Focused on Rehab

All through last week, I kept telling myself I'd make another post, then I don't, I start my 5th chemo cycle, and now it's been almost 2 weeks since my last post. Hope this doesn't become a habit! Over this span of time, I've been focused on rehab. Specifically, getting my legs strong enough for sustained walking in my prosthesis. It's a process that I wish would go by quicker, but with chemotherapy weakening me, and the changing shape of my leg, it's going to take time.

I had a couple of nice crutch-assisted walks to Central Park on Saturday and Monday last week. Then on Tuesday, when I saw my prosthetist for a follow-up, I had soreness in the remains of my lower left leg that was impeding my ability to walk. I also was experiencing some pain there when trying to walk unassisted on prior days. Turned out I wasn't putting on enough prosthetic socks. These are important in getting the right fit. The way my prosthetic leg works, I first put a silicone sleeve with a pin in it over my lower left leg. The pin goes into a hole at the bottom of the socket when I put my leg in. This locks it into place. However, the size of my leg varies day by day, and it's expected to shrink going down the road. This is where the socks come in, to ensure a snug fit, so my leg does not slide around in the prosthesis. I have several socks of different thicknesses to help me get the right fit. I wasn't putting a thick enough layer of socks on, which caused the sliding. This made walking without crutches more difficult. Putting on more socks fixed the problem, and the next few days were great. But then something else developed during the weekend -- the fit became tight at the knee (the socket comes right up to it, with the sides going around it), and loose in the bottom. My theory is that the lower part of the leg has continued to shrink, while the rehab has strengthened the part around the knee, causing it to stay relatively bigger. I've found a balance with the socks that does the job, but with some discomfort that leaves me uncomfortable walking long distances. I see the prosthetist again on Tuesday; I'm sure with some adjustments, this can be fixed and I'll be golden.

The strengthening of the muscles in the upper part of my left leg has really been a big story, though, and for that, I have to give thanks to the physical therapy department at Sloan-Kettering. I came in on a walker for my first appointment in early February, and now I'm able to walk significant numbers of steps under my own power. I still hobble a bit, but much less so than my first unassisted steps back in March, with a gait that feels quite close to normal. I'm to the point where if I'm walking around the clinic when I'm getting chemo, I do it without crutches, and with confidence. This part feels great; with more therapy, exercise, and prosthetic adjustments, I should be very mobile quite soon, and just in time. Cycle 5, which started on Monday, uses the same set of drugs as cycle 4, so while the chemo leaves me fatigued, I still have the energy to exercise, and have been able to gain strength even while undergoing chemo. My next cycle will use a new pair of drugs, ifosfamide and etoposide, the former of which is a mustard gas derivative like cyclophosphamide from cycles 1-3, which were each quite draining. I thus expect cycle 6 to take a lot out of me, so the more rehab I can get done before it, the better. Time to make it happen.