Back to the Grind!

Day 70

  I started back at the gym on December 19th, three days shy of my two month surgery anniversary.  It was the exact date that I projected for myself from the very beginning; the same day my gym would start taking payments out again! I remembered what Dr. Brunet had said to me at my final post-op:  "You can walk on the treadmill for about 20 minutes, use the elliptical and cycle without resistance. If you over do-it, it could set you back, not push you forward."  I started on the bike for 30 minutes with resistance (sorry Dr. Brunet).  It was no problem; very low impact on my feet and at the same level of resistance that I used pre-operatively. It was wonderful to feel my body move again and I was so thankful to be there.  I remember why I loved the gym.  It was my time to reflect, relax, think, stare, sweat, read and decide what I was going to eat for dinner.  I use it to meditate, basically.  Then I moved to weights and found out quickly how much my home workouts actually helped to keep me fit.  I could lift more weight in my arms, shoulders, chest and back than before.  My main focus was now my legs with squats, lunges and weight machines that exercised my quads and hamstrings. This was definitely my expected weak point. I finished with 20 minutes of walking on the treadmill. Dr. Brunet cautioned that people tend to walk on the outside of their foot so I made a conscious effort not to. I describe it as a relaxed hurt.  I closed my eyes to bare through the discomfort with a mission to learn how to properly use my foot again.  

Check out my impressive 2.5 miles/hour

  The last time I used my aircast was December 24th.  I really didn't mind wearing it. But now that I don't need it, it feels fantastic. I walk with a noticeable limp but I noticed today that it's becoming less evident. I didn't end up having to buy new shoes.  Dr. Brunet recommended this because men's shoes have wider toe boxes but it turns out that my shoes do too! The swelling has come down enough to fit what I already own. My winter boots were expensive and less than a year old and molded to my old foot shape. It was weird wearing them at first, but now it feels more normal and becoming less of an issue.

  I'm headed back to work on January 6th (with doctor's note), two weeks sooner than expected. I will still have restrictions and cannot work in the OR until the 31st. So as my final week off is half complete, I reflect on my journey and realize that it wasn't nearly as bad as I thought it would be.  I didn't fall apart, I didn't lose a foot and I emerged stronger than before. 

See the crease on my left big toe? It is evidence of swelling/edema and will dissipate.

My Final Post-op

Day 56

  No more post-ops needed!  Dr. Brunet was very pleased with my progress to date.  I explained to him that within the last 3 days, I was getting some sharp, intense pain on the ball of my foot.  He assured me that this was normal and it was caused from sore muscles. Truthfully, I broke his rules and have been standing or walking over his permitted 15 minutes.  
  I've noticed a hard bump on the top of my foot.  Could it be a screw?  Yup. Dr. Brunet confirmed it. No matter what size your foot is, whether you're 5ft2 " (like me) or 6ft1", the same size screws are used for everyone.  When the swelling decreases, it may become more noticeable when I'm wearing tight running shoes or strappy sandals.  Problematic? I'm not sure yet.

Head of screw

Going forward, these are my post-op instructions:

1) Take the next  7-10 days to transition from the air cast to a shoe.

2) Start walking on the treadmill/elliptical for about 20 minutes.  Today I did 30 min on the recumbent bike and 20 min on the elliptical.  I assumed that since the recumbent bike isn't standing, I could get away with it. My operated foot felt good throughout, my other foot had that same old "hot feeling".

3) Spin classes are okay without resistance or climbing.  (I guess it's just peddling on a bike then).

4) Continue toe exercises.  Squeeze a towel with my toe and press with my thumb on the bottom toe joint.
5) No physio needed!I
6) Expect in 2-3 months to go back to normal activities. It will be a slow transition!

Notice my tan is gone!

  When am I going to get my right foot done?  When my left foot gets strong enough to compensate.  Dr. Brunet said that I could wait until next year but he cautioned that I will notice that I have two different feet.  In my opinion, the sooner the better but I'm not going to jump the gun here.  It's best to make sure I'm fully recovered and satisfied and not make any hasty decisions.

Weighing In

Day 49

  My scale has been taunting me since I had my cast removed last Tuesday.  "Come on, just step on me," it teased.  I went into this surgery in the best shape of my life.  Not body builder or fitness model shape but a respectable 25-30 lbs lighter than I have been in the past 10 years.  Of course, the possible weight gain from resting and recovering terrified me. Did I really want to know how much I weighed?  I tried to be comfortable with a 5-10 lb gain but how would I feel in reality? My body didn't feel the same anymore and my legs looked like a Jello explosion! I definitely could have eaten better than I did.  To avoid feeling defeated, I kept telling myself that weight gain was to be expected and that I had a challenge ahead of me. So, with hesitation, I stepped on the scale.......

  My mouth dropped! I was 2 lbs under my average and 2 lbs over my lightest weight. Basically, no gain! I couldn't believe it. I weighed myself three times just to make sure.  At that moment, I felt relieved and grateful. Phewf! What load off my shoulders!

My theories on this miracle are:

1) My metabolism is still high so I'm still burning more calories as if I'm doing a vigorous workout? 
2) I have developed good eating habits and therefore without realizing it, ate healthier smaller portions than I did when I was heavier?
3) I lost muscle and gained fat (no question mark needed).
4) I worked out almost everyday.  It's actually a really tough routine and takes about an hour and a half to complete. See my semi-weight bearing workout.

  My triumph today was completing push-ups with both feet on the ground. My toe flexibility has improved tremendously which I 100% attribute to my workouts. Pointing, flexing and stretching are foot movements that are automatic with my routine.  To celebrate, I gave myself a pedicure. It's true ladies,  I only need to use one toe separator.  Never thought of that perk!

  As for my mobility, I walk with my air-cast and crutches are no longer needed.  If I use the air-cast for over 15 minutes in an hour, I pay for it.  Now that I can carry things, there's just so much stuff to do around here!  The bottom of my foot is still swollen so when I have my foot flat, my big toe doesn't touch the ground. 

Looks pretty good, don't you think?

One week until my next post-op, I better start shoe shopping!

Phase Two: X-ray Exhibit

Day 44

  Deep down inside, I wanted to be an exceptional patient.  One that would heal faster than the norm.  I knew with these expectations, I was setting myself up for disappointment. Pressure was alleviated when I realized being on schedule was the best thing I could be. 

  My fiberglass cast was removed yesterday.  It was such an odd feeling.  My leg felt so light and I wasn't sure how to maneuver myself off the hospital bed over to the x-ray module. After 6 weeks of being totally dedicated to a non-weight bearing lifestyle with a cast up to my knee, I would now transition to an aircast. I was now allowed put pressure on my foot and perhaps be able to carry a cup of coffee from the counter to the couch. And oh, the shower! No more giant plastic bag over my leg.  I felt like belting out "A Whole New World" from the Aladdin in the plaster room for all to hear, but I didn't.

The scar is healing nicely

  Dr. Brunet explained that I needed to wake-up my bones and muscles. I could start standing or walking for 5-15 minutes per hour and I'm not allowed to bank that time. I had to massage the skin about one inch around the scar and continue with my toe exercises as much as possible.  He expects that in two weeks, I will spend half my time in the air cast and the rest in a men's shoe. Since their toe boxes are wider, it would be my best option for comfort for a few weeks. Jealous?

  I had some x-rays taken for the first time since the surgery. The pins are a permanent fixture.

Three different angles - 6 weeks post

Before and After

  One of the first things I did when I got home was soak my foot in the bathtub. It was amazing to see how many layers of dead skin had built up.  Apparently, my foot looked really good in that regard.  I've noticed that my skin has been re-positioned a little bit. I don't have any padding on the bottom of my foot near the big toe, so it feels very weird to touch it to the ground without a cast.  I'm still numb to touch in a few places but it will take some time for the nerves to grow back.

Nasty, I know!

My crutches will be used less once I build some muscle again.

6 More Sleeps

Day 36

  The count down is on!  Not much has changed with my foot since my last post.  I'm still in my non-weight bearing cast and counting down until next Tuesday when I can walk and let my leg breath.

  I would like to sidetrack for a paragraph from my bunion themed blog to talk about my Mom and the gift she received almost one week ago:

  My Mom received a kidney transplant after over five long years of wait.  She has polycystic kidney disease and over the last several years, my family has watched her battle against her dying kidneys.  It took a lot of courage not to loose hope that one day, she would find a matching donor.  You see, my Mom is a difficult match.  Her high anti-bodies combined with her less common blood and tissue type made it difficult to receive organ donation.  Last June, she was placed on a special list for people with hard-to-match requirements.  Finally, our wish came true and she is likely being released from the hospital tomorrow.  She will now start a new challenge and hopefully get her quality of life back. My family has deep gratitude to the organ donor.  The donor was deceased and the kidney came from Windsor, Ontario.  That person saved my Mom's life and no words can describe how grateful we are.  Please sign your donor card or give blood; you could save a life!

Back to my foot:

  My foot looks like it's disintegrating.  Without the exfoliation effects from wearing a sock or shoes, it's drying up. There is nothing much I can do about this until my cast comes off.

  I bought a Tilt-a-Table from Canadian Tire last week for $13.99 on sale.  It is fabulous! I highly recommend this product for everyone. It's light weight, portable and useful for meals and my laptop.

28 Days Later: My third foot unveiling

  This morning, I had my 4 week post-op.  I went with high hopes that I would receive the good news that I was healing on schedule.  This time, with decreased edema, I was more excited than nervous to see my foot.

  And the two week old cast comes off!  I exercised quite a bit with this cast on so surprisingly, there was no smell nor evidence of any significant water damage. (See Day 16: "Confessions of the Not So Perfect Patient.")

She's looking pretty good

Side view

  It's shocking how dry and scaly my feet were from being in a cast.  I gave it a good clean with alcohol solution before a the new cast went back on.

Underneath; cotton from the old cast stuck to the bottom 

Ankle trick - over pronation; a whole other issue

  The doctors and technicians were impressed with my healing.  "You must be keeping it elevated," said Dr. Brunet with certainty. "As much as I can", I responded, " and I've been exercising almost daily."  "Maybe that's helping the circulation to reduce the swelling," he said. "I'd like to keep you in a cast for two more weeks.  At that time, we will take some x-rays.  There is a 50% chance you'll move to an aircast or you could go into a stiff-soled shoe," he explained. 

  Hopefully, at 6 weeks post-op, I will be able to wear a stiff soled shoe, but either way, at least I will have the freedom to sleep without a cast on my leg. 

Notice the gap is closing between my big and second toe.

Fighting The Mean Girl On My Shoulder

Day 21

  I have never been off work this long.  Before this medical leave, my longest vacation was in Germany for two weeks in 2009.  I wish I could be more productive but being on crutches gets in the way. I do less in one day then I did in one hour when I could walk.  This is discouraging. Of course, I've been trying to occupy my time with this blog, teaching myself how to sew and working out but that doesn't cover all hours of the day.

  Teaching myself how to sew is not an easy task.  I've finally taken my sewing machine out of the box from last Christmas. I've bought most of the essential materials it takes to complete a successful project. I've broken a needle already and have pulled half my hair out.  Over the course of the past two days, I've watched about a dozen sewing videos. There is sewing vocabulary that I had no idea existed!  Apparently, my experience making scrunchies as a child does not qualify me as an experienced seamstress.  So now, I'm at a standstill.  There is no way I can teach myself without going bald. Tim's mom, Maryke, advised me to take a step back so I wouldn't launch my machine into the street.  Thankfully, she is stopping by tomorrow to give me some tips.  Thanks Maryke!!  Maybe there's still hope for me!

  Since I spend a lot of time on my crutches, I've mastered a few skills.  Going up and down stairs being one of them.  At week one, with a heavier plaster cast on, I would scoot up and down on my behind.  Look at me now!  The trick is to make sure your crutches are as wide as possible so your center of gravity is lower which maintains better balance.

  I didn't end up getting a new cast after I got it wet last Thursday.  The cast looks and smells alright and my new Sealtight shower bag purchased from Shopper's Drugmart Home Health Care is working well.

  What I did notice...this is totally gross so stop reading of you don't want to know....

New scratching post

is my accumulation of toe jam.  Yes, this is a real thing!  I've been so focused on protecting my cast that I forgot to clean my toes.  Now, I can understand why some laser eye surgery patients come to their exam the day after their surgery with gunk all over their eyes.  I can testify toe jam is way worse.  Nasty!!!

Confessions of the Not So Perfect Patient

Day 16

  I did something bad.  Something that I was warned about so many times.  I got my cast wet.
  At my one week post-op, Martin, the casting technician, gave me a high five because when he removed my plaster cast, there was no evidence of it being soiled with water.  "What did you do to keep you cast dry?" he asked.  "I bought a special shower bag", I responded with content.  "Well, you did a really good job at keeping it dry, but I would recommend you take a sponge bath instead.  You don't want to have to come back in to get it changed or be out of luck on a weekend with a wet cast," he responded.  A sponge bath?  Out off the question, I thought.  I'm a two shower a day type of girl.  No joke, I shower before and after I workout.  A sponge bath was not happening. "How can you tell if someone got their cast wet?" I asked.  "You can just tell by looking at it", he said, " and it would smell like decay."
  The following Sunday, I got my cast a touch wet.  The water pooled on the shower bag so when I took it off, the water ran onto my cast.  No big deal, I was getting a new cast in two days time and it dried up in about 4-6 hours.
  Today, only two days after my new cast change, it's soaked.  I'm not sure how deep the water penetrated.  I hope I can survive with this one on for 12 more days.  This time, the water actually got inside the shower bag past the rubber bands that were supposed to seal it.  My leg has been itchy and I've been cold all day.  I ran a blow dryer down my cast on the cool setting several times but it doesn't seem to be much help.

  I'm a bit worried I'll have to return to Ottawa tomorrow to get a new cast.  I feel a little embarrassed, after all, the incident did happen on my second shower of the day after my workout.  What will Martin think?  Am I that thick headed non-compliant patient?  I ask my patients to follow specific instructions all the time to ensure their best healing following laser eye surgery.  When they don't listen, it's frustrating.  I am that patient.  Two showers a day Michelle? Come on!

  I guess I'll go out and buy a sponge, darn-it!

Two Weeks Post-op: My second foot unveiling

Day 14

My second foot unveiling was this morning.  I had a dream last night that I was walking on my cast. In reality, I was hoping that I was a marvelous bionic healer and Dr. Brunet would put me in a walking cast today.  No such luck!  I'm healing well but there is still lots of edema that needs to subside.

I was instructed more than once, to keep my leg elevated as much as possible to prevent scarring and prolonged healing. Okay, so maybe my Costco run yesterday wasn't the best idea but it was nice to get out of the house with my Mom.  Besides, I bought a mountain of garbage bags and rode the electric wheelchair with authority. 

NB: I've transitioned from pyjama pants to jeans when out in public.

I thought was going to be late for my appointment this morning, so my Mom dropped me off at hospital's main entrance.  I opted not to take a wheelchair and stick to my crutches.  Boy, can I ever pick up speed with those things.  I was Sasha Fierce, there was no stopping me and people were sure to move out of the way.  I made up some time, got some cardio and presented myself to the reception desk slightly out of breath.  "Sorry, I'm late," I said.  "You're good, only two minutes over, no big deal," replied the receptionist.  Her response made me feel much better about my tardiness.

I was nervous to see my foot again.  At week one, I was so shocked to see how swollen my foot looked and today, I was afraid I wouldn't notice much change.

Removing the cast

Snipping the bandages

Removing the gauze

There she be!

I could tell the edema had decreased significantly.

Do you think I'm ready to be a foot model?

Toe exercise

Removing the ends of the stitches since they are dissolvable.

Applying the fiberglass cast. It's warm going on so it feels really good. 
 Fiberglass is sharp, so a tensor bandage is applied over top.

Dr. Brunet was happy with my progress.  He instructed me to practice toe exercises twice a day and cautioned that it should be uncomfortable.  My next post-op visit is at 4 weeks.  X-rays aren't taken until week 5.

Clearing the Air: Why I got Bunion Surgery

Bunion surgery is not an easy decision.  For most cases, it is 100% elective.  I've been putting it off for over 10 years. When I finally booked the surgery,  I almost instantly regretted my decision.   The thought of going from very active, to not being able to walk without crutches was mind boggling.  I couldn't picture myself alone, on the couch all day, watching TV and petting my cats.  I seriously considered cancelling it.

A great part of my profession involves discussing with people about elective laser refractive eye surgery. I've been doing this for almost 8 years; pros and cons, risks versus benefits.   There are people that I counsel that are great candidates and some not as much and I let them know this.  Laser refractive surgery has done great things for many people.  I couldn't work in this field if it wasn't a success. I think bunion surgery is similar.  I've shopped around, done my research and found my surgeon.  I've weighed out the risks versus benefits and today, the benefits outweigh the risks.  That's when you know you're a good candidate.

What if I lost feeling in my big toe?  What if I couldn't workout with as much intensity? What if I was in my more pain after than I was before?  Bottom line: any and every surgery has risks but so does giving birth or walking across the street or driving a car. You could get hurt or die at any time.  

I've been listening and watching other peoples stories for years.  This was not for cosmetic reasons.  I never thought my feet looked ugly.  I didn't even realize my bunions were unusual. In fact, I thought other peoples feet looked weird because their big toe was straight. I was never embarrassed and never hid my feet.

For my prom, I wore wedges with a half inch rise.  I was ok with that. They were silver and had sparkles.  Who cares?

I could never walk into a shoe store like Aldo, Spring or Payless.  They were out of the question.  I was lucky to find something at Naturalizer even with the wider width.  "We can stretch your shoe overnight," they would offer.  "Sure," I said with hopefulness. It never worked, the shoe never fit.

I bought my own shoe stretcher from the USA.  It's heavy and hardcore but didn't work for me.  "Your shoe should fit when you buy it," said my podiatrist, " you should never have to stretch it."

My shoe collection consists of many shoes that are barely worn. Most of them too big for me. They felt great at the store but in reality, way over compensated for my bunion.  The rest, too tight and not tolerable for more than five minutes.

I would prefer shopping for bathing suits or anything else for that matter. I hate shoe shopping!!!!!

I have a lot of running shoes.  But even they cause me trouble.  Two years ago, I discovered the Nike Pegasus.  This is a fabulous shoe.  Nice and soft, fits my orthotics and a beautiful mesh-like top that expands with my bunion.  Thank you Nike!

My last running shoe purchase was completely unsuccessful.  I returned two pairs and then another two pairs before giving up, four weeks before my surgery.  The Pegasus was not working for me; my feet didn't agree with it anymore.  I tried D width in another brand and my feet swam around in them. I don't have wide feet, I have bunions.

I'm always thinking about my future.  I have polycystic kidney disease (PKD).  I'm saving like crazy for my retirement because I know I won't be able to work until the ripe age of CPP.  My feet are part of this future.  I can't push this off any longer.  I want to be able to walk, run, cycle and stay fit for as long as physically possible.  This is the most important thing in the world to me.  Dr. Brunet wants to operate on me before I develop arthritis and while I can have an ideal recovery.  Now is the time, no more excuses. This is an investment in my future.

Pumpkin carving by Heather and Chris Buckley

The Misadventures of Michatan: the one-legged workout

Day 10

  When I googled "non weight bearing workouts" there wasn't a lot to choose from for people like me. I'm proof that you can have a good workout, even with a cast on your leg.  I'm not a fitness professional so my routine is not scientific. What I can say is that I sweat so much today that I needed to take a second shower.

  This is my comic strip character Michatan.  She was invented in 2004 by my best friend from college, Carolyn and drew this for me this morning.

By Carolyn Bott, 2014

  This was posted on my Facebook feed yesterday. It's motivating because I've worked very hard over the past 2.5 years to become fit and I don't want being in a cast to stop me from doing what I love to do.  

To view my work-out click here.  Love my eighties weights.

 This is my giant shower bag.  No sponge baths for this girl.  My favourite part of my day is breakfast in bed (thanks Tim for mastering the over-easy egg) and my shower(s).

Pity Party: 24 hours of self-commiseration

Day 9

  I was expecting this day to come right around now.  I had my pity-party; it's over now.  I was joking  with friends before my surgery how I picture myself after the surgery: in bed, barely moving with a bag of chips in one hand and drool coming out the corner of my mouth. Yesterday, I was that person.

  Everything I do takes much more effort and three times as long. I'm not that patient yet! Naturally, that made me a little sad.  Also, I drank way too much wine on Tuesday night in celebration of my return to Kingston and my one week post-op.  "Don't drink too much," said Tim. "I won't," I said thinking I have this totally under control.  That was not the case, I was way over my head.  Tim had to work the next day and I woke him up at 3am Wednesday morning to grab me a bucket and kept him up for the next two hours.

  I realize alcohol is a depressant and that I didn't make the best choice. I spent all of Wednesday feeling sorry for myself: crying, eating and staring off into space.  I didn't feel like doing anything and I was alone for the first time since the surgery. Tim bought some all-dressed and sour cream and onion chips the night before.  I found them in the same cupboard as our travel mugs on the top shelf hidden between the martini glasses. You can't hide anything in a woman's house.  She'll always find it!

  "MICHELLE, how are you?" texted Carolyn. "Hi," I responded,  "I'm that person I didn't want to be. Demotivated, bored and eating too many chips." "Watch documentaries on Netflix," she continued, "educate than scare the shit out of yourself."  Carolyn is my best friend from college.  She is the type of person that would say wildly inappropriate things at any time and is absolutely hysterical to be around. "Get Tim to draw dicks on your cast.  Big long skinny ones, short fat juicy ones, itsy bitsy teeny weeny peens." "It's fiberglass, can't really draw on it," I texted.  "Where there's a will, there's a way," she declared.  "Get a thick marker. Silver. Or you could decoupage some dicks on there." "No will here," I responded.  I ended up taking Carolyn's first suggestion and decided to watch a documentary on Katy Perry's 2011 tour. Even beautiful, successful, rich and talented people get depressed too.  I felt a bit better.

  I still have another 4-5 weeks to go with a cast that I can put absolutely no weight on before I get switched to a walking cast.  The good news is that pain is minimal in part to the fact that I've been keeping my leg elevated as much as I can above my heart to improve circulation and reduce swelling and discomfort.

  Anyways, I plan to do a little bit more with myself today.  I have a workout area set up in my bedroom.  In the back of my mind, I'm still going to become a one legged work-out YouTube sensation. But, probably not.