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