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!

2 Weeks and counting

The surgery is 2 weeks from today. I have anxiety about the pain, but I know I will be on meds and will manage it somehow. My real anxiety is the recovery, and I am trying not to over think it and obsess. I am just so dang independent that even the prospect of having to rely on anyone else stresses me out. The other night I kept myself awake just worrying about what a hassle it is going to be just going to the restroom in the middle of the night. I am so happy for my small, single story home right now!

I am so incredibly fortunate to have a bf who loves me and is willing to do whatever it takes to support me and help out however needed. Still, I hate to have to rely on him (ANYONE!) and to make his life hell for a few weeks...or longer. He's currently the only follower of my blog, but this rant is really for me and for other peroneal tendon surgery sufferers, not him :-) I continue to look for ways to prepare and make for the most of my comfort and ease of functioning for both of us during this period. A woman on Runner's World said she bought a pillow at a med supply store that helped keep her foot elevated and in place in bed. I remember when I had my hand surgery I had one of those microbead pillows and loved it...then donated to my cat when I was finished with it! I think I'll look for one of those this weekend, it should come in handy just around the house and in bed, and presumably at work when I have to go back.I'm also thinking maybe some big socks or cover, in case I need to sleep with my foot outside of the covers. I sure can't go shopping after the surgery, so may as well obsess and cover my bases now :-}

Now, if I can just build up significant upper body strength in the next 2 weeks to help out with those damn crutches.......

Pre-op prep

OK, so this is where proof positive that I am crazy comes out. Not only do I border on OCD when it comes to planning ahead, but the anxiety about the surgery makes me just want to grab hold of what I am able to control and over-do/over think it all. But hey, better to be prepared than wishing i was and whining about it :-}

One of my first concerns was showering. Only other cast i ever had was on my forearm and that was relatively easy to navigate. Being a big fan of Amazon, I went online and found myself a shower bench, cast cover, safety handle and a suction cup wall mount so i could move the shower nozzle to a comfortable level. A vision of things to come 30 years from now danced through my head...ok, so it's practice! I also looked through posts on the Runner's World Forum and at the other blog on here and got some great tips. Since making Adam my personal servant for 2 weeks is pretty much out of the question, I needed tips on how to be self sufficient and self entertained for a couple of weeks.

• Loaded up the instant queue on Netflix. I asked friends and family for recommendations of movies and TV shows. Thankfully I have some odd friends and family, so got some awesome and quirky suggestions!
• Made sure I have a couple of good books on hand.
• Attempting to build up some upper body strength for those evil crutches. Ya......I'm gonna need another couple of months....
• Meal planning. Well, thank goodness Adam is a great cook, but don't want him to have to do it all for 2 weeks+. I'm exploring what can be pre-made , maybe frozen. Will make sure I have easy sandwich fixins and some Lean Cuisines on hand for the days I am home alone for lunch. 
• A few recommendations I picked up from people on the Runner'sWorld forum:
• Keep an ice chest nearby with food, drinks and extra ice packs for your leg. Apparently even putting them under the knee helps.
•   Have a safety plan for when you are home alone, at least the 1st week. One woman's advice was that she would text her husband when she got up for anything, including bathroom trips. If she didn't text back in appx 5 mins he would call, if she didn't answer he'd be there w/in 15 mins. My concern is that the KLUTZ I am i could fall over and bonk my head, so i:'m definitely going to do this.
• Keep the doctor's number handy, don't be a hero and if in pain WHINE. So, EVERYONE who knows me knows this will be a mega challenge. I am independent, hate to ask for help and can make the most stubborn bull seem like a push-over.
• For at least the 1st 3-4 days take the pain meds regularly as prescribed. Apparently day 4 is the worst, but after a week it is manageable

I also plan to do what I can on the Wii, like boxing, bowling, tennis etc. I figure that should help keep my blood pumping and get a little exercise so I don't plump up while I'm forced to be horizontal. I am not really a video gamer, tho my awesome friend Bryan swears I should take this opportunity to become addicted to World of Warcraft :-) I'm thinking not....but wish there were some Lego Video Games I hadn't gotten to yet!

I'm guessing the most important prep is repeatedly apologizing to Adam now for what a grumpy, whiney pain in the butt I am going to be! I already foresee myself making him drive me around just so I can get out of the house....just need to find a chauffeurs hat for him...seeing as how I'll have to be in the back seat with my foot up.

The injury, and the long road to the surgery decision

In December of 2008, during a rare snowstorm in Portland OR, I injured my peroneal tendon simply by stomping through 10" of snow that was covered with a thin layer of ice. I basically rolled my heel inside of my custom fit sneakers and didn't think much of it since there were no immediate signs of injury.

I am not sure exactly when the symptoms started, but I think the first time I noticed it was when I stretched way across our bed to give the cat some attention. There was a  snap, much like a rubber band popping in the outside base of my foot, below the ankle bone. It was extremely painful, and after a few times of this happening I knew I must have done something to my foot when I lost my footing in the snow. I waited until late January to finally see my Primary Doc and she referred me to a Podiatrist. Long story short, I NOW know that snap should have been an obvious clue to the podiatrist that it might be the Peroneal tendon, but it took advice from my sister in New York who works for a Podiatrist to push for an MRI which finally revealed the tear. I went through several months of Physical therapy and about 2 months in a boot. There was some improvement, no more snapping, but I am sure part of that is my own avoidance of anything that causes that snapping. Surgery was mentioned, I staunchly refused, that's just how I am....I will always try all the conservative methods first.

About a year ago I went to see an Orthopedist who came highly recommended by several Physical Therapists and my own PCP. He told me that everything that could be done short of surgery had been done, except cortisone injuections, which are not advisable for this injury for may reasons. If you are considering those, please do some research! I do not recall all the details, but do know it can make it worse. He described surgery and the recovery process in great detail and assured me I did not have to make the decisions right away. I'm not sure why no rush, perhaps because I am not an athlete and not at risk of doing further injury by running etc. The description of the recovery process frightened me so much, than in spite of loving this Ortho, I said, "Thank you very much, no." and went on my merry way.

I may not be the most athletic, but I am active, love to walk on the beach, hike, entertain, dance etc. The injury has interfered significantly with my normal activities, just because standing or walking too long or walking on soft beach sand hurts like hell and causes massive swelling. I also miss high heels =) Dansko makes cute stuff, and I am not looking for stilettos, but I'd like to put on some pretty shoes again!

I spent about 4 months pondering the idea of surgery (I wasn't about to do it during the summer!) and finally decided to go back to the ortho last week. Prior to going, I did as much internet research as I could find. If you are considering this surgery, you MUST go to this site, http://www.runnersworld.com/community/forums/injury-prevention/injuries/just-surgery-peroneal-tendon/.0
to say that site has been helpful is a huge understatement....it has been and still is a great resource for me. There is also another blog on here ,http://howisurvivedmyperonealtendonsurgery.blogspot.com/search?updated-min=2010-01-01T00%3A00%3A00-05%3A00&updated-max=2011-01-01T00%3A00%3A00-05%3A00&max-results=25 that I found very helpful.

Anyhow, I walked into the doc's office pretty convinced I would be getting the surgery, but of course had to revisit with the pro. We agreed to do it and now the surgery is scheduled for November 5th. I am extremely anxious, because the recovery will definitely be a long, painful and arduous process, and let's face it, crutches are evil. That said, all the forums and blogs I have found all have this one theme in common, "It's is really, really painful and recovery is difficult, but I'm really glad I did it." So here I go..........