Monday, September 9, 2013

Ankle Time Line (updated for week 10/11)

I will update this post with pictures of my ankle.
Left ankle, day before surgery (8/19/13).
Left ankle, day before surgery (8/19/13).
Left ankle, day before surgery (8/19/13).

 
1 week after surgery (8/26/13).
 
2 weeks after surgery (9/3/13).


3 weeks after surgery (9/9/13).





 4 weeks after surgery (9/16/13).





 5 weeks after surgery (9/23/13).



 

  6 weeks after surgery (9/30/13).




7 weeks after surgery (10/7/2013). Feels more
swollen after physical therapy. 





 
8 weeks after surgery (10/14/2013). Swelling almost gone.





 Week 9, I took these pictures just after doing
the physical therapy exercises. (10/22/2013).






 Week 10/11 (11/5/2013).

Week 3 - Back to Work

This last week has been more enjoyable.  I didn't have to lay down all day and keep my foot elevated.  The swelling in my foot has reduced and doesn't occur as often.  A few days after seeing my doctor I started walking with out crutches.  The first time I tried it hurt my heel too much.  Now I can get around and carry things with me if I need to.  Today I went back to work.  Most of the time I work at a desk.  Depending on the projects I am working on I will spend some time in a lab.  Luckily I don't have to right now.  It's nice to be back to work and feeling productive with my day again.  I take the boot off a few times throughout the day and stretch my foot enough to hurt but damage the tendons.  I feel like it's heeling like it should and now I can't wait for my foot to be back to normal.

Tuesday, September 3, 2013

Week 2 - First Post-Op Visit

It has been two weeks since I had my ankle operated on, well two weeks and one day to be exact.  I have been able to get up and move around more since the first week.  The only problems I have had involve taking a bath.  I have to wrap my leg in plastic and keep it out of the water.  Getting in and out of the tub takes some time and I have to be careful not to slip and hit my foot or injure myself.  It's not really a problem. It's more of an inconvenience. The pain has been managed with ice and elevation and has been minimal.  It still swells and hurts any time I don't have it elevated. Today (9/3) was the first time it did not immediately swell once I got up and walked around to get ready for the day.  I can feel some improvement in controlling the swelling.  I have not used any pain killers since falling back on my foot last week.  Last Saturday I finally got outside for more than a few minutes.  It was my son's 7th birthday.  I told him I wouldn't miss it.  We had a good time with family and friends at a park.  It was nice to visit with them too.  I mostly enjoyed being outside.

Today, I had my first post-op visit.  My splint and bandaging were removed by an assistant nurse.  It felt awesome to finally be able to scratch areas of my leg covered by the splint.  She said the swelling and busing looked normal, and that there was no sign of infection.  She also said the scaring looked really good.

 
  Finally free from the splint.

 Some of the gauze stuck to my heel.

 
Close up of the new scar.
 
I could tell my left thigh had atrophied some these past two weeks.  I could see it more clearly in my left calf muscle once the splint was off. After the nurse removed the stitches a physicians assistant came in to check on the healing, pain management, and to explain the next steps in recovery.  He moved my foot up and down (dorsiflexion and plantar flexion).  He also moved my foot inward (ankle inversion) and said that I am not to invert it outward.  This is to prevent the ligaments around the tendons from being damaged and not healing properly.  It felt good to stretch my feet and leg muscles.  He said I will have a cam boot for the next four weeks, and to slowly start putting more weight on my left foot as tolerable.  He expects me to be walking in the cam boot without crutches in the next three days.  He didn't want me going back to work full time until next week.  I was hoping to be able to go back today.  One more week won't be too bad this time.  At least I will be able to move around more.  My next appointment is in four weeks.  Physical therapy will start after that visit.  I have been sleeping on the couch in the basement for the past two weeks.  I am looking forward to sleeping in my be tonight.

Left leg atrophy.  The muscle feels soft and the skin is stretchy.

 My new shoe for the next four weeks.

Wednesday, August 28, 2013

Fall Back

My foot was feeling great until Monday afternoon, about a week after surgery.  I was headed up the stairs to take a bath when I lost my balance and used my splinted, non-weight bearing, supposed to keep off and protect foot to catch my fall and place most of my weight on it.  Pain!!!!  Nothing but pure pain shot into my ankle and up my leg.  I think I even saw stars.  I don't know how I fell back, but it happened.  I stood on the stairs with both hands pressed against the walls on either side and quickly put all my weight on right foot and yelled in agony.  I was worried I damaged the repair or ripped the stitches out.  I didn't feel or hear any snapping or popping.  It had been a week since I used any of the Oxycontin pills.  I took as many as the prescription allowed and iced and elevated my foot.  It took an hour or so for the meds to kick in.  My foot hasn't felt the same since.  Before the fall it would hurt when it wasn't elevated.  Now the swelling and pain is more intense.  Hopefully it will get back to were it was before the fall.

Sunday, August 25, 2013

Week 1

The pain from the surgery really didn't start until Tuesday afternoon.  Up to that point I had been laying on the couch with my foot iced and elevated.  I felt like I needed to get up and move around some and felt well enough to try.  I spent some time standing, changing clothes, brushing my teeth and taking a shower.  By the time I was done I could feel my leg swell up and the pressure increasing around the incision area and underneath the splint.  I took a few pain killers and laid back down with my foot elevated and iced. 

The only other times I got up the first few days was to go to the bathroom and back.  Being up any longer created too much pain.  Since then, I've been able to manage the pain through ice and elevating my foot that I stopped taking the Oxycontin Tuesday night.  I am still taking the Ibuprofen as needed, and the baby aspirin until I see the doctor again, which is two weeks after the surgery.  As long as my foot is elevated and it doesn't bump anything, it feels fine.   The rest of the week has been spent sleeping, catching up on movies, and reading some books.  Netflix through the Roku have been great.  I don't have to get up or have some one change the DVD if I want to watch something else.  I can only watch TV/movies for so long.  I am ready to go back to work and do something productive for the day. 

Other discomfort I have is not being able to scratch inside of the splint.  There are some spots I can't get too.  Some time the stitches poke or tickle around my foot and I can't do anything about it.  The muscles on my lower leg will cramp up and ache.  If I could only take the splint off and stretch them some.  I think I can make it one more week.  I feel like I can't do much for myself yet.  I can get up and down the stairs, but I can't carry a glass of water with me.  I can't even stand long enough to microwave food.  If you decide to go through this surgery I would recommend having someone stay with you for the first few weeks.

Monday, August 19, 2013

Surgery Day, 8-19

5:30 AM
Wake up, shower, and get dressed.  The kids are already at grandma's house so we don't have to worry about waking them up and getting them ready too. The hospital is only 20 miles away, so we don't have to be up too early.  The pre-admission nurse told me to wear loose clothing that will fit over the bandages.  A t-shirt and basketball shorts it is.

6:30 AM
We arrived at TOSH (The Specialty Orthopedic Hospital) and checked in at the front desk.  After a few minutes of waiting, a nurse took me to a small room with a bed, bathroom, and monitoring devices.  I was impressed some of the technology the hospital used and how clean and professional everything is.  That may be an advantage to a specialized hospital rather than a full hospital.  The temperature reading device was a small hand-held type with a sensor in the end.  The nurse rolled it over the side of my face and the temperature was appeared on its screen.  I'll have to figure out what it was.

After recording all my vitals and receiving an IV, the anesthesiologist came in and explained the drugs he would be using.  He said it would be administered through the IV and the oxygen breathing mask.  Most other peroneal repairs I've read about a nerve block was placed behind the knee.  I'm okay with no extra needles.
Waiting to go into the OR with my new hat.

A few minutes later the surgeon came in to review the procedure, and recovery with my  wife and me.  He is an orthopedic surgeon that focuses on feet and ankles.  One of the reasons I selected him to be my doctor.  He said it would only take an hour, and they would remove the damaged sections of the tendon and sew it back together.  We discussed the possibility of cutting a ligament that helps to hold the peroneal tendons behind the ankle in order to make the repair.  This would mean a longer recovery time.  He also said he would only make an incision as big as he needed to.  He only wanted to cut a few millimeters beyond both ends of the damaged tendon.  Depending on what was done during the surgery will determine if I am put in a cast, splint, or a cam walking boot and the transition to other walking aids throughout recovery.

7:30 AM
The anesthesiologist came back to my room and took me to the OR. With out my contacts or glasses I can't  see any detail, just blurred masses of color.  I couldn't tell what anything looked like.  It was about 15-20ยบ F colder in the OR than the rest of the hospital.  I climbed onto the lowered operating bed while the nurse wrapped me in warm blankets.  I remember the oxygen mask going over my nose and mouth and being told to take some deep breaths.  The ceiling tiles began to swirl and blend together.  I was out.

8:30 AM
The surgeon found my wife in the waiting room and told her everything went well.  He only had to make an incision a few inches long.  Luckily, the tear was in a location that did not required the ligament to be cut and sewn back in place too. This is good news for me.  I don't want the recovery to be any longer than it has to be.  Some time before 9:00 am I regained consciousness.

9:00 AM
When I woke up, my eyes opened slowly.  I didn't feel tired, groggy, nauseated or have a sore throat.  Most importantly, I was not in any pain.  The constant sharp stabbing behind my ankle was finally gone!  Mostly all the strong meds are to blame, but I'll take it.  My sinuses were even clear.  I have had a minor cold since Saturday night.  Once a child gets a cold in our family it usually gets passed on to everyone at some point.  The nurse rolled me into the recovery room were my wife would soon join me.

My foot was wrapped in bandages with a splint.  Hopefully this means a quicker recovery time.  They reviewed my pain medications with my wife and said I could leave after they monitored me for about an hour while the anesthesia wore off.  They wanted to make sure there was no nausea and the pain was manageable.  The nurse asked if I needed any pain meds, but I declined.  I could feel my toes and some some pressure from the splint and bandages, but felt little to no pain.

10:00 AM
I will be non-weight bearing on my left foot for the next two weeks.  We live in a split level home, so too avoid using the stairs as much as possible I set up my living/sleeping area on the couch downstairs.  I have never used crutches before.  A physical therapist came by to teach me how to distribute my weight and the best ways to get up and down stairs.  He then hooked me up to a harness and had me practice walking up and a hall.  I also had to go up and down a step he brought with him.  I didn't think it would have been too hard to figure out.  I never realized the hands should take most of the weight on the grip and the armpit pads are really just to stabilize and keep the crutch in place while swinging your leg forward.

Waiting for the physical therapist and to go home.
  
10:30 AM
I'm on my way home.  A nurse helped me into a wheelchair while my wife went for the car.  My prescriptions were filled at the pharmacy there, so we didn't have to stop on the way home.  I was prescribed 800 mg of ibuprofen three times a day to reduce the swelling, baby aspirin once a day to reduce blood clots, and 5 mg oxycontin every three hours as needed for pain.

Home
I thought I would sleep more and be in constant pain.  I haven't slept yet and have only take one of the pain pills.  It is only 3:00 pm and I don't know how I'm going to make it through theses next two weeks of elevating my foot and being non-weight bearing.  I feel like I need to be up doing something around the house or playing with the kids.  I am grateful for my sick (head cold) and pregnant wife that is still willing to take care of me and the rest of the family.  She is amazing.

Sunday, August 18, 2013

Surgery Eve

Last Friday I called the pre-admission nurse to find out my surgery time.  I am to be at the hospital tomorrow morning at 6:30 am to check in.  Hopefully I'll be able to get some sleep tonight.  I'm not really nervous about the surgery itself.  It's the slow recovery and physical therapy that I am not looking forward to.  The kids are staying with grandma and grandpa tonight.  I'm grateful they live close, and the kids love being with them.  My wife gets to hang out at the hospital all day while I sleep through everything.  I'm not sure who the lucky one is.  If I'm feeling up to it tomorrow, I'll post about how the surgery went.

Picture of my left ankle the night before surgery.  Some swelling can be seen between the ankle and 5th metatarsal.