I Suck

I overdid it, and have to go to Physical Therapy now.
See, after 22 days in captivity, I tried to bust out all of Christmas in 48 hours, and was on the foot about that long (with elevation breaks, though apparently not enough). I was hosting my in-laws and wanted to have a great meal and festive home! I also had the green light to start driving, which I did, around town, hobbling around a bit in my suspension boot. I thought I was doing pretty well, actually!
My 3-week checkup was just last Wed, and I had another today (Monday) - tomorrow marks 4 weeks. Seems being upright so much through the holiday brought the swelling waaaay back up, and was even cause for concern that the pressure had moved the bone settings, so we did another round of X-Rays (no movement, phew!). When I winced through the Doc's application of the manual rotations I'm supposed to be doing daily, he decided I'm not pushing through the pain enough and is sending me to PT. I start Monday. As much as I think it will totally suck, I know it is best for someone else to administer the pain as I don't seem capable of doing it to myself. He also pulled out a few remaining stitches... then I did one myself later this evening. It was far from the wound and was sticking out through the mesh compression sleeve so I just pulled it out with the tweezers, no problem, no pain. I know, TMI.

Here's the crazy thing about today's visit...
While sitting in the waiting room I heard someone coming down the exam room hall on crutches and looked up with absolute sympathy... to see the DOC in a suspension boot and crutches! Seems he broke his foot and is going in this week to the same place for a similar surgery and recovery effort. He joked we may even be in PT together - which would be great, actually, as I like him a lot. Poor thing, I know how much it stinks!

Here's a foot photo from this morning's appointment... you can see the swelling in a pretty large area around the joint/incision; the bottom/ball is really puffed out too. Ow. Still glad I got that pedicure before all of this...

Contrast Bathing + Mobility

Last Wednesday I was told to start "contrast baths" to help reduce swelling.
So the instructions are to soak in hot water for four minutes, then cold (yep, some ice cubes in there) for one minute, and do this cycle four times for a total of 20 minutes. The alternating hot/cold is supposed to expand/contract the area and help reduce the swelling. Admittedly the thought of getting my foot in to water was pretty awesome, I'd been wondering how funky things were getting under those bandages at the 2.5 week mark...
It felt weird of course, but good. My foot is pretty swollen (now even more so underneath, on the ball of the foot, as I start being able to walk around more). It is big and dark colored and super puffy. It looks like a yam (see photo). So Yamfoot and I soak and air dry together twice a day. I've been applying Aquaphor (except near the incision and butterflies) to rehydrate the skin, which is working great.
I took a shower sans bandage/sleeve and standing on the foot with no constriction was ridiculously painful. To offset it I made a lot of moaning noises that I tried to conceal as Christmas caroling. I guess that will just keep getting easier as the swelling goes down. 

I can pretty much walk on it now, when wearing the ugly shoe, though I favor the right side/heel of the foot and still keep the weight away from the big joint or the whole foot. When I go out of the house (yay, I've now had four outings!) I use my big black support boot that I still have from stress-fracturing my tibia earlier this year. It helps distribute the weight more evenly and makes me feel more protected. But my toes still stick out, and man when the big one gets bumped it's The Worst Feeling Ever. Like yesterday, when I adjusted my foot on the chair under the table across from me and inadvertently knocked my toe - C. told me I turned shades of purple he'd never seen before. Also there is a lot of swelling underneath which is partly why walking is still so uncomfortable - seems the small bones at the ball of the foot were also in bad shape and required some resetting in the surgery. Sheesh. So now if I could just fight gravity and keep the blood from rushing down there and creating pressure, I'd be upright for longer periods of time, but I'm very good about those elevation breaks as needed. I'm about ready to leave the crutches behind, though I'd be willing to use a cane for support. Stairs are still tough.

Today I tried to put on an Ugg slipper... no dice. I'm going to have to go find some shoes a size and width larger than normal to get rolling again. Steel-toed, of course...

The Week In Pictures

Phew! So earlier this week, Wednesday, I had my official two-week and third post-op appointment with Dr. Niccoli. The bandages came off, and the stitches (mostly) came out...

Here's the poofy gauze under the red wrap:

So it's not THAT bad!  It actually looks worse now, three days after this photo was taken... the wrinkly skin shows how much swelling there was post-surgery. The brownish stain is the disinfectant stuff they put on under the bandages. I should have gotten a way closer up pic of this.

Some of the stitches weren't ready to come out. I was so squeamish about it - it definitely wasn't great, and I thought it would be much worse. I appreciated the nurse holding my leg down and forcing me to sit still! The doc put butterflies on the length of the 3" incision. I so greatly welcome this safety backup, because I always think it's all going to split wide open when the blood rushes down to it...hey, when you go through this crazy foot surgery, you think about this kind of thing.

Then this tight mesh compression sleeve was put on (Spanx for feet!?) and held in place with some blue bandage and I was sent on my way with a bunch of new instructions:
Increase the manual rotation exercises
Start resistance exercises using the sleeve to "raise" and "lower" the toe
Start "contrast bath" 2x/day (alt hot/cold soak! hooray!)
Green light to start taking normal showers!
Continue the diuretics to help reduce swelling

Ultimately I am making good progress. I was still fatigued, having pain, not getting around much and not feeling that great right up to Day 13. There was a big improvement jump the next day - hitting the two week mark was a big one - massive improvement in mobility, strength, pain, swelling. So if you ever have to do this, believe it that sitting still for the first two weeks is the right plan.



If you're still reading this, and want to see the super gross pic, here is the foot on the one-week bandage change visit:

Week Two: Hanging In There

At last Wednesday's foot checkup I was started on some prescription diuretics to help with the swelling. I was warned to stay extremely hydrated, as these things would be pretty intense. I followed doctor's orders, and he was not kidding... I don't know that I've ever consumed so much water but I can't seem to keep up with it... this stuff makes me light-headed and nauseated. I have also had some other pretty intense pain waves the past few days and have requested a refill on the Percoset. I know it's all part of healing, but I'm pretty wiped out from this constant feeling of fatigue and queasiness. It's making me moody, which isn't good for anyone. Sorry it can't be just my foot hurting without my stomach and head participating!
I'm getting around on the crutches better as I can now bear a bit of weight on my right foot, but can't be upright for long because as soon as the blood rushes down there I'm in trouble, so I have to get my leg elevated for a while before trying again.
I get my stitches out on Wednesday and am hoping this will be the end of the diuretics too!?

On a positive note, yesterday a friend drove me to another friend's home for a holiday hang-out day; it was the right environment for me to get out of the house. I wanted to put my head out the car window like a dog to get the fresh air and take in all the holiday decor that has come up around town during my last two weeks in captivity! It was great to have my same chair/ottoman setup but be surrounded by great ladies and a festive holiday home! I was completely wiped out upon return, but it was worth it. There are two holiday events happening on Wed and Thu evenings this week, but I think I can only manage one of them... fingers are crossed. 

One Week Checkup

Fabulous... first shower! I have this ridiculous thick plastic bag with a rubber sealed ring around the top that is for keeping the dressing dry... now that I can stand up I thought it was time to give this "leg condom" a whirl. Seriously, when you are recovering from anything that keeps you in bed for a while, a shower is one of the best things to make you feel better. (This photo is courtesy of some medical supply site, btw, that's not me...)
I also got myself put together (hair dryer, contact lenses, makeup, street clothes) for the first time, it really made a world of difference in my approach to the day. You have no idea how sick I am of wearing my glasses!

I had my one-week checkup with Dr. Niccoli this morning. I kept my promise to his nurse that I would not pass out this time, though I did get a little squeamish when she was removing the bandages. Wound ooze is just disgusting. Things seem to be progressing well but to battle the swelling I am going on some prescription diuretics, which means I'm going to be drinking gallons of water a day to stay hydrated, so that should be interesting. The wound is so gross... I took a photo of what I can only call "Franken-foot," but it might be too icky to post here. It looked like a couple stitches popped so he put on some butterflys and wrapped me back up. Yes, I cheered like a little kid  when I  was given the option of colored bandage, of course choosing Christmas Red:

I loved C's idea of putting a Santa hat and beard on it, though I have some other ideas for bedazzling this thing. Then again, really, maybe the red is more than enough!? I love it!

So I get the stitches out NEXT week, at the two-week mark. I still have to stay off it, I have to increase my "toe rotations" to 100x/day at a wider radius, and I have permission to move toward walking on it without the crutches. Seeing as how I just figured out the crutches last night/this morning (I hustled across the parking lot this a.m., it was a beautiful, funny thing) I think that will be a goal later in the week. I got home and before long took a spill doing my special inchworm-moonwalk maneuver; I paid dearly in pain, and am thankful for the reminder to slow down.

I also got the "use your best judgement" (read: veto) on going to the Metallica show this weekend, which is a huge bummer. Unless I can dig up a wheelchair, it looks like I might be out.

I'm going to have to start doing some holiday decorating and getting a bit more festive now that my foot has gotten into the Christmas spirit!

Update: I Walked!

Earlier today I was pretty impressed with myself for managing a sort of inchworm-like forward moonwalk move that got me across the room without hopping or using the dreaded crutches. And, I stood at the sink with my foot on the ground (instead of flamingo style) and about 1/3 weight on it, which was pretty new too. So this evening I decided to JFDI and got on the crutches and was able to use them as a tripod with the foot on the floor, taking most of the weight, and actually crutch-walked my way down the stairs, thru the kitchen, and back up the stairs. It helped that I readjusted the crutches - they were an inch too high! Okay, so I'm overheated and my foot is back up on ice, but hey, I walked at the one week mark as intended. Hi-five!

I'm kind of laughing as I proof this... so silly...

One Week Down...

This first week has been quite a journey!
From a foggy, freaky surgery experience and a stressful adjustment period, to smoother sailing propped up in bed for days...  thrilled to see the initial pain issues behind me and a good amount of healing progress underway!

I still can't bear weight on the foot, but I can rest it flat on the ground now (in horror-shoe) for balance when needed. I have so much more movement but still get so fatigued after every hopping-out-of-bed adventure! I keep my leg elevated with an ice pack on my ankle - per the doc, it keeps the foot cool and has helped reduce swelling. It also just feels reeeeally good.

That said, I'm getting frustrated with not being able to get around, especially as I'm not improving with the crutches when I try. I think I get so anxious about not falling that my left side gets tensed up and fatigued trying to offset the right that I over-tire myself and get a little psyched out. It's pretty lame, I'm not proud of this. But I did just promise the receptionist I would NOT pass out at my appointment tomorrow to get the stitches out, so there's a goal... also tomorrow a friend is coming by with dinner and her new (crated) puppies. I'm not sure I'm up for it, but I think I need to force myself to give it a shot.

Speaking of, it's time to get downstairs and find some lunch, so I have to go put my game face on...

San Leandro Surgery Center

If you are in the SF Bay Area, or East Bay area, and have to have outpatient surgery, I hope you have the option of using the San Leandro Surgery Center for your procedure. The place is like a mini-hospital. The nurses are amazing and on top of EVERYTHING. I was very comfortable there and so appreciated the positive demeanor of everyone involved. From Monica who whisked me in and got me set up (I told her, "I like you Monica, you do NOT mess around!"), to Carolyn who did my medical Q&A and got all my tubes/monitors in and was so pleasant and calm,  To Dr. IWishIRememberHisName the anesthesiologist who was kind of intense yet made me feel no pain, to sweet Lou the surgery RN in the operating room who kept checking in to see if we were ready to go yet, and of course to the wonderful Lina who kept me comfortable in recovery and prepared me for departure.  They were good to my husband, too, in keeping him informed and comfortable in their big waiting room.
http://www.slsurgery.com/

Dr. Jeffrey Niccoli, my podiatrist, is also a pretty fantastic guy, I really respect and trust his advice, and he is both professional and compassionate. High recommendation if you are in the Alameda, CA area.
http://www.drniccoli.com

Blogger "Next Blog" Feature

Whenever I visit a blog on blogger/blogspot I often click the "Next Blog" link at top if applicable. Just curious - you can come across some interesting stuff, like the rural English country home renovation I ended up following for months, or a beautiful travel blog, or a lot of content that simply doesn't appeal. I wonder what the "connection" is in blogger's "Next Blog" feature - it's definitely not random. When I visit my friend Marsha's photography site and "next blog" surf, I usually get sent into some category of foreign language sites usually with a political bent. When I "next blog surfed" off my own site, ToesRUs, I hit dozens of "momblogs" or family sites about the new babies/little kids. Which is weird because my ToesRUs blog fits into that category about as much as Marsha's does with the foreign politics. What's the deal, blogger?

Day Five: Frightening TV Choices

Moved back downstairs today, nice change of scenery and better cable access! (Which lead me to some very bad viewing choices, as I am now fully briefed on season one of RuPaul's Drag Race, a drag queen competition reality show. I'm blaming it on the drugs.).
The swelling seems to have gone down quite a bit in the last 24 hours which helps so much. The toe is more flexible (yes, I'm doing my range of motion exercises) and I'm more comfortable with slightly less elevation today as my leg keeps falling asleep. Last night the Vegas slot machine was cranking away - the muscle spasms jerking my toe down are bad; I hope they will slow down as I increase the rotation exercises. Or perhaps that's the cause, who knows. I know it's a sign of healing though, and it's less painful than the first few few nights so anything that I can call "progress" is good enough for me.

Started off the day downstairs with a shampoo in the kitchen - luxury! It was easy to do by standing on my left leg and resting my right up on a stool and just leaning over the giant sink.

Here's a photo of my nurse Angus, he takes great care of me...

Day Four: Steady As She Goes

Today has been a pretty smooth-sailing day. It started with bathing and dry shampoo and new PJ's and some good face cream - I'm beating the gross battle one step at a time and it's lovely.
I seem to get big pain waves in the middle of the night. I don't love those. Sometimes it's just throbbing pain or sharp shooting-needles sensations, other times it feels as if the stitches are going to bust wide open. Not awesome. I finally fell asleep after a big wave last night and was jolted awake from a spasm - it was like my big toe was  pulled like the arm of a Vegas slot machine. Freaky.
The switch from Vicodin has been good too - no more nausea, and instead of feeling weak and shaky I just feel kind of fuzzy and tired. Yesterday I lost the battle with basic function at the doc's office and on the crutches, and got teary-eyed when I struggled to use a pen; now I'm just feeling fuzzy and comfortable and watching weird movies ("Synechdoche, NY" - trippy, dude). And I'm playing less "Bejeweled" to get me through the pain, which is kind of funny.
I'm trying to do some version of yoga twists while I'm in this horizontal state; oddly enough, lounging with your leg elevated actually isn't that comfortable for that long. Anything I can do to not disrupt the foot but twist and strengthen the leg/hips is good good good. 
Besides my husband C. taking excellent care of me and keeping me fed and hydrated, my kittens Izzy and Angus have been great company. "Bizzy" likes to curl up under the end of the down throw (my security blanket this week!) and 'Gus sacks out across my chest whenever he sees me doze off. The older cat, Maggie, comes in overnight to keep an eye on things. They are quite entertaining - Bizzy even dragged her "feather on a stick" toy up to the side of the bed so I can play with her this afternoon. Brilliant!

Day 3: It Feels Goods

Yipes... "it feels goods" or something like that is just one of the slurring nonsense statements I made at the doc's office this morning. I had a pretty rough night pain-wise, and was not doing well with the Vocodin - it just wasn't keeping up. (Nor are my fingers as I try to type this!). I am pretty weak from not moving for three days, having no appetite except for antibiotics and painkillers, and had trouble managing the crutches and getting settled in the doc's office. I felt pretty queasy standing on the X-Ray box and thought I was going to pass out, I got all cold and sweaty and shaky, it was awful. I was in outer space. I came back to life a bit in the reclining chair in the exam room. Dr. N. advised that the pain was from the extensive swelling due to the amount of work done in surgery. The good news was that he gave a thumbs up on progress once the bandages were off.  I was afraid to look, but I did take a tiny peek. Not pretty, but what would you expect? I decided it was too soon for a photo of that. . .  I have to do the manual rotation exercises daily; the doc moved the toe around - no clicking! He cleaned and re-bandaged the foot and showed off the before/after X-Rays.

The "before" X-Ray photo at right isn't very clear, but you can see there is no space around the first/big toe joint where the cartilage had deteriorated, and the cloudy areas are where the bone spurs and damage existed. Apparently the joint was filled with arthritis as well. Who knew?

The "after" X-Ray at left shows a perfectly clean joint where the bone excess was removed, the "air" and space around the joint where the remaining cartilage was re-molded, and the pin holding it all together.  Lovely, isn't it?

I go in next Wednesday to get the stitches out.

So overall Day 3 was off to a pretty awful start and I had to pass on a girlfriend visiting and another checking in by phone as I just wasn't up for it and wanted to rest, but I'm feeling a little better as we roll into evening. C. is bringing home some food (hooray!) and I'll take more painkillers and probably move back upstairs for the night. I'm trying to be patient, I know it will just take time.

Day Two: Ouch Baby, Very Ouch

As my favorite fellow Austin Powers would say, "Ouch baby, very ouch!"
The nerve block started wearing off overnight, and by 3am I could feel every inch of my foot. I could practically visualize each thing Dr. N said he'd repaired. As the kids say, O M G. I'm taking Vicodin closer to every 3 hours to keep up with the pain. I asked my husband to do the honors of the manual rotation exercises of the toe that I was supposed to start today as I just couldn't muster it myself. I've hopped the few feet from the bed to the bathroom three times today, and it takes at least a half an hour to recover from each. The pain is pretty bad. I try to humor myself with some "THANK YOU SIR MAY I HAVE ANOTHER" cheers, or bury myself in "Bejeweled" on my iPhone, but I can't prove it's doing anything either way. However, I know things are as they are supposed to be. I'm just getting through it. Ouch.
I am grateful my husband stayed home with me today, I'm sure I would have overdone it or had a problem had I been home alone, as proven within 2 minutes of him leaving the house this evening when I almost wiped out trying to hop to the bookshelf five feet away. I'm staying put for as long as I can.

This evening got a call from Dr. N's office, he would like to see me tomorrow to change the dressing instead of waiting until Monday as originally scheduled. I'm not sure I'm up for it, but it's the next step and I don't have to look, right? I'm also going to ask about the pain meds just to be sure. Okay, I admit it, I'm pretty nervous about the appt. tomorrow. In the meantime, here's how we're looking today!

The Big Day, Part Two

The ride home in the car wasn’t too fun but I was still a bit out of it. Arriving at the house and trying crutches for the first time ever across the front yard was scary; and neither of us was prepared for the front porch steps… by the time we got in the door I sacked out in the nearest easy chair. I was under strict instruction of no weight bearing on the right leg whatsoever for 48 hours; especially due to the “paralysis” from the nerve block shot. After we got settled I drank a ton of water and had lunch and a nap. I was surprisingly well energized in the afternoon and now can’t remember a thing I did but maybe catch up on some TV. My first attempt at maneuvering to the bathroom was awkward as it's three stairs down; it was exhausting getting there and back. My balance was WAY off and not feeling/using my right leg was pretty weird.

Warning, gory stuff ahead
Late afternoon my doctor called and checked in on me, and repeated what I guess he told me after surgery that I completely did not remember: there was extensive degenerative damage including loose bone fragments in the joint, what little cartilage was left he had to "re-mold" to fill the joint, and a lot of grinding had worn away the bones. He had to sand and reshape them and shorten the first metatarsal bone by a few mm as it was too long (in relation to the other metatarsals), which was one of the things that got me here in the first place. He did not have to use the "Hemi Implant" that we were prepared to do if necessary. I thought it was very cool of the doc to call. He parted with one request – that I start manual rotation of the big toe on Day Two. I’m terrified.

After dozing off again and being well underway on my antibiotic and pain meds by prime time, my ankle jumped a few times – I thought it was one of the cats tugging on my Smurf bootie, but apparently it was an involuntary muscle spasm as the nerve block started wearing off from the top down. I’d had an itch on my knee a bit earlier as a signal that it was on its way.

Getting up to bed was an embarrassing exercise in “reverse seated crab” up the stairs at the doc’s suggestion, which was so much easier than struggling with the wretched crutches and breaking my neck. I started my work on perfecting the “flamingo pose” perched on my left leg and bending my right as I brushed my teeth (aaah…) and C. helped me hop to bed. Another tip I used from the doc was to put an enclosure around my foot – he had suggested a box or basket of some kind to avoid the foot getting tangled in the bedding, but more so as a defensive measure against curious kitties. I had an empty office file box that I slid the elevation pillow into and was protected (and the cat, of course, slept on top of the box). I got very little sleep and around 1:30am could voluntarily move my ankle, which was nice and a little freaky. Around 3am I could feel E V E R Y T H I N G. Ouch. I’d heard a lot of advice/suggestion to really stay up on the pain meds, as in, take them at 3.5 hours instead of 4 hours as directed when the pain has already crept in. Having employed this approach in a previous accident I knew it was good advice. My toe started twitching, which was not my favorite thing. I found that playing “Bejeweled” on the iPhone is an excellent pain distraction. I didn’t get much sleep, but little bits here and there. But I got a high score! The pain was definitely coming on. I hated waking C. up to get me some more water/ice to help offset it.

I started this blog not just because I’ve needed a topic to get myself rolling in the blogger arena, but also because in searching for info about this kind of procedure and more importantly recovery from it, I found little to no info. I only came across angry posts about the prolonged pain, where others said they were good as new, but no one talked about the process. So if this helps anyone, great. If it provides some entertainment/info for my family and friends, excellent. If it bores you to tears and acts as a sleep aid for you, that’s OK by me too. Cheers!

The Big Day, Part One

The Big Day, Part One
Upon arrival at the San Leandro Surgery Center and filling out a million forms (more later on the great staff of SLSC), I was whisked back by the no-BS Monica who I adored, and was suited up in a gown, booties and “hat,” had my correct ankle marked in ink with the doc’s initials, was put on a heart monitor, an IV drip, etc. The anesthesiologist checked me out and was about to start administering my meds when he noticed an abrasion on the top of my foot… the post-pedicure flip flops I wore home the night before rubbed too close to the joint for their comfort, so we had to wait for the doc to arrive to ensure his incisions wouldn’t intersect with the abrasion – there was the chance of them sending me home due to risk of infection. So that caused what felt like a very long delay. I told the nurses, “This place is like Las Vegas! Extra oxygen and no clocks!” which got some good laughs. These ladies, they were fantastic.

The doc arrived (I think I have to try to introduce him to a girlfriend of mine…) and gave everyone the thumbs’ up. By then the anesthesiologist was busy with another patient and we had to wait some more. I dozed off… but heard the doc say, “oh good, ok, she’s out, let’s go” and my eyes snapped open to see him walking out in full scrubs… I yelled that I was NOT OUT and finally got some sleepy med drip that made me verrrry happy and comfy, then an oxygen tube in my nose, then they rolled me over and jabbed the back of my thigh with a ton of needles (OMG OUCH) and administered some anti-quease stuff at my request… I barely remember being wheeled in, trying to delicately hop/slide to the next gurney in my open-backed gown while now paralyzed from the thigh down (try to be ladylike, Christen). The anesthesiologist told me that if I “wanted more” to just tell him. I woke up a few times but my arms were strapped down so I tried hard to open my eyes a lot to get their attention… his voice “do you want more…” was eerie and soothing and I said yes, at least three times, that I remember. I did hear the docs talking, the drill, the music, but was not scared or bothered by any of it, I passed right back out.

I was gently woken up but couldn’t really open my eyes, and was moved back to the other gurney (surely not so politely this time) and was shivering with cold to the point of my teeth chattering. They wheeled me off to the recovery area, where I was covered with a giant paper blanket that they plugged a hair dryer-like thing into, and it poofed up and warmed me up right away. I was pretty stoned and comfy at that point. Once warm, they propped me up and urged me to consume some apple juice and crackers. The. Best. Apple. Juice. Ever. The sweet nurse Lina helped me get dressed and into a wheelchair. I have no idea how long I was in recovery, it was probably a lot longer than it seemed. Truly there was no concept of time from the moment I arrived at 8am until I was discharged just before 1pm. On the way out I had the bright idea to ask Lina to stop at the restroom… a wheelchair-accessible room with a nice nurse lady helping actually seemed better than what would surely be more difficult/humiliating once home with my husband. I was wheeled out a side door where my husband was waiting beside the car. That was the best part of it all. Yaay! It was over!

Smurf Foot, Day One:

(Note: I drafted an email version of this post to a friend yesterday in my Vicodin-induced haze… the above is much more coherent and slang/swear-free… it was a pretty funny read, I must admit).

Bliss Countdown

Today my girlfriend and I went to Bliss SF to get a fancy spa pedicure... I was having visions of a Hobbit foot once the bandages come off, so thought a lovely scrub/rub/polish/champagne (doc-approved) was the right pre-emptive approach and a good distraction as I was getting a little nervous about tomorrow.

Okay, so here's the Official "Before" Photo:

So I go in to the San Leandro Surgery Center at 7:45am Tuesday 12/1. The procedure starts around 9am or shortly thereafter, and I will be in recovery until 12-1pm. My husband will escort me to/from and get me set up at home. Wish me luck!

Pre-Op Visit

My doc scheduled a full pre-op visit last week to prepare me 100% for what to expect walking into surgery and the recovery plan. Upon arrival I received my "special" shoe and a shower-proof bag to keep my leg dry. And a ton of paperwork. I visited with the doc to review the X-Rays again, to review the game plan on the big day from check-in to anesthesia to procedure, and to learn about this very cool titanium implant that he may have to use depending on how bad the joint deterioration is once he "gets in there." We're hoping he won't have to use it, but there is a chance.

I'm told I will be non-functional for the first few days, but that he wants me up and walking around the house after that. I will be on crutches for a while and in that shoe for 6+ weeks (ew ew ew). After a week I go for a post-op visit to get new X-Rays and change the bandages, then at the two-week mark I have the stitches removed. At each visit we will gauge mobility/progress. I should be up on my feet (with crutches?) on Week 3. Hopefully driving at that time too.

When you read online posts or talk to people who have gone through this kind of thing they mostly say that recovery is much longer than expected and the pain is worse and longer-lasting than the doc tells you. I'm hoping that doesn't apply in my case and am opting to stay positive and believe everything the doc says. Really!

P.S. That orthotic shoe is awful - it smells so bad. I unwrapped it over a week ago so it could "off-gas" the fumes/treatments that were on it, and have soaked it with Febreeze a few times, left it in the sunny window, and put it outside for the day, but it just smells like chemicals. Bummer, as I have to wear it at all times for the next 2 months...

Ouch! Cortisone, the Calendar, and Google

I neglected to mention that Doc One administered a cortisone shot at my first appointment to see about taking down the inflammation in the joint. Man did this thing H U R T!   ER Pain Scale 7.5.  Whoa. The Doc suggested some ibuprofen and ice if it started hurting later... no prob. I went on my way running errands and and before long was howling in pain and noticing my foot swelling "through" my gym shoes. I got home and took a healthy dose of Advil and grabbed an ice pack and elevated for several hours. ER Pain Scale 8+.  I'm pretty good at dealing with pain, yet I was hoping this was as bad as I could expect it to get post-surgery.  The next day I was back to my normal daily pain level and wondered what was so great about the cortisone shot!?

To budget accordingly and determine my insurance coverage, I called the doc office to get the name of the procedure(s). And then I had the fancy doctor terms to Google about my surgery... "Hallux Rigidus," the "OsteoCure Plug Implant" (this thing is pretty cool, actually), "Austin Bunionectomy" and "Radical Cheilectomy." Hmm. Below are a few basic info links if you're interested...

• http://www.footphysicians.com/footankleinfo/hallux-rigidus.htm
  
•  http://tornierdx.com/osteocure/plugs.php 
•  http://www.aolhealth.com/conditions/big-toe-got-you-down-it-may-be-hallux-rigidus
  

I'd like to offer a disclaimer that "Google-ing" any medical procedure/symptoms/diagnosis can be dangerous if you are not a physician. And it can be gory, as search results don't include a warning like "this is a surgeon's page, not a patient's page" and you might just click on some graphic surgery images you really don't want to see.

I'm one of those "planner"-type people. I started the search on those terms to learn more about the recovery process and timeline. The surgery is one thing, but the weeks/months following is what I'm most anxious about.  I also wanted to figure out how much this is going to affect my husband and his schedule, as I'm really going to be relying on him the next few weeks. I am thankful for his support and preparation (and muscle strength, and patience of a saint) to help me get around during recovery.

What's the rush?
I opted to do the surgery right away, as I've been laid off for most of this year and didn't see job prospects suddenly picking up in December, aka National Layoff Month (I made that up), so will recover through the hiring-free holidays and get back to work early in the New Year. I also didn't want to start a new job and have to take  two weeks off for this for obvious reasons. The time is now!

I'd like to thank Via Spiga...

It's an honor just to be nominated, but to actually "win" foot surgery as a partial result of poor (read: fabulous) shoe choices? I couldn't have gotten here without the gorgeous ladies below...  Here are three of my faves that are on standby in my closet for the next six months until the swelling goes down enough for me to wear them again... with abandon!

(What kind of woman could have a pink blog site about a bum foot without including shoe pics?)

Diagnosis: Second Opinion

I had been favoring my foot in my yoga classes, where "toe tucking" is a basic action, and mentioned that I was having some trouble and would try alternate pose options until this surgery. Two women in the class stopped me on the way out and asked if I'd had a second opinion, and if surgery was really the way to go - their skeptical tone and urging prompted me to get a second opinion.
Second Opinion podiatrist was a very, very nice guy, funny and witty, and much lower-key than the first. I had two visits with him. In the first, he made what I called a "tape slipper" on my foot and told me to keep a journal for three days. Which I did. At first the tension it created, actually pulling my big toe to the left and allowing some air into the joint, felt pretty good. Though by Day Two the foot was still fatiguing while driving and basic errands, etc. and Day Three was completely uneventful either way. The follow-up on the fourth day included my X-Ray results (he referred to the one showing the bone spurs as "the money shot!") and offered the same surgery diagnosis and "some time in the next year or so" timeline as First Opinion. At that point I had to choose which doctor was going to do it.

I selected "First Opinion" doc to do the procedure. Somehow he just seemed a bit more intense and tuned in to it all which felt better to me than the friendly funny doc. And then I started asking my friends who'd had similar procedures a LOT of questions. And then I started looking it up on the Internet... yipes.

Diagnosis: First Opinion

So after years of throbbing feet due to, in my own assessment, making poor (read: fabulous) shoe choices, I got to a point with my right foot swelling and not fitting in shoes properly that I went to see a podiatrist. I truly thought he'd say "oh it's inflamed, here's a cortisone shot, wear flats, go on your way" or worst case, "you have a bunion, and we fix that by 30 min of using 'Yoga Toes' each day." What I did NOT expect was for X-Rays to reveal prehistoric-looking bone spurs on the first metatarsal joint (that's the big toe) and to learn that the spurs were restricting normal movement, had broken off and were jamming the joint, and that the 3mm-too-long first metatarsal bone caused grinding away of cartilage and normal joint formations. In short, I have filed away the good parts of the joint and had bad outgrowths akin to a spiked dog collar going around the perimeter of the joint. Very ugly stuff. I wish I had a copy of the X-Rays to show you!
My podiatrist, a very cool guy who clearly is into his job and what my films revealed, indicated that surgery is the best route for repair/recovery. That I didn't have to do it ASAP, but within a year or two at most, and that I was an ideal candidate due to my age and attacking this before arthritis and limited mobility set in with age.
So I walked out saying "OK, guess I'm having surgery," and scheduled a pre-op visit and surgery date of December 1, 2009.