10th Week — Post-Op Summary

Normal left foot placement
on the clutch pedal

DRIVING
I tried driving again. I went downstairs with my boot on. Once in the car I switched to a big sneaker. (Ace bandage on, of course) With much effort I drove a few miles to my favorite bagel place and back again. (Not before sitting and having a YUMMY bagel!)

Can only use this section of my foot.

The problem is that I have to be sure not to apply pressure to the 4th metatarsal bones. This leaves me with the first three to use. Doing this, places my foot more to the left, BUT there is a bit of a wall that doesn't allow me to go much more left than you see here in the photo.... 

With the sneaker, my foot placement on
the pedal puts too much pressure near the
4th metatarsal bones.

And with a big sneaker on, it takes up much more room than a naked foot as in the photo above.

So when pressing down my foot bumps into the left wall, and it forces my foot to the right, causing me to put pressure on my 4th metatarsal bones.

While trying to drive like this, let me assure you that the clutch pedal gives a lot more resistance than the accelerator pedal (all the way to the right). I can feel pressure under my bunionectomy incision and intensely in my ankle. That night my ankle swelled up. I won't be driving again for a while.

FELL
I didn't have my boot on. I had a little slip in the kitchen. I was able to stop the fall, but my heal hit the floor and bore weight. Yup, I had to take a pain killer and ice it all night.

PAIN
Outside of the pain induced by the fall, pain was bearable this week. It's an underlying constant aching. It sometimes goes up through my hamstring to my buttocks, and stays a while.

SLEEPING
This is getting better, thank God. I wake up a lot, but am able to at least go back to sleep. 

EMOTIONS
This was not such a good week. I can't stress enough how I do not recommend doing this post-op alone**. It's a struggle sometimes to not have a pity-party. The effort it takes to do things and the loneliness at times is too much to bear.

THERAPY 

Before surgery                             Post-Op

It does seem as though the bending backward of my toes is improving with my exercises.

         The way it is.                 The way it should be.

But the range of motion when bending my toes forward is limited by the Bunionectomy I had. See the difference? This will dictate the height of heels I can wear in the future.

This is my right foot. (no surgery) While the bunions cause their own problem, the range of motion (bending) is fine to fit into this shoe.

NWB - Non Weight Bearing

It took me forever to gingerly struggle to put my left foot in this shoe. It's not in all the way (I can't crimp my toes properly to shimmie into it like we women do.) But you can see I don't have the full ability to bend to walk in this shoe. But the two bunions look much better, no?

CONGESTION

Making Guacamole! ;o)

I still raise my leg up in the kitchen and bathroom to avoid the discomfort of the congestion.

DISABILITY
I'm on disability. I get 8 weeks at 100% salary coverage and 4 more weeks, if I need it, at 60% my salary. Normally a doctor determines when you can go back to work. But my post-op doctor is relying on me to tell him when I can perform the responsibilities to my desk job without pain because of the oddity of the situation. 

The oddity is that I can not sit upright and put my foot up and be OK. That causes pain up my leg after about 30min. I NEVER ANTICIPATED THIS! No doctor or other brachy-ers online ever mentioned this. I would need my job to supply me with a lap-top so I can be reclined with my leg up, instead of the desktop they gave me to work from home. (My public transportation commute-to-work is too dangerous for crutches.)

After the 12th week, if I don't return to work, three things happen:

1. It goes into Long Term Disability, which is like opening a whole other claim.
   
2. My job is no longer protected under the FLMA law. 
   
3. My 60% salary is no longer paid by my job, but by my disability company.  

I didn't like the idea of not being protected under the FMLA. So I made arrangements for my doctor to sign the proper "return-to-work" forms, and talked to me employer to get a laptop delivered to me. This is the only way I can start work again.


Working now means I will use up 11 of the 12 weeks allotted to me. This leaves me one (1) unused week, that hopefully I can use when I get my bunionectomies for my right foot in a few months— I hope. That 1 week, and one week's vacation time should do it for recovery for the bunionectomies on my right foot. I hope! I can still work from home after that surgery. Let's see how things work out.

**I do have a friend who comes every other week to take me grocery shopping. And another friend who visits every Friday with me. And sometimes I'm blessed and a friend is able to take me out for a bit on a rare free day. And still, the cabin fever and loneliness I feel is terribly difficult to manage sometimes. I'm alone sometimes for 5 days straight without human interaction or the ability to go outside.

I'm sharing this so those whom this applies to can prepare themselves, but the truth is, not too many people have my exact situation— 1. live alone, 2. drive a stick-shift vehicle, with Brachy surgery on left foot. Add all these together and it's very hard to bear the affects of the long post-op.

I have found that I've had to take my own advice and utilize some of the positive links on the right side of my own blog.

7th Week — Post-Op Summary

Here's how things are looking. Still swollen and quite tender. But a miracle still. This is a process, and perhaps the 'wow-factor'  that I've finally had this done hasn't hit me yet. But I'm sure as pain subsides and agility returns I'll be able to enjoy the amazing thing this surgery means for me. I'd just like to walk already, ya  know. ;o/


FLEXIBILITY

I'm bending both right and left sets of toes with all my might here.


PAIN 
This week my heel and large tendon behind my ankle have been a pain—literally. You've ever heard the saying, "It has to hurt if it is to heal" ? Well I'm hoping that's why it ached so much this week! ;0) (I want to note that I'm starting to think that I'm feeling more discomfort than I should because I'm home all day without my boot on. (against doctors orders... what if I fall?) And because I do for myself, I think my foot is getting too much movement (giggling?). Is this causing me more pain at night?)

SLEEPING
The heel pain has caused small spurts of sleeping. I awaken many times during the night tossing, trying to find a pain-free position. I can't fall back to sleep and am awake 3 hours at a time. (In one of my past posts thought this was remedies after reducing my medication, but I guess it's back)  Thank God I'm on short term disability, this kind of sleep would negatively affect my work. (It's important to note that I am off all Meds right now. I'm sure if I were on Meds I'd be sleeping pain-free.)

DR. VISIT

Dr. Yes took no xrays as there would be no noticeable changes since the xrays taken 2 weeks earlier. (No news is good news.)

WHAT WOULD YOU DO?

Dr. Yes told me to start maneuvering my 4th toe. (Put my index finger behind the base of the toe and softly press forward. For two minutes, 3 times a day.)

However, Dr. West, my surgeon, told me specifically not to touch my toe until the 10th week when he would provide the exercises I should do. If Dr. Yes is wrong in his recommendation, it is possible that my toe will pop-up like it use to. And if that happens, I would be up against an additional surgery to correct that! What would you do?

Well I decided to start Dr.Yes' recommendation because my Brachy isn't as distorted as some Brachyans. My fourth toe never touched the floor, but it didn't pop-up as severely as some other cases I'm familiar with.

I couldn't remember to do it during the day so I'd just do it once at night in front of the tube. But I noticed my foot would ache a lot more when I was trying to sleep. So I stopped. I will try again next week.

DRIVING

I had asked my surgeon if I could put weight at least on my heel and he said 'no'. But just 2 days ago I made my way downstairs to my car. I wanted to see if I could use the area under my 1st three toes to press down on the clutch. Maybe I could at least drive myself to my doctor's appointments, right?  

NOT. No way. Didn't happen. I can't believe how hard I had to press against the clutch to get it to move only a smidge! My foot doesn't have the strength yet. I'm amazed.


BANDAGE

Attending my scars twice a day got me real tired of wrapping and unwrapping the ace bandage. It also felt a little hot with them on. So I thought I'd go get a roll of gauze, but I found something better. Isn't it snazzy? ;o) It's a mesh tubular bandage.


Very light weight and comfy.;o)

I use this type of gauze pad directly on the incision sites. Non stick (or non-ouchie ;o) With Neosporin.

I found this type of gauze uncomfortable against my incisions, so I don't use it. The non-stick pads are the way to go.
 

NOTE (Hypertrophic Scars)
I wanted to say something about the bandages and scars. I got the large size (tube bandage) on purpose so it would be loose fitting. But I don't think it's wise to do this at the beginning of a scar. Incisions need some snug pressure against them to avoid the scars becoming Hypertrophic.

Hypertrophic Example.
© Prime Health Channel

It's been proven that while doctors can prescribe topical ointments (OTC and otherwise), and/or give injections directly into a hypertrophic scar to reduce its 3D characture, THE BEST THING TO REDUCE THE HEIGHT OF A HYPERTROPHIC SCAR IS PRESSURE. 

I know this because I had surgery some years ago and have a couple of 6" scars that became hypertrophic! Think about it, a person with a scar running vertically down their abdomen demonstrates this. The scar is very 3D-like above and below where their belt line is. But the part of the scar that gets the pressure from their belt is nice and flat.

Also, I'm not sure, but it is possible that not all skin on the body is created equal. Is the skin on your neck more susceptible to hypertrophic scaring than your knees, etc.? If so, what about feet? I don't know. (I do know that the world of medicine thinks some skin pigments lend themselves more to scaring like this than others.) But I'm not taking any chances.

That being said, I will be watching my scars and if more pressure-time is needed I'll be switching back to my snug ace bandages. ;o)

Ciao!