21 January 2015

The Forney Journey: Learning to walk again

27 Jul 13: Going home is a huge transition – awesome, but a lot of work, especially for J.  She is responsible for the daily wound care routine, and the amount of supplies given to them by the hospital weighs almost 100 lbs.  Maj Forney is confined to the power chair and can’t assist around the house or with the kids. J. is running the household, caring for the kids, ensuring Maj Forney gets to and from every appointment, and then tending to his wounds after the children have gone to bed.

Each night, J. transfers Maj Forney to the shower chair to get undressed, rolls him into the bathroom for a bathing, covers him in towels and then rolls him into the family room for wound dressing. They watch a movie while J. dresses his wounds, the majority of which are still open, even five months later. In the beginning, the process takes almost 4 ½ hours, and J. rarely makes it to bed before 0100 each night.

To help J. with the three kids, they hire a nanny, assisted by a Special Compensation for Assistance with Activities of Daily Living entitlement from the DoD. A daytime routine emerges: kids up, fed, to the nanny. Then Maj Forney up, dressed, fed and loaded into the van for medical appointments.

Aug 13: The highlight of Maj Forney’s day are his PT/OT in the Burn Gym (yup, that’s the name) – so named because burn patients have special requirements as they rehab, specifically, stretching and range-of-motion work on affected skin and joints, as well as the muscular atrophy from longer recovery times. He spends two hours every day at the Burn Gym, working on all areas of his body: fingers, hand, grip strength, upper/lower body strength, standing, walking.  And some cardio – a hand bike with one hand – his knees don’t yet have the range of motion to pedal a bike. In fact, Maj Forney isn’t actually allowed to bend his knees yet, so even in his power chair, he wheels about with his legs sticking straight out.

He progresses rapidly and at the six-month mark, can stand from the power chair unassisted, walk with only the aid of his walker and is able to walk out of the gym to meet J. in the waiting area at the end of a session.

20 Aug 13 – Maj Forney feels weak throughout his PT session and is unable to make it all the way to the waiting area. As J. retrieves him, they decide to go to the Burn Clinic just to have him checked. He has a fever of 103 degrees and is admitted immediately.

The open area on his right knee, where the patella was still exposed is infected. Not by one, but five different bacteria; this is what caused the fever. Maj Forney is back in the OR the next day, the first of four surgeries to debride the wound, remove more patella and graft over the open areas. This process takes him through mid-September. 

Sept 13: Maj Forney is finally discharged and becomes a Center for the Intrepid (CFI) patient, with a new PT and OT. He is much stronger and ready to start making significant gains. His wound care is down to 2-3 hours a day and, with the kids in school, he and J. switch wound care to the mornings.  After that, he heads down to the CFI for his daily 4-hour rehab sessions.

Oct 13: Maj Forney’s walking improves rapidly, and he has now ditched the walker in favor of a forearm crutch. The grip on his remaining hand as well as his upper body also gain significant strength.  By the end of the month, he has switched to using only a cane.

October 2013
Nov 13: The Forneys attend the Marine Corps Birthday Ball and Maj Forney makes his way out to the dance floor for one slow song with J. They receive a standing ovation and shouts of “Ooh-rah”.

USMC Birthday Ball, Nov 2013
Dec 13 – Jan 14: December starts with a promotion to Lieutenant Colonel. Another series of graft surgeries slow him down a bit, but LtCol Forney sets his sights on being out of his power chair by New Year’s.  He doesn’t quite meet that timeline, but by the end of January is only using it to get to and from the hospital and in between long appointments.

Promotion to LtCol with the family, December 2013
Feb – Mar 14: Hypertrophic ossification (HO), excess bone growth triggered by trauma, especially burns, has grown across LtCol Forney’s left elbow joint, completely locking the joint.  His ortho surgeon and a reconstructive surgeon work together over three surgeries to excise the HO, put a small muscle flap across the exposed bone, and graft over the elbow to close it.  (LtCol Forney celebrates the one year anniversary of his mishap in first of those elbow surgeries.) 

After this, it is rehab, rehab, rehab.  Once he recovers from the elbow surgeries, LtCol Forney ditches the power chair and executes long movements with a one-armed drive, manual wheelchair.  This takes some getting used to, and it’s a while before he can go anywhere in a straight line.

LtCol Forney and his daughter cook "breakfast for dinner" -
this is his first time cooking again since the mishap. (February 2014)
Apr – May 14: LtCol Forney begins the driving evaluation at the CFI and the VA.  He ends up having only one evaluation with the rehab driving specialist at the VA, where they arrive and the specialist says, “Let’s go for a drive.” LtCol Forney takes the VA’s van for a spin around San Antonio; he doesn't run over a single pedestrian. Two weeks later, he takes his road test and receives his Texas driver’s license. The evaluator’s comment? “Your driving was flawless.” Duh, he's a pilot. 

During this time, LtCol Forney is also getting fitted for his first prosthetic, a temporary one, for his left arm.  The process takes a long time because of the poor condition of his skin on that arm. He initially only wears the liner without the socket and slowly works up to an hour with the socket.

With the prosthetic - best moment out of this?
"My 3-year old kept looking at me and saying, 'Daddy, you've got two hands!' It was awesome!"
30 May 14: LtCol Forney gets fitted for his custom IDEO leg braces (Intrepid Dynamic Exoskeletal Orthosis). Below is the short list of things he used to take for granted that the IDEOs now allow him to do once more (again, another first since the mishap): 

  • Take normal length strides.
  • Walk without a cane and not feel like he's about to fall over.
  • Side step, in both directions.
  • Stand on his left foot long enough to raise his right knee to waist height.
Rockin' the black socks, white shoes combo....
The rest of the spring is spent gaining strength and independence, and LtCol Forney soon no longer needs the wheelchair.  He has had 26 surgeries up to this point.

The big news? Clearance from his doctors to take a family vacation in June.

Questions for LtCol Forney: 
1) What was your focus during this part of your recovery?
  • Just getting back my independence to take some of the load off J. and make things a little easier for her.  At this point, the goal was to get to the point where I could drive, get an adapted car, and free J. from having to devote every minute of every day to taking care of me.
2) What was the hardest aspect of your recovery at this point?
  • It just seemed slow.  Especially looking around the CFI at guys missing legs who were doing CrossFit [workouts].  I know they had been there for a long time ahead of me, but I was impatient.  Plus, because my left arm was severely burned and there were epicell grafts all over it, it took forever before I could get a socket.  Amputees with blast only injuries (no burns) who were hurt months after me got fitted for prosthetics months before me because they had no skin condition issues.  That really tested my patience.

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