Posted by: brendan | March 7, 2008

Post Op - Week One

Day 0 - no pain at all for first 24 hours due to popliteal nerve block I had.   I started on pain meds (hydrocodoine) that evening as instructed by doc as the nerve block may wear off kind of quickly.   Pretty uneventful day at home, set up in the basement, resting, elevating, ice.   Everytime I get up to go to the bathroom, the blood rushes to it and it feels like a lead weight.

 Day 1 - I actualy called my ortho doc’s nurse after about 26 hours, as I was still completely numb from the nerve block.   I was a little nervous that things may have been permentantly damaged, but couldn’t find any serious side effects on line.   I got a call back from the nurse a few hours later and she said not to worry, that sometimes they just last longer.   My toes were warm, so there wasn’t a circulation issue, although she mentioned that I could loosen up the wrap on my splint if it felt like it was getting tight.   After noon, the pain started to hit, my toes had that tingling sensation like they were coming too after being asleep for an extended period of time.   I was already on 1 pill every 4 hours, but by 8 that night, I took 2 for a dose (recommended 1 -2 every 4 hours).   That second pill knocked me out, and although I don’t like the way it makes my head feel, my foot felt fine.  

Day 2 - back to 1 pill every four hours, pain not bad as long as I’m laying down with leg elevated.   When I get it to take a leak, I’ve got about 1 minute, and then wham!   It’s like a lead weight on my leg.   My knee is already feeling it, I’m trying to keep it supported as my leg is propped up to  as to not put additional strain on it.   I made it upstairs for the first time to get some couch time.   The harder pillows of the couch are not as comfortable on my leg, so I can’t take it for too long.    I forgot to mention that we put our 3 year old in full day day-care for these first three days (usually only part time for 2 days), and this was a huge help for me and my wife.   Ohh..constipation is a side effect of hydracodoine….was able to go today for the first time since surgery…ouch!   At least the plumbing is all working.

Day 3 - Boredom is setting in, starting to work on this blog.   Found out the iTunes rents movies for day, although the selection is not great.   My pain was good for most of the day, I actually skipped a dose of pain meds.   Turns out that was a mistake, as it takes twice as long to get them to start working again…found out the hard way, but not sure how else to find out if you are ready to get off of them?   

Day 4 - trying to decide if I should return to work next week or not?   I’m a little nervous about the surgery location…seems like if I can stay in bed for another week, it would be best.  Any thoughts?

 Day 5 - Think I’ve decided (thanks for the advice all) that I’ll stay home for week 2 post op.   I am able to work from home, and it just doesn’t seem to be worth the risk of a fall to get back to the office.   Got into Facebook in the past 24 hours and have reconnected with some old friends…this is definitely an upside of being laid out.   These are things that I never get to do with 2 young kids and a busy life.    My knee on the injured leg is starting to bother me a bit when I get up to move around.  The splint cast feels like 100 lbs of dead weight swinging from my knee.    Today is the first day that I can sort of sit up and have my leg elevated (not above my heart) and it doesn’t throb.   Still keeping ice on it when I can…probably 2-3 hours total per day.   Slept well last night, and have not had a pain pill since last night before bed…it will be good to get off those.    Got outside for just a few minutes of fresh air…it’s fairly warm in Fort Collins today.   My wife has windows open and candles lit, claiming my foot stinks…not an infection stink, just the sweaty cast smell.    I can’t complain, as she has been super helpful so far, but if I don’t get to helping with our 3 year old soon, it could be a neck wringing for me!    I took a bath with splint out of tub a few days ago…think I’ll try this cast cover shower kit to get in the shower.   We’ll use a plastic chair in the shower…oh fun!

Responses

I don’t think you should be moving for at least 2 weeks. If you do decide to go back to work, if it’s a desk based job, then you can just prop up your leg on the desk most of the time.. or if you can work from home, that’s probably better. You might want to ask your doctor as well.

It is a desk job, my doc said it would be OK…I’m just more concerned about an accidental fall, I’m probably safest in bed. Thanks for the advice.

Hey, i lit the candles and opened the windows to let some fresh air in on this beautiful day, not just due to the sweaty cast…gotta give me SOME credit :)
love you and glad to be taking care of you :) me

sounds like my home..
important to have a good support team..amazing how when we slow down a little we smell the roses so to say..
congrats on having a loving wife

I couldn’t do this without you Amy!

Ross - are you in the same boat right now with ATR?

Brendan - I’m about a week earlier than you…had my surgery on 02/27 and having my first post op apt tomorrow. I’ve been back at work since last Tues (03/04). I have a desk job and have been elevating my leg on the desk. Was too bored at home. It’s been fine at work so far. Wife drops me off. Co-workers have been real nice to heat/bring my lunch to me. It was a little tough trying to find a comfortable position, but I now have some boxes and a pillow to rest my injured leg.

All the best to your recovery.

Thanks for the input Stan…I decided to stay home this week and work from home…we have VOIP at work, so if I have a laptop, it’s pretty close to being in the office. I do miss the people connection though. Would look foward to hearing about your post op visit tomorrow…mine is this Friday (11 days post op)…good luck!

Brendan - came back from my first post op apt. After removing my plaster splint cast, the surgeon checked the stitches to make sure there’s no infection. He checked my angle of dori flexion (how high my toes can point up) and assess the stretch of my achilles/gastro muscle by applying pressure on my toes. He mentioned that everything healing very nicely, particularly that I can put my foot at 90 degrees. I asked him about the type of sutures he used for reattaching the tendon. I’ve heard ‘fiber wire’ many times so I asked him if this was used mentioned in this blog. He mentioned that he doesn’t like using fiber wire because it is not dissolvable. He uses a dissolvable type of suture. As he was pleased with the healing, I asked if I can be put on the ‘agreesive’ protocal which meant partial weight baring. I was fitted with a fiberglass cast with a shoe so that I can bear partial weight. I basically can rest my injured foot while washing dishes, but not walk without crutches. It’s definately a good feeling getting the green light to bare some weight. 4 more weeks of this and I’m going back for a CAM boot.

Stan - thanks for the update…congrats on getting what you wanted for the rehab protocol….looks like you were 13 days post op at your appt?

Sounds like you had a similar plaster splint cast that I have now…did you notice it digging into your heal at all?

Did he remove your sutures from the incision..or were those dissolvable ones too?

So you will be in the same plaster cast for 4 weeks?

Brendan - re: my first plaster splint case, I felt a little compression on my little toe, but no digging in the heel. I was told that the initial plaster case is put on in a way that allows your feet to expand. Maybe they didn’t put enough cushioning in the heel part.

The surgeon had my entire leg washed since he mentioned that it has been 2 weeks since it has been cleaned. He cleaned the incision site and replaced the 3M thin tapes (the one that helps to bond the site together) with new ones. The sutures are dissolvable ones so he did not remove those.

I will be in the new walking fibreglass case (not plaster) for 4 weeks. It’s a lot lighter and you’ll feel much more comfortable. Since he was able to put my foot at 90 degrees and cast it at 90 deg, he gave me a shoe that goes over the cast to walk on. He doesn’t allow his patient who cannot maintain 90 deg to walk because the pressure will be on the toe rather than the heels. Well, not really to walking, but being able to apply weight on it.

Stan -
You have been getting really great medical care.
I can’t believe that he had your leg washed and replaced the tapes. Where is your doctor’s practice? Are you going through insurance?

I am quite amazed. ;)

I ruptured my achilles tendon in left leg from heel bone in DC but lived in NC where I had surgery on May 7, 2008. I also broke my left elbow head which has slowed down the PT needed to get the leg awake to begin the PT regime to recovery. I was put in a large and heavy boot that must weigh 20 pounds or more. I had to sleep in it for six weeks with leg evelated. Swelling after surgery for weeks was awful. This has been a very slow process for me. I am a 63 year old woman that has no patience for this slow and long process. I go to PT 3 times a week and have to do the regime at home also. My main pain is due to a very large blister at the incision of the heel that has been there now for over three weeks. Blister keeps draiing and due to dead skin all around the heel and bottom of foot which causing me pain when I walk with the boot on it. I stopped taking pain meds after two weeks from surgery date. My doctor told me recovery can be 3 to 6 months. With the PT, my knee also has started hurting me at times. I have a great deal of a burning sensation in the outer side of my ankle also.

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