7 weeks post-op. Progress.

Rehab
I had the second of my PT appointments today. It was fine, but I don’t feel like it’s moving me forward much. The referral form from the surgeon said I could do “active dorsiflexion exercises” (flexing my foot), including with a theraband, and “passive plantarflexion” (pointing my foot). In other words, I am to flex my foot, sometimes against an elastic; and my PT is allowed to move my foot into a pointed position, but I’m not supposed to do it myself. The form also said I am not allowed to bear weight without my air cast on. If the surgeon had spent more time with me at that last appointment I would have told him that I have already been doing dorsiflexion and plantarflexion exercises, circles in both directions and writing the alphabet with my toe for several weeks, and my mobility is quite good (even my PT was surprised at how easily my ankle and foot are moving). I think I’m ready for a bit more. Plus, I notice some patients were starting to get weaned out of the boot at 8 weeks (next Friday for me), but I don’t see my surgeon again until 10 weeks. But my PT is following his instructions to the letter. Since I don’t want to pay to do exercises that are even less ambitious than what I’m doing at home, I am only going once a week. I chose this PT because it is across the street from my office, but my GP recommended I see another who has done a lot of work with ATRs. I made an appt. to see her next week. If she says the same thing, and would stick to his instructions exactly, then I’ll keep going across the street for convenience. (This PT is killer with the massage, after all.) On the other hand, if she thinks I could do a bit more than I’ll travel the extra distance to work with her. I’m not trying to be a difficult patient, but I want the best possible outcome, and a lot of what I’ve read seems to suggest earlier ROM and weight-bearing result in a stronger tendon long-term.

Aches & pains
The most significant of these, since ditching the crutches completely, has been my lower back on the side opposite to the injured leg. I’m certain it relates to the difference in height between my air cast and shoe. I have been playing around with all my boots and shoes and the heel lifts out of the cast. I know, I shouldn’t care about appearances, but there have been a couple of combinations that, while promising mechanically, were far too humiliating to leave the house in. The heel lifts weren’t comfortable in my other shoe, they dug into the sole of my foot and made it uncomfortable to walk, which defeated the purpose. I think I may have it figured out now. I bought inexpensive Dr. Scholl’s “back pain relief” orthotics and put one into my sneaker on top of the factory insert (I wish they sold them as singles!). Now that the heel lifts are out of my air cast I feel like my legs are about the same height. Last night I went out for dinner with friends, and wore a dressy shoe with a short wedge heel, since my sneaker would have looked even sillier with a dress. That also worked fine. One other minor pain, my big toe (injured leg) is sore near the nail bed and I can’t figure out why. At first I thought it was pressure from the seam on my socks, but I’ve adjusted that and it isn’t better. I’ve also loosened the strap across the top of my foot, but that’s not helping. I tried a blister pad covering the area and that helps somewhat, so I’ll just roll with that for a while.

The scar
The Mepiform I wrote about previously certainly seems to be reducing the scar formation. From what I’ve read online, silicone has been used in scar management since the ’80s, and apparently, it works by hydrating scars so that they soften and flatten over time. The bottom stretch of my scar that was raised/puckered because of the way the skin had been pulled together and stitched is now flat and almost all of it seems to be healing up fine. But I almost think the Mepiform is too effective at softening the skin. There’s a small patch at the top of the scar that was healing fine at first, but then became irritated (perhaps by an ingrown hair?) and I think the silicone in the mepiform actually made it worse — it doesn’t allow it to scab up and heal. I took it off for a few days to let that section dry out, and it’s already looking better than in the photo. I will put the Mepiform back on in a day or two.

Uploaded photos below.

This is my Frankenscar and swollen ankle at 3 weeks post-op. What ankle bone?

Finally, driving
Chuck, I did it! At 7 weeks post-op everyone in my life is fed up with driving me around . . . but no more than I am fed up at being stuck without wheels. I wasn’t especially worried about most of the naysayers, but my husband was not keen for me to try driving left-footed, and since they are also his children I’d be driving around, I bided my time. But this week his schedule at the firehall meant he couldn’t drive us, and my parents were not available, so he finally relented and gave me the thumbs up to give it a try. I went out several times on my own first. There is no console in my Honda CRV and it has a cupholder/tray that drops out of the way, so I slide over and jam my right foot in there. It’s a trick to get in and out, but once in, not too uncomfortable (not to be done in a skirt though, I realized quickly). At first I was WAY too heavy on the brake with my left foot, but otherwise I figured it out quickly. It’s really not hard. The main concern raised by everyone else — that I would step on the gas instead of the brake — is quite unlikely. The gas pedal is the more difficult one to get to for the left foot. And as I suspected, 22 years of driving experience holds true no matter which foot you drive with, my ability to read traffic and follow the rules etc. has not been affected. I’m going a bit more slowly than I would usually, to adapt to the change and because I don’t want to risk even a fender bender or getting pulled over. But oh, the freedom! Yesterday I dropped the boys off at their respective schools and picked up groceries. Tomorrow I plan to hit the gym on my lunch break. It feels incredible to be getting back to my usual routines, and maintaining a constant supply of milk for my coffee in the morning, rather than running out every few days (and nagging my husband to pick it up), will be a giant relief. It was definitely the little things that were driving me nuts!

So … onward. Happy healing everyone!

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