The road to recovery

The plastic surgeon left the decision for increasing the loading on the foot up to the physio and the orthopaedist, but his estimate was another 4 weeks until I could increase the weight on the foot to 40kg, and 4 weeks again before I could put my whole weight (just over 80kg -- 200lbs) on it. Then, they would measure the pressure distribution on the sole of my foot, and I would get a proper shoe made. The orthopaedist said that as far as he was concerned, I could walk on it properly immediately. So that left it more or less up to me. Things were going so well that a week later, I decided to increase the loading on the foot to 30kg. I also started cycling, initially pedalling with the heel.

After twenty weeks
Figure 13: After twenty weeks

After twenty weeks
Figure 14: After twenty weeks

Progress was so good that after another week, I increase the loading to 40kg (100lbs), and after a third week, I stopped using the crutches, thereby putting my full weight on the foot. The only problem with this was the muscles on the top of the foot hurting somewhat, presumably because they were stiff. Cycling properly, with the ball of the foot, helped exercise them without overdoing it. (Cycling is gentler on the foot than walking.) I had been using the wheelchair less and less, and so at this point, I gave it back to the hire company from which it came.

I asked the plastic surgeon how long it would be before I no longer had to use the compression stocking, and he told me one normally reckons on about six months after the operation. I find that somewhat hard to believe in my case, as after months, the foot still became red and swollen, even after only five minutes in the shower.

The oncologist takes blood off me every six weeks to check tumour markers. He says they look at two: S100beta and MIA(broken link?), which seems pretty standard.




Date
S100beta
MIA
pg/ml
ng/ml



13.07.01 < 20 10.82
11.09.01 < 20 11.88
25.10.01 31.2 11.09
11.01.02 25.4 9.57
12.04.02 36.6 9.26
11.07.02 < 20 11.41
04.10.02 < 20 12.11
10.01.03 < 20 11.92
15.04.03 < 20 8.79
16.10.03 < 20 9.45
20.04.04 25 9.01
14.10.04



Apparently they would start becoming problematical at 200pg/ml and 9.82ng/ml, respectively. Apparently, although normally my MIA value would therefore be worrying, the fact that it is stable indicates that it is OK. He confirmed that a soft tissue melanoma is an amelanotic melanoma.

On the 16th October 2001, my lymph nodes were examined with ultrasound. There were a couple in my left inner thigh that were a little larger (1.9cm) than they might be, and which should be looked at when I have the PET in November, but otherwise, a clean scan!

At the beginning of November 2001, after walking around the flat barefoot one morning, I managed to put a blister in the flap. Not having any feeling in it, I only noticed in the evening whilst examining it. It took several weeks to heal. I also got an infection from a stitch that hadn’t dissolved properly. It also took two weeks to heal.

A PET scan at the end of November 2001 was clear! A week later, I picked up my new orthopaedic shoes, which had taken 5 weeks and 1500 ($1500) to make. These look like ordinary shoes and are a huge improvement on the temporary “bandage” shoe I had before. It took a couple of weeks for the muscles/tendons/ligaments in my lower leg and foot to get used to the new level of activity; I had a sore and swollen ankle for a while.

On the 11th January 2002, I saw the oncologist. My progress was such that I’ve switched from 6 weekly to 3 monthly checkups.

On the 15th March 2002, my lymph nodes were examined again by ultrasound. The largest in my left inner thigh was 8.7mm - less than half that from three months previously - probably because the foot had improved so much. I’ve bitten the bullet and ordered a pair of sports shoes so that I can take a little more exercise. The down side - another 1200.

I got the sports shoes on the 3rd April 2002. They are a welcome change from the clod-hoppers from the first visit to the cobblers, and ‘only’ cost 800.

A checkup on the 12th April 2002 was clear.

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