Monday, September 24, 2012

Back to Physical Therapy!

I got evaluated by Physical Therapy on Friday, and I've been hurting ever since!

Basically I am only stretching. I am so tight after not walking for just those 9 days or so that I have to stretch my foot/ankle/toes back out so that I can walk correctly. Friday Dave spent time measuring my movement and stretching my foot, ankle, and especially my toes out. I got hooked up to stim with ice and then instructed to stretch (I was given stretches for my calves, ankles, and toes - my Achilles tendon is keeping me really tight) and to ice down at the end of the day, and two other times a day if I can. Also, I still can't do anything activity wise. According to Dave the progression is swimming, biking, elliptical, walking on treadmill, and then running on treadmill. Right now my incision is not all the way closed so I still can't submerge it in water, so of course I can't swim. I JUST WANT TO BE ABLE TO EXERCISE!!! I feel like a blob, and I am SO frustrated.

Over the weekend I tried to stretch when I could, but only remembered to ice one night. My leg is so tight!! I had a lot of trouble stretching out even. And the part that was the most sore? My toes! What?? Who has ever had sore toes before? It's a weird feeling.

Looks like I'll only do PT for 4 weeks this time. One of my main goals is to get back into a real shoe. Because my incision is still open I have to wear the post-op shoe for at least this week. Then I hope to transition into an open backed shoe soon. I'm nervous about it because it's really tender back there and the post-op shoe is really protecting it. So I am trying to be patient with this too!

Today I went back to PT for my first real session. It was very much the same as Friday. Dave moved and stretch my foot/ankle. Then he massaged my scar tissue around my the outside/back of my ankle and deep down to my Achilles tendon. OUCH! That hurt and I am still sore. It has to get better from here, right?

Even just doing this is incredibly hard and painful. Ouch!


Sunday, September 16, 2012

One Year After Surgery

Yesterday marked one year since my ankle surgery. This is a landmark I've been waiting for. It was supposed to be a marker that I could measure my progress by; but after having my second surgery two weeks before this anniversary, I've had quite the setback. I'm just starting to walk again after the second surgery and I'm having to go back to physical therapy, which I wasn't supposed to need to do. I'm ok with going because I recognize that I definitely need to get into PT - I'm not walking well at all. I'm just wondering when it will actually be that I can say "I'm better," or even, "I'm doing really well," when someone asks me. I'm definitely frustrated. But, I do recognize that most likely with more time (and lots more patience) I will get better. And maybe someday I will be better than normal and get back to real activities that I love - like working out (maybe even boxing again??).

When I get down about my ankle and the fact that I have been on activity restrictions for one and a half years now, I've gained weight, and in general my life has been put on hold, I try really hard to look on the bright side. There are people who have worse things happen to them, who aren't going to get better, and whose illnesses or injuries really permanently change their lives. The people I think of the most are our men and women in uniform. How many of them come back injured physically or permanently loose the use of their foot or other body part? And how many of them protect us, but are injured in other ways we can't see? These heroes are inspirational.

This experience with my ankle and having surgery, just like everything else I've been through in my life, is just part of who I am now. As a very wise supervisor would say, it's "woven into my tapestry." It's changed many things about me, but in the end there's nothing I can do about it, it's just something that happened. It's taught me many lessons, and I try to look at it the best way possible. I hope writing my story here helps my friends keep up with me, as well as gives others some hope that if you're going through something, keep going! It will get better! And I hope I've shared some of the hope and kindness I've been shown, as well as the lessons that have helped me.
I feel like I should have made a celebratory cake! One year since surgery!

First Week Back to Work

After getting my bandages off at my doctor's appointment Friday, I've been working hard on my walking. I tried to put my boot on when I got home, but it actually hurt even more because the boot makes your ankle stay in a 90 degree angle. So I chose to wear my post-op shoe instead - it was much more comfortable and actually a lower level that I would have graduated to in a week anyways. Friday I tried to start putting weight on my foot. IT HURT! I had to take lots of Advil and do it slowly. Ouch! Saturday I walked around the house using one crutch. I could not walk without the crutch, and it was pretty painful to put weight on my right foot. Mostly it was painful getting up and starting to move again. The more I tried walking on it, the easier it got. Sunday I finally graduated to not using the crutch! I did limited walking around my parent's house and my sister's house. I still could not walk up or down the stairs. In case you're wondering how to go up and down stairs when you can't walk, you crawl up on your knees, and scoot down on your butt. It looks pretty awesome.

Monday I went back to work. I wore my post-op shoe, and found a cute outfit to match. I was limping, but I made it through the day with some Advil and finding places to sit with clients while at the nursing home. I did not push any wheelchairs that day! None of my clients noticed my foot, but all the nurses did! Tuesday it was a little easier to walk, but I was still limping. Luckily I had mostly paperwork to do since I was admitting a client. However, my client was also moving to a new room and I ended up walking back and forth with her to keep her calm through the process. Finally I got her to sit in one place! Wednesday was another really long day and one of my clients needed to go shopping. I ended up walking all over Target with her. I have to say we were quite a pair - a 70-something year old woman who can't breath well and me limping around allover Target! This was the day that really did me in. Luckily Thursdays are our meeting days, so I had significantly less walking to do - a meeting and paperwork, plus a lot of driving with clients. But after the day before, when I got home, I had to go straight to bed to put my foot up and ice it. I planned to get up again, but I just couldn't. Friday I had already worked more than enough hours for the week, so I had a lighter schedule. Thank goodness!! I saw my clients, ended up pushing a few wheelchairs to take people outside to the garden to meet, but got to leave a little early when my client work was done and our paperwork system went down for over 2 hours... Efficiency at its best I tell you. But back to my ankle - by Friday afternoon I was so exhausted from working so much all week, after 10 days of not doing much at all, my body was DONE. I had to take a really long nap to even get moving again, and then I went to sleep that night ASAP.

I've been struggling a bit with how to wrap my foot. The doctor told me to put a Bandaid on it, as if a Bandaid would stay on a heel... So I've been keeping it wrapped the way Dr. Buchanan wrapped it after my appointment. I also am VERY nervous about all of the scary things that live in the nursing homes that I work in that could get into an open wound. I have been keeping my incisions wrapped and covered with multiple layers. The problem with wrapping is that I've accidentally wrapped it too tight a couple times. Over the weekend I have been experimenting with wrapping less and have finally gotten it down to two Bandaids! Going back to work I'm planning to cover it a bit more though.

Best news: After getting back into my schedule of massaging my other surgery scars with coco butter or Scar Zone, plus allowing them to get some air, my scars have gone back to being a beautiful soft pink color!!! No more ugly purple or bright red scars! YAY!!

I'm continuing to work on my walking and I go to see Dave at physical therapy to be evaluated on Friday. I can't wait to get back to walking normally! At least I am able to walk up and down the stairs now - one step at a time.

Friday, September 7, 2012

Post Op Appointment Disappointment

Well I was under the impression (thanks to Dr. Buchanan) that I was just going to walk right out of my post op appointment today like normal. I started to realize yesterday when I tried to put some weight on my foot that that was not going to be the case. And it wasn't. I've decided I'm going to stop listening to Dr. Buchanan's deadlines because he is way too optimistic for the way my body heals.

I got to the appointment and they took me back to be X-rayed. The nurse took off my bandages and they were feeling a little wet. Great. Apparently having the ice cuff on is the cause of this. For me it means my foot looks crazy (aka really gross). As if that craziness wasn't enough, when I looked at my scars from my previous surgery, THEY WERE PURPLE. Yes, purple. I was pretty upset about this because before surgery they were a very nice light pink, almost white! What's happening?? The techs took my x-rays and wheeled me into my room to wait. I tried moving my foot around a bit, but it really hurt. It has no range of motion and moving it in certain directions causes a lot of heel pain.

Dr. Buchanan came in and took off the last dressing covering my incision. He was happy with the way the incision was healing, and said that although it looks like "a tiny incision for the simplest surgery ever" that's not the case. Obviously the screw was causing a lot of pain and it's going to take a little time to heal. He wants me to go back into wearing my walking boot for the next week to protect the incision while it continues to heal. He also wants me to work on walking. He says I'm not going to damage anything that they did. (Yes, but it hurts!) I asked what happens if I fall or something since I currently have a hole in my bone. He says my bone is "like Swiss cheese" but it will heal itself and it's very unlikely that it would break. Also I have to go back to physical therapy. What?? I didn't think I was going to need to do that again! Ugh! Mostly it's just annoying because I don't have time for it. Dr, Buchanan seemed unsure why my incisions were looking so purple, but said it could be from it being wrapped and swollen, plus the "orange paint" they put on them during surgery. Ah! I hope they go back to normal soon!! So overall Dr. Buchanan was happy, but I was pretty disappointed.

On the way home I called to get into PT with Dave since he has an office in Herndon too, which is closer to my office. I can't get in for two weeks. But as Dr. Buchanan - and my mom - tell me, I already know all the exercises. So I guess I'm starting it myself. We also stopped by DMV to get my handicap parking pass. I didn't think I'd need it this time so I hadn't gotten one, but since I can't currently walk without an assistive device, and it's unclear when I will be able to walk on my own for a bit, now I have one again. It is very convenient.

So for now I'm walking in either my post-op shoe or boot with either my walker or crutch. It hurts. It feels almost like it did first walking after the first surgery. THAT HURT SO BAD! It was like a broken bone was walking on the ground with no padding - and that's pretty much what was happening. This feels almost as bad. I accidentally tried to take a step without my crutch earlier and I fell over in pain and from weakness.

I am in pain. My foot hurts and now my shoulders and arms are hurting after all the work they've been doing. But I have been off my prescription painkillers for about 3 days now, which is good news.  And I haven't taken any Advil today, which is my own fault. We have a rule in our house if you are in pain: you are not allowed to complain unless you've done something to try to fix it. It started with my mom and now we all do it - if you start complaining she will ask you, "Did you take something for it?" if your answer is no, she tells you, "Then I don't want to hear about it." So I'm off to take some Advil now. If I'm still in pain later, I'll let you know - because I'll be allowed to say something about it then.
It looks yucky enough from here - you should see the bottom. You can still see the "yes" and doctor's initials on my leg. Bleh!

Monday, September 3, 2012

Recovery Part II

My recovery from my second surgery is going well and is a lot easier than the first time. For one, I am definitely in less pain than the first time. After my first surgery I had some heavy duty painkillers that could be taken every four hours. After three and a half hours it would have worn off to the point where I was crying and doing everything I could to make it until I could take another one (only icing and talking to someone to be distracted helped). Eventually the doctor's office let me take more meds, which just made me sick to my stomach. I couldn't sleep through the night without waking up from pain and I couldn't get in a comfortable position to sleep in for weeks. This time is way different. I am still in a deal of pain, but it feels manageable this time. I have Vicodin for pain which, while still a heavy painkiller, is less than I needed before. (I can't think of the name of what I had before, but it required my license to be checked to pick it up at the pharmacy. Vicodin doesn't.) And while I can take it every 4-6 hours, I am only needing it maybe every 5, and made it most of today without taking more. The biggest difference I noticed was that I slept through the night since the first night after surgery. YAY!! Maybe it helps that I've done this before and I know how to arrange my pillows, or that I just had a screw removed with one small incision instead of my ankle reconstructed with four huge incisions, but I have less pain and I can sleep, so I am happy!

Sleeping is actually the main thing I have been doing. I've been getting dizzy (I think from meds) which makes me nauseous if I don't go to sleep. I have an antibiotic that has to be taken twice a day on an empty stomach, and Vicodin that needs to be taken with food so my stomach doesn't get upset. Who decided that was a good idea? It's hard to fit everything in. But other than meds, everything is going well. I'm a bit weak. I'm staying in my bed, watching TV or sleeping, and just taking it easy. But sometimes using my iPad or computer for too long makes me dizzy. I'm honestly a little bored because other than my foot, my body feels fine, so it seems like I should just be able to get up and do things.

My sister asked me if I could tell if my foot felt better yet. Basically my foot feels like someone removed a giant screw from it. It hurts! So I think it's going to take some time to heal after this surgery and be able to tell if it's helped. I'm ready to be patient with my body this time.

My arms and my abs have been getting a great workout too. Between walking with my walker, to getting around my room and to the bathroom, my arms have been working hard. And my abs are the other thing that hurts - I think they're working really hard to pull me back into bed or keep me moving forward with my walker. Because I am actually an 80 year old woman and use a walker...

I am off work the rest of the week to continue to recover and rest. It's especially hard since my job requires walking and driving everyday. I also push people in wheelchairs most days. And I do all these things while carrying my own bag, water bottle, notebook, etc. I'm also at risk everyday of being attacked by a psychotic client - it's one of those things that they don't mean to do, and it doesn't happen that often, but it doesn't seem like a good idea to do my job when I can't get away from someone who tries to grab me if I needed to. My post-op appointment with Dr. Buchanan is on Friday, and I should be good to go after that. I actually can't walk even on my toes right now because I chose to have my ice cuff put into my bandages after surgery, instead of being put in my post-op shoe. Friday I should graduate to the shoe. Fingers crossed!

Hooked up to my ice machine. Still one of the best purchases ever made!

Second Surgery

I had my second surgery on Thursday and it went really well! My mom and I arrived at Woodburn Surgery Center just after 11am, I got registered, and then they took me back pretty quickly. I got changed into my fashionable hospital gown and accessories (read: awesome socks with anti-slip grip), and they went over my medical history again (seriously this was like the 5th time). The first snafu came when they tried to put my IV in. My veins are always hard to find, but not being able to drink any water since the day before wasn't helping the nurse find them any easier. The only place she could put it was in my wrist. It looked uncomfortable, but they numbed the area, so I really didn't feel it until later. (Later trying to walk with my walker my wrist has been really painful).

Just before surgery Dr. Buchanan came out, went over what they were going to do today (take the screw out of my ankle to eliminate pain) and what to expect, and initialled my leg that was being operated on. This is one of the weirdest things to me - I know they want to get everything right, but when I have to write "yes" on my leg and the doctor has to initial it, it's just so weird! The next snafu was about my antibiotic. I am allergic to the antibiotic that everyone usually gets before surgery, so I have to have a different one. Apparently this is the same antibiotic I got last surgery as well. However, last time I didn't start getting the antibiotic until I was going under for surgery. Apparently this antibiotic can be "caustic" and getting it a little earlier this time meant that I felt it burn a little going in. Luckily I was taken back to the operating room pretty soon thereafter.

I walked back to the operating room with my nurse, who carried my IV bags, and I got on the table. The nurse said that as I lay down on the table my eyes got really big. Yes! They probably did. That was when it really hit me what was happening, but I wasn't nearly as nervous as last time. This couldn't be as bad! But sadly I knew walking into the operating room was the last time I'd be walking on two feet for a bit. It was very cold in the operating room, and all the doctors and nurses were very busy. I was aware the anesthesiologist gave me something in my IV that calmed me down. And after that I don't remember anything until I woke up in recovery...

When I woke up in recovery this time I wasn't crying! Victory! Funny story - my nurse in recovery, Wanda, remembered me from last time and how much I was freaking out when I woke up. Oops! hehe But this time I was ok - I was very calm. Until the next snafu - I suddenly began itching so badly! I was under anesthesia less than an hour total, so my antibiotic was finishing up in my IV. We think it was an allergic reaction to the antibiotic. It started with my scalp and was moving down my body. Wanda said I had a read line across my forehead. They helped me get my stylish surgical hat off, prepared Benadryl, and got the anesthesiologist while I scratched my head like a crazy person. The doctor came pretty quickly and gave the order for a half dose of Benadryl, since they were trying to wake me up and Benadryl was going to put me back to sleep. God bless IV's! The Benadryl worked right away. It stopped my itching and only made me a little sleepy. I drank my water and ate a couple crackers and they got my mom to come in. They brought my screw out to me and brought me a bag to take it home in. WHAT?? Thanks for cleaning it up, but I don't want that screw you just took out of my body! I took a good look at it - it was black and pretty long, maybe 4-5 inches? It looked like a normal screw. And then told them, "No thanks!"

I got a Vicodin for pain and ate some graham crackers and ginger ale with it to make sure my stomach was ok. Then it was time to go over instructions and get dressed. They got the wheelchair to take me out and before leaving I embarked on my first adventure on one leg - going to the bathroom! I remember this being the HARDEST thing to learn to do last time! Wanda helped me in and offered to stay and help but I knew I could do it myself. This time I was more prepared. I think my left leg is a lot stronger and prepared to do everything itself this time. I did it! Wanda continued taking me out to my mom's car and helped me in. Before we left Wanda told me she didn't want to see me back there again - unless I was there just to visit. Ok Wanda. I'll try!


This was the best my veins could do today. I was numbed at the time, but my wrist still hurts today! Owie!

Going home!