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Surgery and the hospital - good times, good times!

November 6th, 2010 by melanie

October 15, 2010
I did something that my surgeon thought was hilarious - but he also said it’s a good idea. I took a Sharpie pen and wrote on the sole of my “good” right foot (upside down, I might add!), “Right foot, wrong foot!” Then I wrote on the left sole (the messed up foot), “Left foot, right foot!” He cracked up when he saw that, and whipped out his phone to take a picture! But seriously - it’s not a bad idea to mark the correct foot, and make a note on the other one as well. Wouldn’t it suck to have BOTH of them cut into? People do make mistakes!

After all the questions, and laughter, they gave me a happy pill, which totally relaxed me. I chose to have general anesthesia, but you can also have a block or epidural if for some reason general anesthesia’s not the best choice for you. Personally, I didn’t want to be awake during the surgery.

I remember cruising down the long hall to the operating room, and cracking some (I’m sure very lame) jokes about Six Flags rides, and I remember them saying, “OK, Melanie, let’s move you over to this table” and they scooted me over, and then they said, “OK, ready? This is going to be very quick.”

And BAM - instant and total oblivion - not sleep, not gradually melting away - but sudden, total nothing. I remember one instant of “Oh, ___, here we go!” and that was it.

An hour and a half later, which seemed like, oh, one second, I heard a faraway voice saying, “You’ve had an operation, Melanie. Time to wake up and go to recovery!” (I think I must have said something like, “What’s going on?” or probably something more stupid sounding than that!) I woke up on my side, because they laid me on my side for the operation. I am quite certain I was drooling on myself!

As soon as I realized where I was (in about five seconds of drowsy confusion), I suddenly started talking and asking questions, and someone said, “Wow, she sure did come alive quickly!” I felt alert and pretty coherent within just a minute or two.

I felt discomfort, like a tight, burning sensation, in my heel and up the back of my leg, but it was not at all unbearable. They immediately asked me if I was feeling any pain, and when I said yes, they asked me to grade it (on a scale of 1-10 it was about a 4), and they immediately gave me something in my IV which worked in about two minutes.

I forgot to mention this earlier, but they had given me something for possible nausea before the surgery. I didn’t feel nauseous at first, but all of a sudden I got a wave of it. They immediately gave me some sort of pill which worked quickly, so I never did actually throw up, and the nausea went away. One weird note though - you would think I would be starving, since by then I hadn’t eaten in 15 hours, but I had absolutely no appetite -then, that night, or even now (the next day).

The doctor came in and talked with me and told me that everything had gone great. He said when he got in there, the damaged tissue was easy to clean out, and that the tendon looked very healthy, except for the tear, which was easy for him to sew up due to the healthy stability of the rest of the tendon and tissues. He didn’t have to do a lot of debridement either. He said that my recovery time ought to be really great.

I could pretty much comprehend what he was saying, but it was sort of like when you’re a teenager and you come home drunk, but your mom catches you in the hallway - you’re trying to act sober and talk straight, but it takes a lot of concentration - and it’s probably pretty obvious you’re not really coherent.

If I had not had an earlier negative reaction to morphine, they would have given me that, but instead they gave me Demerol during my recovery room stay, which worked well enough. The pain abated from about a 4 to a 2 on that pain scale, but I could definitely tell that someone had been doing something to my ankle.

I had another reaction to whatever - the surgery, or pain meds, or something - my teeth started chattering, and my hands started shaking, even though I didn’t feel cold. It was really pretty funny, because my chin was wobbling like CRAZY - but after a couple of minutes of this, it was tiring. The nurse took my temperature and it was 96, even though like I said, I didn’t FEEL cold. She got me some warmed blankets and put one around my head and shoulders and one across my lap. Immediately the chattering and shaking quit. So if this fairly common shaking starts with you - ask for those warmed blankets right away. Heck, even if you’re NOT shaking, ask for the blankets - they feel great!

After the chattering drama was resolved, they moved me from recovery to a regular room. I was feeling pretty chipper and alert. My husband helped me get my regular clothes back on, and the physical therapist came in with (TA DA!) THE CRUTCHES.

I’ll cover those in the next post -they deserve one all their own.

By then I was feeling more alert, but also more tired, if that makes sense. I was ready to go home.

Michael went to get the car and they wheeled me out to the curb. Suggestion - try sitting in the back seat rather than the front. If you can navigate (with some help) into the back seat and stretch your casted leg out across the seat, it feels MUCH better than letting your leg dangle over the seat. I have found that elevation is CRITICAL to keeping the pain at bay. Even a few minutes of lowering my leg stirs up discomfort and pain, which elevation quickly decreases.

After calling me “Miss Daisy,” my husband drove to the pharmacy to pick up the extra strength Vicodin with acetaminaphen, and I fell asleep in the car. When we pulled up at the house, I got my first real taste of the crutches.

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Things go from bad to worse

November 6th, 2010 by melanie

One month later, I returned for the evaluation. There was absolutely no improvement. At that point, the doctor told me (in under two minutes) that I would need to wear the cast for another 4 weeks, and begin physical therapy three times a week to stretch the tendon and improve my range of motion.

Here’s where I think things really got off track. I believe I should have had an MRI at this point - because unbeknownst to us, there was a tear in the tendon - which was made WORSE by the physical therapy that I faithfully did for about three months. Finally, I just stopped going to PT because it just didn’t feel right. I told them I was feeling burning and numbness and that things were no better, but I really got no response. In fact, they told me that I could take off the AirCast, and just exercise that ankle every day, and that things would gradually improve.

Meanwhile, I was doing some internet research of my own on the problem, and realizing that Achilles tendonitis (which was my official diagnosis) was a long, slow heal, so I pretty much resigned myself to just pushing through.

Well - pain is the great communicator, and my ankle began to communicate with me in a louder and louder voice. From August through September the pain became so disabling that I was spending most of every weekend with my foot elevated and on ice. I was going through bottles of ibuprophen like water. And then my sciatic nerve rebelled (probably due to the limping and favoring of that left leg) and I went to a chiropractor.

She gave me great advice. She told me that she could make me feel better, but that anything she did was a temporary fix, because my Achilles tendon was the source of the problem. She took one look at it and scheduled an MRI.

INTERESTING. The MRI showed a two inch, lateral high grade tear, as well as tissue damage. Basically, my tendon was hanging by a thread and could rupture at any moment. My chiropractor (my new personal hero) immediately asked me if I had a preference of orthopedic surgeons so she could refer me, and fortunately - I knew a good one.

Dr. Michael Langford had operated on my husband’s elbow a few years ago, and is one of the best orthopedic surgeons in the area. He is swamped with patients, and the wait time to see him was months - but I asked if I could fax over the MRI results to him to see if I could get in earlier. This was effective - as soon as I did so, I got an immediate appointment.

He determined that the MRI was correct, and after consulting with his team, they determined that I needed surgery, and that I should wear the cast till we could coordinate my husband’s work schedule and my leave of absence, which was about two weeks. He told me that based on the length of time I had been trying other methods, it was pretty obvious that a non surgical approach was not only not working, but counter productive - and I agreed.

So…we scheduled the surgery for October 15.

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Good tendon gone bad!

November 6th, 2010 by melanie

One year ago (in October 2009) almost to the day, I fell off a step ladder and definitely stepped back hard on my left foot, but the pain wasn’t severe at the time. Over a period of several months, though, I noticed that my left ankle was very stiff in the morning, or after a few minutes of sitting still (like at my desk at work). Then it began to actually hurt (quite a bit) after periods of rest, though the pain did subside after a few minutes, and usually didn’t bother me again till I rested. What got my attention was that my knee and ankle started “popping” a LOT - and it got to the point that the pain and stiffness was pretty severe UNTIL both the knee and ankle popped.

This began to affect my usual routine of walking for about an hour each morning. First infringement on my lifestyle…

I think the “coup de grace” was when we moved in April (6 months after the pain and stiffness began). We had a two story house and I must have run up and down those stairs 50 times. Though I was careful to wear really good athletic shoes with good support, within a few days, I realized things had reached a critical point. My knee and ankle were swollen and I had to elevate the leg, pack it with ice, and take lots of ibuprophen - all of which were effective. But I was worried now, and finally went to my family doctor, who immediately referred me to an orthopedic specialist.

Now, I am going to sound like an old fart, but my first alarm went off when I met the doctor. She looked like she was a small child.

Her “bedside manner” was basically nonexistent. She looked at my foot for about 30 seconds, and sent me down the hall for an X ray. When she got the results, she immediately said I had no arthritis, no fractures (honestly, I could have told her that), and that she felt that the very obvious lump on the back of my ankle was bursitis and that I also had a Achilles tendonitis. She put me in an AirCast, telling me to wear it for one month, and return. She said she felt my ankle simply needed rest. She said I could take the Air Cast off when I got home each day from work, as long as I was sitting down for the most part. My instructions were to wear the cast for most of each day.

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Hello world!

November 5th, 2010 by melanie

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