5 months post-op

Well....there's nothing like starting a blog and not following through. I am just doing an update for those of you on Runner's World who i sent a link to recently :o)

The cast was removed 12/16 and I transitioned to boot and started Physical Therapy in January. I started with 2x a week and am now going only once a month. The boot was on for a month and I transitioned to sneakers but quickly got back into my Dansko Mary Janes for work and now wear those almost daily except when I am going to be walking a great deal or when walking our dog. My range of motion has improved significantly, due in part to following some basic strength and ROM exercises early on in PT and just due to paying attention to my body's signals and just trying to do normal walking with increased distance and speed.

We spent 3 nights at the OR coast mid March and did a fair amount of walking on the beach, in parks and in Astoria and my foot held up way better than pre-op. There was a bit of swelling but I just elevated, iced and of course took advantage of the hotel hot tub! 

The biggest thing I notice hanging on 5 months later is sensitivity around the scar. My PT said to expect that for at least a year post op. I need to be better about daily massaging of the scar area, it is the only way to work that tissue and reduce the sensitivity. The scar itself has healed really well...i will try to get a current pic up this week! I think massaging that area, the fascia and the calves and shins are what I need the most at this point in addition to just walking and good ROM stretches.  I am not the best at homework, but early on I was quite diligent about it just because I had lost so much strength from the 6 weeks in the cast.

I will be starting acupuncture soon...I did it before and my ortho and PT are both big proponents of acupuncture, but i recognize not everyone is a believer. For what it is worth, I started acupuncture as a last resort to address chronic back pain (24 years now) and discovered herniated discs through the process. i was a full blown skeptic and am now a fan. It's no miracle, but with the right practitioner I think most people will experience positive results.

Ok, if anyone happens to read this and has questions I am more than happy to answer anything! I was scared to death to get this surgery, fur a handful of reasons, so if I can be of any help i am glad to do it!

New cast and healing

Thankfully I got through the really bad day last week and pain is continuing to decrease. Went in yesterday to remove split cast, remove sutures and get the regular cast. Foot looks good, not as swollen as it feels. Suture removal was not fun but only moderately painful and finished pretty quick.

Continued chllenges are mobility, independence, and of course pain. I have a random nerve twitch about an inc from the incisiion, toward my toe, that likes to twitch periodically and cause a weird sensation and some pain. Switched to Vicodin, which does not help much but I am glad to be off the oxycodone and more alert. Working from home just a few hours a day, will return to work next week for 2 days then off for Thanksgiving.

True life savers have been the cast cover, bench and shower nozzle holder...have been able to shower daily thanks to these items! Also, having Adam set up the ice chest etc when he goes to work. My good leg gets fatigued when hopping around too much, and when on the Oxycodone I was a bit dizzy and shaky.

Here are some pics from doc visit yesterday.

A Bad Day

Thanks to my OCD and Type A tendencies, I was all prepared for day 3 or 4, the worst pain according to multiple blogs etc I had researched on this topic. When day 3 came around and my pain was all located in my back, I falsely believed I had weathered the storm. My whole life I have had results contrary to the norm when it comes to medical issues, so it came as no surprise I did not fit the mold with the post op experiences this time. 

Yesterday I woke with dread, knowing I would need to call the doctor's office for a refill on my oxycodone. I was down to the last 6 out of 40, and even though I stayed within the prescribed dose, I feared making the call, worried I would be judged for overusing and drug seeking (never mind that I have zero history of such behaviors). The doctor's office responded to my voicemail and in fact encouraged me to refill w/20 pills rather than the 20 I mentioned in my message. There was zero judgment, only concern for my well being and comfort. 

Shortly after getting off the phone I began experiencing tremendous pain in my foot. It was a sharp, bitter pain that occasionally shot up my calf or my shin. It was approx 9:20 am and I took my 1st oxycodone of the day. An hour later I was clenching my jaw as the pain cntinued, feeling as if there were a dozen spiders with the sharpest of fangs biting around where I imagine the incision is located, nearly shooting me off the couch with pain...and I have a pretty high threshold for pain! I took a 2nd pill and assured myself that calling in the refill was in fact necessary. I did my best to manage the pain the rest of the day, though at one point after lunch and attempting to nap I lay on the couch with tears just pouring down my cheeks. No doubt that part of the struggle is just the damn sense of helplessness. 

This morning I woke up to immediate pain and took a pill before even leaving bed. Determined to wean myself off the pain pills the next 2 days, I made a plan to limit myself to 1 every 4 hours and using ice and ibuprofen to manage. By 9 am I was feeling nauseated and just downright moody. I hade made a mess attempting to carry a travel mug of coffee back to the couch in a bag...the cup tipped over en route and the lid slid open, coffee spilling into the bag, on my book and thru the hole in the bag to the floor. I reminded myself I seem to be having a bad day and not to overreact. By 10 am my foot was screaming bloody murder, and for whatever reason I'm just not at my best. I was trying to straighten up the clutter on the coffee table and spilled the entire mug of coffee everywhere...thankfully I had a washcloth handy and cleaned it up, reminding myself again not to overreact. I was acutely aware of the dark cloud surrounding my brain and determined to not let it get the best of me. I decided to find something to eat to settle my belly and take another pill. 

After settling down I grabbed the XBox remote so I could watch some movies on my Netflix Instant. The WiFi wasn't working, something we have been fighting with the past few days. I again reminded myself to not overreact, knowing damn well I have been precariously perched on the edge all morning. I decided I would play Miss Fix-it and deal with the modem and the router, knowing full well they just need to be rebooted. I'm not entirely sure what happened next, all I know is I went from decisive and solution focused to a sobbing pile of goo in the blink of an eye. Assuming I just needed to let it out I just let it go for a few minutes til I feared I would hyperventilate and slowly reined it in. I dragged myself tp the office to reboot the modem and router, and while waiting pondered why I feel suxh a mess TODAY. Yes, surely the immense pain in my foot is not helping one bit, but I am an independent, intelligent woman, with a MA in Psych and tremendous skills in stress management. I think that today, 6 days after surgery, I am simply exhausted, both mentally and physically, with the level of effort it takes to do the simplest things, and that combined with the unbearable pain, the boredom and the desire to just have my routine back....well shit, I am just human. 

I refuse to let this engulf me, it would be far too easy to spiral down into some depression, but extraordinarily difficult to pull out of, so I am trying, to find  something in between. I chose to put this all in the blog, because while it is possible no one will ever see it, I know damn good and well the value of journaling. 

I definitely need another pain pill. The sharp, evil pains in my foot do NOT need to be tolerated and will do no one any good, least of all me. It's not as if I need the pain to remind me to stay off of it, I want too badly for this surgery to be worthwhile, so I am being diligent about following doctor's orders. I may also need to just have a screaming, crying tantrum....followed by a nice nap. Hey, there is a reason that works for kids! Also, it may help to admit I am not superhuman. I thought I was getting off easy when days 3 and 4 passed and I did not feel the excruciating pain everyone else described. So, it was delayed, and maybe because my dr is awesome, but it has arrived now, and with a god damn vengeance. So, my schedule may not go as planned, I may need to stay doped up for a few more days before weaning, so I need to figure out a way to not judge myself for that and not get overly frustrated for that which is beyond my control. That's right, I said it....beyond my control. 

Alright Erin, buck up, let out that primal scream, feel sorry for yourself for a damn minute and stop trying to be the perfect patient! Life sometimes wants to be a bitch, you can't ALWAYS be the bigger one....sometimes you have go home crying...but tomorrow is another day and maybe THEN you'll have the strength to be Bitch on Top!

Now, if you'll excuse me, I need to go cry!

Post Op Day 3

Today or tomorrow is supposed to be the worst day as far as pain. I have definitely noticed an increase in pain and acute awareness of the incision. Honestly, the primary sources of  pain and discomfort are my back and my left leg. I knew this was going to aggravate my messed up back, just didn't know how much. I think the major aggravation comes from sleeping with my leg raised (throwing off my hips) and just having to sit so much. The sciatic issues and herniated discs are totally different and aggravated by different things and it just happens I am doing things to aggravate both. I am also finding a great challenge relying on just my left leg, which is certainly exacerbated by being weakened by pain meds etc.

To manage the swelling inside the cast I am using an ice pack contraption purchased a couple of years ago for my back. It has two pockets for ice packs and wraps around and secures with velcro. I find that keeping the foot cooled, albeit only a bit sine the cold can only penetrate so much, helps keep the swelling down a bit and therefore minimizes pain from the incision touching the cast. 

Thanks to all the pre-planning and purchases form Amazon I have been able to shower no problem, which feels great. Being heavily dependent on Adam for so much is very frustrating, I am trying to do things as possible but tire very easily. I am taking the percocet every 3-4 hours to stay ahead of the pain and know that is contributing to feeling weak. 

Honestly, so far I feel I have been very lucky with the level of pain etc. I presume today and tomorrow will be the worst and hope it is all downhill after that, at least as far as pain. I typically do not want to take pain meds and believe staying ahead of the pain has been crucial. I am definitely considering how to submerge my whole foot in a bucket of ice to prevent swelling since that seems to be the biggest cause of pain other than my dang back :-) The times where I have been pushed to tears have been from back pain....perhaps that is a blessing in disguise....distracting from what could be significant foot pain.....

Surgery day

All in all, surgery day went well. The doc repaired the tear in the brevis (shorter part on the side of heel), which we knew about. There was also a small tear in the longus under the foot that he had to tear a bit more to be able to stitch and repair properly. That totally validated the pain in that area and will not affect recovery so I'm happy about that. 

Surgery was scheduled for 10 but they took me back closer to 10:30. For some reason i got hiccups right before the put me out, which had everyone in the OR cracking up :-)When they woke me up in the OR the doc was still there and I was just clear headed enough to ask if it was a bad tear and wheter he used dissolvable or permanent stitches. He said wasn't too bad and permanent. I found out about the 2nd tendon later when Adam fille dme om on what the doc said to him. When i got to recovery i asked the nurse the time and she said 12:37, so i am guessing actual surgery time was about an hour. Thankfully i was not feeling nauseated from anesthesia, but I specifically expressed concern to the anesthesiologist and she said she'd use anti-nausea....i would assume that's standard but don't really know. My throat felt sore so I asked for ice chips, and the RN gave me dilaudid and something else which quickly made me nod off, though somewhat aware of my surroundings. I am pretty sensitive to loopy meds. They got me back to the short stay unit about 30 mins or so where Adam filled me on on the doctor's comments and my RN gave me crackers, water then some percocet. I nodded in and out and they checked my vitals every 15. Finally I got up to hop to the restroom and shortly after I confirmed I felt more than ready to go home. My pain level was hovering around a 2, and the TN assured me I could take up to 2 of my oxycodone (generic percocet) at home if needed. I was in the car by 3...longer day than expected, but also was told my surgery was scheduled for 9, so arrived at the hospital at 7 am.....sans caffeine :-/

The biggest challenge upon arriving home was how to hop up the one high step into the house...mostly because i was weak and shaky. With Adam's encouragement and waiting to catch me i managed :-) I went straight to the couch and he made me a sandwich. I was surprised at how alert i felt and low pain level. Still, I wanted to stay ahead of the pain so i took a pill after my lunch and dosed off about 30 mins later for about 2 hours. 

Sleeping wasn't too bad. I am sleeping in the guest room for the time being to avoid Adam or i kicking one another on accident and because I know i will toss and turn. I propped my foot on 2 pillows, was able to sleep on back and left side (cast is on right foot). I woke 4 hours after going to bed and popped a pill. One problem is hip pain, which I presume is partly from elevating my foot. I have a bad back including herniated discs, so I expect this situation to aggravate it a bit. Early this morning i reduced it to 1 pillow and was able to sleep on my belly for a bit, which is my preferred position. 

The one thing I was unprepared for is the pain in my left ankle from having to put all my weight on that. I am going to use the band exercises prescribed in PT to strengthen my bad foot and see if that helps. I also have weird arches, so making sure I have a supportive shoe on should help. 

Pain level is increasing only a little today....so far. I expect it will increase as the numbing the doc did wears off. Wiggling my toes regularly and icing under knee, per recommendation from others online. Will also start with ibuprofen, for both my back and my foot.

Less than 48 hours to go

I have been doing quite well with the stress and anxiety. I am a Girl Scout and about as prepared as can be :-) THEN.....last night I realized how challenging it is going to be to get in and out of the shower. If it was just a stall it'd be easier, but I have to get myself over the tub....on one leg...and balance on crutches. I obsessed over this trying to fall asleep last night then had lots of stress dreams about the whole event, even actually thought about the risk of death just from the anesthesia....totally out of character for me! Tonight I am going to do a little dress rehearsal on getting in and out of the shower. I don't care how crazy it seems, I figure it is better to have a trial run while i am functional and not in pain or on pain meds. 

I am excited for this to be a distant memory, when I can laugh at how I obsessed. I just need to focus on the fact that I have about 6-8 days worth of mom-made meals in my freezer, including Green Chile Stew! There have to be some perks to something like this, and if it's not homemade meals by mom being shipped 1,500 miles, well then I just don't what it could be =)

Dangit!

Two realizations i had this morning that made me growl, both concerning my return to work and 4 weeks or so in a cast, maybe even longer total time on crutches.  


The first: What if the elevators aren't working? Thankfully I am only on the 3rd floor, but what a pain in the tookus. 

The 2nd: I will not be able to carry my lunch from the kitchen area back to my office. Basically this will require some thinking about how to accomplish putting my food in my backpack to make it back to my desk. I realize people have to deal with much bigger challenges in their lives, it's just these stupid inconveniences that keep popping up and making me frown a bit in anticipation. Seriously, I think my treat to myself after this ordeal is over should be to replace my roller skates I (stupidly) threw out before I moved to OR......These are cute!