Saturday, November 29, 2014

Update: June thru November

I haven't posted for several months, because I've been busy with health issues. Before 2014 ends I wanted to describe what happened after my second toenail surgery:

By late May both of my big toes had bulky bandages. So I could only wear sandals with velcro straps around the ball of my foot and over the toes.  That didn't provide much support while walking. So I was unbalanced and slipped several times while walking on concrete sidewalks with rocks or sticks.  I only sustained a few scrapes and bruises from those falls until June 28, when I was walking downhill on a sidewalk with scattered landscaping rocks. I slipped on the rocks, slid downhill and fell on my left hip.  When I tried to stand I felt excruciating pain down my leg.  So my husband ran home to get the car and we drove to 'Urgent Care' where I received x-rays which weren't definitive.  So then we drove to a nearby hospital to get a cat scan, which showed a non-displaced fracture of the femoral neck (large leg bone which fits into the 'ball and socket' joint at the hip).  Based on that x-ray I was admitted to the hospital immediately, had nothing to eat until late the next day, and nothing to drink after midnight.

The next morning I had surgery to stabilize the femoral neck fracture with 3 pins and 3 screws.  In recovery my surgeon told me I could walk on that leg now.  Despite problems with medication (the anesthetic made me nauseas and Demerol for pain made me throw up my first post surgery meal), I finally got some IV Tylenol and did well after that. That afternoon I was given a walker and was walking well the next day.  I was released the next day with a walker, which I used for 2 weeks before getting a cane and leaving the walker for my cockatiel who liked to perch on it.  After a week on the cane I started physical therapy and abandoned the cane to walk unassisted.

 After 10 sessions of physical therapy I noticed that I had developed new muscles in my thighs and hips.  So I decided to try on my heavier clothes (fall/winter pants, jeans, skirts) to see what still fit. After a day of trying on pants, I was a little stiff. After the second day of standing in a small closet in a cramped position trying on clothes I could barely move without excruciating pain in my back. I could no longer do most of my pt exercises without pain. Around that time I was scheduled for another x-ray of my surgery site (left thigh) and visit with my surgeon.  He said my femoral neck fracture was healing well, but suggested I get an MRI and get more pt for my back.  I decided to wait until after the MRI before starting pt so the therapists wouldn't have to guess what my back problem involved.

The MRI showed that I had a bulging disc at L5/S1 in my lower back as well as several (old) vertebral fractures.  I had recently gotten a DEXA bone scan which showed significant osteoporosis in my back and right (nonfractured) thigh bone. So the vertebral fractures and osteoporosis were consistent with loss of height (about 1-1/2 inches) over a 30 year period.  So I went for more physcial therapy, which focused on strengthening my back this time.  After 12 pt sessions I'm doing well, but I continue at home physical therapy exercises daily to prevent more back problems. I still have occasional pain and stiffness, but I can easily walk 3-4 miles or about an hour without stopping and do almost everything I previously did,except lift heavy objects without pain. 

However, when my naturopath saw my DEXA scan results, she freaked out and wanted me to start a complicated program for bone health, which included talking many supplements, adding biodentical HRT and cutting my thyroid supplement dose drastically.  I'm doing most of that now, but I'll describe that process and problems in another post.

Thursday, May 15, 2014

Toenail Treatment Finale Part 2

Yesterday I had my second total matrixectomy (removal of toenail and matrix 'envelope' at the base). After enduring the same procedure on my left big toenail one month ago, I had the same procedure done on my right big toenail. (For anyone who hasn't read my previous 'toenail treatment' posts: longterm untreated toenail fungus caused bone spurs on the ends of my big toes, which prevents normal nail grow out, even after I finally treated and eliminated the fungus. Rather than endure bone spur grinding and skin tuck in hopes of normal nail grow out, I opted to just remove the toenails, which had been problematic for about 35 years.) The second matrixectomy went as smoothly as the first. My doctor wisely distracts me by asking about my cockatiel.  However, he tried a new bandaging technique, after I told him how much the first toe surgery bled. He wrapped the first dressing with a small ace bandage hopefully to reduce swelling and bleeding. Unfortunately the second sugery site bled much more than the first. Oh well, the idea sounded good at the time.

For 48 hours after total matrixectomies I need to keep my foot elevated, which also reduces swelling and bleeding, but mostly reduces pain.  I can't take narcotic drugs (which make me vomit) or NSAIDs like Alleve which causes stomach pain and inflammation. So I rely on Tylenol for pain. However, I can't take more than 4-5 capsules daily without getting sick from overdose symptoms. My low weight and my nonuse of drugs make me vulnerable to overdose symptoms from painkillers.  Nevertheless, I can take a tylenol capsule about every 5 hours and endure the worst of my post surgery pain.  I suspect I also have a high pain tolerance level after enduring 30+ years of undiagnosed gut pain, which I later learned was celiac disease, food allergies and gut bug infections. I never took anything for celiac or allergy pain. I wanted to discern the cause, rather than mask the symptoms. So I also learned to keep myself distracted.  I can sense the pain, but I don't obsess about it as long as I know the cause and treatment.

Next week I return to my podiatrist for a dressing change and another dressing change (to just a bandaid) after another week. As I learned from my first total matrixectomy 4 weeks of healing removes most of the pain and allows the skin to grow over the surgery site.  On my left toe (first surgery), I just replace the dressing daily with a large cloth bandaid (after applying antibacterial ointment).  I can wear most of my sandals on that foot now.  However, in order to accomodate my swollen toe from my second surgery, I wear old sandals which allow for adjustment at the toe and ankle straps.

So for the next week I'll be sitting more often with my foot propped up and blogging more often, IF my cockatiel will stay away from my laptop.  Usually he wants to watch singing cockatiel videos and/or peck the keys (with disastrous results) anytime he sees me with my open laptop.  Fortunately he got bored with the video thing after an hour. Now he's on top of his cage foraging for sprays of oats which I hung around his cage to keep him entertained ... at least for a few minutes.

Friday, April 18, 2014

Dress Like Your Bird Day

4 days ago (before toenail surgery) we had very warm weather. So I wanted to take my cockatiel Kiwi for a walk outside in the sunshine.  I would never consider letting him outside without a flight prevention harness.  Fortunately we ordered from Avian Fashions a 'flight suit' (harness attached to a birdy diaper garment) even before we brought Kiwi to live with us. After less than a week of getting Kiwi accustomed to seeing the flight suit, he began playing with it (chewing on and dragging it around his play table).  So we thought he would be ready to wear the flight suit.  He resisted every attempt to put him into the suit.  At one point he even stopped playing with the suit. However some touch training and millet rewards got him more comfortable with the garment.  However, with my hand recovering from injuries from the cast for my fractured elbow, I needed an extra pair of hands to get Kiwi into the flight suit. With my husband's help we got Kiwi ready to see the world outside our house. in his flight suit.

Because the weather was so sunny, I dressed in yellow jeans, tee, sweater and a straw hat with an orange band.  I wore Kiwi's colors!  After we got him into his orange flight suit, we took him outside immediately so that he would associate the flight suit with a good experience.  After a little pruning (a blueberry bush) in the front yard with him attached to my shoulder with harness, we decided to walk around the block twice to let Kiwi see new things and hear new sounds.   

Although Kiwi ate lots of millet (his favorite seed treat) as reward for getting into the flight suit, we needed lunch. So we went home, had lunch and set out for another walk this time around Greenlake.  We had just walked to the business area (restaurants) near the lake, when someone wanted to take a picture of me in my sunny yellow outfit. I told her today was 'dress like your bird day'.  Then she saw Kiwi and wanted to take several pictures.  So after we returned home I asked my husband to take more pics on my camera.  You can barely see Kiwi's flight suit, because it closes in back and attaches to the lanierd leash in back, but you can see the orange leash (which attaches to his flight suit) around my neck.  That should really be called an 'antiflight suit', beause he tried to fly off me, but only got as far as my wrist.

He wore the flight suit for almost 3 hours. The inserted diaper (cotton wafer) absorbed guano very well.  I feared we'd need to wash the flight suit, but the diaper protected it well and slipped out easily.  I hope Kiwi asociates the flight suit with good experiences.  He was 'cruising' on my shoulder as I walked the lake. Most of the time he was cuddling next to my cheek.  Sometimes he closed his eyes, but I suspect the wind bothered his eyes.  Nevertheless he was glad to get out of the flight suit.  I just hope he will tolerate it the next time we have a sunny day (and my toe surgery has healed enough for me to walk).

Thursday, April 17, 2014

Toenail Treatment Finale Part 1

After years of unsuccessful treatments for toenail fungus, including grinding, removing the toenails (which grew back with fungus), and soaking daily in Listerine, I finally successfully treated the fungus on my 2 big toenails with daily applications of oil of geranium mixed with DMSO.  A year of that treatment eliminated the fungus so that the toenails would regrow normally. Unfortunately during all the years when I had thick, fungus laden toenails, I developed bone spurs on the ends of my toes from pressure from toenails.  So the 'healthy' toenails could only grow into the fleshy, bone spurred ends of my toes and become 'ingrown'.

One podiatrist suggested I could either (1) keep trimming the nails as best I could or (2) have the toenail and matrix (envelope holding the nail) completely removed so that the nail would not grow back or (3) get the bone spur removed and flesh tucked to allow room for the nail to regrow naturally.  Option 3 sounded most promising for healthy looking nails.  However, that meant major inflammation and recovery after surgery.  Nevertheless, I planned to pursue that option with that doctor UNTIL I discovered he wasn't covered under my medicare plan.  I didn't want to pay for surgery outa pocket.  So I got a referral for a doc who was in network. 

The new doc saw the x-rays taken by the previous podiatrist, when I saw him 4 months later. However, he said the toenails were already looking ingrown and removing the bone spur may not cause normal regrowth.  The toenails had been damaged in the original accident and then later removed by an inept podiatrist who didn't remove the matrix, but only removed the toenail which grew back with fungus.  With that much injury and that much passage of time the new doc thought regrowing normal toenails was not possible.  He suggested option 2 (complete matricectomy), which would prevent toenail growout.  That would still require surgery, but not as complicated. 

So after enduring 2 more months of ingrown toenails (and daily application of analgesic ointment), yesterday I had a total matricectomy on my left big toenail.  The anesthetic prevented me from feeling anything beyond pressure.  However, I was advised to elevate my foot as often as possible for the next few days above my heart level to prevent swelling and more bleeding. Unfortunately I had to walk a long ways to my husband's car in the clinic lot. Then I had to walk up 2 flights of  stairs into our house.  By that time my toe was throbbing. So I took another tylenol (my 3rd for the day with my upper limit of 5 daily) and propped up my foot.  However, getting to sleep with my left foot propped up and my left arm propped on pillows and ice bags was almost impossible.  I finally gave up about 4am and read for another hour before rearranging the pillows and blankets and finally drifting off to sleep for a few hours before I had to get up and take care of my bird. Hopefully I can sleep better tonight.  At least I had my foot elevated for about 8 hours last night. 

The good news is that I may be able to walk around after a few more days. I will return to the clinic to have the dressing changed next week. The dressing look pretty bad now, but my sandle hides the worst blood stains.  The bad news is that I have to endure the same surgery on my other toe (right foot) next month.  Hopefully the first toe and my fractured elbow will have healed enough to make the second matricectomy process go more smoothly.

Non-displaced Fracture of Olecranon

On March 21 I fell and fractured my elbow.  My husband and I were walking home from a restaurant near our house. He turned to say something and tripped me with his foot. I fell in front of him and tripped him with my body. Fortunately he wasn't injured, but I suspected I broke my elbow.  Later that day x-rays confirmed a non-displaced olecranon fracture. Urgent care personnel splinted my arm from upper arm to fingertips and gave me an oversized sling, because they didn't believe the smaller size would fit.  2 days later I returned, because the splint was wrapped so tightly that my fingers were swollen and tingly.  Also the sling kept falling off and my splint slipped out within a minute after tightening straps.  They rewrapped the splint, which relieved finger symptoms, but refused to give me a smaller sling. I wore the splint for 5 days before returning to get a cast.

I was pleased with my pink cast, but still couldn't get a properly fitting sling. Like urgent care personnel, the ortho doc and assistants blamed us for not adjusting the oversized sling often enough (every 60 seconds???)  I experienced the same 'blame the victim' treatment when my cast was removed.  X-rays showed that my fracture had developed a soft callous long the fracture line/ However my fingers, hand, wrist and forearm were swollen to twice the normal size.  The tech would wrapped and set my cast had not put enough padding around my bony hand and wrist.  I have always bruised easily and am taking horsechestnut for venous insufficiency.  However, I suspect the overly large sling forced me to bear the weight of the cast on my hand/wrist/forearm.  Nevertheless the doc and tech tried to blame me for not raising my arm often enough (false).  Then the doc said the 'hematoma' (swollen bruised parts) resulted from the elbow injury (false).  He also thought I injured my hand/wrist in the initial fall, but my hand/wrist was normal 5 days after the fall, before I got the cast without much padding outside the elbow area.

They initially rewrapped my arm in a removeable splint and told me to exercise my elbow w/o the splint 4 hours daily. However, the splint exacerbated pain from my badly bruised hand/wrist/arm.  After 10 minutes of pain, I returned and asked them to reconsider the splint.  Instead they gave me a brace with velcro straps.  The good news was they gave me a size small sling which fit my arm perfectly with the splint.  The bad news was the brace was too big for the small sling.  So I was left with the original oversized sling.  After 3 days of more pain an swelling from the brace pressing bruises, I realized my bruises would heal better w/o the brace.  I could also exercise my elbow more often Unfortunately someone bumped my elbow a few times a few days later, but x-rays showed no new fractures or obvious displacement.

When my hand was sooo badly swollen with bruises, I discovered that aloe vera gel helped heal bruises and reduce swelling.  Now over a week later, my left hand almost looks like the right hand of the unfractured arm.  I have also recovered more range of motion with daily use of my elbow. I continue to ice the elbow at meals and at night, but still need to reguarly take tylenol for pain.  (I can't tolerate NSAIDs or narcotic pain meds and have to limit tylenol to no more than 5 daily, because I don't weigh as much as the 'average' adult and can overdose on the recommended no more than  6 daily limit (as I experienced after oral surgery last year).

I see my ortho doc again next week to check elbow healing progress with x-ray.  He wanted me to begin physical therapy, but I had to cancel the appointment because I can barely walk now. I had a total matricectomy on my left big toenail yesterday. My toe is wrapped in gauze to control bleeding, but I also need to keep it elevated as often as possible for at least the next 2 days.  I'm doing pt on my elbow with daily activities as well as recommended rotational exercises throughout the day.

Saturday, March 15, 2014

How Kiwi Changed Our Lives

Our cinnamon pearl cockatiel "Kiwi" moved into our house 19 days ago.  Within 24 hours I and my 'nightowl' husband began living on bird time. Cockatiels need at least 2-3 hours with their 'flock', which means my husband and I. (I suspect he actually gets about 7-8 hours with us.) However, cockatiels also need 10-12 hours of sleep each night. Because Kiwi won't even be 5 months old for another 10 days, I keep his cage covered for almost 12 hours. Covering the cage prevents 'night frights' (usually caused by seeing shadows, lights or hearing strange noises during the night).  A thick blanket over his cage keeps the cage temperature moderate, even when night temperatures drop.  We also installed thermal blinds in Kiwi's room to moderate the temperature.  Kiwi rapidly adjusted to his 'schedule' of sleep time, out of cage time with us, meals with us, in cage quiet time or feeding time and sleep time. 30 minutes before I cover his cage and turn off lights for the night, I turn on a low light and put on a relaxing harp CD.  Sometimes he goes to his feeder for one last snack before I cover his cage. More often he settles into his highest night perch in anticipation of total darkness and sleep.  Of course, keeping him on a regular schedule led me to  go to bed and get up earlier.

Because cockatiels need fresh fruits and vegetables, but must avoid excess salt, fats and sugar, our diets have slowly improved. We bring Kiwi downstairs to share our breakfast and lunch. So we avoid any foods he can't eat (like leftover chocolate Valentine's cookies) at those meals.  He loves to eat many fruits, vegies and grains (gluten free breads, muffins or cereals), which we eat.  He gets about 70% of his diet from specially formulated pellets for cockatiels, which he eats in his cage. However, we try to supplement the pellets with cockatiel safe fruits and vegies, grains, and occasional nuts and seeds (I use millet for training).

Previously I never seemed to find enough time for sewing in my studio. After my studio became Kiwi's room, I finished at least one sewing project daily, because Kiwi needs lots of time with his 'parents'.  Having a bird on my shoulder/arm/sewing machine makes some alteration projects quite challenging. Nevertheless I now seem to accomplish more than ever.. 

Most of all Kiwi has trained us to be loving bird parents very quickly. My husband is the chief neck scratcher/feather preener.  So Kiwi loves to spend quiet time getting his neck preened or just preening his own feathers sitting on my husband, while he reads the paper.

I am responsible for maintaining fresh water and food in the cage (including clipping fresh stalks of brocolli and other vegies to the cage), giving Kiwi regularly 'misting' for feather health and decreasd dander shedding, bringing him down for meals, encouraging him to play with new toys, and training him to fly to me on command. (I forgot to mention that I also replace cage floor paper daily, clean cage parts weekly and the entire cage monthly.) I'm so pleased that Kiwi will fly across the room on command and land on my shoulder now, even without millet reward. That targeted landing training has almost eliminated crash landings after startled flights. Often I can coax Kiwi to land on me after he begins a startled flight.  Sometimes, he just flies to me without command. Maybe he began to see me as a safe place, when he's startled. However, Kiwi loves to just be whereever I am, pecking at keys on my laptop, pulling thread while I sew (or hiding in the garment cloth), and of course eating breakfast and lunch with me.  So I suspect I'm 'big bird' or prime parent, while my husband runs a close second place parent with his neck scratching/preening. 

I never imagined that Kiwi would change our lives so much, but I'm so glad he did. A friend recently said that she wouldn't want the responsibility of a pet to 'tie her down' so she couldn't travel.  We have the option of boarding Kiwi with the pet shop owner, whenever we travel.  However, I've travelled so much in my life. I had lived in 26 different places by the time I was 26 years old. I've been across the country several times, toured Europe when I lived in Germany for 18 months and returned to Maui to celerate our wedding anniversary 7-8 times (I've lost count).  We may return to Maui to celebrate our 20th anniversary, if I can bear to leave Kiwi for 2 weeks. Yet I would be just as content to stay home with Kiwi and live on 'bird time'.

Saturday, March 8, 2014

There's a Cockatiel on My Head!

Six weeks ago I visited my favorite pet store. We haven't had a pet since our yellow lab died in 1998. However, my family had a parakeet when I was very young. So I always visit the budgies and cockatiels at that shop.  Over the years I began to prefer cockatiels, who seemed friendlier and interactive.  During that visit I met a very friendly cockatiel. A shop employee asked me if I wanted to meet that bird. He hopped onto my finger and nibbled my thumbnail.  It was love at first nibble. lol That cute little cockatiel even let my husband (who is more of a dog person) pet him.  I later realized that bird chose us, more than we chose him.

That day we learned that the owner was moving her store to a new location. So we could not 'adopt' any birds for at least a week, while she moved.  During that week I definitely decided I wanted that cockatiel for my upcoming birthday present.  Then we learned that another bird in his cage was diagnosed with a bacterial infection. So all the birds in the cage (including my new friend) would need to take antibiotics for 14 days. That meant we would have to wait another 2 weeks to acquire our new pet.  During that time our area experienced a rare snow storm. So the owner didn't start the 2 week antibiotic regimen for a few more days. 

Before we could actually bring home a new cockatiel we converted my previous sewing studio to a 'bird room'.  We covered my 3x8' cutting table with craft paper, assembled a large cage, filled it with perches, toys, food containers, added 'out of the cage' toys to the table, and 'bird proofed' the whole room (as well as many other rooms of our house). Of course all that preparation required several trips to local pet stores. We also purchased 2 cockatiel books and dug out all the 'Bird Talk' magazines, which I acquired many years ago, when owning a bird was just a dream.  I assembled an emergency bird first aid kit, hoping I'd never have to use it. Finally we installed thermal blinds to keep the room temperature more in 'bird range'.

The big day arrived over 3 weeks after my birthday.  We drove to the pet shop, signed papers, bought food and 'travel cage' and carried out our new cockatiel. We previously decided to name him 'Kiwi' because, cockatiels fly wild and free in the Australian outback. So I talked to Kiwi, while holding his towel covered travel cage on my lap during the drive back home. 

After a challenging transition from travel cage to home cage (a palace by comparison), Kiwi rapidly adjusted to his new surroundings, but especially to having so much more attention and 'out of cage' time. I won't go into much detail in this post, but I will say that Kiwi prefers being on my shoulder to anyplace else, except maybe perched on my breakfast bowl eating oatmeal.  My husband is Kiwi's designated neck scratcher. So Kiwi enjoys spending time with either or both of us. He literally 'walks all over' us. Kiwi's newest discovery is that he can climb up my pony tail (and scrunchy) to roost on the top of my head (hence the title of this post).  I could go on and on about Kiwi's antics, but I'll save that for another post. Our lives have greatly changed since Kiwi came to live with us, but more about that later ...