PT Appointment #2 and one step forward, 1 or 2 steps back …

Well let me first start out with my one step forward, 2 steps back story …

My doc gave me the OK to get rid of heel lifts and go barefoot on Monday.  So I’ve been slowly weaning away from the heel lifts.  Adding a few more hours of flat time each day.  Well,  unfortunately, I didn’t listen to what my foot was telling me yesterday.  My foot was warning me at the 5 hour mark (and part of that time I spent standing and cooking in the kitchen) and I ignored it and went another 2 hours without heel lifts.  Well today I’m in lifts, achilles is aching and sending periodic shooting pains and is generally unhappy.  I’m guessing I’ll be in lifts all day today.  So the lesson is - listen to your foot and don’t ignore it when it starts getting unhappy!  I think I’ll be icing it shortly too.  :)

I saw my PT today and told him I overdid it yesterday.  He said overdoing it once in a while is OK since you need to learn the current limits of your foot but if you overdue it too much then you may need to go back a step for a day or two to get back to where you were.

My PT said I was walking pretty well with lifts.  Barefoot I’m not walking quite so well.  I can feel it too - it feels tight when I start rolling forward.  He said the foot/leg doesn’t have the strength for a good push off yet.  He measured my knee-to-wall distance.  I think the right foot was 15 cm and the left (surgery) was 10 cm.  I’m going to measure the same thing differently - bend to get the knee to the wall and then measure how far back my toe is.  He tested out my flexibility and said it was pretty good for where I’m at.  He then gave me exercises focused on building strength - going up on tiptoes, a couple of one footed squat exercises and a hip bridge.   And after doing just a few practices of each my achilles is even more sore!  LOL!  He told me that these will be hard so if I have to take a day or two off from doing them that’s OK.  I’ll see him again on 11/19.  My exercises are:

- lean on bed/table/counter, go up on toes, drop back down to flat foot slowly,  start by going up with both feet and drop down with just the surgery foot and as the surgery leg gets stronger start going up and down on just one foot.  And, as the leg gets stronger move my body to be more vertical until I can do it standing upright

- similar exercise to the above but bend the knee slightly and keep the bend constant as I go up/down on tiptoes, and initially lean on something and let the arms hold some of my weight and as it gets stronger put less and less weight in the arms

- stand on surgery foot, put other foot on a chair and squat down while torso is vertical.  I should feel this in my quads if I’m doing it right

- stand on surgery foot, put other foot on a chair a bit further away, lean forward and squat down.  I should feel this in my butt muscles if I’m doing it right

- lay sideways on my surgery side, do a hip bridge with elbow and foot on ground.  Initially do it with both legs together but as my hips/core get stronger do it with the top leg in the air.  One can do this with the hand on the ground but I have a very unhappy tendon in my wrist so putting that kind of pressure on it is not a good thing right now.

I’m going to continue to do some of the flexibility exercises I was doing as well.  Definitely will keep doing the wall push achilles stretch.

My achilles is definitely not happy right now.  My mantra for the future is …. I will listen to my foot and do what it wants me to do immediately, not 2 hours or more later!  LOL!

3 month doc visit

Saw my doc today for my 3 month visit.  I’m OK to ditch the night splint - YAY!  I can ditch the heel lift - YAY!  I can go barefoot - YAY! And I can start some eccentric exercises - YAY!  I’m OK to jog - YAY! - but since I’m not quite walking normally yet I don’t think I’ll be jogging anytime soon - LOL!  Since I know it took a while to transition from heel lift to flat I will only go barefoot for short walks at this point.  I spent a bit over an hour in a croc as I made my lunch and after that I could feel the achilles complaining so I went back into my clogs which essentially have a heel lift since they are "high" heels.  So over the next week I’ll spend more and more time in shoes with no heel lift until my achilles is comfortable with a flat foot again.  I tried one eccentric heel drop and that was all I could do - LOL!  My doc said go up to my toes using both feet then drop down with just the left foot, holding weight in my arms as I do it.  I think I will hold off on these until I can actually go up on my toes while standing.  I see my PT on Friday so we can discuss the plan based on what he knows I’ve been doing for the last 2 weeks.    I can also use a stationery bike (as opposed to recumbent) and the elliptical machine (in flat mode).  So I’ll start doing the elliptical tomorrow when I visit the gym.  I recall that I also had to work into that slowly for my right foot.

Now the REAL work begins on strengthening and stretching!  Woohoo!

And I see him again in 2 months.

First PT appt at week 10

I went to see my PT guy.  I picked the same guy I had for my right foot since he knows what I want and was very competent.  He checked out the flexibility, … and said it was all looking good.  My docs instructions weren’t all that clear so I had him go through an email the doc sent me where things were laid out more clearly.  He’ll also confirm with my doc as well.  Anyway he said it is still too early to work on strength and flexibility in a more serious fashion so he asked what I’ve been doing for the band exercises and I showed him.  He then brought me a blue band and showed me a different way of doing the same exercises so I isolate just the foot muscles.  It is much harder to do it that way - LOL!  So I at least have a new way of doing the same thing which will focus more on just the foot muscles.   I go back in 2 weeks, at the 3 month mark, which is when I get to start the REAL PT work :)

He did give me another exercise to do for my shoulder though.  I really tweaked my right shoulder during the NWB stage and it still isn’t back to normal.

But one good thing is that I’m done with the boot now!  Yay!  Still have to have lifts, use night splint and no barefoot yet.  But every little thing that gets me towards full recovery helps.

2 shoes!!!

Finally I get to start the transition into shoes (with a heel lift of course)!  Actually I cheated and started the transition 2 days ago - LOL!  I wore my clogs a good portion of the day.  I wore my tennies yesterday (the official start day) and the 5/16" heel lift must be less than what I get with the clogs because by the end of the day my achilles was not too happy.  I might have been in shoes too long too ….  I’m supposed to be 1/2 time in boot, 1/2 time in shoes.  So today I’m staying in the boot longer and we’ll see how the achilles feels tonight.  So glad I’m onto the next big step in the recovery process!!

And now I can retire the knee scooter! Yippee!

2 shoes finally!

Got the OK to start walking in the boot!

Finally got to see my doc at the 5 week mark.  My earlier appointment was pushed out a week since his wife had their baby early.  He had me push on his hand and said my strength is good and he said the achilles felt good as I was pushing.  He also gave me the OK to start walking - yay!  A week earlier than I expected.  This time he will have me transition through wedges.  I’m starting at 9/16", then transition to 7/16", then to 5/16".  This is definitely different from my right foot.  For that foot I just started walking in the boot, no wedges, at week 6.

One thing for sure - I’m a LOT taller with the boot and the wedge - LOL!

OK to walk!

Retired so far!

11/5/2018 - This is the 12 week/3 month mark and I get to retire all kinds of things!  I can remove the heel lifts and walk barefoot so I’ll be retiring the shower stool and the heel lift I made to wear in my croc when I was in the shower.  And I can stop wearing the night splint - woohoo! I’ll note when I actually retire the shoe heel lifts. I’m still needing them so they aren’t retired just yet

Shower stool is retired!

Night splint is retired

shower heel lifts retired

10/23/2018 - I did my last 4 hour stint in my boot and now it and my evenup are retired!

boot and evenup are retired
10/11/2018 -

Next thing to be retired is my knee scooter!

knee scooter is now retired!

And the guest bathroom! Now that I’m in shoes I can shower on 2 feet using my crocs with a heel lift I made from some very firm foam padding from something that was shipped to us. I’m still using the stool in our shower since I can’t stand on one foot yet in order to wash the good foot.

guest shower is no longer needed since I can stand on 2 feet!

9/21/2018 -
I only used the crutches for about 2 days after I started walking in the boot. And even then I only used 1 crutch. I mainly used them when I was NWB to get from the drivers door to the back of the car where my scooter was. I’m not good on them so I didn’t want to risk falling and injuring the surgery foot. I did fall on them when I had my right foot surgery so this time I was extra cautious with them.

crutches are retired

9/19/2018 -

I used my bell one more time a few days ago when I was upstairs and just too tired to scooter to the stairs and butt scoot down the stairs to go get some ice. I also wanted to use it while a mutual friend was at our house visiting. She got a big kick out of it - LOL! Now that I’m walking it is much easier to go up/down the stairs to get something so I’ll let hubby off the hook. :)

bells to summon hubby if I need something
8/30/2018

I get to start my "retired" post earlier with my left foot than I did with my right. I showered with my bare foot tonight - whoopie! So the cast cover is retired. The incision area is covered with steri strips and still has scabbing. Once the steri strips fall off I can start scar massaging. That can take anywhere from 1 week to 3 weeks.

Cast cover is now retired!

Stitches are out!

2 weeks post op and my stitches are out!  I had to be a bit pushy about it - LOL!  The nurse initially told me the doc didn’t want them out until he saw me next - which was in another 2 weeks.  I did NOT want stitches in that long so I got a bit pushy.  So she had my doc come in to check it out and things were healed enough to take the stitches out - yay!  He even said I could do some gentle ROM exercises.  That was a surprise since I couldn’t do any ROM on my right foot until the 4 week mark.  It could be because the damage in the left foot wasn’t as much as the damage he found with the right foot.  So even with the same person and same doctor the recovery protocol differs because what the surgeon found during surgery was different.  In a day or 2 I can wash my foot too - that will be nice.  Have to wait for the little stitch holes to heal up.

Foot before stitches.  Heel is to the left

Foot after stitches were removed. Heel is on the bottom

And - if the nurse or doc doesn’t offer to spray the incision area with numbing spray before stitches come out - ask them to.   On my right foot the nurse just pulled them out and it hurt quite a bit!  Granted there was more postop bleeding from the wound in the right foot which probably made things a bit stickier around the stitches.  The nurse today had the numbing spray ready to go and I only had one little sting from one of the stitches.  Much easier on me than the first time around.

Booted!

Well the new cast/splint I got yesterday and my foot did not get along. The edges of the plaster support hit my ankle right where the swelling is on the left and where the incision is on the right. Needless to say I finally cut it off this morning to get some relief. No sleep last night so I went in today to get it redone. Since they can’t really do the splint different my cast tech called my doc to see if he could just put me in the boot. And YAY! I’m booted now. Wearing my comfy night boot and showing my walking boot. I won’t be walking for another 5 weeks but it will keep my foot safe as I scooter around during the day. No generic black boot this time around!  Not sure when they switched to an aircast or perhaps I got one because my feet are so sensitive.  :)

I can honestly say I had no problems like this with the right foot.  It was just so uncomfortable and I couldn’t do anything to get relief other than cut the dang thing off.  I’m sure the fact that I’m off the percocet added to my inability to sleep.  But I got another round of nausea 3 days after getting off percocet.  I’m feeling much better in many ways tonight so maybe the damn drug is finally metabolized out of my system.    Things were bad enough last night that I was considering taking it again, but then I would think about the nausea and that kept me from taking it again.

I'm booted!

5 days postop

Just got back from my 5 day check.  Cut off the splint, checked the wound, put on a new splint.

Foot 5 days after bone spur surgery

Since the percoset was making me very nauseated and light headed I stopped taking it 2 days ago. However, after the "exertion" of going to my postop checkup and back more of it metabolized and made me nauseous and light headed again - I felt bad enough that I took another anti-nausea pill. I was pretty surprised! Then I did some reading and found that percoset can be detected in your urine up to 4 days after you stop taking it …. ack!!! So I need to do more activity in order to get this stuff metabolized and out of my system. So some laps with the knee scooter and some exercises are in the plan now. I really want to get my stomach back to feeling normal again.

Fortunately tylenol and icing are taking care of the bit of pain that I have.

And the recovery process starts again!

Elevating at home after surgery

And the healing process begins again ….

Had surgery on my left foot yesterday to remove a bone spur/Haglunds deformity.  The doc said the damage was less for this foot.  Not surprising since I had the bone spur on my right foot for over a decade before I had it removed.  However the pain is greater on this foot.  I’m guessing that is because before surgery I was getting pain in many more areas of my foot (nerve under the ankle, pains shooting up my calf, pain all over the bump area) compared to my right foot (just pain all over the bump area).  So more nerves/tendons/… were annoyed before surgery and probably got annoyed during surgery as well.  Or the long term painkiller they inject at surgery may not be as effective on this foot.  Who knows?  The pain meds keep it down to a throb and it’s not much more painful than before surgery so I’ll manage.

So now the 3 week ice/elevate process begins.  I go in Monday for a check of the surgery site.