An update on my foot

Christina here…

You bunch of heathen nonbelievers are too kind. I’m amazed, inspired, humbled, and awed that so many people cared about me to send donations to help cover my mortgage and medical bills due to me smashing the living shit out of my foot with my own car.

Here is an update, and some info if you want to follow my foot saga, as I don’t want to turn this blog into “What Would Christina’s Foot Do?” or something.

On the same day JT posted the post above asking people to help me, I woke up with a fever. After checking like five times to make sure it was a real fever (not one of those fakey fake ones) I drove myself back to the ER. They admitted me and kept me there for four days in IV antibiotics.

Every time I change the dressings on my foot, it looks worse. While in the hospital, my orthopedic surgeon decided to do an incision & debridement surgery – That’s where they make incisions in you to drain fluid and clean or cut away all the necrotic tissue. The only problem is that my foot was too swollen for anything other than some small incisions, so they just cleaned my foot really well.

My foot is gross: all of my toes except my big one have turned black (back in the day they called that gangrene!) and there is this black necrosis on the dorsum (top) of my foot. I won’t post any pictures, but if you want to be really grossed out, here’s a video of me doing a dressing change that I took last night. This foot is the most disgusting foot I have ever seen and I can’t escape it because said foot is attached to the end of my leg. You’ve been warned.

I went to my surgeon this morning.  He wanted to wait a few more weeks and then perform a transmetatarsal amputation (that’s where you amputate all your toes and part of your foot, basically) and then wait until that heals and do a fusion of the cuneform bones perhaps, and then maybe do a few more surgeries. He said that I would probably be looking at two years of reconstructions before my foot is finally done, and even then, the surgeries might not work and I may end up with a transtibial (below the knee) amputation anyway.

I do not want to work for two years with the ultimate outcome to perhaps, at best, have a paralyzed, fused, skin grafted, scarred, sloth half foot. How functional would such a foot really be? Answer: not very.

I’m an active woman. I am the main breadwinner in my house. I don’t have the time nor the inclination to nurse this thing for two years, only to have it possibly amputated in the end anyway.

I made a decision. I’m not going through that. I can’t do it psychologically, and I can’t do it financially.

In two weeks I will be Christina Stephens: occupational therapist, wife, atheist, research scientist, sister, daughter, blogger, friend, sex-positive, polyamorous, below-knee amputee.

I am okay with this.

I think I just wrote that as much for myself as I did for you guys.

I think Aimee Mullins put it well: (when reflecting on showing a group of kida her 12 pairs of prosthetic legs)  - “Just like that, I went from a woman these kids were trained to see as disabled to somebody who had potential that their bodies didn’t have yet – somebody that might even be super-able.”

YouTube Preview Image

So, a couple of things.

1. I’m going to start Vlogging about my experiences at this Youtube channel. As an OT, I think I’ll have a unique perspective, being on both sides of the therapeutic relationship.

2. I can’t work for at least two months after my surgery. Another attempt at panhandling: the best help I can get from anybody right now is a financial hand. So here’s the donate button (GRRR.. I’m trying to figure out how to make it show up!):

Here, clicky this handy donate link instead while I ask JT how to make the button go.

3. Yes, I’ll probably get a scarlet letter A laminated into my sweet new prosthetic leg.

Learn more about Christina and follow her @ziztur.

About christinastephens
  • Glodson

    Sorry, I couldn’t watch the video. I’m already a bit under the weather, to say the least, and I don’t think I could handle that.

    But I am glad for the update. I am glad you found an option that is good for your life, and that you are okay with it. Sorry, I’m not so good being supportive. Take care, and keep us updated.

  • Karl Wulff

    You will make an awesome Bionic Woman. Worst thing about this will be having to tell people over and over again, “No, actually my amputation is *not* what inspired me to become an OT, but maybe it did inspire me to be an even better one”. Thanks for the update. Courage! K

  • JoeTheJuggler

    I’m not sure if this is a typo: “I can do it psychologically, and I can’t do it financially.” Based on the “and” I suspect you meant “can’t” in both cases.

    • http://www.tastylaystee.wordpress.com TastyL

      I suspect it wasn’t a typo, and that she means she CAN do it psychologically, which of course she can, because she is a strong and amazing woman. My thoughts are with you, babe.

      • Brad

        TastyL, there would still be an error.

        • http://www.tastylaystee.wordpress.com TastyL

          After re-reading, yes, I totally see that. I was just trying to think positive for Christina I guess

  • christinastephens

    LOL, I fixed it.

  • LeftWingFox

    Hugs if you want ‘em, I’ll try and throw some money in the jar when I can.

    And yeah, Aimee Mullins’ legs are spectacular. I love the combination of art and science that went into making those intricate and functional designs. Even the non-functional ones are pretty spectacular; The cheetah costume she wore for the Creemaster Cycle with the digitigrade cheetah legs… if I would walk on those, I’d probably take ‘em.

    • christinastephens

      <3

    • ecolt

      I saw Cremaster Cycle at the Guggenheim when it first came out. Those cheetah legs were a definite highlight, and the amazing glass stilletos she wore in one of the other scenes.

      Is it wrong that my other thought, though, was that with a prosthetic she’ll now be able to “teach kids a lesson?” I’ve watched way too much Arrested Development!

      In all seriousness, though, best of luck with the recovery. I really wish my financial situation was stable enough for me to give money to anyone but my landlord and bill collectors. If my situation changes at all in the next few months, I will definitely be tossing what bit I can your way.

      Also, it’s not much, but if you’re going to be home and not able to do a lot anyway, try the Mechanical Turks on Amazon. Basically you get paid a few cents each to do little surveys and psych questionnaires and, at like $10 or $15 you can transfer the money into your bank account. They don’t pay out a whole lot, but when I was unemployed a while back I’d spend a bit of time doing mindless tasks on there and get like $20 or $30 a month. Like I said, it doesn’t pay out a whole lot, but every little bit helps when you’re really tight and it’s something you can do in bed without much real effort.

  • Praedico

    I watched the video… please tell me it doesn’t smell anything like it looks. I don’t think I could handle dressing a wound like that. At least, not on myself; I get squeamish when I have to deal with a blister on my foot.

    Good luck with your impending cyborg status! I’m glad you’ve got the option to get it dealt with relatively quickly in a way you’re ok with. Keep on being awesome, Christina :)

    • christinastephens

      It smells like Gak, courtesy of 3 kinds of antibiotics. ^.^

    • Steve

      Necrosis doesn’t actually smell *that* bad. The tissue is completely dead after all. What’s really, really gag-worthy are bacterial infections. The horrible smell is indescribable.

  • http://www.atheistnomads.com Dustin Williams

    That must have not been an easy decision, but it’s one you can feel confident with. I wish you the best with the new leg!

  • http://www.atheistnomads.com Dustin Williams

    Okay, I just watched the video. That is some serious damage. I’ve gone through debridement a few times with minor incisions when I had an infected brown recluse bite on my big toe. While it looked very nasty and horrible, your foot has it beat by several orders to magnitude. Also, in my case amputation was what would happen if the antibiotics didn’t work, but fortunately the did their thing, I am very sorry that you have so much damage.

    From my experience with the long term effects of the scaring, the pain comes back and says. The spider bite was 11 years ago and I’ve had reduced mobility ever since and relatively severe tendinitis for the last 9 years. I even broke it a few years later when I stubbed it on an inflatable obstacle course, although on the bright side the break didn’t hurt that bad since there’s been a bit of nerve damage.

    Considering how bad the damage to your foot is, you will be saving yourself from a lot of surgeries and a life time of foot pain. Sure, the prosthetic won’t be a nice as the real thing, but in your situation it’s definitely the lesser of two evils.

  • guest

    Holy crap! I missed all that. That’s awful. Good luck with the surgery, Can’t they just remove the foot? you could get a cool metal foot, kicking people would be so much fun! (sorry, trying to cheer you up here) Anyhow, stranger to blogger, hope you get lots of hugs from friends and have fantastic doctors!

    • Steve

      My guess is that the stability and quality of life with half a foot isn’t actually better than with a prosthetic leg. Probably worse. When you walk you roll your foot and put a lot of weight on just the front part. Replacing the front part of the foot with a prosthesis won’t allow you to walk properly.

      • christinastephens

        Bingo! Prosthetics are extremely good at mimicking a natural gait at all but the fastest speeds (and that’s when you just go get a Cheetah leg made, specifically for sprinting. Which I won’t, because I hate sprinting)

  • http://freethoughtblogs.com/dispatches Ed Brayton

    Wishing you a smooth ride through surgery and recovery. I’ll promote this on my blog tomorrow. One of the amazing things about the secular community is how much we help each other out when someone is in need.

  • ben porter

    we will get you a sweet dragon engraved leg with the scarlet a

  • Rikitiki

    Plus, you’ll have the bestest pirate costume EVER…just need to craft that wooden leg between now and then. ;-)

  • Rufus

    Just tell me that you won’t do what one of my relations did: After he managed to act as a one-time-only landmine clearance system he managed to recover his severed leg, took it home with him and had it stuffed and mounted over his fireplace with a plaque showing the date and place that he misplaced it.

    • Otrame

      Hey, that’s how he copes. I admit it seems morbid as hell to me, but then again, it’s not my leg.

      • Rufus

        He never really copes at all, life is (as he has told me) too short for worrying about it.

        As someone so active, he’s got himself a little sideline in testing-to-destruction prosthetics. So far he’s managed to abuse to breaking point just about every one that he’s had. Admittedly, the fact that he keeps “modifying” them doesn’t help (I’m reasonably sure that the average prosthetic leg does not come with a bottle opener built into the end).

        • Zinc Avenger (Sarcasm Tags 3.0 Compliant)

          A bottle opener in the end? Depending on which end you mean, that could either be uncomfortable, or really awkward to reach with a bottle.

          • Rufus

            It was completely useless, but he’d somehow managed to take an appropriately sized chunk out of the front end of his first blade, and glued the bottle opener into the notch. The way it sat he had to take the blade off to actually use it, but it made a good party trick…

    • christinastephens

      That’s hilarious, but since I actually have MRSA, I don’t think they will let me keep it. Wouldn’t want my MRSA bugs to spread around.

      • Rufus

        How about a big tank of formaldehyde for it instead?

        Then you could try passing it off as an original Damien Hirst, and sell it for enough to cover a whole assortment of legs.

  • Otrame

    Sorry you have to lose the foot, but if I were faced with your choices I think I’d do the same. As long as that crushed bone and soft tissue is still attached the chances of infections, blood clots and a whole host of other bad things are too high.

    Your own training tells you that losing a foot is hardly the worst thing that can happen to you. You’ll do fine. When (if) it gets you down, tell us about it. We like you and we’ll listen.

  • Epinephrine

    Wow, that’s really unfortunate. It sounds like quite the difference, going from trans-metatarsal to trans-tibial, is it possible to split the difference? I don’t know much anything about it except that I thought that preserving as much limb length as possible would be best. I’m sure you know a ton about it, I am just surprised that you have to go past the ankle.
    Wishing you the very best, and a speedy recovery after.

    • christinastephens

      I could split the difference and get a Symes, which is basically where they take your foot off but don’t cut your tibia/fibula.

      Problem: you’ll definitely need a prosthetic either way. However, because you only have a few CM of clearance between the bottom of your nub and the floor, your prosthetic choices are limited to low profile ones, which means you can’t have a shock/rotational force absorbing foot, which means you can’t run or jog or jump, and you have a bulbous end on your prosthetic (for the lateral and medial malleolus) which isn’t very pretty. the ONLY, and I mean ONLY advantage to symes is that in an emergency you could fully weight-bear on it for a few short steps, and you can’t do that so much with a trans tibial. That one advantage does not outweigh all of the disadvantages.

      Symes amps also have problems with circulation down to the ankle and often revise to below-knee anyway because the blood supply down there, without the foot and associated ankle movements to move blood from the bottom of your nub back up your leg, sucks. My ortho doc doesn’t even perform symes amputations anymore because of the problems they have, and I commend him for it.

      So, less is more.

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  • Andrew Kohler

    So sorry to hear that you’ll have to lose the foot, but it sounds like you’re doing a very admirable job coping and taking control of the situation. Fortunately, the scientific method and the hard work of human beings motivated to do good (funny how that works, isn’t it) has resulted in very good prosthetic technology. We secularists can’t offer prayer for you, but we can offer something better: our best wishes, love, and solidarity. Get better soon; we need you in the blogosphere (and elsewhere, too) :-)

    P.S. I haven’t thought of Gak in so many years; I think I may be confusing it with oo-blech (or however you spell that; pronounced “oo-bleck”), this absurd substance I made in elementary school for some educational purpose that, in retrospect, is less than clear.

  • Phillips Howard

    The fact that things have gotten this far out of hand, indicates a clear case of medical malpractice.

    This should not have gone this far.

    A Med Mal Lawyer could probably make arrangements to finance the proper treatment so that you didn’t have to undergo the great amputation. I know you say you are “OK” with that but I think you have not been fully informed about all the implications.

    • otrame

      Philip, not all bad outcomes are the result of mal-practice. She crushed her foot. When I first heard about it I thought it was very possibly going to be lost. Her doctors have tried conservative treatment, partially, I suspect, because they don’t get smiley faces when they take one look at something like that in the ER and say “Well, that’s got to come off.” She’s had time to see the results of the damage, and the docs have done the best they can but crushed bone and soft tissue results in poor circulation and that results in infections. She’s being very smart to go with the amputation. It is not the fault of her doctors that it needs to happen.

      • http://noadi.etsy.com Noadi

        I don’t know, it sounds like the ER dropped the ball. I don’t know if getting the proper diagnoses right away would have helped, it may not have, but there was some serious underestimation of the damage to start with. Whether it’s enough to be considered malpractice, I don’t know, I’m not a lawyer but it might be worth getting the opinion of one.

        • Steve

          What I don’t quite understand is how they could have missed the extent of the bone fractures during the first tests. Even without a CT, it’s a bit hard to go from two to four broken bones.

          • ButchKitties

            When my guy’s foot was run over by a car, the ER missed several of his fractures in the initial X-rays. The hospital warned us when he was released that metatarsal fractures are often only visible from one angle so the extreme swelling could potentially mask them in the initial X-rays. Then again, the fractures missed in his x rays were relatively minor. They weren’t his real problem; it was the swelling and infection that were the biggest threats.

            Blah blah blah, heading to Paypal now for a donation to go with my well wishes.

    • christinastephens

      I’m not sure if you mean I’m not fully informed about all the implications of having a TTA or not, but I wanted to let you know, if you meant it that way, that I am. Here’s why:

      In addition to the normal research one would expect when making this kind of decision…

      1. I’m an OT. That’s occupational therapist. I went out of my way in grad school to learn about amputations and prosthetics and orthotics , beyond the normal curriculum.
      2. I took an independent study (while in grad school) at an orthotics and prosthetics lab. I was there all day, every Friday, learning how to make prosthetics and seeing what amputees or people without amputations who used orthotics dealt with. I ended up knowing enough that I taught the two classes on prosthetics/orthotics for the students a year behind me.
      3. In my research lab, I worked on a research project on a powered ankle prosthesis for below knee amputees and/or people who lack normal foot function, as from a stroke. Another lab built the ankle and then had amputees/people with stroke come in and test it out while we captured their kinetic and kinematics with motion analysis and EKG and compared them to a standard prosthesis or an orthotic. We never published because Ossur makes a powered ankle prosthetic already and ours was too bulky so the idea got sidelined. I might even get Ossur’s powered ankle, but I don’t like how it looks, and I don’t like that you have to turn it off, so maybe my lab can pick up where we left off with the powered ankle prosthetic, with me being a major tester of said prosthetic.
      4. I read pretty much every research article on choosing a TAA vs salvage vs reconstruction vs other types of amputation I could find when I first determined this might be the eventual outcome a few weeks ago.
      5. Several OT clients of mine are/were amputees and/or have had lower limb injuries, and I also have another friend who is a BK amputee, a friend with a transmetatarsal amputation (who hates it and wants it revised to TTA) and my aunt (well actually my mom’s aunt) is a double above knee amputee.

      Really, the only way for me to be *more* informed about the implications would be to go ahead and get a degree in O&P and in orthopedic surgery. I don’t have time to do that in two weeks.

  • http://explorebooksellers.com marcus

    Done! My Valentine to you.

  • Zinc Avenger (Sarcasm Tags 3.0 Compliant)

    I don’t know, it seems a bit of a waste to replace part of just one limb with a vastly superior mechanical prosthesis. What are you going to do, enter the Olympic 100m hop? You should see if they have some sort of discount if you get both done. Then you can properly lord it over us lowly pure organics!

  • Gwen

    Christina, how are you doing? I watched your vid. Ouch. Are you in pain? What can you do while you await your surgery date? I’m sending huge hugs (if wanted) and support.

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