Keeping my muscles in shape

Daily Tip: Don't stay in one spot for too long! You'll start to get stiff, which makes you feel bad all over. 

This post deals specifically with a new problem that I have encountered. While my mobility is increasing and I'm getting around better, I still struggle with having my foot not elevated for longer than 10-15 minutes or so. My doctor still says that elevation is important and I need to continue that, but what that also leads to is pain and discomfort in other areas!

Because of the elevation, I am primarily sitting/lying down, and always on my back. Because of this, I've developed some lower back pain and pain in my right hip, as well as just feel a little tense and tight all over. I talked to my old PT and he indicated that this was due to the extra stress on my piriformis muscle.  For those of you like me, I had to look that up:

Piriformis!

Now that I look at it, it makes perfect sense. I want to make sure that when I do become weightbearing in 6 weeks that the rest of my body is ready to compensate for my foot's learning curve! 

I was able to get some relatively easy stretches to do that can be done in the bed or sitting  up temporarily!! 

Please know that you should absolutely check with your doctor to make sure that you can be doing things like this, but again most can be done in the bed and don't directly involve your foot--but everyone is different!

This video may seem silly, but it's been great for me!

I've also been rolling my ankle in circles and and writing the alphabet with my foot, too! :)

Whatever works--just stay as active as you can!!

Week 2 (Part 2): Doctor's Office

Daily Tip: Invest in a fanny pack or crossbody purse! If you're on crutches you can still wear it--and if you have a scooter like me, you can also put it in your basket! Women need their purses, lol! :)

So the second part of Week 2 about my doctor's office is a little late because it WIPED me out.  14 days out, I'm still at a place where trips outside of the house are very exhausting and take a toll.  The preparation of getting ready, riding in the car, waiting in the waiting room, etc. is demanding on your recovery, mostly for me because it interrupts my ability to elevate.  When I got home from the post-op, I slept a few hours. I also had some pain in the night and needed to take a pain pill.  I've been in out of sleep all day today, not moving much.

But back to the doctor's office visit--the 14 day visit went extremely well! I didn't have to take x-rays. The nurse unwrapped my foot, and again, the doctor was very pleased.  One awesome thing to report is that I have minimal to no swelling, really. Weeks 2-3 are really when most people see swelling, so we were all pleased at where I I was. We attribute the constant elevation to the lack of swelling. I have been elevating 20+ hours a day, only taking the foot down for trips to the bathroom.  It's annoying but it WORKS:

14 days post op! No swelling!!!

 The doctor said that the stitches look good enough to come out!  While this made me very happy, I wasn't excited about actually getting them OUT.  All in all, the process itself wasn't bad. 

Stitches out, yay!

The actual incision site (the long part in the middle) is still somewhat numb. However, the stitches that line each side of the incision do have feeling. So the part that was the most uncomfortable was pulling each individual stitch out from left to right. I can only describe it as a tender, burning feeling. When that was all said and done, I was still left with an overall tender, stinging feeling at the incision site. The nurse actually told me that the pain medicine that I had taken before doesn't actually do well for that, but that it is good practice to take some before each visit.

They then placed antibiotic cream on the site, wrapped it in a layer of gauze, then placed a sock on top, then wrapped in an ACE bandage. The sock helps with further compression.  It sounds like a lot, but it's actually less bandaging then before--halellujah!  I got a prescription for the cream, and I have to place that on the incision site once a day.  I was also told that I could stop icing unless I did experience some type of throbbing or swelling.

When I got home, I still had some discomfort, so I did apply an ice pack.  All night, I struggled to get comfortable, and then I realized that I may need to take a pain pill. That did work. I'm just extremely groggy and tired today.  

All in all, I'm still very pleased with my recovery so far.  I'm following the rules, and fingers crossed, I've hit the stage of recovery that will allow me to feel some relief from pain as long as I'm elevating and being still!

Oh--one other thing!  We also rented a wheelchair today. While I LOVE my scooter, it's becoming obvious that if I feel well enough to get out and do something like the mall or a restaurant or the park, that the scooter is not the best transportation.  It doesn't allow for elevation, and it's still a lot of work, scooting yourself around!  So we rented one from the local medical supply place and it's quite reasonable ($75/4 weeks).  It came with extendable legs, so I can put my leg out and elevate.  Looking forward to some freedom with that!

Week 2

Daily Tip: Update those Netflix queues and add those Kindle books before surgery! This is the point where the cabin fever starts to set in and it's nice to go straight to my lists to pick something!

So from here on out, I'll probably just do a weekly update, unless something interesting happens :) It will give me a change to update the Prepping Your House for A Foot Fusion section, Meal Prepping! section, Awesome DIY Ice Packs section, and other sections!

Today will round out week 2 since the surgery. I have a scheduled post op today, hopefully to get those stitches out and to get some more x-rays to see how I'm progressing.

Pain management has been a lot better. I've been able to sit up for longer periods of time as long as I'm elevating, but the main pain factor is coming from not elevating and taking the foot down to get on the scooter or go to the bathroom, etc.

I've also developed a nagging new symptom - itching! I expected the sutures to itch as the foot heals, but it's actually been the areas around the stitching and not actually the incision. Without doctor clearance, I took the little antiseptic patch off of my foot and about an hour later the itching relieved. I think I could possibly be allergic to that.

Other notables in Week 2? I'm getting better movement in my ankle and toes, as I've been trying to do little exercises in bed!

Subsequent post from the doctor's office today to follow.

1 Week: Doctor's Office (WARNING: Graphic Photos)

Daily Tip: Make sure your doctor completes paperwork for you to get a temporary handicapped hang tag for your car.  It usually is valid from 6mo-year and you will need this, especially if you are nonweighbearing or just getting back to walking. You have to take it to the DMV in person, so it's best to knock it out BEFORE you have the surgery.

Take a pain pill about an hour before your doctor's appointments. With all of the moving, poking and prodding, you'll need it.

Getting to leave the house is exciting and terrifying. Up until this point I have been using the computer chair to wheel to the bathroom because it's extremely painful to let this foot feel gravity.  But in order to get to the doctor's office, I have got to be able to move around on the scooter.  
I have a KneeRover Deluxe Knee Scooter - got it from Amazon (again not me in the photo!):

It's pretty durable and seems to be able to handle turns well and has a brake, which is super important. Today's test is using it, using it well and getting used to the feeling of that surgery site pointing down to the ground. PAIN.FUL.   But we shall see.




So I got up and dressed and was promptly exhausted. 

The CAM walker boot that I have, while great, was difficult this time around due to alll of the gauze and padding and ACE bandages and probably swelling with my foot.  It also straps directly over the incision site. But we press on, lol.  It was difficult riding in the car without elevation. I was able to try to place the large boot across my waist, but that was also uncomfortable.  All that being said, the scooter transports great so it was good to pull up to the handicap accessible ramp, get the scooter out, and just scuttle into the office.  While waiting the scooter also serves as a great way to keep the foot elevated.

And now the moment of truth! I first took some x-rays. This actually proved to be very painful, as it required me to actually place my foot down on the x-ray surface. That pressure, along with the blood rushing to my foot was NO fun.

The nurse then came in and removed the bandages. Behold, a first look at my foot since surgery day!:

Stitches!

Everyone was really pleased with the way my foot looked! No signs of any type of infection and I had very minimal swelling in the foot.  Albeit gross looking, the stitch technique is designed to help my scar heal flat, as I have a skin tone/type that is prone to raised scarring.

After wrapping me back up, we got a chance to look at the x-rays:

Frontal view

Side view

Doc and team were delighted with the angling, and placement of the hardware and screws. Additionally, I got a change of pain medication. Other than that, the report was excellent. No immersion in water or anything that will get the foot wet, but stitches should be able to come out at the 2nd post op appointment on Day 14. Yay!

In other news, I need a pain pill and sleep. Tired, exhausted, and the pain is coming back. But we made it, lol.

Day 4-6: Pushing Through

Daily Tip: If you have friends or family that love you, hopefully they will offer to set up a meal train for you! This will save your life, as the first week is a nightmare no matter how much you plan!

Pretty much the same routine here. Minimal movement (turning over, bathroom breaks) because anything that isn't elevation causes extreme pain as the blood begins to run down to the surgery area.  Couple that with freshly cut bone, displaced nerves, dozens of stitches and foreign metal objects in your body and you start to wish you had a catheter instead.

Icing and elevation--so critical at this point. I've been icing and elevating continuously--only de-elevating for the restroom. It's so important for the healing process and to minimize swelling.  

The first week can be described as dicey, because both my husband and I are settling into the new norm.  I need constant assistance. I'm lucky that I have a spouse that works from home, but he DOES work--so fitting in breakfast, lunch, dinner, bathroom trips, water refills in the middle of business meetings has been really challenging. We did some pretty decent meal prep (or so I thought) but the stresses of all of this made it nearly impossible to get a cooked meal in.

A lot of people may say, "let us know what you need"--if you're comfortable, I totally say tell people ahead of time to bring you a meal in that first week or two.  If you are reading this and you're a person that knows someone that will be having this surgery (or any for that matter), just put in your head now that you will find out what day is best to bring a meal and just take it!!  The folks that have just dropped by a random meal have saved our lives.

Tomorrow is post-op visit #1, so the first chance to get a look at the incision and x-rays! Also my first jaunt out of the house, so we'll see how that goes!

Day 2/3: Boom.

Daily Tip: Keep a 'snack drawer/basket" on the nightstand with crackers, applesauce, granola bars, etc. If you have to take a pain pill during the night (which you WILL) you can easily get to something to coat your stomach in anticipation of the pain pill.

So day two wasn't eventful, really. Pretty good night, sans waking up to my pill alarm, and all in all, pretty normal.  I started to think that maybe it wasn't going to be sooo bad...

And then came Day 3.

I don't know if it was the full wearing off of the local, or if it was just setting in that I couldn't do much of ANYTHING except rolling over in the bed, or what--but it all hit with a vengeance! Around midday, the pain crept up, but it still felt so sudden. I can only describe it as a tingling, that turned into a burning, which led to a tightening feeling that turned into an all out pain/ache. Nothing I did made it feel better and I could NOT get comfortable. I would get immediate relief after taking a pain pill, but that would start to wear off after about an hour or so. I tried the 'gateway method' that my doctor's office suggested--taking the pain pill, then following up with 2 ibuprofen 3 hours after the pill, then taking the next pill as scheduled. I did get some relief from this.

Surprisingly, most of my pain from this point on was during the day.  I feared the night, but as long as I stayed elevated, I had no problems.  

Day 1: Surgery Day

Daily Tip(s): 
Have a come home plan! Most people don't think about how they are going to get OUT of the CAR and IN the house. You're too looped to be on crutches or the scooter. Mine consisted of pulling as close to the front door and being placed in a computer chair and wheeled to the bed!

Start sneaking a fiber supplement (Benefiber, Metamucil, etc. into your water now--and drink LOTS of fluids! Also start taking something like Colace so there won't be any problems, lol!

The day that I had been planning for for months finally arrived! (For great tips on planning for a foot surgery, keep your eyes peeled for my posts on that).

I was careful to follow doctor's orders--the standard no eat/drink after midnight, but also to stop taking any NSAID's a week before surgery, because of their blood thinning properties. I also hated to take off my nail polish on my toes, so I made sure I had a great coat on my fingers. :)

I was the first surgery of the day (5:30am) so not much activity at the OR.  I got checked in, dressed in hospital garb, and after that, prep went rather quickly. My IV was started with Tylenol and Clindamicin (antibiotic). We discussed my general anesthesia and local anesthesia (nerve block). The doctor came in and patiently listened to me second guess everything. :)  He put me at ease again, and then proceeded to mark the foot that the procedure would be taking place on.

Shortly thereafter, the OR nurses came in to wheel me back to surgery.  Side note: you have to remove all of your metal jewelry of course, but they did allow me to keep on a silicone wedding ring, which was nice. I don't remember much between the room and the OR, because the last memory I have is being wheeled to the door. BOOM. OUT.

When I woke up, I had spent an hour in recovery and found out that the procedure had taken just under three hours.  The doctor was pleased with the fusion, was able to place the hardware--and get this--discovered a hidden EXTRA sesamoid that was also pressing against the joint. Anyone need an extra sesamoid?  He was able to remove that as well.

Though groggy, I was in no pain. I knew that it was CRITICAL to get ahead of the pain. LET ME REPEAT--get AHEAD OF THE PAIN. Do not be fooled by the local anesthesia or nerve block--begin to take those pain pills as soon as you get them as directed.  I learned this the hard way from a previous surgery.

Got home and in the bed, and immediately began to elevate and ice.  Again, I'll have a separate post on stuff I bought, but I bought a leg elevator pillow that changed the game. It was amazing and extremely stable and allowed me to elevate (not me in the pic, lol!):

I also tested out a million DIY formulas for ice packs before I found the magic recipe--Dawn dish soap! Amazing and super reusable.  Anyway, my first day/night was a blur of elevate, ice, sleep, wake up and take pain pill and repeat. I survived.

Where it all started.....

So I think it may be good to explain how I got to the point toe fusion. For the sake of brevity, it all started over a decade ago.  I had a bunionectomy that was very successful in 2007, but several years later, a different doctor (I moved) determined that I had a bipartite (separated) sesamoid that was causing me pain in the same foot. The critical decision was made to remove the sesamoid.  All seemed well!

Fast forward a few years, and I began to have trouble with the big toe joint in that same foot.  Popping, locking, aching. I was in the mid stages of osteoarthritis (Stage III) For several years, I was able to keep the pain at bay by getting cortisone injections into the joint 3-4 times a year. 

When I got to the point that I was no longer getting the relief I needed, we reassessed surgery as an option.  Unfortunately, the removal of the tibial sesamoid under my foot left my foot extremely unstable and there were very few procedures that would preserve stability for years to come other than the MPJ fusion. 

As an active person in my 30's I was devastated--but also gotten to the point where I had to admit that the current pain was also significantly affecting my quality of life--no running, exercising or heels without pain. So I made the difficult choice to go ahead and have the surgery.  I chose to come back to my original DPM, and I'm so lucky that he was committed to exploring all options and subsequent opinions and didn't bully me into having the surgery.

So yes, folks, here's how we got here!!

Welcome to my foot fusion reality blog! :)

Hello! If you have have landed on my blog, it means that you are probably looking for some information on the foot fusion (arthrodesis) procedure. Hopefully this will be a good resource for you!  

Once we determined that an arthodesis was in my future, like you, I hit the internet hungry for resources on what to expect, how to prepare, what recovery was going to look like, etc.  Other than the very clinical info from doctors and WebMD, I realized that there were very few sites that had anything to do with real life experience. I vowed that if/when I felt up to it, I wanted to create a place where I could share my experiences for people to get an idea of what they'd actually be going through.

I'm currently 10 days postop, so I hope to be able to give you an accurate play by play of what's going on as it happens. In between, I also hope to be able to share some tips and tricks that I've found to be really helpful!  

Please check out the other sections at the top right of the page:  Prepping Your House for A Foot Fusion section, Meal Prepping! section and Awesome DIY Ice Packs section for my tips on these things!

Here we go!