As the title says I have undergone a z plasty surgery on my Achilles tendon and I also had a subtalar implant inserted AND a bunionectomy all done at once. I am at this day 8 weeks post op at the time of this posting and would like to share.
How it all started…
I am a 47 year old active duty Air Force for 25 years and have been suffering from Achilles pain and sore heels for the last few years. I blamed the pain on bunions that I had been diagnosed a few years prior. My own misguided reasoning was that the bunion pain changed the way I was running causing the pain I was experiencing all over my lower legs, which to a certain degree I was right as confirmed by my doctor, and yes, I was that guy who always complained that “my bunions hurt” which always gave a chuckle to those around me. Nonetheless, I also constantly had sore (and tight) calves, Achilles and feet. I was later diagnosed with plantar fasciitis by military orthopedic doctors when stationed in Okinawa. I was prescribed prescription orthotics, physical therapy and even injections. You name it and I have probably tried it! Nothing seemed to give me relief of pain and being in the military, I had to maintain my physical fitness standards, which meant—PT (physical training in this case) would continue. I would very frequently get very painful muscle pulls/tears in my calf during high intensity exercises such as running and basketball but even after those episodes, I still experienced the pain in my feet, Achilles and calves every day. This pain continued daily with no relief! After discussing my options with my doctor, my last resort was going to be surgery, which was explained to me that it was to be a band release of my fascia. However, I would have to wait until I changed duty station since my time was up in Okinawa and I was to be reassigned to the states.
Upon arrival in the states here in Montgomery, Alabama, I was referred to a podiatrist who suggested surgery as well, but instead suggested to do an Achilles lengthening and add a subtalar implant. The subtalar implant would be to correct my over pronation. The method for the Achilles lengthening was to be the percutaneous ATL which was to be 3 cuts across the Achilles but after the doc’s further review, z lengthening was chosen. I was also told that they were going to revisit my toe and go in and see if they could get some more mobility out of my big toe. So right leg/foot would be having THREE SURGERIES IN ONE!
12 May 2015 Surgery Day!
I arrived for surgery 0830 as instructed with my wife and daughter and was taken to a room. I met the nurse that said she would be taking care of me during my stay and directed me to strip down completely and put on the “the gown”. I am a larger size guy so “the gown” always found a way to reveal sensitive areas at the most awkward of times. LOL. No biggie for me. She took my vitals, laid me down, put in the IV and put blankets over me in preparation to be wheeled to the OR. I then was visited by my anesthesiologist who explained and laid out how everything would be going down in the OR. I got worried at first since I admitted to having a sip of water earlier that morning (habit of mine) and that caused some concern to the anesthesiologist to the point where I thought they were going to call it off. Luckily, since it was only a sip of water and the amount of time since I had ingested, I was giving a green light. *whew* I would have absolutely sucked to mentally prepare for the surgery and then to have it postponed due to a small error on my part. Note to anyone preparing for surgery…when they say do not eat or drink anything, do not eat or drink ANYTHING!!! I was then wheeled into the OR which was filled with a group of young residents that were listening intently to what I would assume was my Doc’s operations gameplan. I was then positioned on my stomach, where “the gown” really started to annoy me in this position but oh well, let’s get this party started. The last thing I remember was the anesthesiologist attaching the IV and asking me if I was comfortable.
I woke, right side up btw, in the recovery room and the first thing I noticed was there was the wrapped cast over my right foot. I looked around and thought to myself “hell yeah everything went great!”. I was rolled back to my room where my wife and daughter were waiting. I was given cookies and juice and was allowed to put my clothes on. BTW, I should mention to wear very accessible and easy to put on clothes on your surgery day. My choice was t-shirt, cargo shorts and my sandals which worked out great. This might not be the best during wintertime, but you get the picture. I was given two types of pain killers and a laxative since they said the anesthesia could could cause constipation (didn’t need and they missed mark because I had the runs the next day) and was told to not take a shower/bath until I was given the okay. I was also instructed like most here on the blog NO WEIGHT BEARING WHATSOEVER! I was given a ride to car and a pair of crutches and was homebound. I did not have any pain once I got home and the first day went without incident.
Pain rears its ugly head the next few days, but took the meds as instructed and it kept most of it at bay. Speaking of pain, crutches added a level of pain to the equation. The crutches I received were probably the cheapest on the market, thus they were not very comfortable and caused mostly my hands to hurt and by the second week, my tennis elbow showed up using them. I had a visit on May 15 where the Doc cleaned and examined my stitches and redid the bandaging. We talked about pain, numbness and swelling expectations and remedies and was given my next appointment.
Ok, crutches sucked! My hands hurt from using them, and my tennis elbow got pretty bad. I got online and bought my own knee scooter and I have to say it has been fantastic. It actually got me out of a small depression I was going in. Oh yeah, by this time I started to smell an odor about myself even though I was doing the sink baths. My solution was some industrial garbage bag and duct tape. I had a place to sit in my shower and I carefully kept my wrapped/sealed leg out of the direct stream from the shower and I felt/smelt great. My next doctor’s visit removed the stitches from my Achilles and big toe, but left the implant incision stitches in since they did not look as healed as the other two. I also got fitted for my walking boot, but was given instructions that I still could not put full weight on it but I could remove to sleep. Had a pain to start bothering me at this time on top and the outside of my foot which felt like electricity whenever I moved my 3rd ,4th or pinky toes or if anything brushed or touched any area on the outside top of my foot. I thought it strange at that time since it was so far away from where all the cutting was going on.
Nothing out of the ordinary. The new pain that is bothering me on the top outside of my foot seemed to get worse. Found a stitch coming out of my toe that the doc (actually the technician) missed. I tugged on it a little and it didn’t budge. I left well enough alone and ignored it till my next appointment. Oh yeah, people kept asking me about my knee scooter when I was out! Beware that kids will want to ask you for a ride if you have one. My daughter said that I need to stop smiling so much while on it and maybe I would seem so approachable, but I do admit it is fun! Get used to stares and questions when you are out and about on them as a lot of people have not seen many of them at this time. I am sure they are going to get popular because when I went to rent one before buying mine, they were all rented out!
Had appointment with Doc where he removed the rest of the stitches, including the stray toe stitch and discussed the “new pain”. Had xrays taken and told that everything looked good. I was given a LIMITED full weight, meaning that nothing high impact. Realized that I have ZERO calf strength at the time!
I tried limited full weight and found out that it was pretty painful at first. Not so much the Achilles, but I could definitely feel that implant. I was also given the OK to go in a pool and I find that very therapeutic.
Started to walk (if you want to call it that) or hobble without too much pain. I can tell if I overdo it because I would be rewarded with soreness later on in the day.
I am able to get around but I seem to have a limp that will not go away. It is not a pain limp, but simply a limp that I cannot seem to change to my normal gait. I believe it is because I still cannot get lift from my calf when I walk so I am hoping that the physical therapy will help me there. For those of you who are wondering, I have not start physical therapy yet and was supposed to get scheduled at my next appointment, but I was notified that my appointment has been moved up another week so I probably won’t see it till then. I am too scared to try something on my own and since I don’t have the doctor’s permission I am not going to press my luck. I did that once before by not giving my toe enough time after my last surgery so that is why they went back in this time because of my impatience.
Present day. My appointment for doc’s visit was cancelled/rescheduled for next week. This kinda sucks since I was hoping to start PT (physical therapy) this week and be given the ok. I have been trying to walk short distances in shoes (yes I know I have not been given the green light for this yet) and I am able to do so without much Achilles pain, but I am now finding that the pads of my heel and outside edge of my feet are sore perhaps due to my implants that are causing my step to change. I am also still walking with sort of a limp since I still have not developed my calf strength yet. Just waiting for a PT date.
I am happy to see and read other blogs and their experiences which made me realize that the road to recovery may be a bit longer than I really expected. I opted for my surgery to get rid of pain, but I think I didn’t really consider that the recovery was going to be such a long road
No Comments »