Injury Timeline

Sunday, October 25, 2015

The Return of FrankenFoot

It's been a little over a week since my hardware removal surgery.  Recovery has been great actually.

Yesterday, I was allowed to take off my dressing.  It revealed a slightly swollen foot, with two new incisions (one on the top on my foot, the other along the side/bottom).  Overall, it did not look that bad.  The sequel is never as good, I suppose.

My incisions are a little sore still.  I don't like the prickly feeling of exposed stitches. When the blanket touches them in the bed, I want to just pull them out.   I technically should be waiting until next week to sleep with my boot off, but I am cheating a little.  Shhh!!!  The doctor originally said that there wouldn't be any stitches on the bottom of my foot, but when I took off the dressing it appears there are stitches there.   Also with a lot of dried blood on my foot, so I'm guessing the removal of that pin didn't go quite as smoothly as anticipated :)

I've been allowed to start putting as much as 50% of my body weight on my right foot!  I am slowly phasing out the scooter.  I am only using it when I a) need to get somewhere fast (midnight potty runs) or b) if I need to carry something in my hands.  Otherwise as much as possible I am using my crutches.

I went to physical therapy on Monday, and Stephanie taught me how to get the weight ratio right.   It's a bit tricky to get, but we started out with a scale and a book.   First, I had to figure out what my weight was, and thanks to surgery last week I knew the number. She marked half of my body weight on the scale with a green sticker.  It wasn't a digital scale, it was the kind with a needle.  I stood on the book with my left foot so that I would be level with my other foot, since my boot makes it slightly uneven.  I slowly started to put weight on my right foot, which was positioned directly under the scale.  I started switching my weight back and forth between the book and the scale, and the goal was to hit the green sticker every time to hit 50%.  I did this for a few minutes, to get used to and comfortable with the weight.  Then, she had me close my eyes and repeat the exercise, to see if I could hit 50% without looking.  After a couple of tries I was nailing it pretty well!

Then I started to walk with the crutches around the room, learning to walk all over again.  Starting with all the weight on my heel, and then kind of "roll" my foot so the weight then gets pushed through the arch, then the ball, and then the toes.  I had to take small steps.  How did it feel?  It wasn't painful, but uncomfortable.  The best way I can describe it, is that it felt like when your sock is kind of bunched up in your shoe right underneath your arch.  That pressure you feel on the bottom of your foot, kind of crampy and a bit achy.  I thought it would hurt more quite honestly, but with the help of the Superfeet arch supports my doctor recommended, it wasn't bad at all.

I worked on some additional exercises before she sent me home, which included some squats, a session of 5 minutes on the Total Gym doing leg presses, and balance work on my right foot.  I actually was sweating pretty good, and it felt great!  My foot was definitely sore after all that, but it was the first time I'd used it in 112 days!  Wow.

Next week, I'll start 75% of my weight, and go down to one crutch, after my appointment at TOSH to remove my stitches.  I also was told to bring a shoe to my next appointment.  A SHOE!!  She told me to get at least a half size or a full size up from my normal size.  Between the insert and swelling, my foot probably won't fit into my normal shoes.  There are constantly just left shoes laying all around the house so I hope that starts to change.

As I left my appointment, she brought my scooter over, and I was like "Hell No!  I'm walking out of here!"  And she just looked at me and said, "OK, but don't over do it!"  I got that mischievous grin on my face when I know I'm about to do something I am not supposed to.  So, Nate rode the scooter out to the parking lot while I crutched along.  We got a lot of weird looks.  One guy stopped me and said that it wasn't right!  Haha.

It feels great to start walking again, even if it's heavily assisted on crutches.  It feels impossible to walk barefoot.  I don't know when I will be able to do that again, but I don't want to attempt it any time soon.   From what I have read on other blogs, that may take a while!  For now I am just happy I can have two feet on the ground.

Thursday, October 15, 2015

Surgery....Take Two

I had my second surgery on October 13th, two days ago, to remove two pins from my 4th and 5th metatarsals.

I went in for my 12 weeks check-up appointment (it actually was 13 weeks but who's counting?) to see Dr. Van Boeurm at TOSH.  It was standard procedure, I was taken back to the exam room, whisked off down the hall for x-rays and back to the exam room to wait for the doctor.  Getting to be an old pro at this, really.  While waiting, I could hear my doctor on the phone arguing with LDS Hospital.  He apparently had ordered an MRI for one of his other patients and even though the order requested an MRI for the whole foot, they only did half of it.  He was pretty upset.  I felt bad for the patient, because he'd come in to TOSH to review his MRI with my doctor but now couldn't see him because of the mix up.  He was limping around the office too, so I can't imagine how frustrating that would have been.

I soon saw my doctor and he reviewed my x-rays.  All looked good, so he confirmed that we were on for surgery the next day.  He must of read my chart wrong, because he said that after surgery that I would be put back in the boot and continue non-weight bearing because protocol is 12 weeks from the procedure.  I was like HOLD ON A MINUTE!  It's been 13 weeks!  And then he reviewed the chart and confirmed I was correct.  He instructed me to make an appointment with Stephanie (my physical therapist) on Monday to start weight bearing at 25%!  Wahoo!  I asked if I could put weight on the foot before seeing Stephanie, and he said if I could figure out how to get to 25% by using the scale, he was fine with it.

I had my last meal, La Luna Mexican and Froyo from Yogurtland.  Quite unexciting, but it was delicious.  I called the surgery center and was told that I needed to check-in for surgery at 11:30 at the hospital.  My previous surgery was at 9AM, so I thought this was a little late and it would suck waiting that long to eat or drink.  Within the hour, a nurse called me back and said that there was a last minute change to the surgery schedule and that I'd been pushed back to 1PM.    1PM?!  That was really going to suck.  Also, my husband is going to a Java programming class Tuesday - Thursday nights + Saturdays.  I was hoping that he would still be able to go to school once he got me home from surgery but this would be cutting it close.

I also hadn't clipped my toenails since the injury.  I just let em grow.....  It totally scared Nate.  But I finally clipped them before surgery, the last thing I did on Monday night.

I got checked in, mostly on time.  They took me back and got my vitals.  Several things upset me.  I haven't had access to a scale in almost 3 months, and I used to weigh myself everyday.  I couldn't really get up on the scale anymore by myself so I just stopped weighing altogether.  I still was tracking my calories everyday on MyFitnessPal, and my exercise calories (which I burn about 600 per session, 4 times a week.)  I thought I actually may have lost weight through all of this, but nope!  I hopped on the scale to see I had gained almost 15 pounds.  I'm not quite sure how that is possible; I've definitely struggled with my weight in the past leading up to the injury but I didn't see this one coming.  I'd been going to a nutritionist at St. Mark's Hospital for almost 7 months prior to my injury and we still could not figure out how to get my body to lose weight.  So that was kind of like a dagger in my heart.  Then, the nurse took my vitals.  My blood pressure was way high.  I'm normally about 110, and I was over 140.  Then, she said my oxygen was low and my heart rate was too high (I was at 134bpm just sitting in the hospital bed).  Ugh.  What has my body done to itself??

I saw my head nurse, Laura, who went over all of my paperwork and medication history with me.  She also started me on an IV of liquid Tylenol.  Dr. Van Boerum and some of his partners believe doing this before surgery helps with dulling the pain receptors and can be beneficial in minimizing post-op pain.  That's kind of cool.  I also had to kind of explain a lot about how my NuvaRing works, so that was kind of embarrassing.  She was trying to get a gauge on the last time I had taken all of my medications and when we got to NuvaRing it became quite challenging.  I don't take it.  I put it in my vagina, and then I take it out of my vagina.  The End.

There was a whiteboard up this time with all the names of my various doctors.  Helpful, because last time they just all got called Ashley.  My expected surgery time was now 2:50PM.  Do they KNOW I haven't eaten since midnight last night?  Yes, they knew.  I asked.  Mega bitch was starting to emerge in all her glory.

I met with my head nurse, my admitting nurse, my OR nurse, and then finally my doctor.  He had me right "Yes" on the foot that needed to be operated on.  He also explained how he would be removing the pins.  The pin on the 4th metatarsal would need an incision about an inch long and a couple of stitches.  The pin over my 5th metatarsal (the one going vertical and I can feel it sticking out on the bottom of my foot...gross) was being removed in a much more barbaric fashion.  He said that basically they were going to put pressure on the skin around that pin until it popped through, then they would just pull it out with the pliers.  Why tell me that lol?  The good news is I won't need stitches for that method, it'll just literally be a poke hole.

 It felt like we waited FOREVER.  We were watching hospital TV and every damned commercial was for pizza, or sandwiches or buffalo wings.  Blergh!!!  Nate was playing the role of supportive husband, so, he also decided to fast right along with me.  I pleaded with him not to do it; no reason for us to both be cranky bitches.

Finally, it was time, around 3:30.  The last person to see me was my anesthesiologist.  He pumped my IV with "relaxation drugs", I said goodbye to Nate and off we went in my wheelchair down to the surgery room.  It was just as I had remembered, freezing cold.  I hopped up on the surgery table, they strapped me in and my anesthesiologist put an oxygen mask over my face.  He told me to take some deep breaths, and assured me that it was just oxygen.  That's the last thing I remember.  Was it really just oxygen?  Probably not, that bastard.

I woke up in the recovery room, to very minimal pain in the foot.  I felt pretty anxious though.  I have a really bad case of panic disorder which is mostly controlled, but I think they just had me on so many drugs, I felt like I do when I feel a panic attack coming on.  I was also thirsty, so the nurse brought me a cup of ice cold water.  I didn't stay in recovery very long, within a few minutes they brought Nate in, and within a half hour I was discharged.  They delivered my prescription pain meds to me bedside (nice!) and the nurse told me I should be good to go for a while because they'd given me a full shot of morphine right before I woke up.  Sweet.  But also not sweet, because I was super anxious.  But not in any pain.  The nurse gave me some Lorna shortbread cookies as we wheeled out to the car.  It was 5:30 now, and I knew Nate was not going to make it to school.

On the way home we got McDonald's and ice cream!  I was so excited to eat.  But I had to take it really slow so I didn't puke it back up.  I also immediately came home and started drinking my "poop juice" (aka Metamucil) because I remembered how horrible it was from the last surgery.  I settled in the my bed/nest on the couch and just drifted in and out of consciousness for the next few hours.  We are currently marathoning "Heroes" and I think I may have missed an episode or two.

So far, recovery hasn't been that bad.  It is different from the first surgery for sure.  First of all, this surgery took approx 40 minutes, where as my first surgery was almost 3 hours.  I only needed a light amount of anesthesia to keep me out during the procedure and it was not as deep as it was before.  I was not groggy for very long after waking up.  I also had been freaking out about pain.  Right before surgery my doctor said that if I rated the first surgery pain as 80/100 (which yes, it was the most painful thing I've ever experienced) than this surgery would be somewhere around 4/100.  I still expected a lot of pain, but when I woke up, I didn't really feel much.  After the morphine wore off, my foot started feeling pretty sore, so I took a pain pill or two and it was cleared right up.  I think the most challenging parts of surgery #2 are not pain related.  I have a whomping headache, brain fog, fatigue, nausea... all of that fun stuff.

So, I'm pretty excited about all this progress.  I get to meet with Stephanie on Monday for a weight bearing session.  I was also instructed to by my doctor to get these shoe inserts (Superfeet) for arch support when I start weight bearing in the boot.  He says they are the one of the highest quality over the counter inserts you can get.

Thursday, October 8, 2015

The Final Countdown

It's less than one week until my surgery!  I've just been trying to keep myself distracted and hoping that the time passes quickly.  I've already done my pre-registration and pre-admissions prep & paperwork, so all I need to do is show up on the 13th with an empty tummy and a urine sample.  Because again, I need to prove that I am not pregnant!

I do have an appointment on the 12th, which will be my final check up.  I am actually 13 weeks post-op, and the plan was to have this surgery at 12 weeks, but my doctor was out of town last week.  He will take some x-rays and validate that enough healing has occurred to remove the two pins going across the 4th and 5th metatarsals, which are holding the cuboid and cuneiform bones in alignment.  I will still have the screws over my 1st and 2nd metatarsals and in the plate on my navicular.  I will need another surgery in about a month to remove those, unless something changes on Monday at my appointment.

I'm so ready for this surgery.  Words can't explain how done I am with the NWB and scooter life.  The past 3 months are about to be behind me for good!

These days, I feel like everything hurts BUT my foot.  Mainly on my left side.  I still have pain in my left ankle that I sprained in the fall, but it's not nearly as bad as it was.  It feels like it might be getting better, but the progress has been really slow.  I've also got this really annoying pain in my left hip.  It's sore all of the time now, and it feels a lot like my IT band at times and radiates around my pelvis and glutes.  I no doubt have been putting a lot of strain on my left side and it has had to overcompensate.  I am balancing all of my weight on my left side a lot, like when I stand still on my scooter, or when I am hopping around unassisted.   I hope that is what has been causing that pain, and I hope that when I start to walk normally it will work itself out once the muscles are being used as they are intended to.  I'm just trying not to worry about that right now, and just get myself healed from the next surgery.

I'm not entirely sure what to expect from a hardware removal surgery.  I've read other blogs and talked to others who have had it, and it seems like everyone is different in the healing process.  I know that it won't be nearly as painful as my initial surgery, but I'm still being put under anesthesia, going under the knife and getting stitches.  It will take about 10 days before I am healed enough to have the stitches removed, and be allowed to bear weight.  I'm curious how my body will respond to this 2nd surgery.  I know the 1st surgery was much more traumatic, but it was pain like I have never experienced in my life!  Once the pain subsided, I got horrible dizzy spells for a couple of weeks after, and standing upright for any length of time resulted in waves of nausea and feeling faint.  I'm hoping that doesn't happen again.  I also ran out of energy really quickly.  Simple tasks of showering or going to the bathroom felt like massive feats.  So, I guess I'll wait and see this time around.  Luckily, I have some banked sick time at work!

The Utes are getting ESPN College Game Day this weekend for their game vs. Cal, and I have every intention of tailgating and going into the stadium again!  This could very well be my last game as a gimp.  There is a game next weekend, but I have no idea how my body will be reacting after surgery and if I'll feel well enough to go.  If I'm still taking pain meds and/or getting my dizzy spells, I am making the smart choice and parking my ass on the couch!   Also wait and see.  If not, we have another home game on Halloween and I'll be for sure ready to go by then!  I've even got my Halloween costume picked out, and hopefully I'm able to walk by myself, even if it is in a walking boot.

Nate's been lecturing me about not trying to push it too much while I am on the home stretch.  I was working on my pull ups the other day; I've pretty much lost all of my gains there.  I was telling him about it and explaining how I had to kip up to get any leverage.  I got a nice "talking to" about not kipping and how our marriage might just be in jeopardy if I managed to injure or break anything else just weeks away from being healed.  I did listen to him (a little).

Surgery is so close, I can almost taste it!  I wonder what surgery tastes like?  Probably like copper.