Merry Christmas!!

Merry Christmas & Happy New Year….

from our family to yours!!

Surgical images

Fluoroscopy is an imaging technique which allows the surgeon to view real time images of internal structures…like watching moving x-rays on a TV.

I noticed one of these large machines in the operating room during the first surgery (I was already out of my head on Versed when they wheeled me in for the second surgery so I don’t remember anything). The doctor uses this machine to view the placement of screws and pins during surgery. Shortly after I was taken to my hospital room a nurse came in and handed my husband a pile of printouts from the fluoroscopy machine. I don’t know why they gave them to us, we didn’t get them the first time. But they were interesting to look at. In one of the images you can see the end of the drill which is being used to place the pin. Also, in many of the images you can see someone’s finger bones, evidently they are holding my foot up.

 

You can see how the heel was moved over and screws were used to keep the heel in it’s new place. Notice the finger bones of whoever is holding up my foot.

 

The image on the left is of the screws & plates in the arch. In the image on the right you can see that even though my arch is now lower, the toes are curled up so high that I would still have problems if they weren't fixed.

The left image shows the big toe corrected but notice how curved the other toes are. The right image shows the placement of the pins in the remaining toes. Note the tip of the drill showing at the top of the image. (No, I don’t have 7 toes, the last two bones are actually someone’s hand.)

The pins are all in place and ready to be cut to a shorter length.

Made it through the second surgery.

Well, I made it through the second surgery, although things didn’t go as smoothly as I would have hoped. I had a different anesthesiologist this time (because you don’t get to choose) and for whatever reason, this guy thought general anesthesia would be the best way to go…he was WRONG! He gave me general anesthesia with some local anesthesia injected around the ankle. Unfortunately that was woefully inadequate and I was in terrible pain when I woke up. I had a short period of time during day two in the hospital in which I was somewhat comfortable (the pics where I’m smiling) but the vast majority of the time I was in quite a bit of pain. The anesthesiologist I had with the first surgery was right when he said it would be difficult to control the pain without a nerve block. So…if you have a choice, I would recommend spinal anesthesia with a femoral nerve block….having tried both ways, I can assure you that this way is the one that provides the most reliable pain control. The general anesthesia also made it very difficult for me to wake up afterwards and I have quite a bit of memory loss from the time shortly before and after surgery. For example, I don’t remember kissing my husband goodbye or being wheeled into surgery. But he says we kissed goodbye twice and he walked down the hall with me towards surgery; unfortunately I don’t remember any of that. I also had a very hard time waking up afterwards; below are pics of Rex unsuccessfully trying to talk to me about 3 hours after surgery.

View Full Album

 

I had quite a difficult time with nausea because pain meds just don’t agree with my system and since I didn’t have the nerve block, I had to take a lot more pain meds. I spent the evening feeling very bad and throwing up every hour or so until approximately 4am when they finally found a medicine that helped me stop vomiting. It was not a very pleasant night, to say the least.
About 1pm the next day I was feeling pretty good. I’m not sure why but I had a period of time of about 3 hours in which I didn’t feel too nauseous and my pain was under control. I don’t know what we did differently but during this 3 hour period I actually felt quite human and was able to smile and enjoy spending time with my husband.

View Full Album

Now that we’ve gotten home, I’ve found the secret to pain control, at least for me. It’s as simple as changing position. For whatever reason, I can only remain comfortable (and relatively pain free) for about an hour. At the hour point I will start experiencing a lot of shooting pain and burning. But if I just change my position, I can be comfortable again. It’s really strange. I’m taking my Oxycodone every 3 hours (as prescribed) and then I just change position from left side to right side every hour (or vice versus). For whatever reason, I can’t get comfortable on my back for more than 10-15 mins so I only eat in that position. Perhaps that’s why I was so uncomfortable in the hospital, because you spend the vast majority of your time in the hospital bed on your back.
My foot looks a bit better this time, you’ll notice there’s no blood seeping from the big toe and soaking through the bandage this time. But it looks like they put a stitch in the end of the big toe this time so that must be why.

I want to thank everyone for their prayers and well wishes…I really appreciate it!
I’ll update again soon.
Dana

Time for Round 2!

Well, tomorrow’s the big day…surgery #2. I’ll be going into the hospital to have my right foot done, hopefully it will match my left foot when all is said and done. LOL

I’m excited but also very nervous. In some ways it’s nice to know what’s going to happen because you feel more prepared. But it’s also a bit more nerve-racking because you know how much pain and inconvenience you’re in for. But, I’m just shooting for small goals, a week at a time. I’ll make it, I made it the first time and I can make it again.

I’ll post pics and info as soon as I feel well enough to get on the computer. Wish me luck!

Merry Christmas and Happy New Year!!

Physical therapy done...for now.

Yesterday was my last physical therapy session until I'm ready to start up again for the other foot. My foot is doing really, really well. Physical therapy has really made a huge difference. The home exercises combined with the twice weekly appointments with the therapist have really strengthened my ankle and given me a much larger range of motion. I'd say my foot is about 75-80% at this point. I don't think it'll be much longer before it's at 100%.
My next surgery is less than a week away. I'm beginning to get pretty nervous. I really hate to start all over again but I'm so happy with the way my first foot is doing that I definately want to get it done. My new foot looks normal, it fits into normal shoes and most importantly, my balance is better on that foot now. The first week is the hardest, so I'm just looking to Christmas as my goal. Christmas day will be a week and a day after my surgery so I know that by the time I get to Christmas I'll be feeling better.
Please keep me in your thoughts and prayers on Thursday morning (12/17/09).

A very Merry Christmas and a Blessed New Year to you all!!

Wearing a normal shoe!!

The physical therapist had me bring in my new shoes last Wednesday (I wear a half size bigger now). We did the entire therapy session in the shoes and he told me I could start wearing my shoes for a half day and then work my way up a little everyday until I reached a whole day in my shoes. However, I must say that I’ve been a naughty girl…it felt soooo good to be out of that boot that I’ve been wearing my shoes all day since Wednesday. I haven’t had any problems. Of course, Thursday was Thanksgiving so I didn’t do much walking around and Friday was “Black Friday” so I only went out of the house for a short while to avoid the craziness in the stores. However, I did do several hours of shopping on Saturday and I put up the Christmas tree Saturday night. So my foot has been aching a bit today. I’ve stayed off it most of the day and have been icing it off and on. But I’m very excited to be back in normal shoes again!

I would definitely recommend ordering wide-width shoes because your foot will still be swelling off and on while wearing the shoe and you definitely don’t want to be forcing your foot into a shoe that’s too tight!

I ordered the New Balance 769 in double wide. They are very comfortable…and cute too!!

Amazed by the results

Every time I look at my feet I am amazed by the results of the surgery. It’s unbelievable what modern medicine can do. I’ve already noticed that I can balance much better on the “new” foot.

Yesterday, I went swimming for the first time since the surgery. I thought my foot and ankle might be sore when I kicked my legs but they weren’t at all. I was able to lap swim, water jog & do everything else I did before surgery…it was great!!

Physical therapy is getting challenging.

The physical therapy is beginning to get more challenging and I'm having quite a bit of soreness afterwards now. But I'm already noticing improvement in my foot and ankle. I'm able to walk around the house in just my socks with only a slight limp and I only have to put the boot on to leave the house. However, I do still sleep with the boot on just because I'm afraid my husband might accidently kick my foot during the night. LOL

The therapist said I should bring my other shoe in soon so that we can work on getting me into it. Unfortunately when I tried the shoe on the other night, I realized that it no longer fits. My foot is so long that the toes rub up against the end of the shoe. So I've ordered new shoes and they should arrive some time next week. It will be exciting to get back into a real shoe again.

I'm less than a month away from the next surgery...time is really flying! Even though I've been through this all before, I'm beginning to get a little nervous. I hate to start all over again but I just keep reminding myself that this is the last time I will ever have to do this. The other day my mom said "Aren't you glad you're not an octopus?" My answer..."YES! I am sooo glad I don't have 8 feet!" LOL

Physical therapy begins

I went to my first physical therapy appointment yesterday. I was a little nervous that my foot would be sore afterwards but it wasn’t. The exercises were pretty simple. I used a few exercise machines designed to help strengthen my ankle and increase my range of motion. My ankle is pretty weak from being in the cast. I was also given a stretchy band and a list of exercises to take home. I’m supposed to do each exercise twice a day, 20 times each.
The home exercises are pretty simple. I put the loop of the band over my injured foot and then pull against the band. I can increase the resistance just by holding the band tighter. It’s a bit challenging; by the time I get to 20 my foot is just about worn out.
The most exciting part was when the therapist told me that I should be back into my normal shoe by December 1st!! Wow, I can’t wait!

View Full Album

Getting better everyday…Next surgery scheduled.

I’m beginning to understand why the doctor said I’d be ready to have the other foot done by next month…I’m making improvements everyday. Sometimes I even surprise myself with how well I’m doing. The pain I was having in my heel and ankle has diminished significantly in the last week. I’d say I’m only experiencing about 10-20% of the heel and ankle pain that I was last week. I’m walking without a cane or any other aid and I can even walk fast enough to keep up with my husband now! LOL Yesterday we even stopped over at Best Buy for a little light Christmas shopping and I walked around the store for about a half an hour. That’s the longest time I’ve spent walking (without sitting or taking a break) since the surgery. And I wasn’t even in pain when we were done!
The doctor’s office called today and informed me that I’ve been scheduled for surgery on my other foot on December 17th at 715am. Exactly 3 months after the first surgery…kinda weird. I’m hoping that’s a good sign. I’m not looking forward to doing this all over again but I am looking forward to getting it all over and done with. So...in a little over a month, we’ll be going back in for round 2! LOL

Laura, how are you doing? Has your pain improved? Are you able to get around your house okay? Hope you’re feeling better!
Dana

A successful doctor visit!

I went to the doctor’s office yesterday afternoon. He was very pleased with my progress. He said the x-rays looked good and he was very happy with the way my foot looked. He said I can start physical therapy next week to get weaned off the cast boot and he even said I can start swimming again anytime I want to. I was pretty surprised, I thought he’d make me wait at least a few more weeks before swimming.
No worries about trying to get through the airport or courthouse metal detectors…he said all the metal in my foot is stainless steel and won’t set off metal detectors. Yeah!!
As far as the ankle swelling and pain, it has gotten a lot better in just the last two days. So maybe one week is the magic time frame that it takes for your foot to get used to walking again. It started feeling much better on Thursday and Friday; that’s exactly a week since I started walking. The doc said the ankle is part of the foot and moving all the foot bones around causes the ankle pain; it’s all connected.  You can see in the pic that the swelling isn’t gone entirely but definitely looks much better. The doctor said the heel pain was due to the screws and, like everything else, would go away with time. I’ve been using “Mederma” scar gel on my scars 4 times a day and it’s already beginning to make a noticeable difference. They seem to be getting flatter and smoother already.
                             
            11/07/09                        vs.                             11/03/09
As far as getting the second foot done…the doctor blew me and Rex away when he said we can schedule it for December! Next month!! I thought he’d say 6 months or something! But he said there will be a big difference in the next 4 weeks and I’ll be ready by then. So…they’re gonna schedule me for December and we’ll get it over with. I’ll be so glad when it’s all done and over with!

No I’m not smuggling a softball!

Well, I’ve made it through 5 days of walking on my foot now, although I only walked on it for half the day today. I’ve been having a lot of swelling in my ankle since the day after I started walking. It doesn’t seem to matter whether I walk a little or a lot, it swells anyway. The only difference is how much it swells…the more I walk, the bigger my ankle gets. My foot was really sore after work last night and when I got up this morning it was still pretty sore so I decided to give my foot a break and I used my scooter at work. I only walked on my foot to go out for dinner (I elevated it during dinner) and to stop by the pharmacy on the way home. The photo below is how big my ankle was after just that small amount of walking….no, I’m not smuggling a softball in my ankle!

If I walk on my foot all day at work my ankle will be almost twice this size. And I don’t do a lot of walking at work. I have a desk job and I only get up if everyone else is too busy to get me what I need. I think the biggest problem is that I can’t elevate it properly at work. The company nurse did her best to set me up with a way to elevate my foot but it doesn’t get my foot above my heart which is the key to controlling swelling. My desk is horseshoe shaped so the only opening is behind me, therefore I am surrounded by desk and because of that I can only get my foot so high without running into the bottom of the desk. What I end up doing is trading off between sitting with my foot on the thing the nurse invented and balancing my foot up on top of my desk. On top of my desk feels the best as far as my foot goes but it kinda hurts my back to sit with my foot up so high for very long and it isn’t exactly the most lady-like way to sit. LOL

So when I get home from work I soak my foot in an ice-bath for 20 mins then wrap my ankle in ice packs for another 20 mins. That seems to reduce the swelling pretty quickly and then I’m just careful to keep it well elevated for the rest of the evening. This to shall pass….right??

Finally walking and back to work!

I returned to work on 10/29 but I wasn’t allowed to walk until the next day on 10/30 so I had to take my scooter to work the first day. After that I was walking with the aid of a cane. Although you might call it hobbling or limping rather than walking. I did pretty good for the first two days but after that I began having a significant amount of pain in my heel and ankle. I had to take a few pain pills over the weekend, I wasn’t too happy about that because I’ve been off the pain pills for about 3 weeks.

I’m trying to limit my walking as much as possible to help with the pain. I’m fine in the morning but by the end of the workday, I’m exhausted and in pain. I’m sure this will get better with time so I’m trying to be patient, but it sure is frustrating. When I see the Dr. this Friday I’m gonna ask why I have so much pain in my ankle. I’ve had the ankle pain from the beginning and I see that Laura has experienced ankle pain following her surgery as well. Seems odd that the ankle would hurt since they aren’t actually doing anything with the ankle.

When I first began trying to walk it was pretty obvious that I was gonna need a cane, at least in the beginning. The boot is rounded on the bottom (sort of like a rocking chair) so you have to be careful not to go over backwards. Also, the boot sole is much thicker than your shoe sole so you are essentially walking with one leg about 1-2 inches shorter than the other. It’s a bit difficult to balance. I found a cute pink cane at the medical supply store so at least I don’t look too much like a granny! LOL

Prayers needed

One of the commentors on my blog, elle_114 (Laura from England), will be having this same surgery tomorrow October 28th. I'd like to ask that everyone keeps her in their thoughts and prayers tomorrow.

Don't be nervous, Laura! We're thinking of you and praying for a smooth surgery and a quick recovery! Please let me know how you're doing as soon as you feel up to being on the computer.

Good luck and God bless,
Dana :)

Knee socks are a MUST!

I’ve found the secret to making the walking cast boot a little more comfortable…knee socks and a bandana. The boot seems to slip quite a bit which causes discomfort, especially when it creates rubbing on an incision. Also, the skin on the leg is in pretty bad condition after over a month in a traditional cast and it peels off terribly. Keeping in mind that the boot liner is not machine washable, this isn’t really something you want to have happen. A knee sock keeps the shedding skin off the boot (and out of sight) while also helping to keep the boot from slipping so easily (and it’s washable!). But, all knee socks are not created equal. The ones I found in Wal-Mart and other local stores were very thin, cheaply made, stiff and came in boring colors. You really need a knee sock that is thicker to help cushion the incisions and is made of mostly cotton to make it softer and stretchy. We’ve all seen those cute patterned socks in the stores that are polyester and very stiff…that doesn’t work out well when you need to stretch it over a post-operative foot. I found a great sock store online called “Sock It To Me Socks” http://www.sockittomesocks.com/ that has knee socks made of 75% cotton, 20% polyester & 5% spandex. They are thick, well made, stretchy and come in really fun patterns. I figure if everyone’s gonna see my socks, they might as well be fun!! I bought monkeys, skulls and ladybugs. Looks like I’ll be back on their site soon to order more because my two teenage daughters are in love with my socks…Christmas is just around the corner…can you say “stocking stuffers!”.
 
The bandana works really well to keep pressure from the back of the boot off the rear heel incision if folded carefully and placed in the back of the boot’s interior. Any old bandana you have laying around the house will do…nobody’s gonna see it. Of course, I’m not allowed to walk in the boot yet…so this may not be as comfortable once I start walking on it.

Pins are out!

The pins are out and I even got a walking cast!! Originally I was supposed to have a regular cast put back on after the pin removal and then I was supposed to come back on the 28th to get the walking cast. But I was doing so well that he allowed me to get the walking cast as long as I don't try to walk on it till next Friday. That means I can take a real bath and wash my leg! Yeah!! But I still have to wait 2 more days for the pin holes to heal before I can do that.

The pin removal wasn't nearly as bad as I thought it would be but it was uncomfortable. Especially the first pin, for some reason that one seemed to be stuck and it was pulling on the incision on the back of my toe when he was trying to remove it. I didn’t realize the pins would be so long, turns out they were as long as my fingers which was pretty surprising! I laid down and told the Dr. I didn't want to watch. You can hear him on the video teasing me because he had kept telling me it didn't matter if I watched or not, watching can't make it hurt more....I didn't agree. The video is below.

 

They took more x-rays (I think I’m gonna be glowing by the time this is all over) and I asked if I could see them. They said “No problem, we’ll give you copies”…so I came home with print-outs of my x-rays. It’s pretty freaky…with the pins in there I look like Wolverine!! LOL

 

After the pins were removed we took a pic of the holes that were left. No too bad…I think it’ll look okay after they heal.

The funniest thing was comparing my “new” foot with my “old” foot. As soon as they removed the cast we noticed a difference. The new one seems to be quite a bit longer…I think I’m gonna have to buy new shoes!!

I now have a “walking boot” cast. The large gray dot is a pump which I can squeeze to pump up the boot’s interior liner so that it fits better. Although I must say, it wasn’t too comfortable trying to sleep last night. For some reason my foot kept sliding up so that my heel was resting on the edge of the plastic piece in the back and with the incision back there it didn’t feel too good. I think I need to play around with the pump some more. Unfortunately it only pumps up around the ankle, I think it would work better if it pumped up around the foot too. I still have gauze wrapped around my toes. But I plan to wear knee socks as soon as I can take the gauze off (2 days) since the boot liner isn’t machine washable.

The “Operative Report”

Doctors tend to speak in generalities because they seem to think that most people don’t want to know the details. But I’m a details kinda gal. I can imagine much worse than what actually happened so I like to know. Therefore, I requested the hospital to send me a copy of my “Operative Report”. (You are entitled to a copy of any or all of your medical records, but they won’t offer it…you have to know to ask.) It arrived in the mail on Saturday and was quite an eye-opener. Turns out there was quite a bit more done than I originally thought. Now I understand why each medical professional I spoke with in the hospital said something along the lines of “Wow…you’re having a lot done today”. And why the anesthesiologist said “There’s no way we can manage adequate pain control after the procedure without a nerve-block…I wouldn’t let anyone do this to me without a nerve-block” when he was trying to explain why he needed to use spinal anesthesia instead of just putting me out. Although the mystery of why I was so sick afterwards when I only had spinal anesthesia was also solved with the report. Turns out I was given a combination of spinal and general anesthesia, which would be why I can only remember bits and pieces of the surgery, mostly at the beginning and very end and why I felt so nauseous until the next morning. Five individual procedures were performed during the surgery…1. Plantar fascial release, 2. Calcaneal osteotomy, 3. One through three tarsal/metatarsal fusions, 4. First toe IP fusion and 5. Hammertoe reconstructions on toes two through four. Once everything was completed I was left with 3 pins in my toes and 1 screw in my big toe (which I was aware of) as well as 8 additional screws and 3 plates (which I was not aware of until I read the report)…..surprise!! Turns out the additional hardware is located in my heel (2 screws) and my arch (6 screws & 3 plates). So after the pins come out I won’t be free of foreign objects, the 9 screws & 3 plates are permanent. Which is fine, I don’t mind as long as I have a more normal foot…but this just shows why it’s important to request your records. Unless you’re one of those people who’d just rather not know. It also provided some vindication for me….I’d been telling my Mom and my Husband ever since I saw them after the surgery…”they put a screw into my heel, I felt a drill in my heel…it didn’t hurt but I could feel the feeling of drilling and the pressure of something pushing hard into my heel”…I don’t think they believed me. Now we know I was right, it actually did happen. Below are pics of the hardware in my “bionic” foot (as the kids call it).

According to the report, these are the type of screws and plates that were placed during surgery.

A big THANK YOU for all the continued support!

A big THANK YOU to everyone for all the continued support and prayers! The cards and well wishes just keep rolling in. Just about everyday I'm receiving something that makes me smile. I truly appreciate it!! Thank you all!

Pin removal is next!

I have an appt Oct 21st to have the pins removed from my toes. At that point, all foreign objects (stitches, pins, etc) will have been removed from my foot and I will be just 1 week away from being able to place weight on the foot. If the Doctor doesn’t have any objections, we plan to video the pin removal for the blog. So we’ll see how that goes. I can’t wait to get the pins out; they aren’t as uncomfortable as they look but I’m always afraid of snagging them on a blanket or something.

This pic shows the entry site of the screw on the end of the big toe, the stitches marks on each toe and the pins. The cover has already fallen off one pin, as you can see.

Left foot....before and after

Wow!! Compare the before and after pics!! This is the same foot...it's almost unbelievable!

Stitches out....new cast

Well, the stitches are out and a new, better fitting cast is on! I was in the doctor's office for about an hour and a half today. They took off the old cast, took x-rays, removed the stitches and put on a new cast. The Doc said the x-rays looked great and the bones seem to be healing well. The worst part was removing the stitches. I've had stitches removed before but it never hurt like this. They painted all the incisions with iodine right before they removed the stitches so of course the iodine ran down into the wound and burned/stung like crazy!! I wasn't too happy about that, but otherwise, everything went very smoothly. My foot has been sore since I left the doctor's office but I kinda expected that since they messed around with it for so long. I'm sure it will feel better by morning. As promised, here' some pics of my "Franken-foot".

This is what my foot looked like when the cast was first removed. There's a lot of dried blood on the big toe and there was some sort of covering over all the incisions.

Here are 2 of the 3 incisions on the heel.

Here's the 3rd heel incision and the pins. You can also see the small incisions on the underside of the toes where the tendons were cut to insure that the toes don't curl up again. Notice how much lower the arch looks now compared to the before pics.

Here's a view after the coverings were removed from the incisions. You can see a bit of bruising and discoloration.

A gnarly view of the pins.

Feeling better after everything was done and over with.

My new cast. Regan was pretty grossed out over the fact that it shows my toes so much.

Can't wait for a new cast!

Okay, I'm no longer scared to get a new cast. The swelling must have really gone down over the past few days because my cast is suddenly WAYYYY too big. It moves all over the place and almost feels like it could pull off. It's actually becoming quite uncomfortable because it pulls the weight of the cast down on the top of my foot when it shifts down and considering that those bones were broken, it doesn't feel too good. But my appt is tomorrow so I don't have much longer to wait.
I'm doing pretty well with the pain so I thought maybe I could shift to only taking extra strength Tylenol last night. Unfortunately, it only worked for about 12 hours...at that point I was just too uncomfortable and my foot was throbbing way too much so I had to take an oxycodone. I guess it's still too early. But I'm hoping to get off them in another week at least. They make me feel car-sick all the time which isn't a very pleasant way to live.

Stitches are coming out soon...

My stitches are due to come out this Friday afternoon. I can't wait to see what my foot looks like (I like gross stuff...LOL) but I'm scared to death to have the cast taken off. I'm afraid the bones in my foot will be like mashed potatoes. But my pain level has dropped significantly in the last week so I'm hoping that means that it's healing well and nothing will go moving around when the cast comes off. I'll update with pics of my "Franken-foot" after the appointment.

Another move towards independence

I made another move towards independence today....taking a shower unassisted! I had purchased a shower chair but what I didn't count on was not being able to get in & back out of the shower by myself. We have shower doors rather than a shower curtain so space is limited and I quickly realized during my first shower attempt that I was unable to get into or out of the shower on one foot. My husband had to lower me down onto the shower chair and then I'd have to swing my good leg in while leaving my bad leg outside of the shower. Getting out was just as difficult. Mom and I took a road trip to Home Depot this morning and I bought one of the better shower chairs which stands partly outside the shower so that you can sit down on it outside the shower and then just slide over into the shower. It works slicker than a whistle! What was funny was watching Dalton, me and mom trying to put this shower chair together in the middle of the living room this morning. How many people does it take to put a shower chair together??







Another helpful item for showering is a cast cover. They are a bit pricey at $12.99 for a package of two but they are reusable and well worth it to avoid getting your cast wet or damp.