6.5 Months Post-Op Update

  (28 weeks)

I'm doing better, thank God. It has been touch and go with trying to walk in sneakers at the track with a reasonable pace. As you would imagine it's difficult at the beginning, but if you keep at it, it gets better. It feels good to get out and move. 

I did have a little something I'm not happy about though. Because the fourth toe sits lower than it should, while walking, the entire bottom of it (its full length, not just the tip) rubs against the sole of a shoe with more force than a normal toe would. This caused it to blister. 

I didn't want this to derail me at the track so I would wrap it with a band-aid. The healing seemed slow no matter how much Neosporin I was using. One morning I got the the track and realized I had forgotten to bandage it, but I wasn't too worried because the blister had been drying out. I improvised and wrapped my toe with a piece of paper. That seemed to work fine until I got home.

I then realized that the paper prevented my 5th toe from moving properly and it now had a blister as well! Fun stuff huh?

PAIN

The pains I use to have in my heel are gone.

The congestion is also gone.

I'm working on the sciatic nerve pain that developed during this whole process. It has lessened, but very slowly, and I have to work at doing exercises to accomplish this. I'm happy that it's improving.

The past month has been a time of endurance. Going out to do a few errands and getting home with a leg that begins to ache. I rest it and then I'm fine again. So it's a matter of building up my endurance. I can't wait till I can go to a museum and walk through the art for a day and not be hurting by the end of it. The thought makes me smile. ;o)

So the platelette feeling on the bottom of my foot was temporary. At 7mo, it's gone.


So is the tendon pain, and need for prescription painkillers. Halleluyah!

What I have now is stiffness. In the morning, the tendons and joints (bunionectomies) are very stiff. I have to stretch it all out to get started.

I've been walking for 4 months now and I have yet to walk in closed dress shoes. I've spent my time in flip-flops, I was unable to fit into a pair because remember, I had the bunionectomies on my right foot just 8 weeks ago. It still gets swollen and the incisions are too sensitive for a hard closed shoe.

Winter is coming so maybe I'll spend the time in a comfy boot. Hard closed shoes may have to wait for the spring?

One of my biggest lessons is this blog. I love that I accomplished what I set out to do, which was to tell all of it in detail so those considering it will be able to plan and anticipate accordingly. But the negative side affect it had on me was just that, negative. It made me focus each week on what was not working, the pain, etc.

I believe this did not help my own healing process. It's a lesson learned for me. I always knew that staying positive can work wonders and now I have my own personal proof on that account.

So in your journey, get the info, compare notes, but feed yourself good thoughts DAILY! It will help a lot. ;o)

The Big SCIATIC Post

I didn't even know that sciatic was a nerve, or where it was. I mean, I've seen people grab the back of their hip and complain about sciatica, but that was it. Unfortunately I am now much more educated with it.

The stuff I found online doesn't seem to apply to me though. Much of the sciatic issues mentioned stem from lower back problems and disc issues, which I have none. I think it's possible that I might be able to help someone out there by sharing what happened and how I'm dealing with it.

"The sciatic nerve is a large nerve fiber in humans and other animals. It begins in the lower back and runs through the buttock and down the lower limb. It is the longest and widest single nerve in the human body." [wikipedia.com]

After going through this pain, reaching out to my doctors, and getting nothing that has actually helped me, I was forced to take matters into my own hands. ("I" even had to ask to be sent to physical therapy.)

My online search and my doctors had advised the following exercises. However, they only gave me very temporary relief. I always ended up back at square one within a few hours.

I thought I had hit the jackpot with this one,
but it offered no permanent or growing relief.

This did nothing for my sciatic nerve. It helped stretch my heel cord (tendon)
which I need too but nothing for my sciatic pain

After weeks of no help, I started to pray. It then dawned on me that perhaps it's the way in which I'd been sitting that was aggravating the nerve. I had a congestion issue in my leg and was sitting in a position that helped that issue (A). I began to sit up (B). While I had to deal with the congestion in my leg (it was better that 3 months ago), I started to feel relief of the sciatic pain.

So it seems to me that my sciatic problem happened because of the way I was sitting for 3.5 months. (update: as time passed I realized the nerve must have been aggravated during surgery.) It put pressure on my nerve for an extended period of time. Sitting up began to help, but did not solve all of the pain. 

I kept praying. The following two exercises came to me out of nowhere and have been offering me growing relief at a slow pace.

I do these without the band

This one was on my mind for a long time.
But I was afraid it would aggravate the nerve. It's helping though.

I'm now taking either ibuprofen or naproxen twice a day to keep both pain and inflammation, if indeed it's an issue, at bay.

After being able to start getting relief I canceled my physical therapy appointment because I asked Dr. Yes if physical therapy would make me do stretches I'm already doing. He said that was probable. ;o/

However, I'm going out soon for surgery on my right foot. I'm curious to know if they have anything further to offer. So I will be going to at least one physical therapy appointment to see if they can lend anything additional that will help me RECOVER from this and not just manage it.

I'll keep you posted.

What I Feel When I Walk

Walking on the floor with bare feet is too painful at this point. I use nice cushy open shoes in the house, and my new sneaks outside. (with ace bandage around my ankle.)

While these plates do not exist in my foot, this is what it feels like if I walk barefoot on the floor. It feels as though I have these two platelets under my soles. It hurts as if there isn't enough 'meat' under my soles to cushion them. They feel sharp and it hurts.
__________________________________________________

This is a visual representation of the hardware actually in my foot. 7 screws, (there is a narrow plate used with the 6 screws) for the bone graph.

Week 15 — Post-Op Highlights

Howdy.
A picture is worth a thousand words right? I'm definitely visually adept, but there is more going on than this photo can tell. So I'll tell you. ;o)

IN A SNEAKER!

Saw Dr. Yes last week. I've graduated into sneakers. Went out and got a good pair. I choose a men's (I need the extra width) Nike Air Max Run Lite +2. They were the most comfortable to me out of the selection. I also choose them because I would be able to add some comfort insoles in them without a problem. I needed a sneaker that would have enough space top-to-bottom (vertically) in the front.

I got 2 kinds of insoles. One for Heel pain relief and the other for the Sole.

I wanted them both in a men's size for the extra width, but was only able to find one. ;o(

Nothing seems to take the pain I feel away, but this is better then just the insole that came in the sneaker from the manufacturer. ;o)

Because the ace bandage would be too bulky, in a sneaker my Doc gave me this snazzy TIGHT sock. It does my scars good. (Remember the post I made about pressure being the best thing for scars?) 

My ankle and foot need the support (especially while driving my stick shift) so the sock is a good thing. But I do find that my foot starts to ache after about 5 hours. It's too snug after that time.


But I still wear my ace on top of that for ankle support.

PAIN
Let me be clear, while I am now out of my boot and off crutches, I'm walking with a great deal of pain and discomfort.

There are three things going on in the pain department:

    1. Both front and back of the sole of my foot
        are quite painful when I walk. It feels as though have metal         plates there, right under the skin of my soles.

     2. The Achilles tendon (Heel cord) is very tight

     3. My sciatic nerve

I had complained of this pain maaaany weeks ago and after describing it again to Dr. Yes this past week, he simply told me what it was. GO FIGURE! He gave me stretches to do.

The exercise was to stand arms-length away from a wall. Place palm of hands flat on wall, lean into wall by bending elbows... bringing the body toward the wall while heels remain on the floor. I found that this addressed the Achilles tendon, but not my sciatic nerve pain. 

I knew nothing about the sciatic nerve so I looked it up. I found this stretch was the best one so far:


For me however, I need more than this stretch. (The pain is persistent.) I have sent an email (because it's the weekend) to both of my doctors explaining the pain even though I am doing all the stretches, and requesting actual physical therapy. I'll let you know what they say. (In the meantime I've started taking Advil for the Ibuprofen. I'm hoping it relives the inflammation.)


WALKING

Stretching the Achilles tendon (heel cord) is Soooo necessary. With effort, I am able to go up stairs one foot in front of the other like normal (need bandage on).

But going down stairs is a totally different story. There is no limberness in that tendon. Until this happens to you, you never realize how it actually helps you go down the stairs.

I'm working daily to stretch this out. While I do not have permanent improvement in my sciatic nerve, I do experience permanent improvement in this tendon with my stretches. ;o)

There are stretches on YouTube for this tendon, but I find they aren't the best for those of us who have had Brachy surgery because we can not fully put weight on the foot yet. This is what I came up with that works best for me:

SLEEPING

I'm now enjoying full sleep through the night! YAY! ;oD

CONGESTION
This is improving also. (See: STRANGE)

NUMBNESS

(the images used to show the numbness areas in this post are old images of my foot. Just the highlighted sections are current status.)

Week 13 & 14 — First Steps!

Howdy! I thought I'd start off with something funny. Check out my toes! The toes on my left foot try real hard, but I can't spread 'um. ;o)

Last 2 weeks have been a bit of a whirlwind for me personally, but things are progressing. (videos below)

Let me get right down to it. Normally your doctor will give you instruction as to how to start walking. Each person is different, it also depends on the method of correction. My doctor kept me on crutches and my boot for week No.13— partial weight bearing. For week No.14 I could try ditching the crutches only in the house.

But I really ended up not following doctor's orders and overdid it. I wish I could tell you how week 13 would be for you, but mine was really not normal. I made personal decisions that kept me on my foot waaaaay too often and let's just say it was more than partial weight. But those were "my" personal decisions I made to spend time with some family.

I do not recommend planning outings or entertaining during this time! So I don't know what it would feel like to ease into walking.


PAIN
So I went from having trickled down on the pain between wk 9-12 and now I'm back up again. The pain is different. It is very difficult to explain. You feel pressure in areas where you feel weakened. You feel like there is a bruise under your heel. Your foot aches and your ankle swells a bit too. And walking is short lived because of the discomfort— you'll prefer to sit. 

But I have just kept going. Living alone all this time makes me grateful that I can finally get up, get something, and carry it back in one of my hands (been using only one crutch, yay). I would love to be pain free after 12 weeks of great discomfort and trial, but I tell myself I've only been putting weight on it for two weeks.


I still can not sit upright with my leg up and be ok. My leg starts to hurt after about 30min. So I have to sit 'reclined' with my leg up. (I sound like a broken record with this! I wish walking-pain was all I had to deal with.)

But this is all passing. Just like the hard times during the 12 weeks passed, this will too! ;oD

Anywhooo let's get to the good stuff!!! 

Week 13—
This is what an bird's-eye-view photograph can not show you! ;o)

Week 14—
First Steps... Crutch Free!

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.

8th Week — Post-Op Summary

A bit of a breakthrough this week. YES!

The first bit of good news is I finished my taxes! ;o) At a turtles pace, but they are done! Yay!

That soon was coupled with an unseasonably warm day this week. I got to open my windows and let some fresh warm air flow through the apartment. (I can't walk Missy yet so she does all her business on her wee pads— the venting was needed. ;o)

PAIN

Heel pain I had last week diminished. Looking at my scars I decided it was time to bathe without a plastic bag on my foot. (I had not wanted to do this until the skin had really bonded together well— I didn't want incisions to reopen.)

Running water on my foot...OMG, this was amazing!!!!! I hadn't done that in 52 days!!! It was awesome. I gently scrubbed my foot with soap and water. (Had only periodically washed with a damp washcloth.) It was dreeeeamy!

MORE GOOD NEWS

I actually could put on a regular sock without it bothering me now. Wooohoo! (tried shoes... not happening yet.)



STRANGE (congestion)

I have to talk to my doc about this. Whenever my leg is down it changes color. (and becomes painful) I presume it's blood. The feeling of this several weeks ago was painful. Now the feeling is just uncomfortable. But the color thing is a little un-nerving. Gonna ask about it. Looks purple-ee. (what this is: see: "PURPLE-EE (CONGESTION)")

SCARS
Apposed to last week, this week I decided to go back to the ace bandage. I feel my scars still need the "pressure" for the scars.

Also, at the end of this week I decided one morning to massage my scars. (Doing it in the morning ensures any pain from it will subside by nightfall.) I thought it would be good for the scar tissue, to hopefully help heal with more flexibility.

Genius that I am, I did it too hard! The tendon underneath my Brachy scar swelled up. (made me panic a bit) and the opposite side of the heal-scar swelled up too! OY. I put the ace bandage on tight, checked it now and then. By the following morning things were fine.

A friend of mine went to physical therapy for a scar on her finger. She did confirm my thoughts about massaging the scar tissue. So I will continue, but gentler.

SLEEPING
Horrible. I have to do something about this...

LANDMARK

I'M 3/4 of the way through the 1st phase! YAY! 4 more weeks and I should be able to take my first steps! WooooHooo! 

TOE
This week I've been moving my toe as Dr. Yes recommended. Not remembering 3 times a day though. I do see immediate difference as to where the toe lays, but after a while it seems to revert back. I think I have to really do it 3 times a day and understand that it's a slow process. Let's see what happens.


Have a great week!

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!