5 Weeks PostOp - Neuropathy

So yesterday was the 5 week mark since my surgery. Everything (except my nerves) seems to be healing well as far as I can tell. I am down to the last 10 degrees in my boot and set to be at neutral at week 7. Incision looks decent, and swelling is under control (more during the day, quickly subsides with elevation/ice).

I am having one problem that is, honestly, debilitating. Quick recap: had a nerve block during surgery that was supposed to last 1-3 days. It ended up lasting about 15 days before it began to slightly wear off. Doctors assured me it was ok and that some people just take longer to rid of the anesthesia drugs from their system.

After it began wearing off I went from sensations of pressure and pins and needles, to now having constant 24/7 burning and stinging pain in my toes (mainly big toe) and the ball of my foot. I do also have the numbness along the side of the foot from the sural nerve being irritated but there’s no pain there or burning, just numbness and it doesn’t bother me much.

But man, my toes and foot. This is the worst pain I have ever experienced. It has last about 1.5 weeks now. It is debilitating and is giving me anxiety becuase it doesn’t take a break and I can’t sleep for more than 30 min at a time and that’s if I am lucky. I literally stay up all night just doing breathing exercises to try and get through the pain and discomfort.

Taking hydrocodone (norcos) and anti-inflammatory is doing absolutely nothing to help. As soon as my brother can take me today, I am going to urgent care to see if I can get some cream or any kind of temporary help until I can see my surgeon this week (hopefully tomorrow).

Has anybody experienced this kind of nerve pain in the toes, foot, or anywhere? How about at this stage of 5 weeks post op? If anyone has info or feedback you would be helping me tremendously. Anesthesiologist and Surgeon assure me this will go away but I can’t help being afraid and also knowing I cannot deal with this pain for months as I have read it could take up to a year for nerves to heal.

Anyone have suggestions for my urgent care visit today? Should I ask for any certain meds or creams? At this point I am more anxious to rid of this nerve pain than I am to start walking, just horrible. I hope for my sake someone here has dealt with this, but I also hope for the sake of their sanity nobody had to deal with this pain..

3 Weeks Post-OP Update

Hi everyone, today is exactly 21 days post-op for me and things are going as expected. For obvious reasons, I haven’t spent this much time at home in my entire life. But I remember working 60 hours a week and wanting little more than a full day spent at home so I’m taking it in stride. Always good (hard) to keep perspective.

First two weeks, I elevated 23 out of 24 hours a day. The other hour was spent using the restroom, showering and scooting around for food. Reading through a lot of the experiences on here, I realized I am lucky to live on a first floor apartment with no stairs, and hardwood throughout so I can ’scooter’ around easily.

This past week (week 3) I began ROM exercises with the boot off about 5 times a day, as well as working on the rest of my body to stay somewhat activated and loose - stretching, multi-directional leg lifts, isometrics, etc. Still elevating and icing about 18-20 hours a day.

I think at this point I will begin reducing my elevating hours and increasing my mobility. This week I plan on crutching around my complex everyday for the sake of a workout. I will also hit the gym every so often to work on upper body and core strength and flexibility. Whatever I can do either on the floor or the stationary machines.

At the week 4 mark, I will be able to start swimming. My wound is healing very well so far and I can swim in the vacoped boot (have an extra liner to change and wash). In no circumstance am I going to remove the boot, especially around the pool. The dangers seem obvious. I am lucky in tate I have multiple swimming pools in my complex and one indoor that isn’t warm, but surely not as cold as the outdoor pools. I will be taking advantage of this for sure.

Also have a gym in my complex with a seated recumbent bike and multiple spin bikes. When did you all begin biking and how so? I have read a lot of people using the spin bikes quite early? Leaving my doc an email to ask but usually takes 2-3 days to hear back.

I begin PT on January 23rd, which would be 4.5 weeks after my surgery. I am happy about that as my surgeon said he usually doesn’t send patients for PT until week 7 or 8, but he’d refer me sooner since I wanted that. I know early manual therapy, scar tissue mobilization, and other therapy techniques will be very beneficial to me. PT is still a concern for me because I have Kaiser insurance. From my understanding, I won’t be getting a dedicated therapist to guide me through the whole process and manage my progress, but rather I will go in and work with whoever is there that day. Seems like a terrible plan to me, how are we supposed to come up with a game plan, get to know the patient, monitor progress, etc?

So, I am going to have to pony up out of pocket for a good sports PT. I know a group in town that works with professionally athletes from all sports, I am going to book a consultation this coming week. I know PT is critical, and I don’t want to be treated like any random patient when my goal is to get back as close to my pre-injury levels as possible, whatever that may be. Will keep you all posted on this.

In my younger days up until about 22 years old I had chipped bone on the medial malleolus multiple times and srained the ankle multiple times. After an incredible therapist fixed my imbalances I stopped injury the ankle and had not hurt it again in 8 years, including playing full seasons professionally overseas. Well, now that my ankle is immobile in this boot most of the day, I am feeling my ankle joint aching quite a bit. Classic “arthritis” feel. i expected this, no concerned, but a bit painful. Had a couple days where I had the boot off for an hour 3 or 4 times those days because the ache was just too much..

Only other concern I have is my sore calf. the entire calf from the back of my knee down through the Achilles is pretty sore. It is not terrible, but I can squeeze lightly an portion of the atrophied calf and it is sore. The Thompson test wouldn’t make me scream, but I would say ouch. The soreness has been there since about 3 days after surgery. I am going to begin PWB today so we’ll see how it reacts. Anyone have experience with this kind of soreness?

As tough and slow as this has been, I remember waiting for surgery and researching the time frames for recovery, and to think I am already into the fourth week is promising. Time doesn’t wait for anything, so it too will pass, that much I have learned.

Hope to hear from you guys about the calf soreness and any feedback you have. Talk soon.

Paul

The path is the goal..

Well here we go - I am sure you all know the feeling I have when saying that. And I will admit it is comforting to know I am not the only one. Thanks to all of you in this community for sharing your experiences and being a part of this, it can be quite the “virtual” safe haven at times.

Also a quick thank you to the founders of this, I will surely do my best to support this site any way I can.

I am on here to share my experience with you guys in the hope of getting any valuable feedback I can from those who have been through this before me, and to genuinely join people on the journey back to full health that can understand what I am going through.

So here are the details:

12/12/18 (Evening) - Complete rupture of right AT playing basketball

12/22/18 (Late Morning) - Surgery

12/28/18 (Afternoon) - Fiberglass splint removed, placed in walking boot with 3 heal wedges (approximately 1.5 inches total height).

Surgeon - NWB until 1/5/19 (two week mark) then progress to WBAT in boot - approximately 25% per week. Full weight bearing in boot by week 6. Shoes by week 8-10 with the heel wedge.

About me:

I am a 30 year old male that has played basketball my whole life, from 5 years old to playing overseas professionally for a short period. I am and always have been in pretty good physical condition and this injury came out of nowhere. I was simply shooting around at the local gym for about 10 min after having done a leg workout when I planted my right leg behind me to push off for a driving layup and felt the infamous “kick/shot”. My calf completely coiled up and I immediately knew what happened. It was heartbreaking.

I had never felt any achilles discomfort prior to the injury, but I have had multiple injuries to the ankle and the big toe of that foot in the past. Either way, these seem to be “freak” injuries and I don’t care to know if any of that had any effect as I am in the here now and (hopefully) on the road to recovery!

I am on day 8 post-op and feeling okay aside from one side effect that I will end this post with as I am hoping someone here can chime in or has some advice. On day 6 I went into have my splint removed and my leg looked great. Sure it was skinny, amazing how quickly it atrophies right, but I had nearly no swelling at all and the incision looked good. I was excited as I had expected to see a lot more swelling/bruising, but was hard pressed to find any at all!

I am now in this uncomfortable franken boot from Kaiser (Surgeon is great. Kaiser sucks in general, but I digress), BUT I have the Vacoped coming in this Thursday, 1/3. CAN’T WAIT for that. I’ve heard enough from you all here to know it’s going to be refreshing to wear, to say the least.

My surgeon is quite progressive and wants me on an early weight bearing and early ROM protocol. His views line up almost exactly with what I was hoping for after doing hours and hours of research following my injury, so I am happy about that.

Now to the one issue I have faced - I was a given a lower leg nerve block that was intended to last 1-3 days. I am currently on day 8 and my leg is still numb. I have most of my motor sensation - I can control the muscles, wiggle my toes, move my ankle etc. But my sensory nerves are all out of wack. The leg feels like it does when you fall asleep on your hand - pressure with tingling or pins and needles sensation.

I am somewhere between extremely concerned and not sure what to think because I have no control. My surgeon said this happens sometime, albeit not too common, and that traditionally it will wear off within days or weeks (but could possibly take a few months). I am also in direct email contact with the anesthesiologist, and his last response to me was as follows:

“Hi Paul-

I’m glad you came in today and that Dr. Fogelson checked on your healing. Nerve injury from nerve block is thankfully exceedingly rare, especially with the use of ultrasound. During your nerve block, we had no issues with hitting a nerve, which sometimes may happen during a block and cause transient nerve damage. If we hit a nerve, we would know immediately as it would cause sharp electrical pain down your leg and you’d yell. Additionally, the way your nerve block set up and how it started to wear off (albeit slowly), I am confident that this this block will wear off. It’s just a matter of time. This isn’t scientific, but drink plenty of fluids to flush the local anesthesia medication out of your system and try to move around if you can. I know this can be concerning, but you’re recovering well. Hope it keeps wearing off over the weekend. Keep me posted. ”

Has anyone here had a nerve block done? If so, when did it wear off? Also, any complications? Has anyone heard of a nerve block not wearing off for this long? I am hoping for the best because I have that choice. I had the choice to be positive since the day of my injury and I am fighting as hard as I can to maintain that. That is what I can control, and I will do that.

I truly hope to make some connections on this blog, you people are amazing, both those who have recovered and those still fighting. This is tough. And you guys are even tougher. I will be too. Thanks for your time!

Please comment, introduce yourself to me, ask any questions you may have, and please please offer any advice you feel necessary. I am not a master, and I am open to learning always. Hence beginnersmind, because a master’s mind has no empty space for new knowledge, it knows it all.

One love, Paul.