This week I had my 6 week post-op visit with my surgeon. I was hoping for some good news, namely that I could start putting some weight on my foot again in anticipation of learning how to walk again.
When I got to the office I got a few x-rays done to check the status of the osteotomy healing. My surgeon showed me the x-rays of my foot (complete with new hardware!) and said my bone healed beautifully. Actually, the exact phrase she used was a bit different... she called me a "freak of nature" for healing so quickly! I was thrilled. Since the bone has healed, it means I can start putting 25% of my weight on my foot in the boot this week, then 50% the next week, 75% the next, and then 100% in the boot, after which I can wean off the boot and into a normal shoe by the end of July - which doesn't seem all too far away! It is a best case scenario for healing from this major surgery.
I attribute the fast healing to a few different factors: first, I was in excellent general health going into the surgery; second, I do believe the supplements I was taking really did help speed up healing; and third, the Class IV laser therapy I have been getting before and after surgery, which is scientifically proven to accelerate the healing process and reduce pain. If you haven't heard of K-Laser, I highly recommend you check it out!
My PT session this week was a bit of an eye opener. It was the first time since surgery I had tried to move my great toe, and it was incredibly stiff. My brain was trying to send the signal to my toe to wiggle, but nothing was happening! With the help of my physical therapist I was able to wiggle all my toes by the end of the session, as well as practice shifting my weight while standing in preparation for gait training. I also got the OK to start indoor stationary cycling for 10 minutes per day in the boot.
It has been amazing to simply be able to touch my foot to the floor (in the boot) this week. I didn't realize how much I missed simply standing upright and so I've just been using the crutches for a little balance or support instead of hanging on them. This also means stairs are much easier to tackle and in general I can move around quite a bit more. But since I have been moving around a lot the last few days, my foot has finally begun to swell - pretty much the first major swelling I've had since surgery. If it starts to feel too uncomfortable I will just go and elevate it on some pillows and use an ice pack and it goes down in a few minutes.
I am very much looking forward to the next few weeks and getting back on my feet again!
It's hard to believe it's been one whole month since I went under the knife! Much has happened in the last two weeks with my recovery.
Three weeks post-surgery I had my first official post-op appointment at OHSU. My bulky splint finally came off and I got to see and touch my foot and lower leg. After being stuck in the splint for three weeks the skin on my leg was dry and scaly and my calf had atrophied quite a bit, which was all to be expected. There was some dulled sensation in my lower leg due to minor nerve damage. Apparently this should resolve completely in several months.
To both my and my doctor's surprise, there was almost no swelling or bruising in my foot and ankle! This is good for two main reasons: 1) less swelling usually means less pain, and 2) less swelling means stitches heal better. Having no swelling with major foot surgery is highly unusual. I chalk this up to keeping the foot elevated most of the time and possibly my continuation of bromelain and curcumin supplements - both anti-inflammatories.
The stitches on my lateral ankle and top of my 1st metatarsal had healed well enough that I got them removed during the appointment - 11 stitches total. Not too bad for a major surgery! After the stitches were removed I went into a pretty comfortable CAM boot which I will wear for another 9 weeks. As this was week 3, I still have to be non-weightbearing for a while longer.
I had my first post-op physical therapy appointment this week as well. This doctor also remarked in all her years of practice she has never seen so little swelling after foot surgery. With my foot out of the boot, I did some ankle dorsiflexion exercises with her, which I have to continue 3x/day for the next three weeks. My ankle feels very stiff and weak but I'm sure if I do the exercises regularly mobility will improve.
One of the week's most exciting developments is finding a way to do cardio at the gym. I have been lifting weights 3x/week but miss getting my heart rate up more - plus, I want to stay in decent aerobic shape until I can get back in the pool or on a stationary bike again (3 more weeks!). The rowing machine at the gym was the ticket. I simply placed a platform next to the machine and rested my boot on the platform. I took care to not place any weight through the foot as I pivoted lightly on the heel. The current plan is to incorporate the rowing machine into my gym routine 3x/week.
Only two weeks out from surgery and I now have ZERO pain. In all honesty I am amazed at how fast my body is healing.
Last week, about 10 days after surgery, I started my PT exercises at home. The current PT focus is on hip abductor and gluteus medius exercises with a Theraband. I have also been working on strengthening my abs with boat pose and bicycle crunches and my upper body with modified push-ups. The first day I tried my PT exercises I was pretty exhausted after 30 minutes but it did feel really good to move my body again!
Over the weekend I also started going to the gym again which was a massive win. Using my knee scooter to get around, I was able to do upper body exercises on several of the machines and also tried some quad raises with less weight than I typically do. While it felt good to get back into the swing of resistance training, I also found that I needed a nap afterwards. I also made sure to have a large protein shake as soon as I got home.
A game changer in terms of regaining some independence at home this week has been the iWalk 2.0 hands free crutch. Although the name and branding are a bit over the top, I have found this mobility device to be indispensable around the house. Being able to make my own coffee or a simple meal the past few days has meant not only my husband gets a break from caretaking, but I also get to use my surgical leg in a quasi-walking manner. Due to some expected atrophy of my right leg, using the iWalk the first time was definitely challenging. Over the past few days I have tried using it a little more each day to the point I was able to fix myself a meal yesterday, and even clean up the kitchen afterwards!
Just four more weeks to go of non-weightbearing - I can do this!
This last week has been a bit of a blur, but I am happy to report that my surgery on May 16th went very well.
I arrived at the OHSU Center for Health and Healing at 5:45am and went home around 1pm after a four hour long procedure. In addition to sedatives and general anesthesia, I was given two regional nerve block shots in my right leg before the surgery, rendering it completely numb from mid-thigh down. The anesthesiologist used an ultrasound device to place the nerve blocks in the correct spot. It took longer than expected because they said I had so much leg muscle it was hard to find the nerves! After the procedure, the anesthesiologist installed a nerve block catheter in my leg to numb the sciatic nerve for 72 hours after surgery. A slim tube protruded from behind my knee which was attached to an external pump releasing a set amount of nerve block per hour. I believe this absolutely helped me control my pain levels with less narcotics after surgery.
The first few days at home were challenging. Getting used to life on crutches, especially with one numb leg, was its own hurdle. I needed help going to the bathroom and getting in and out of bed, which was where I spent most of my time. Pain management consisted of elevating my foot above my heart 23.5 hours per day, staggering Tylenol and ibuprofen, and occasionally taking prescription pain medication if I had breakthrough pain. I had a series of alarms set on my phone to remind me to take my medications before they wore off, and a notepad to keep track of what I took when. Overall my pain levels in the first 72 hours never got above a 2 or 3 because of this system.
I was also prescribed a 'baby aspirin,' 81 mg 2x/day to help prevent blood clots from forming due to inactivity.
One thing that surprised me was my huge appetite. I ate so much the week after surgery and drank about twice my normal amount of water - which is already a lot! I tried my best to stick to my diet of high quality protein, fresh veggies and fruits, and whole grains, and my amazing husband brought me all my meals (and coffee!) in bed. I started drinking cups of bone broth throughout the day, because it felt nourishing and was high in collagen.
On Thursday morning my nerve block catheter had to be removed - a moment I was dreading, because this meant the feeling in my leg would return. In anticipation of higher pain levels I took an Oxycodone an hour before the removal. My husband gently pulled out the catheter from my leg, which in itself was a painless procedure. Then I braced myself for what ended up being the worst pain I have ever experienced in my life.
About an hour later, I could acutely feel the screws and plate bracing my 1st metatarsal. I could feel the large incision on my lateral ankle, inside which my newly sewn ligaments and tendons were throbbing. Bone and ligament pain was a brand new - and nauseatingly visceral - sensation for me. It was something I had to breathe, and occasionally scream, through. Thankfully, this passed within a few hours and I was just left feeling exhausted.
One sensation that has not gone away after the nerve block wore off was a burning pins-and-needles feeling in my right great toe which extended to the sole of my foot. My toe, which is poking out of the bulky Jones dressing, is hypersensitive to any kind of touch - if a blanket or piece of clothing brushes it, a zap of pain shoots up my leg. I am hoping this is temporary nerve damage or bruising and not a permanent problem. It seems to improve every day but is still very much present.
Throughout the week I have had a number of visitors which really brightened my mood. Boredom has not fully set in yet because daily life tasks take so much energy. Regular naps are imperative. For instance, taking a shower was such an ordeal that I slept most of the day after. Although still cumbersome, crutches have gotten much easier although I am in bed 99% of the day.
Yesterday evening two friends came over for a backyard BBQ. It was gorgeous out and I was grateful they could carry me down the four steps so I could sit out in my backyard. When things were wrapping up I crutched back over to the steps, thinking I could make it up to the house by myself. I was not so lucky. After two steps, I was about to lose my balance and caught myself on my splinted foot to stop from falling. It was excruciating, partly because I landed on my great toe, and partly because I was so angry at myself for not accepting help when I could have used it. I sincerely hope touching down with part of my weight for a split second doesn't prolong the healing process. Of course I can't make it a habit, but ultimately I don't think it did too much damage.