them.

----------------

Saturday after the ParkRun.... 

:-( My poor stump is in such bad shape. Blisters, and lots of pain. 

The leg shortening worked well for the first half of the race. I was at the half way point 15 minutes earlier than last time. I was feeling good.

Then my stump bottomed out. PAIN.... I stopped and took the leg off and added a thick stump sock, hoping to stop the stump from going so far into the socket. That made the socket very tight, and I could feel throbbing, which means blood can not get out of the stump. After about half a km, the stump was again bottomed in the socket. Every step hurt, and the throbbing meant I could not add more socks. 

The second half of the run was on pavement, and it took me 25 minutes longer than the first half, which is on rough terrain. 

I could feel blisters forming on the stump, then the blisters popped, and soon the sweat was getting into the popped blisters. 

I finished with a very slow time, went straight to the car and removed the leg, then headed for home. Once home I could not put the leg on because the stump was so sore. Fortunately my crutches were in the car, and I could get into the house.

A quick shower, and lots of anti-inflammatory drugs, and into bed.

I was not able to put the leg on for three days because of the swelling of the stump. I had two rows of blisters, and lots of sores on the end of the stump.

The next 10 days were short walks only. I did get to try out the "Toys". The rotation adaptor was put aside. I could not find a use for it.

The screw pylon was also set aside. The sliding of the pylon in and out of the knee and ankle, worked very well, and is quicker than screwing in and out the pylon.

The extension assist ended up having a benefit I had not considered. The spring makes the leg go straight much quicker, and it slammed straight. I was able to set the extension resistance more, and then the fast extension got smoother. The biggest benefit was that the spring locks the knee as a soon as it is straight. I no longer need to make sure the knee is straight, and locked before putting weight on it.  It automatically goes straight and locks. I like that a lot. I feel much safer.

I tried the different springs. The stiffest was very stiff, and may have been ok for a hard core sprinter. The lightest spring was ok for walking around the kitchen. I ended up using the middle firm spring.

I next put on the variable ankle. I doesn't seem to have enough travel to be of any use. I took it back off, and put on my solid ankle. Then after two days I decided to try it again. It weighs more than my solid ankle, and I can feel the extra weight. It does seem to help some when walking down hill, because I can lower the toe, and that allows the knee to break loose on downhills. But then I took it off.

Then a few days later I put it back on. Duh!!!

I went to a place that had a long wheel chair ramp. It is about 10 meters long, and is exactly a 10 degrees slope. 

I set the ankle so it is good for flat ground when the toe is at the farthest up position. Then before going down the hill, I push the button, and stomp on the heel to force the toe as far down as it will go, then push the button again to lock the ankle in that position. With the toe down like that it is very hard to walk on level ground, but I can walk normal down the slope. That is very nice, because I normally have to walk down slopes with a stiff prosthetic leg because the knee will never break loose. With this variable ankle set to max toe down I can do the wheelchair slope easily. 

The price of the variable ankle is about R12,000 ( $1000). 

Yesterday I went to get measured and fitted for a new socket. Hopefully it will not be one that allows bottoming of the stump.

The new variable ankle is almost one cm longer than my fixed ankle. I need to shorten my pylon, so it will be adjustable like I did on the ParkRun. But since I am getting the new socket in a few days, I will wait before cutting the pylon.

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Nov 14 2016 - Leaving for America...Flight Cancelled....Now to Plan "B"

07:00
Up early getting things done. I am still waiting for authorization to get 6 months of medicines from the medical aid people. I fear I'll be going for 6 months, with only one month of drugs.

I just did laundry.

I should be at the prosthesis place in an hour. For a last check and tightening of everything.

I am finding the air bladders to be more uncomfortable than using stump socks. Stump socks distribute the weight all over the stump, where bladder only press where the bladders are. It is far easier to just pump the bladders when the socket becomes loose, or my stump goes down inside to far, than it is to put stump socks on, but there is more discomfort. The bladders are great for when I am in a store, or someplace that is inconvenient to put on another stump sock.
If I give a pump every hour or so, then the stump never gets too far into the socket, and when the bladders get uncomfortable, I release the bladders, and put on a stump sock.

Of course the whole bladder/stump sock thing is for when I am just walking short distances. On a long walk it would be different. If I plan my day for only short walks, then I can manage quite well. I have not used a cane for 2 days, and have been wearing the prosthesis for about 10 hours a day.

Every evening when I take off the liner there are blisters on the stump. The blisters go away over night, and by the morning they are usually gone.
Blisters can have many reasons for forming. But they form easier in hot and moist conditions. Like inside my silicone liner. I am paranoid about any chemicals inside the liner, and I wash the liner every time I take it off with special bacterial soap that has no added chemicals, and I rinse the liner well.
I don't think the majority of my blisters are caused by friction. Some are caused at the edge of where I put slippery lubricant. The skin gets a shear force where the lubricated area ends, and the sticky silicone begins.

Little blisters on the end of the stump are caused by the suction sucking water out of the skin. Those go away in a few hours when the suction is reduced.

The worst blisters are at the edge of the air bladders. It is like the increased force of the bladders makes that skin slide less than the skin right next to the bladders, and that shear force causes blisters. They don't go away so quick, and can sometimes still be there the next morning.
--
Nov 15 2016 - Tuesday 08:10
I got up early, and re-re-rechecked my suit case. Made coffee, then checked online for mail. First thing was a letter from Delta Airlines saying my flight for today has been canceled. The incoming flight didn't happen because a truck hit the plane while loading the baggage in Atlanta.
They rebooked me, but there is no "wheel chair" accessible flights available this week.
I sent a mail to my travel agent, making it her problem. Now I wait.

Yesterday I spent 4 hours with the prosthetic people. They were great. I got tons of spares and foam, and tape, and glue, and screws, and bolts. They showed me how to do every thing to repair the prosthetic leg if necessary.

The Medical aid came back saying that since my medication was on their Oncology plan, I could not get advanced medication. I can only do that on "Chronic" medications, so they are transferring all my Oncology medicine to Chronic. This can take a week, so I was leaving today with only one month of medicines.

I will have to eat out till the next available flight, because I ran my house out of food, planning on leaving the fridge off and open from this morning.

--

In the old days, the only thing in life, that was out of your control, was nature.
It used to be that a person worried about the weather, getting eaten, volcanoes, meteorite strikes, and earth quakes. Now a person's life is affected by SWAT teams, legislation, traffic congestion, bureaucracy, and corporate greed, in addition to nature.
I guess that is why some people prefer to live in Northern Alaska or Canada. There you only contend with nature.  What a refreshing thought.

--

16:30

Delta just called and said they will give me the same seat and wheelchair access tomorrow. So maybe I'll only be a day late.

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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.
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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)

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. :-)

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May 20 2016 - Testing the Total Knee 2000

14:30
Last Wednesday they took a new plaster cast of my stump. Bradley first measured my stump circumference, and said it is much smaller, and time for a new socket. We are not sure if this will be the final socket, or just another temporary socket on the path to a permanent one.
The constant wearing of a silicone liner, or a sleep shrinker sock gradually reduces the volume of the stump. Some people have a stump that looks like a skin covered bone. My stump varies in volume more than most. That makes it hard to fit snugly inside the socket.

Here is the nylon sleeper sock I wear at night. This is necessary to make the stump small enough to fit in the socket the next morning.

 If I don't wear a liner for a few days, then my bare stump is so large, that it won't even fit in the socket. If I wear a liner and wrap the stump, then the next day my stump is so skinny, it goes right to the bottom of the socket with little touching of the sides. This variance in volume is why I use stump socks. Stump socks  are toeless, fluffy, wool socks that are used to increase the volume of the stump.

Stump socks like these go between the stump liner, and the socket.

A tight, snug fitting socket makes feedback from the prosthetic leg much more sensitive. I can easily "feel" the leg when it hits the ground, and I can "feel" if it is locked before I put weight on the leg. Each layer of stump socks reduces the sensitivity, and makes the leg feel more "sloppy".
Also having layers of wool sock between the leg socket, and my stump makes the alignment of the leg to be less precise. The prosthetic leg is allowed to rotate on the stump more than a tight, snug socket would allow.

I normally wear 3 stump socks now to get a tight fit. I am looking forward to the new socket that should require no socks. Of course needing no socks, also means that a slight swelling of the stump may prevent the stump from being able to fit into the socket. A smaller socket means more control and feedback when everything is working as should, but also means less variance is allowed in the volume of the stump. Socks can add volume, but nothing can reduce the volume except constant wearing of some kind of stump shrinker.

While I was at Bradley's, his next patient arrived, a 5 year old boy. The way this boy was zooming and jumping and climbing left no doubt that this kid was used to his prosthesis. He lost his left leg below the knee about 2 years ago. while I was getting my leg on, he came over, and swung on the parallel bars. He looped his feet and lower leg through his hands, and hung by his knees. Cool to see.

Today I decided to give the Total Knee 2000 a good walk. I walked about 4 km in 1:20. The total knee swings forward much easier than my Mauch knee. It also feels more stable once it is down and locked. The ease and quickness of change from locked to floppy still worries me. But I never stumbled or fell.

This short video shows how easy the Total Knee 2000 locks and unlocks
https://youtu.be/m6Mjxi1Wm9U

One thing I did notice was while walking with my Mauch Knee, I sometimes hear the toe scrape the ground. Just a slight "swish" but enough to warn me that my attention is not all there. Today the Total Knee never did a swish. The fact that it shortens the leg on swing forward is a welcome, noticeable, characteristic.

Maybe tomorrow, I'll try a walk to the mall.
--

Feb 23 - 24 - Last Chemo (KOW) :-)

Feb 23, 08:00
I have a busy day planned.
First, my last blood test is this morning.
I have a prosthesis appointment at 13:00 to get the leg adjusted for my new shoes.
Then at 14:00 I have a physio appointment.

Tomorrow will be my last chemo for awhile. I have done 16 weeks of weekly blood tests and chemo. I am looking forward to no needles for 6 weeks.
I am also looking forward to finding out how much of my chemical imbalances are chemo related, and how much are drugs related. I believe my narcolepsy is chemically induced from the chemo. That is why I will wait about 5 days after my last chemo before I will risk the drive to George.

My eating habits will improve while I am being fed by Maddie in George.
 I think that eating only a hand full of rice a day, is healthier than eating a box of Twinkies and a bag of Doritos. Healthy eating isn't only about eating healthy food, it is also about NOT eating unhealthy food.
Except that some foods, such as ice cream, are nourishment for the soul, not the body. :-)

Today is cool and cloudy. A relief from the high temperatures from the last week. This whole week should be cool and cloudy with afternoon rains.

Yesterday I walked 2.0km in 41 minutes.
--
16:00
Blood taking was normal. Hopefully I will not see the blood ladies again soon.

I had a long list for Bradley, the prosthesis guy .
Bradley says he has a good friend, Allan Oats that does prosthesis in George, and he recommends him highly. He says I'll be in good hands for any emergencies while in George.

He grounded off part of the socket.

He adjusted the leg for the new shoes.

He changed the setting to be better for faster walking.

Whew...Physio was rough, Leonie must have some Nazi blood in her. :-) We first went over all the exercises she wants me to do while in George. Then we did all the exercises. Then she played like she was my girlfriend, and had me explain each exercise to her and teach her how to help with each one. There are about 10 exercises, and maybe half need a partner.
Maddie and I will have to go shopping in George for exercise toys. I'll need a brick, a tennis ball, a soccer/basket ball, and a heavier sand filled ball.
I had to shower when I got home.

In the parking lot was an Indian guy selling samosas, so I bought lunch.

The physio has me tired, but also lots of Phantom pain. I am trying to cut down on drugs. I have picked a bad time to do that.
--
Feb 24, 18:00

I ran out of pre-paid internet last night and couldn't publish yesterday's blog.

Today I first went to the prosthesis place and got some stump socks. Many people on the internet use stump socks.
When I wake up in the morning my stump is a bit large, and won't go into the socket as far as it should. So I walk around with the leg too long for a few hours. I sleep with a compression sock on the stump at night, and it helps, but not 100%.
By around noon the leg fits perfect. This is usually the time I go for my walks.
The fiberglass socket is shaped like a cone, so as the day progresses and I keep putting weight on the leg, it squeezes the stump and forces it to get smaller.
By around 2 or 3 in the afternoon, the stump is fitting too far down into the socket. As the volume  between the stump and the socket bottom gets less, the vacuum tends to get more. This extra strong vacuum makes blood blisters on the bottom of the stump. This can be painful.
The stump being too far into the socket not only makes the leg too short, but it allows the stump to hit the bottom of the socket.  This also is painful, and it is often on the blisters.

Bradley came up with two ideas. They make soft "volume control pads" to fit in the bottom of the socket to decrease the volume between the socket and the stump. This helps to reduce the vacuum, and the soft pads keep the stump off the bottom. He also gave me some stump socks. Because I don't have a problem with the bottom of my stump, the socks have the ends removed. I put them up high near my groin and hip. This widens the upper part of the stump, so the leg doesn't go in as far. He gave me 3 socks, so as the stump shrinks, I can keep adding socks.
Some guys on the internet have stumps that shrink a lot. They may add up to 5 socks as the day progresses.

I next went to get the blood test results. My Leucolytes (white blood cell) count was fine. My Haemoglobin count was the lowest it has ever been. So I recon Maddie will be feeding me chicken livers. Yech!

I was early, so I checked in with the chemo place on my way to get coffee at the restaurant. They said they had a cancellation, and could start me then. I went straight in.
All chemo patients have an interview with the oncologist before each session. Since I was early, she quickly asked if everything was OK, and I said yes. She said she would talk with me after chemo instead.
They started the IV and the four pre-chemo bags of chemicals, then started the actual chemo drug, Paclitaxel. I saw this bag was labeled 152mg, where I normally have 132mg. It is normally chilled, and I could feel the cold go in the arm. Air tends to stay in solution of the Paclitaxel, so they put a 2 micron filter in the line to trap any air bubbles. This dose of Taxel was very milky with trapped air particles, and it was cooler than normal, so less air escaped the solution.

After about 10 minutes the drip stopped. They pushed and pulled the IV in my arm, to try to get it flowing. They decided that they needed a different vein for the IV.
They put in another needle and IV. Grrr...
This one also failed to flow, so they tried another Vein and IV. GGGRRRRR!!!!!
Now my sense of humor had fled the room.

I start trying to trouble shoot the IV system. It must be very similar to aircraft hydraulic landing gear. Right? So I shooed the nurses away, and squeezed the hose. When I squeezed near the IV, the little bubbles moved back and forth like they should. If I squeezed up at the bag no bubbles moved, so obviously there was a blockage. I then squeezed on each side of the filter. On the IV side the bubbles moved, and on the bag side nothing moved. Therefore the filter was blocked.
I explained that if the Taxel solution is too cold, then there will be too much air, and the filter will get full of air, and this will not allow any fluid to flow. I told them to bring me a different filter, and I would change it. I must have said something blasphemous. They looked shocked, and sort of backed off and then said THEY would change the line AND the filter.
Of course then the Taxel started flowing again.
After I chatted with the oncologist, she gave me a form to get blood checked in George after 3 weeks. Then she gave a 6 week prescription for all the drugs I will need. She will call the PET/CT scan people after reading the blood results after 3 weeks, then the PET people will call me with a date for the PET scan, and I'll drive back to Pretoria. So the next time I'll see the Oncologist will be when I have the PET results in my hand.

My precious wind up, single handed watch took a real hard knock today, but thankfully it kept on working.

Now to sleep lots, or stay awake lots, what ever the chemo Gods proclaim for the next few days. Then to start packing the car for the trip. I can't wait to "be on the road again".
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PS: KOW = Knock On Wood