Ahhh …. got to do some cardio today!

I had my hubby drop me off at 24 hour fitness so I could get in some cardio. Did two 500m intervals on the rower. Had to rest my right leg periodically since it was sticking out to the side, holding my right foot off the ground, while my left leg was strapped into the rower. Then did some of the standard exercises I’ve been doing at home - leg lifts, pushups, weight lifting while sitting or kneeling, ab exercises, … Then I got on the recumbent bike and did a mile. It is REALLY hard to get my little left foot strapped into the bike tight enough to be able to pull on the pedal effectively. At least the bike had a middle platform I could rest my right leg on - LOL! I tested out resting my booted right foot on the pedal to see if that bugged it and it did, a tiny bit, so I mainly let it rest on the middle platform. However, it was much easier to pedal with the right foot at least providing a little downward weight while the left pulled up :)

I did email my doc when I got home to see if it was OK to rest the foot on the pedal since I am still NWB. He said that was OK as long as I’m on a recumbent bike, and I just REST it. That’s good since it makes life much easier for my left foot :)

It was great getting in a decent cardio workout - even if I am back into wimpy land for how much of a workout I can do. I’ll do it again next Tuesday when my other friends are doing the High Intensity Interval training class that I was doing before surgery. Can’t wait to get back to that - but that is months away. At least I can say hi to all of them and do my own little workout while they do HIIT.

3.5 weeks postop

Saw the doc today and get to do some ROM exercises. Just simple up/down and side to side movements - but anything is better than just keeping the foot in the boot all the time! :) Found out another difference between Haglunds Deformity surgery and straight ATR. Often in Haglunds (and in mine) the achilles is detached from the bone so the repair that needs to happen isn’t just tendon reattaching to tendon, but also tendon reattaching to the bone. And he told me that NSAIDS are OK after the first 3 weeks since the type of healing that goes on at that point isn’t affected by NSAIDS. The first 3 weeks involves platelets responding to inflammation which is part of the healing process and needs to be allowed to happen and NSAIDS interfere with that.

So I’m still NWB until my 4/3 appointment but do get to do a few exercises to improve range of movement and keep the ankle from getting too stiff. Progress by baby steps - LOL!

1-footed Exercise!

So I was doing my own little exercise routine but decided to use google to find more things to do. So I searched for non weight-bearing exercise after foot surgery and found this video: https://www.youtube.com/watch?v=TxNyo1yRh60

I’ll have to check with my doc to see if I can bike yet and I know I can’t do the ball exercise yet. Some of these I was already doing - but youtube brings up more 1 footed exercise videos as well with some ideas for exercise that I didn’t come up with. So my after breakfast routine will be one or more of these videos combined with any of my own regimen that these didn’t cover.

So don’t just be a lump - get down on the floor or in a chair and get moving! :)

Das Boot!

I think the cast dept at Kaiser is tired of seeing me - LOL! They knew I would probably be back in on Friday for another cast redo so between them and the nurse I saw on Monday they convinced my doc to get me into the boot today. We got a call this AM to see if we could come in to get booted. So here it is.

My booted foot

And my complaints about how little sleep I’m getting were also heard. They gave me this boot for night time use. I sure hope I can sleep with this one.

Hopefully I can sleep in this boot!

And I got to wash my foot for the first time in 2.5 weeks! The bottom part of my incision is quite scabby and is much more tender than the top for some reason so all I could do was blot it with a soapy wash rag and then rinse it with running water. I used one of my hubbys socks so I could get it on without bending my foot. Here is my washed, socked and booted foot. This boot feels so good since there is nothing hard pressing on my heel and lots of soft foam surrounding it :)

My foot is washed, socked and booted!

First 2 weeks

So I’ll start by saying I didn’t have ATR.  Rather my achilles was cut and reattached in order to remove a LARGE bone spur/growth that was behind it.  Here are the happenings and pictures from the first 2 weeks.

I’ve spent most of my time laying around with my foot elevated since I had surgery on 2/17.  I’ve had a bone spur/growth (Haglund’s deformity) under my achilles since at least 2004.  That’s the earliest date I can find for when I went to Vegas for a soccer tournament.  I "discovered" this growth after my first tournament when I was hobbling around in pain.  Went to see a doc about it and was told about the bone growth under the achilles.  Went through PT and continued to do the exercises off/on from that point on since they told me both my achilles were REALLY tight and might snap if I didn’t keep working to keep them flexible.  I suspect my small feet (size 6.5 women) and height 5′ 8" may have something to do with the creation of this too.  I have these growths on both heels but my right foot is much worse, probably because I’m right footed.

Anyway - fast forward to 2007 when I saw another doctor about it because my achilles was continually annoyed and more so when I played soccer - which I do 3-4 times a week.  He gave me the run down to fix it - surgery followed by 3-4 weeks in bed with elevation 90% of the time and no weight, 3-4 weeks 50% elevation and no weight (aka NWB), then start doing weight bearing in a boot and PT and hopefully in 9-12 months back to normal.  This doctor was very blase about whether I could play soccer again.  Since that is a requirement and he was so non-committal I passed on the surgery, put more pads in my soccer shoes, wore clogs/crocs most of the time and started using a silicone gel pad slip on when I put any closed back shoes on my right foot.

Fast forward to 2015 when I saw a doctor again - turned out it was the same guy I saw in 2007- sheesh!

Here’s my foot before surgery - isn’t that a lovely protrusion?  The dotted line is sort of the bone area that will be removed.

Bone spur before surgery

View of bone spur from behind

Well fast forward even more to the end of 2016 and the annoyance is more and it is more debilitating. I was also starting to get random shooting pains when I’m just sitting so things are getting worse. I tried a new surgeon and he was much more enthused about making sure I can play at least as much soccer after healing as I do now.  He couldn’t promise anything but if things go normally then I’ll be back on the pitch maybe in September.  He also didn’t call me a "soccer addict" as the other doctor did.  He wouldn’t say I would be able to play more than before - LOL! My foot limited me to 1 game a day and I could not play in full game tournaments that have you playing intense soccer for 4-5 days in a row.

I liked this surgeons attitude and verified that he has done the surgery many times before and planned to have the surgery in February after I got back from my Tucson buying excursion. I also started exercising more intensely (Monday - weight lifting class, Tues - high intensity interval training or a soccer game, Thursday - high intensity interval training or a soccer game, Friday - Orange Theory, Satuday - soccer, Sunday - soccer) in order to get stronger and to lose a little weight. Turns out I didn’t lose much weight but I did get stronger and found out I gained muscle mass based on how my weight changed after my surgery - LOL! Hubby and I are both consulting so he can be at home when I’m in non-weight bearing mode and so I had the surgery on 2/17.

Here is the foot the day after surgery on the pillows, raised above my heart.  Turns out part of the bone spur broke off so I’m sure the random pains I started getting were from that bone piece poking me.

My big foot, elevated, after surgery

Before the surgery my doc kept warning me that this was going to be very painful and, honestly, he definitely had me a bit scared. I have never had any surgery before. He said he was sorry that this would be my first surgery since it would be so painful. YIKES!!! Well, fortunately, I never really experienced any pain. I did take percocet for 3 days at the full dosage so I’m sure I stayed ahead of the pain (another lesson learned from my mothers many surgeries) and maybe that’s why I never really felt any pain. I knocked it down to 1/2 dosage for 2 more days until I had my first post-op appointment. I didn’t know what would happen there and wanted to be ahead of any pain. That appointment was pretty non-eventful. My elevation kept the swelling down so the only visible swelling was due to the surgery and the incision area looked good. They rewrapped it and sent me on my way. I’m sure being able to keep it elevated most of the day and night helped a lot in not having any noticeable pain.

Unfortunately I’m in the "Princess and the Pea" camp when it comes to sleeping so once I was off the percocet sleep has been hard to come by. I usually sleep 2 hours wake up, move around, try to get comfy, repeat. I’m getting maybe 4-5 hours of sleep if I’m lucky and not all in one shot. The wrap/cast/splint on my foot and having to keep it elevated REALLY bugs me when I’m trying to sleep. Can’t even get naps in! Ah well a full nights sleep will be that much better when I finally have a foot that is free of casts/boots.

Anyway here is the foot at the first post-op appointment - Franken-heel at its best! And notice that my ankles aren’t too visible at this point.

Franken-heel - 5 days postop

And here is the knee scooter I’m using. This is wonderful since I found out, the hard way, that crutches and I are not good friends.

I went in for several redos of the wrap/cast/splint since the cotton padding would compress after about 2 days and then the splint going over my heel would really start to annoy it - yes I’m Ms. Princess and the Pea. The last time (last Wed) they put me in a plaster cast which is much worse than a fiber glass splint so I’m going to nix that idea if they are still splinting me today instead of putting me in a boot of some sort. I’ll just have them send me home with some padding so when things start pushing on my heel I can take off the ace bandage, add more padding and wrap it back up myself. Here is my foot last Wednesday. I have ankles, tendons and bones visible! And the heel is so stylishly shaped - LOL! - no big bulge!

Foot 12 days after surgery

And the incision (this is 12 days after surgery).

Incision 12 days postop

I am still doing some exercise - knee pushups, hamstring raises with my good leg, V-ups, situps with my legs on on an ottoman, lifting weights for my arms (either sitting or kneeling), hip flexor stretches on both legs, leg lifts. I’m going to do some of the Classical stretch classes I have recorded if I can do them on my knees.

Of course I mustn’t forget to show you my steady companion on the bed - Gino! He was quite perky when he wanted me to share the dried apricots and almond snacks I had. When I was taking the percocet I ate ginger snaps to help with the nausea, apricots to help with keeping things regular and was quite surprised both the dogs loved the ginger snaps!

Gino snoozing next to me on the bed Gino likes almonds and dried apricots

And here is my regular visitor - Max. He’s not into just hanging so he comes upstairs several times during the day to check on Gino and I. He may bring a toy up and if he does I’ll get on the floor and play with him for a bit. If he REALLY wants to play he’ll jump up on the bed with the toy. No mean feat for a little guy like him since we have to put a hassock next to the bed for him to use to get up on it.

Max comes for a visit Max likes the view from the bed

And, finally, the soccer blanket that keeps half of me warm all night when my right half is outside the blankets so the foot can be elevated on pillows.  I bought this years ago from a soccer pals sister who makes these blankets.

This keeps half of me warm at night :)

Sutures are out!

It is now 18 days post-surgery.  I’ll add another post with the earlier happenings later.  Just to clarify I did not have an ATR rather I had a very large bone spur/growth removed under my Achilles (some call this Haglunds deformity but my doc didn’t).  This required cutting the Achilles, grinding off all the bone growth and reattaching the Achilles.  When I forwarded articles about the shortened recovery time for ATR to my doc he said those don’t apply to my surgery so I’ll be waiting until the 6 week mark for PWB.  I’m guessing the recovery is different because the connectivity sheath is still intact for an ATR but has been cut in my case in order to expose the bone and the connectivity sheath has to regrow as well.

But back to yesterday.  I did get the sutures out and that didn’t feel too special.  One thing I learned as I helped my mom with her recovery through 2 hip replacements and other surgeries is to speak your mind and be insistent about things. I’m sure most folks don’t go in for a cast change every 2-5 days but I did because all the padding would get compressed and start putting painful pressure on either my incision or my skin.  When they were a bit doubtful about it one time I told them I would unwrap down to the splint and put foam or bubble wrap between it and my heel if I didn’t get in.  I would have too since I only get about 3 hours of solid sleep when the cast feels ok and that goes to about 1 hour when it starts rubbing on things.  What can I say - I’m the Princess and the Pea when all body parts are normal.  The slightest wrinkle in the sheets has to get fixed or I can’t get to sleep.  Having a cast is way more annoying than a sheet wrinkle.

Anyway I talked about all these cast changes with my nurse and other techs in the area confirmed I had 3 cast changes in 10 days so when the tech started to put on this plaster cast he used as little plaster as possible to make it lighter and more comfortable.  He told me to be careful with it since it is just strong enough to hold my foot at neutral and can’t have any weight on it.  I could balance on the edge of the other cast since it was so heavy and my foot in it was so loose by the 2nd day so my foot hung freely inside while the cast outside held some of my weight.  We’ll see if I’m back for a cast change by Friday - some areas are already getting loose probably because I’m a wiggler so I’m continually moving my foot and wiggling my toes.

The doctor was supposed to be at this appt and wasn’t so when the nurse told me I wouldn’t come back for 3 weeks I told her she was wrong.  The timeline the doc gave me was that scar mobilisation (aka massage) starts in week 4 and you can’t massage a scar in a plaster cast.  Also the wraps/casts are pressing on a nerve on the top of my foot which causes my big toe to feel numb just under the skin.  The doctor was supposed to discuss this with me.  So I left with my cast and emailed the doc this AM with questions.  As I expected he’ll have me come in next week to get a boot on (both for doing the massage and to minimize the pressure on the nerve in my foot).  So if things don’t jive with your understanding ask questions and if needed raise a fuss.

As to how things went after the suture removal and slowly pushing my foot to neutral as the cast hardened … it hurt.  I didn’t realize that the post surgery casts/splints let my foot hang down a bit until the tech started slowly pushing my foot to neutral (aka right angle to my leg).  It was definitely uncomfortable.  Once I got home I started getting these random sharp pains in my heel.  No idea why but they happened enough that I knew it would be a Percocet night.  Haven’t taken them since day 5 after surgery and on day 8 when I gave up on crutches after a fall.  I started with 1/2 a Percocet but felt no relief after an hour so I took the other half.  I did get 5 straight, drugged hours of sleep which felt great!  I got probably another  1.5 hours of intermittent sleep after that.  I did forget to take the anti-nausea drugs though so after my 5 hour wake up and bathroom visit I had to lay on the floor for a bit to keep things down before I could scooter back to bed and take the meds.  Interesting that 1/2 a Percocet doesn’t make me nauseous.  So far today I’ve only had a few of those pains so haven’t needed any meds.

Here’s my foot after suture removal - love seeing my ankle again - LOL!
foot after suture removal

One more thing … If the nurse says something contrary to the recovery plan outlined by your doc verify with him.  I asked the nurse if I still had to elevate 90% of the time and she said no, just elevate as needed.  Since I’m still in week 3 and my timeline said 90% through week 3 I checked on this with the doc and he said follow the plan so here I hang with my foot on pillows.  :)

Hanging out in the bedroom with foot elevated and my daily companion, Gino, checking on things

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