2 weeks post-op

Short Version:

PWB with the Vacocast! Yay! Only concern is that my wound is still a bit open for about 1cm

Long Version:

Pre-op

The day of my surgery went fairly smoothly. I was a add-on in the Day Surgery Unit so I got to the hospital at 8:00 am in case they could sneak me in early in the day. I ended up having to wait until about 5pm. I hadn’t eaten since 11:30pm so I was pretty hungry! All the rooms were private so I was pretty comfortable. Just before the surgery my anesthesiologist gave me options. I chose to be knocked out and to not have a nerve block with the hope I’d be discharged that night. About 10min later I was being wheeled to the OR. I had been switched to a larger bed because I was hanging off the standard one so it was difficult and pretty funny maneuvering the bed through the halls.

Op

The OR was a lot bigger than I had suspected. There was all sorts of impressive lights and machines. I was trying to focus on calming my nerves and trying to not freak out. They rolled me next to the operating table/bed and joked that they’d do all the hard work of moving me over after I was unconscious. There were 5 (or 6?) people in there not including myself. The nurse gave me an oxygen mask and told me to focus on taking deep breaths. I found this quite calming as it gave me something to concentrate on. The anesthesiologist explained that he was going to give me a sequence of drugs and explained the possible sensations I would have. I was very thankful that my nurse had run a tap into my saline IV for the anesthesiologist so I wouldn’t have to get poked again in the OR. I probably would have found that unnerving. I guess I’m a wuss :). The first drug made the room spin but not in a dizzying way. Also all the sounds had an echo effect. Another one made my eyes very heavy and I felt very sleepy. The anesthesiologist said “OK, goodnight!” as he gave me the last one.

Post-Op

My waking up was pretty pleasant. It was similar to waking up from a deep nap. I didn’t feel groggy or inebriated but still quite sleepy. The first thing I did was ask the nurse what time it was so I knew if my wife was still at the hospital. She would have had to leave to pick up our children if had gone too late. I had been under for roughly 1.5hrs, which was what the nurse had told me she expected.

Before too long they wheeled me back to my room and I just relaxed and hung out with my wife for a bit. I didn’t have too much pain, but I wasn’t comfortable either. They had put me back in a half cast. I was disappointed with that as I felt much more protected in the full fibreglass ones. The nurse explained that they did the half cast to accommodate for swelling. My foot was extremely plantar-flexed, more than it had been in the cast and it was also slightly inverted and supinated. My toes felt a bit numb but they still had good blood flow. About that time my wife had to go get the kids and my brother came in. I was there for a couple of hours while the nurse checked vitals. I also had to show her that I could keep food down and that I could urinate. The charge nurse gave me 12 Percocet pills and a prescription for T3’s. It was pretty funny when the nurse had me count with her how many Percocets she was giving me and had me sign for it. After that I was was discharged and off home I gingerly went.

The last 2 weeks

Honestly, the last two weeks have not been fun. Because of my previous  failed attempt at non-op treatment, I was pretty scared something else would go wrong. I’m on paternity leave with a 4 year old and 10 month old. So with my non-op attempt, I had no pain so I was pretty active. This time I had pain and I wanted to give my achilles every opportunity to heal. I was on the couch with my leg raised for about 23.5 hrs a day. This was a bit of a childcare logistical dilemma. Luckily we have amazing neighbours and my dad was able to help out a bunch this week. I had the kids by myself for 4 or 5 days and it was very challenging but we managed. I was on the percocet for the first 4 days. I was prescribed up to six per day but I usually took about three. I still have one left. They were especially helpful for getting comfortable enough for sleep. After that I moved to the T3’s for a bit. I still have a ton of those left as I’ve been off those for about a week now. Honestly, the constipation was getting more uncomfortable than my foot. Most of the pain I’ve had has been moderate. I’d say <5. There have been a variety of kinds of pain though. My ankle and foot were just generally sore the first couple of days, I also had a sore throat and a cough from being intubated during the surgery. Most of the pain has been on the bottom of my heal from where my foot has been resting on pillows. I would just have to hold my foot in the air above my body sometimes. It’s been pretty hot here lately so having my leg wrapped in gauze and layers of tensor bandage has been quite uncomfortable at times. I’d take my temperature pretty often just to make sure I didn’t have a fever due to infection. The last few days the top of my foot has been quite sore at times. I think it was just tired of being flexed and compressed for that long. I’ve felt similar feeling being stuffed into a kayak for hours so I wasn’t too worried about that.

Mind games

The worst part of the last two weeks has been dealing with the doubt and worrying. There were a couple of factors that put me into a slightly pessimistic headspace:

  • My non-op treatment failure and the fact that the doctors couldn’t tell me why it had failed. Maybe there was something wrong with my healing abilities?
  • I never got to talk to the surgeon after the procedure. She wasn’t available after recovery. I talked to her secretary a few days later and she made it clear that she was extremely busy. I could have pushed the issue but decided not too.
  • 2 weeks without checking on the wound seemed like a long time to me.
  • My check up was on aug. 10, I had a trip booked from the 11 to the 27th. If they wanted to see me a week later or something I might be without my family for a big stretch.
  • Inactivity. I’m a very active guy and not having that as an outlet has been difficult.

The low points have been seeing two of the races I had signed up for come and go. There was one other pretty hilarious “low point.” I had been wearing long shorts since the surgery that covered my knee, I had a bit of itch just above my knee, when I looked at it I noticed my knee was red. I started worrying about infection and called Health Link (free service where you talk to a nurse and they give advice), I had her stumped, so she had me mark the outline with pen and monitor how fast it was spreading. 1cm/hr=go to ER, otherwise go to a clinic within 24hrs. The next day it was exactly the same. At this point I was pretty sure it was just a rash and not infection so I tried rubbing some coconut oil on it. The pink rubbed off! It was the disinfectant they used. Doh! I had dismissed that possibility because I had another dark splotch of disinfectant on my knee and I hadn’t noticed the slight pink hue the rest of my knee had. I had been so wound up about something going wrong that it felt really good to have a laugh with the wife. I started feeling more optimistic after that, but still felt the need to not get my hopes up.

Dr. Appointment

The appointment was at 9:30 and the splint started coming off at about 9:35. It was the same guy that had taken my cast off before. He remembered me and we talked about what happened the last time. This time I was vocal about what I wanted and when to proceed. No spasm this time! The foot felt pretty limp actually. The splint was off and I got the first look at my leg. It looked pretty pathetic but not as bad as I thought it might after being in a cast for a month. My foot had some bruising but not too bad. They flipped me over to take off the bandages. That hurt a little bit, like taking off a big bandaid. They had to “cut a couple ends” which I presume meant stitch ends that hadn’t dissolved yet that were stuck to the bandage. The wound looked mostly like what I’ve seen here on the site except there was about 1cm open. They didn’t seem too worried about that. They cleaned off my leg and then placed what must have been at least a dozen steri-strips over the wound and told me to keep them on for as long as possible. Doctor palpated (I don’t remember her doing this but she later told me she did) and was happy and told me I could get in the boot. I had brought my vacocast with me so there was some discussion about how it’s settings aligned with there normal procedure of wedges. They wanted to make sure 30 degrees was enough. The guy hadn’t used one before so I helped him help me getting the boot on. My foot had been splinted well past 30 degrees so it felt really weird putting my heel into the boot. It didn’t hurt at all, just felt weird. After that I got a sheet with their protocol on it and made another appointment with the doctor in 5 weeks time. So it’s been a good day! I still haven’t tried putting too much weight on it. I’ll probably ease into it very slowly, but I’m looking forward to making progress!

Wow, I wrote a lot. I suppose it’s for posterity. Also, I found it cathartic.

major setback

I partially ruptured my achilles playing basketball just over 2 weeks ago. I’ve been in a cast the whole time and was SO looking forward to getting it taken off and starting the protocol.

Immediately after the cast came off I had involuntary dorsiflexion and felt a bad pain in my achilles area. When the doctors checked it out I failed the Thompson test and he felt a large gap. The plan is for me to have surgery tomorrow.

I’m pretty depressed about the whole thing. I’m worried that one freak muscle spasm has severely degraded my chances to regain function to the level that I had hoped.