3 Days P.O.

Its amazing how much you focus on your pain when you don't have very much else to do.  This morning it was all about my toes and how sore they were until I was offered the prospect of my first shower since Thursday (its Sunday in case you weren't keeping up).  For the last half an hour or so its all been about mobilizing the wash gear and the fun leg bag to keep my cast dry and the towels and everything else.  I have just managed to get back into bed and my foot/lower leg aches like hell but at least I feel clean.

We did a bit of a cast removal this morning for cleaning purposes.  The main pain I'm having during cast removal at the moment is caused by the re-routed tibialis posterior tendon.  Because this is obviously used to holding my foot upright in position and has been moved around, trying to hold my foot upright in position unaided is a bit of a challenge and makes both the removal site, and the re-attachment site, hurt.  Secondary pain is caused by blisters which I'm told I have underneath my 2nd, 3rd and 4th toes.  I got some quite impressive ones last time I had this done so their presence doesn't bother me but they are a little irritating!

Blisters on toes 2, 3 and 4.  If you're wondering where it is on 2 its basically the WHOLE toe!

2-full Days Post-Op

Did my customary Saturday leg swing today.  After being rested in an upright position for two full days in a row my new surgical sites did not appreciate being lowered to below the knee height.  Blood rushed to my foot causing some considerable, but bearable pain.  Since I was still taking some considerable pain medication I didn't manage to walk anywhere but it's set me up for my next piece of recovery advice.  For this stage post-op I have found it best to lower the affected leg over the side of the bed about once every 20-minutes/half an hour or so and lift and lower it using your thigh muscles.  This lets your thigh get used to the extra weight of the cast and lets your new leg get used to the blood flow.

Pain currently at an all time low, probably around a 3.  Not improved by the current set of nurses who are extremely patronizing and still insist on trying to make me wiggle my toes and, despite my yelps of pain, poking them!  I suspect if I still had the adorable ladies from this morning I'd be on a 1 and be less annoyed!

2-ish Days Post Op

A little toe pain this morning,  Not assisted in any way by the rude and abrupt on call team who dashed in and asked me, in an extremely patronizing manner, to wiggle my toes.  I pointed out that they had pins in and were not really wiggle-able and was then asked, in an even more patronizing manner, 'not even a little bit?'.  I honestly don't know where they get some of these people.  Since I could not produce sufficient wiggle for Dr Rude I was poked quite stiffly on one of my toe knuckles, which have lovely stitches in them and don't appreciate being poked and so this elicited a nice gasp of pain from me.  This obviously wasn't enough for the sadist nurse who was accompanying Dr Rude because she then yanked the dressing down further and poked a different toe producing a yelp loud enough to be heard by the staff nurse who came in after to give me clean sheets and sympathy.  I'm thinking of getting a sign put above my bed saying 'No I can't wiggle my toes' to save me time!

Other than the slight toe pain the nerve block appears to be all gone so I can lift my leg and move it around quite happily now so I'm hoping the physio will be in for a bit of morning practice with some kind of walking aid....not the zimmer frame PLEASE not the zimmer frame...

1.5 Days Post-Op

Into surgery around lunchtime (12) yesterday and out by around 3pm, so relatively short.  Quite a lot of immediate post-op pain but since this is the second time I've done this I can say it varies between surgeries.  Last time all my post-op pain hit first thing Friday morning, this time it was as soon as I'd woken up in recovery.  This is, of course, the best place to get post-op pain where all the doctors who recently operated on you are close at hand with anaesthetists and batteries of drugs.   I was given both popliteal and femoral nerve blocks and was informed the popliteal one (immediately behind the knee) may not have worked as well as it could have done!  Needless to say I was whisked away into oblivion fairly swiftly by the wonderful anaesthetist and his array of syringes and with the exceptions of a number of awakenings to check my blood pressure during the night I slept rather soundly

I call this 'Foot in Cast' - First time I could use the camera after the drugs!

This morning bought a revelation in the form of Mr Cooke who said he has taped some of my surgery for teaching purposes which was rather exciting.  They have changed the manner of lateral calcaneal osteotomy entry to make the initial incision much smaller.  This has resulted, for me, in considerably less post-op bleeding from the heel but it means all my pain was focused much more in the toe area.  I have, of course, requested the video which I may post here if possible.

Because all my post-op pain was yesterday it meant I could get my dressings changed first thing this morning, something which didn't happen last time until the Monday morning.  I am still short a camera connector but will update with pictures soon.  Everything looked extremely neat and while there was a little oozing it was largely happy, I suspect I was too early to witness any significant swelling but have noticed throughout the day that my cast has got snugger and snugger so I suspect I'm quietly puffing up as we speak!  Fortunately the cast system has changed considerably since I was young and we're no longer on the fibre glass plasters but rather a nice flexible resin-type affair with removable straps across the front so I can open it up and have a good calf scratch should I wish to.  It also saves time when it comes to the stitch removal because I can just pop it on and off for the local nurse.

So at 1.5 days post surgery I ache a lot below the right ankle but on a scale of 1-10, where recovery yesterday was most definitely a 10, I would say we're only on about a 6...which, with the PCA pump, is completely manageable so I will now try and get some kip in before someone desperately tries to take my blood pressure again!

Car crash with just the plaster off...

Slightly better with all the bloody dressings off...

Considerably better after a good clean!

Here we go...

Morning all.  So today is the first day of my blog letting you in to all the ins and outs of having surgery to correct some of the foot problems caused by CMT.  I will attach some pictures of my foot as is as soon as I find the connector to my camera so you can see the before, during and after picture of what goes on.

Today I'm in for a whole load of tendon and heel shifting.  If you're interested, and don't mind fairly gruesome surgery pictures, checkout www.footsurgeryatlas.com and search for 1) Jones Procedure; 2) Tendon Transfer for Foot Drop and 3) Calcaneal Osteotomy - The Lateral Approach.  Having had a chat with the surgeons this morning the latter procedure has been recently modified so they can now do the whole thing through a really small incision which will be exciting.

So all I have to do now is sit around and wait for the next few hours until I get called up at which point I will add the updates that I suspect you're all here for...pain and pictures!

Just so we're up to date before we start though, here is what my foot currently looks like:

Date...

Sigh.  So despite the original 'we must do both within 6 weeks' line taken by all concerned the super-duper surgeons are not available AT THE SAME TIME until the end of July, so my next surgery will be the 28th unless they get a cancellation before (unlikely).  While I am now appreciating the fact that my left foot will be fully functional by the time my right one is done I'm not loving the whole mismatched feet thing...my current problem being that none of my old shoes really fit my new foot that well and I can't shop for new shoes until I find out if the second foot will be the same size!

To cure this I have resorted to purchasing an incredibly cheap pair of those sloppy ugg fakes that would fit ANYONE.  This may have been a mistake.  1) it's summer and 2) they're cheap.  Hot weather plus cheap furry boots equals lots of sweat.  I'm sure I don't have to draw you a picture, or even send you a smellogram.  I do, in fact, have one pair of Birkenstocks that vaguely fit my new foot, however, because of the curliness of my old toes its now sore to wear it on my old foot but not my new foot.  This is so complex.

Anyway, 5 weeks and counting...

Stitches out!

Yay - the stitches are finally out!  Took around an hour, the nurse and I didn't count them but feel in retrospect that we should have considering how long it took.  Definitely at least 5 per toe plus a good row on the heel and the first metatarsal and a few carelessly scattered ones around the ankle.

The whole thing was still very puffy so it didn't look that great but I was reassured once more by the nurse that this is perfectly normal, it has been only two weeks afterall.  However, it spurred me on into some cleaning action.  One of my first jobs when I got home was to go gently over the whole area with some cleansing wipes (the Simple ones from Boots) which took off some horrible coloured gunk!  I allowed the foot 10 minutes or so of breathing time during which I did my best to gently massage things to encourage the flow of stuff back up to where it should be.  I finally applied a layer of Bio-oil to those scars that looked the neatest and let it gets some air for around 20 minutes.   While I haven't managed to reach the heel yet that is my task for later in the evening.

Overall feeling a lot more comfy now all the plasters/extra bandaging has come off although not necessarily happier with the look of the thing!  Soon, I'm sure, it will look like a beautiful foot.  In the meantime its back to some weight bearing exercises...