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.