Injury Timeline

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.

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