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.

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!