I had a moment today when I put my roller-blades on for the first time in many years. This used to be my favourite thing to do but had to give it up because it became so uncomfortable. Today, I truly feel a triumph in my journey and riding these wheels never felt so good.
My family doctor had trouble referring me to an orthopedic surgeon for guidance so we decided that it was best that I seek out a Chiropodist for advice which is covered under my benefit plan.
Here are my concerns:
1) My big toe is stiff and has lost some range of motion consequently,
2) My third toe is taking on extra force creating shooting pains when I walk, mostly without shoes on.
3) My plantar fasciitis is re-manifesting - it took me two years to get over this the first time!
I was advised to:
1) Continue my toe crunch exercises - I've been lax on these.
2) Get more stable shoes because I over-pronate (flat foot) - my shoe should not twist like this.
A twistable shoe is a big no no for over-pronators!
3) Get orthotics to even out weight distribution and prevent over-pronating.
So this is my plan and I feel once my third toe pain is gone, I will be 100% happy with my outcome.
During my visit with my family MD, he gave me a copy of my OR report. GOLD! Here is a great website that will break down the medical terms:houstonmethodist.org
One of the draw backs of being your surgeon’s last patient
before he retires is being left with unanswered questions. The expected healing
time for Lapidus surgery is 6 months and I’m there. Of course, as a health care
professional, I acknowledge every patient heals differently. But that’s hard to
accept when YOU are that patient with a potential prolonged healing or even,
complication.
My concern:
I avoid walking on the inside of my foot and do not use my
big toe (Biggie) to push off. Biggie has
a limited range of motion, so putting my body weight on her to propel is
uncomfortable. To compensate, I use the outside of my foot and my third toe (Small)
to take on Biggie’s load instead. This is particularly painful when I walk around the house in socks or bare feet. I prefer to wear
something with a sole like slippers or even running shoes for more support.
My question:
Will this resolve itself with time and patience? I can’t imagine
surgery as a solution, but is there something I can do to improve my range of
motion? Or, is this just the way it’s going to be? I need to know….
I saw my family MD today and we discussed my concern and
question. He told me he would refer me to an orthopedic surgeon in Ottawa who was in his graduating class in 1977. I promptly belted
out: “My boyfriend was born in 1977,” not to make him feel old but because nearly
every appointment I have with him, he enjoys recalling the opening of his
practice, the month and year I was born, August 1981.
Despite this set back, my feet look great (I love my scars)
and I went for my first pedicure a couple weeks ago.
My shoe shopping
experience was not fun. It felt like a FAIL! Shout out to my friend Nancy for witnessing it! I went to multiple shoe stores and could not find comfortable fitting shoes. My old frustations returned, everything felt super tight or loose on one foot or the other. Clearly, my feet are about 1/2 size difference due to the natural healing or some long standing edema. It is apparent that I can’t
wear cheap shoes and I don’t think I will ever be able to wear anything other running
shoes and flats with good support. High heals are out of the question. I did find one cute pair of flats at Aldo which I would have never been able to wear before my surgeries. They are leather so they will stretch but I cannot wear them for more than a couple hours because the sole isn't strong enough.
"How
is your foot?" a patient asked me as I brought him into my exam room.
"What do you mean?" I asked. "Last time I saw you, you didn't
have shoes on," he said. "I guess… better!" I replied surprised
as my memory returned of me apologizing for the lack of footwear. My foot felt
pretty good today and I forgot it was sore enough to remove my shoes only three
weeks before. Progress is slow, so much so, that without reminders, they are
hard to recall.
My second experience has
been a longer recovery. The first metatarsophalangeal, or MTP joint is stiff;
therefore, my toe still does not bend. My brain tells me I can bend it but when
I look down, nothing is happening. It’s painful to propel off my big and second
toe thus movements that involve toe bending of any kind are uncomfortable such
as brisk walking, standing on my tippy toes and lunging. Two weeks ago, I was reluctant
to begin higher impact plyometric workouts again but I forced myself to try
knowing that I could have difficulty. From my understanding, strengthening my
calf and ankle could significantly improve my discomfort. I remain hopeful as I
continue foot and ankle exercises outlined by my physiotherapist. My ankle is sore
but hasn’t been a focus for me until now.
Tim and I vacationed in Costa
Rica at the beginning of February (3 months post-op) and I was concerned that I
wouldn't be able to participate in some of the activities offered. Admittedly,
walking more than 2km was challenging because I compensate by taking pressure
off my right foot resulting in discomfort in my hips, legs and left foot. I
have recently hit a milestone running 5km on the treadmill which put a smile on
my face.
Up to this point in
my recovery, even with the set-back, I believe I made the correct decision to
cut my relationship with my old friend Paul Bunion. I estimate I’m 70%
healed. The grand finale to my
journey is to make my first shoe purchase. I’m anxious to shop at a mainstream
shoe store because I harbour old reservations that their shoes won’t fit. I
guess I’ll find out soon enough!
Now that I look at this picture, I see my feet look pretty even. Perhaps the edema has subsided enough to purchase my first pair of shoes?
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:
I slept in alot so I my first meal was around 11 am. This likely cut about 200-300 calories from my day.
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.
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.
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.
I worked out almost every day to fight the blues
as well as to stay motivated.
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.
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.
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 .
Yesterday, the Kirschnerwire (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:
