Monday, September 24, 2012

To Do or Not to Do....

I am sure if a fairy walked in my door and asked for me to wish for something, I don't think I would say "get rid of the MS", I think I would say, "make me walk again." Well, there is no genie in a bottle in my life because I have to work hard at everything I do! Specifically, walking.

I have forever done searches on ways to make foot drop go away -- my searches yielded everything from the common orthotic options to a surgery that can correct this malady. Surgery, a simple option? No surgery is simple. A highly trained technician performs his or her magic and you can only hope they were not having a bad day when they work on you! What is foot drop? This is experienced by about 30% of people with MS, I believe, -- and in several others, including stroke, brain injury, parkinsons, cerebral palsy and other neurological conditions. What happens is the nerve that lifts the foot is paralyzed. So, your foot is paralyzed and you don't have a normal gait. I use a WalkAide to work the foot out because it is programmed to lift the toes when I walk. I also use a small brace that requires me to haul my foot around but prevents spraining a paralyzed ankle. This is how I have lived for over a decade.

So, then I read this:  Naturally one's first response is to get excited. I am 46 and still have the ability to recover -- I'm not 76. This is a 2008 article and this surgery has been around for a while. I'm sure they have only perfected it.

So, that is the first stage -- I see the article, get excited and think about walking again. Maybe I could go on vacation and walk on cobble stones? Maybe. Hey I could even walk up and down the street outside my house. Walking quite normally and looking up at things when I walk and not down at my foot that could turn at any moment. Right? I used to do all this so why not again? I'm sort of young so why not live a little?

Now for the rub. Tendon transfer is what they do. They take the existing tendon that now pushes the foot down -- which happens to be just fine. It is the tendon that pulls the foot up that is the problem. They take this tendon (the one that works), I believe, splice it, thread it through the appropriate hole and use the spliced one to replace the paralyzed one. So, after the surgery, the brain has to be retrained to use this tendon to pull the foot up and not push it down. I have read varying recovery times. Lots and lots of rehab. There is recovery that goes with all this. I've seen numbers as much as a year. 

OK, foot drop is not the only issue here. You have heard me go on and on about spasticity. For god sakes, the left lower leg hardly bends. So, if I got this done, the spasticity will remain. I also have balance issues because of this. Looking at my feet when I walk -- that is more complicated than just staring at the foot. That has to do with "attention" a cognitive construct having to do with lots of environmental stimuli. The brain doesn't just la-de-da look at things and enjoy them! The brain has to compartmentalize objects and not get overwhelmed.

This puts the surgery in a different light, doesn't it?

For now, I will talk to my neurologist and keep thinking on things. Either I manage as I have been for years or I make a life change. I'll know to make the right decision, I hope.

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