Not a Fat Sentence

Day 60

  My return to the gym was day 58. I spent 30 minutes on the bike at moderate resistance and walked on the treadmill for 15 minutes at 2.5mph. The treadmill was not at all comfortable, but this isn’t my first rodeo. Yesterday, I rode 45 minutes on a spin bike. I cannot "climb" yet so I stayed seated and experimented with my pace. And it hurt like a...use your imagination... to clip in and out.

 I can now put two feet down on the ground for plank and push-ups but not without soreness and stiffness.  My big toe still refuses to move on its own. Admittedly, I have been pushing my boundaries. “This is not a race,” Dr. Brunet reminded me at my final post-op. One year ago, at the exact same time post-operatively, I was still religiously wearing my fracture boot on my left foot. This time, I barely wore it at all. I prefer a shoe, however, my foot is still swollen enough that it is still one size larger than the other.  Luckily, I kept some of my larger shoe sizes, so I can choose from a small conserved selection.  

  Incredibly, I actually lost 6 lbs within the first 6 weeks of my surgery. If you are worried about weight gain during your recovery, if you watch what you eat, this will not be a “fat sentence”. You do have to pay attention to your diet, you shouldn't ignore it. These are the reasons for my weight lost:

1. I slept in alot so I my first meal was around 11 am. This likely cut about 200-300 calories from my day.
2. I couldn’t grocery shop or be in the kitchen long enough to make complex meals. Eggs, bananas and chicken were major parts of my diet. I cut down on bread but still had half an English muffin every day.
3. I recorded my food intake on My Fitness Pal. I find a food diary the most valuable tool because if you are honest with it, you can recognize what you can do to cut calories.
4. I consciously did not eat junk food that I knew I couldn’t burn off. That being said, I did not totally deprive myself either.
5. I worked out almost every day to fight the blues as well as to stay motivated.
6. I believed that I could loose weight and put my mind to it. 

  Time is passing by much faster now that I am independent. There is so much stuff to do around here when I have both feet on the ground.  I do have limitations; I still cannot stand for over 10 -15 minutes without my compensating leg and hip making it unbearable to stand any longer. When I start to sweat and can't think properly, I need to sit down.

  My blog has been very useful to compare where I was last year at this time with my left foot. For those of you expecting to have one foot done at a time, I highly recommend that you take notes. The first foot you are basically going through your experience blind, the second foot I found to be much easier with experience to reflect from.

Long time no post!

Day 55

 A month has past since my last update. Two weeks ago, X-rays were taken and Dr. Brunet gave me the go ahead to start walking. Since then I have been interchanging between my fracture boot and my running shoes.  Luckily, I still have one pair running shoes that are a size larger than my norm so my right foot can fit; the only caveat is that they're bright pink. I still take my crutches along when I expect to be out for longer than 30 minutes. I started driving on December 5th (6.5 weeks post-op) and on December 11 (7.5 weeks) I was able to make the two hour drive to my parents house in Ottawa with the help of cruise control. I feel like I can finally enjoy my time off with my new found freedom.

  My big toe is still lazy four weeks post K-wire removal. Dr. Brunet encouraged my continuation of physiotherapy and was confident that with time, my toe movement would return. The video below was taken on Friday December 3, 2015.

  I am looking forward to returning to the gym in three days and anticipate to return to work in early January 2016. 

Shaved Leg, Tapered Pants and Physiotherapy

Day 26

  I took it upon myself to schedule a four week post-op, only one week after my previous appointment. Since I stayed in town at my parents' house and live two hours away, I wanted the opportunity to clean my foot and get a fresh cast to last me until my next post-op in two weeks. I arrived with my emery board and moisturizer ready for a quick pedi. I was mildly concerned that I was unable to bend my big toe since the K-wire was removed the previous week. To my surprise, Dr. Brunet decided to remove my cast two weeks earlier than I expected. Not because I am a super human healer, but I needed physiotherapy for 1st metatarsal-phalangeal weakness. I was instructed to continue with absolutely no weight-bearing and wear my fracture boot for support.  "I recommend that you start physio to get that joint moving again," Dr. Brunet explained, "I don't think you're an unreasonable person, so I will take you out of your cast with the condition of no standing or walking. Your X-rays in two weeks will really tell me if you can bear weight at that time." Not an unreasonable person? I'm pretty sure he's read parts of this blog. 
  Is this good news or bad news? My first thoughts were that I could wear my tapered pajama pants and shave my leg. Beyond that, I was optimistic that this was a common complication and with time and effort, will eventually resolve. No two feet are the same; they won't heal the same and every surgery is different.

   Alexandre, the casting technician, made me a wonderful splint cast to get me home since I did not have my fracture boot with me. Admittedly, I have been wearing it around the house since the fracture boot is heavy and bulky.

  Along with physiotherapy, I was instructed to start ankle movement, toe towel crunching exercises, scar massage and hot and cold therapy. For more information on the latter, visit Contrast Hydrotherapy .

Splint cast

Right foot progression

K-Wire Removal: That's What She Said!

Day 20

  Yesterday, the Kirschner wire (K-wire) was removed from my foot. There was no need for anesthetic as the wire was inserted through my bones which contain no nerves; however, all my toes were fairly sore afterwards. It wasn't a pleasant experience but it wasn't the most uncomfortable either; Tim stood next to me holding my sweaty hand throughout. The 5 inch wire was inserted during my lapidus surgery, 3 weeks ago, to help elongated my tendon.  Today, my big toe is very stiff and won't bend on its own, so I will have to work on it to bring it back. I recorded my K-wire removal in the video below:

Fiberglass cast; looking good!

Out with the Wheelchair, In with the Knee Walker

Day 10

  I ditched the wheelchair this time and opted for a brand new mode of transportation: a knee walker. NB: this does not replace your crutches. Compared to my first experience, I'm certainly more active and independent around the house with its help. I am able to carry things, especially items from the kitchen to the living room without the stress of spilling my coffee everywhere.  It even came with a panier (there are certain words that I prefer in French). I ordered it online at kneewalkercentral.ca The cost was $312.00 including shipping and it arrived in 4 days.  It was quick to assemble and significantly lighter than a wheelchair. My benefits covered 90% of the cost, so be sure you check with your benefit company to verify inclusions for your unique plan. I took it to the mall today to run a quick errand:  it definitely has potential for good speed and on bumpy asphalt, it was surprisingly comfortable. I think I put a smile on strangers faces as I dashed by them. 

Check out this ride - the need for speed!

You can't beat this look!

Right Foot Revealed: Not for a Weak Stomach

Day 7

  I arrived at my one week post-op at the Ottawa General Hospital with questions: Did the surgery go as expected? Was the pin needed to stretch my tendon unusual? Why I'm experiencing more long lasting discomfort than last time?  

  "I suspect you experienced more pain because I put a temporary pin in your big toe," Dr. Brunet explained. "Without the pin, your toe was shooting forward up in the air. I could have cut the tendon but I prefer to stretch it with the pin instead.  Your body is starting to reject it so we could probably take it out in a couple of weeks."  His instructions for my pin extraction (a.k.a. k-wire) were to eat a solid lunch beforehand and take a pain killer on route.

  For now, my big toe is immobile. I'm looking forward to the pin being removed so I can move my toe around. It's a very awkward feeling.  Luckily, my steady stream of acetaminophen is helping with the pain management.

The pin is keeping my toe down in order to strech the tendon

She's georgous only to her mother

Round 2 of 2

Day 1

Back to the Future Day

  I recognize that I have great and perhaps somewhat unrealistic expectations: the surgery, recovery and outcome had gone so splendidly for my left foot, is it realistic to expect the same for my right foot? 

  I was expecting a general anesthetic(G.A.) like my first experience but my lingering upper respiratory infection increased the risk of bronchial spasm so my best option was now a spinal block combined with sedation. "So, if the spinal block is less risk, why would one chose a general anesthetic?" I asked the anesthesiologist. She explained that some people don't like the idea of being awake, or having a needle put in their back and it is preferred because of flow. You can recover much faster from a G.A. than a spinal block = more surgeries completed. There was an irrational part of me thought that I could beat an anesthesiologist at their own game. You got me last time, so you’re not going to get me this time, I thought. "How do you feel?” my anesthesiologist asked as the fentanyl was entering my veins. “A little strange,” I said as she prepared to insert the needle. “Round your back like an angry cat,” the nurse said. I felt a small pinch and then she laid me down gently on the operating bed and put a sheet up vertically to block my view of my feet. “Can I see?” I asked as I crunched to peak overtop. “No,” the team answered assertively as I lay back down. Fortunately, my anesthesiologist knows better than I and my plan to stay awake didn't playout. I was nicely sedated for the entire event and woke up just in time to wave goodbye to everybody in the operating room. 

    "Can I please have some ice chips?" I asked the nurse since I was a now a pro and knew what I could forward to. "Not yet," she replied, "we need to wait until you get some feeling back, maybe another half hour."  Two hours later, their first attempt to switch me from the bed to a rolling chair was unsuccessful.  "Try to squeeze you butt and thighs," the nurse urged.  It wasn't happening and back into the bed I went. It took 4 hours for the feeling in the bottom half of my body to return. Wow, with my G.A. I was out within an hour last time; huge difference in recovery.  Dr. Brunet explained that the Lapidus procedure went as planned; however, he had to put a temporary pin in my big toe because my tendon was too short and it needed to be stretched. The pin is expected to remain for 3-4 weeks.
  I left the hospital painless, peppy and pleased with my first dose of acetaminophen and hydromorphone in my system.  "Have a look at my foot," I urged my Mom once I made myself comfortable at home. She removed the sock covering my foot and I think I was more shocked than she was.  There was lots more blood than I had seen at the hospital. It wasn’t long before my pain dramatically increased. I had the chills, nausea, vomiting and the clock slowed down so that I could feel every intense palpitation in my foot. By 1:30 am, after leaving a voicemail at Dr. Brunet's office out of desperation, I decided to double my dose of hydromorphone and take a sleeping pill.  Eventually, I was able to fall asleep and with Dr. Brunet’s approval, I was able to manage my pain more effectively.

Day 4
  Today, my pain has reduced significantly without the influence of medication. It’s amazing how fast the body heals. I expect to have my plaster cast replaced with fiberglass in two days and get a first glimpse of my new foot.

Notice the pin in my big toe. The Jays game is on!

Aerial view. Ready for Halloween.

31 Days and Counting

11 Months Post-op

  I am counting down the days until my next foot surgery scheduled for October 21, 2015. Now that I know what to expect, I am way less nervous and not an emotional mess like last time.  I plan to enjoy my long days with HBO, Netflix and a few borrowed DVDs.  I look forward to an early breakfast brought to my bedside by Tim (lucky me!) and sporting a variety of sweat pants for 60 days.  I will rediscover my morning routine of non-weight bearing exercise followed by a seated shower and cautious crutching down the stairs by noon. It won't be long until I get to ride in my fancy cycling shoes that have been sitting in my closet for two years. My hope is that my recovery will be similar but I understand that the results of my first surgery won't necessarly predict the healing pattern/outcome of my second surgery. It's hard to believe that almost a year has passed and I'm ready to do this one more time.

I'll soon be able to wear stylish shoes!

Preparing for Round Two

8 Months Post-op

I am very happy with my reconstructed foot. Thank you Dr. Brunet! My foot is essentially pain free. The skin around the scar is still a little sensitive and I have lost some superficial nerve sensory near the scar but this is VERY MINOR and was expected! The pin in my foot is not a problem in terms of rubbing on my shoe ( see my concerns from Day 56) and I definitely do not cause the metal detectors to sound at the airport.

  I'm beginning to mentally prepare myself for round two as my surgery is scheduled for October 21, 2015. Will I recover the same? I often picture how I would be a year from now. Will I be better runner or faster cyclist?  I gave up rollerblading years ago because I no longer fit comfortably in the boot. No more blisters and calluses between my toes from excess rubbing. Most importantly, I look forward to the pattern of my socks looking symmetrical when on my feet.

At the hospital for my right foot consultation. Note the scar on my left is much more faint.

  I recently had a consultation with Dr. Brunet. He verified there was no change to the progression of my right bunion and its severity is not as bad as my left but it will still require the same procedure and recovery.

  I'm looking forward to the end results and I am not hesitant to proceed again.  Now that I know what to expect, I'm looking forward to spending time with my parents, doing modified workouts, watching movies, working on my hobbies, chilling with my cats and welcoming Tim home after the work day.

  The bucket below was in one of the plaster rooms at the hospital.  It's interesting what needs to be labeled these days.

Beware of the bucket

Don't let my scar Fool you

5 Months Post-op

  April 1st! Just past my five month milestone.  Improvements are now subtle as I journey away from my surgery date of Oct 22, 2014. To date, my experience has been better than expected. I can run, jump, pivot, climb and fly (wishful thinking). "A new foot and wings please, Dr. Brunet."
  There are still times that I limp after a long day in the OR but it's my bunioned right foot that bothers me most.  I had an incident, last week, where my I closed a door on my left foot which resulted in a bruised nail-bed. It hurt, of course, but self-inflicted pain has been my only hindrance.

  I went for my first pedicure last Monday.  I had been reluctant since the skin around my scar was still sensitive and numb in some spots.  "Surgery!" the pedicurist exclaimed, "I'll be gentle," he added. And on went the gloves and out came the tools. He had no hesitation putting his hands on my foot including my scar and I was getting ready to squirm from distress but I was fine. The only squirming I experienced was when the emery board tickled to bottom of my feet!

The crease beneath my big toe is slowly getting better

The crease beneath my big toe is slowly getting better

  I am actually proud of the scar on my foot.  I know it will always be there. It may not be the prettiest for sandal season, however, will remain a testament from my experience.  I can't wear flip flops or any shoe that requires a strap to go through my first and second toe since the toes on my right foot are so close together that they crunch on the strap. I'm looking forward to having surgery on my right foot so that I feel more balanced, and yes, can wear pretty shoes.  (Not heals though, don't worry Dr. Brunet, I won't wreck our work.) Instinctively, I put more weight on my right foot over my left.  It would be nice to wear bowling shoes without Paul Bunion sticking out and rubbing on the side.  Well, at least he waves!

Comparing Pains

  "What did you do to yourself?" inquired a familiar gym mate as I hobbled down the stairs a few weeks back.  "I had bunion surgery," I replied.  "Oh, did they cause you a lot of pain?" she asked. My immediate answer was YES but how much pain is a lot? I had nothing to compare it to.  It's not like I could attach someone else's bunionized foot to my leg and give a solid answer. The pain was tolerable and I vouched that I could live with it for a few more years.  I remember, before my surgery, while standing in the shower after a workout, my bunions red, sore and throbbing.  This was my norm. My frustrations came from the impossible task of finding comfortable, well-sized shoes.  My podiatrist, who miraculously cured my two year episode of plantar fasciitis with orthotics, informed me that my feet had excellent range of motion and will be surprised to know I had this surgery.    

  "I hear the recovery is painful," a stranger said with sympathy.  "Not really," I replied. "My foot was numbed for the first 36 hours, I had adequate pain killers for 5 days, I was in a cast to my knee for the first 6 weeks and then an aircast for another 3 weeks."  The most painful part of my recovery was when I decided to go Christmas shopping the same week I got my aircast.  Standing in one spot, due to my indecisiveness, for more than a couple minutes was excruciating.  With my heavy winter coat on, my temperature was rising and my blood pressure was dropping.  I had to let go what I was carrying and sit down on a display. My non-operated foot was still compensating by bearing much of my body weight and it was in so much pain, I was going to faint.  Lesson learned.   

  Now that I have one "normal" almost healed foot and the other with Paul-B still attached, I can give a more concrete answer. YES, they were painful.  YES, the surgery was worth it. And YES, I'm looking forward to getting my other foot done.  In retrospect, the throbbing, shooting pains were not normal. I just put up with them.  My new foot is quiet, it doesn't yell at me after exercise.  The skin near my scar is still tender to touch and still numb in some areas. The odd dull aches are becoming less frequent.  My limp only appears when I've been walking all day at work. I'm now used to the shape of my new foot. So this is what other people's feet look like?

Swelling still evident 3+months post

Three months post-op: One Foot Out The Door

Day 89

  I'm about to celebrate my three month milestone and my foot is performing better than I expected.  My cardio intensity and strength training is at approximately 85% . I've jogged several kilometers at a time on the treadmill, added back plyometric training and weight lifting (legs). I struggle with lunges since my range of motion is being tested but have already seen a huge improvement in the last 30 days.  Dr. Brunet told me that I should be at 100% by 6 months post-op. I feel like I may be ahead of the norm since I kept fit during the time when many are sedentary.

  I went shoe shopping for the first time since surgery!  My foot's new figure dropped a size and fit every shoe beautifully. Of course, I still have to accommodate my other foot, so I kept my old numbers and ended up with my reliable friend Nike Pegasus (really a fantastic shoe). 

Still a favourite

  I'm not a big believer in creams, lotions or potions that heal scars but I happened to find some Vitamin E oil hanging around. So, I'm using it...just in case!  No harm done!

I found it in the "lost goods box" in my closet

Applying the oil for good measure

  I haven't used my accessible parking permit much since I stopped using my aircast.  It's still good for a few more days but now that I'm walking and standing without pain, there is no need for it.