5 week post-op checkup, PT ahoy.

April 13, 2017

I had a 5-week checkup today with no surprises (it’s actually day 34 but who’s counting?). That’s a relief given my fall last week and the fact that every little twinge made me think I’d messed something up. I’ve felt good but it was nice to see the doctor give my leg a once-over and say that everything looks like it should.

I’m cleared for neutral in the boot, I can slowly start PWB, and I’ll have my first PT appointment late next week. Also continuing the gentle ROM exercises with the boot off. Neutral isn’t too much of a stretch now (ha) but I’m going to leave my little heel wedge in for one more day so I can get used to the idea. The fall spooked me so I’m feeling extra careful these days.

Has anyone “interviewed” PT places before the initial session? I didn’t get much guidance from the doctor - he said all 3 that are in-network are good - but I want to be confident in the PT plan. I suppose I can always change providers if I don’t like how the first visit goes.

Aside from having the checkup to look forward to, this was a fairly boring week. I have random pangs and twinges in my calf and ankle. Nothing that causes alarm, really. The incision looks good - most of the scabby stuff is gone. The skin around the incision is sensitive, especially by the end of the day. Sometimes it feels angry and irritated, other times it’s almost numb. I’m assuming the nerves are still figuring out what the heck is going on down there.

Overall, I guess boring is good at this stage. At least next week it’ll be boring with a dash of PT!

The dreaded slip and fall. Or near-fall.

April 5, 2017

Man, just as I was feeling good about keeping myself protected in the first 4 weeks…I go and fall on my injured foot (in the boot, thank goodness) last night.

It was the simplest, thing, too - just crutching in to the bathroom and my right crutch slipped out from under me on the tile floor. Before I could even think about what happened my right leg was out and catching the brunt of the near-fall. It hurt, but it was more of a burning sensation up and down the back of my heel and calf. I did my best to quickly prop myself up with the other crutch and stumble around a bit. I think I pressed the bad leg down twice reflexively. My leg flexed in the boot a bit - there’s a little give in the upper part of the liner - but I can’t imagine it moved very far.

It’s hard to separate the physical feeling from the initial fear. And there was a lot of fear. The pain and burning stopped as soon as I got weight off of my leg. In the end it felt more like a stretch than anything worse - no tearing or popping sensation. There’s no swelling and the incision looks fine. Basically, everything looks the same this morning as it did before the stumble. I have the same basic ROM but haven’t pushed that. I just strapped the boot on tight and will now keep my fingers crossed.

My guess is that my calf flexed/tensed for the first time in 5 weeks and most of what I felt was tightness related to that. I did have a few little twinges in the upper calf, like a light calf strain, but those went away within an hour or so.

Well, I made it 26 days before a fall. Here’s hoping that’s the last one! I’m not quite sure whether I’ll check in with my doctor this week. I have an appointment next week…without any other signs/symptoms I’m inclined to wait for the scheduled visit unless I start noticing swelling, bruising, etc.

25 days post-op. Waiting waiting waiting.

April 4, 2017

This week will be a grind. My next appointment is on 4/13 so there’s nothing like that to look forward to. Now I’m back to my regular weekly schedule and tasks as a stay-at-home dad, only everything takes twice as long due to iWalking or crutching around.

Random thoughts:

  • My boot is comfortable, and I enjoy the freedom of being able to take it off for showers or resting on the couch. I still have the discomfort of the casts in the back of my head so really anything is better than that 3 weeks of frustration. My only complaint is that the boot liner is loose and can irritate my incision. The assistant who fitted the boot mentioned that Breg used to include two socks and they don’t anymore. I checked out options online and decided to buy 6 pairs of tube socks (hello, ‘80s version of me) for the same price as one “official” Breg or Aircast sock. The tube socks work great - I put them on, fold them halfway down my calf, and the incision has some nice padding. And with 12 I don’t have to worry about washing them all the time.
  • My incision gets irritated now and then but appears to be healing up well. There’s still a lot of scabby stuff hanging on, which is kind of gross. I clean the area each time I take my boot off and change out my sock - I sweat like a pig and it’s already warm here so I’m paranoid about keeping everything clean in there.
  • I started using a cold therapy wrap on my ankle and foot a couple times a day and that’s reduced the swelling a bit. I think it also helped with ROM. My doctor didn’t give me any specific advice when he mentioned doing gentle ROM exercises (he also didn’t mention any icing) so I made up my own routine based on some protocols here. Basically, I do 15 side to side movements, 15 super-gentle up and down movements, 15 toe curls, and the spell-the-alphabet thing. Ice wrap before and after that, and I stop any movement if I feel any discomfort. Each day has been a tiny bit better, especially after I added the cold wrap component. I don’t notice any extra swelling or discomfort after these exercises so I figure I’m okay at this point.
  • My secret hope is that being diligent with the early, gentle ROM stuff will somehow get me driving faster. Only time will tell!
  • Seeing my foot move, even slightly, has been a nice morale boost. I finally stopped wanting to barf every time I saw my swollen foot and incision, and I’m starting to think I might want to play tennis again. (Immediately after the injury and surgery I never wanted to exercise or move quickly again.)
  • Others have recently mentioned the fatigue at the 4-5 week mark and I have to agree. I’m not even fully 4 weeks past surgery and I feel like I’ve been extra tired at the end of the past 2-3 days. I guess it’s another one of the stages…I’ve been doing more work in the yard and around the house, but not enough to make me feel so wiped out (or so I thought).
  • Still taking vitamin C and adding a protein shake as a mid-morning snack. Not sure if that helps, but why not? I’m trying to eat well and maybe even lose some weight over the next couple of months.

That’s about it. I’m in one of those doldrum periods - a ways to go until the next appointment and milestone. I’m hoping to get PWB clearance next week. Fingers crossed for some kind of progress indicator like that.

Second post-op visit (20 days since surgery)

March 30, 2017

I’ve officially hit the boot stage of this process. I went in for a checkup and to get the rest of my stitches removed, and my doctor decided I displayed a cautious enough nature to graduate from his horrible, 3-ton plaster casts to a Breg Genesis Walker boot that I can take off occasionally for gentle ROM exercises and showers. (more on boot selection in a moment)

Everything appears to be progressing nicely. I can actually move my foot up and down a bit, so that’s a big change from the immediate post-injury phase when it was just flopping around. The incision site is less swollen and less squeezed and wrinkled up. The only issue was the assistant struggling to cut the remaining stitches out. On the first visit the PA got 6 out in about a minute at most. Today it felt like 10 minutes of picking and pulling and snipping. I guess the doc sewed them up pretty tight.

I’ll go back in 2 weeks, at which point I’ll be at the 5-week post-op point and will most likely move to PWB. After that, PT starts somewhere in the 6-8 week range. That seems to match up with the average times I see around here, or might be on the conservative side a tad, and that suits me just fine.

I’m so happy to be out of the cast. The 9 days since my last visit weren’t bad in terms of pain…it was more mentally challenging due to general cast discomfort. The last one was super heavy and didn’t quite conform to the shape of my ankle and foot like the previous one. By the end of each day it was so uncomfortable that I was seriously considering cutting the damn thing off and showing up at my appointment with nothing. The boot feels like it’s made of feathers in comparison. Now I can loosen the boot straps, adjust the air pressure, or even take the entire boot off if I want. It’s a big, if only temporary, morale boost.

I held off on the Vacoped purchase to see what the doctor came up with. My insurance company gave me mixed information about reimbursement for a purchase I made on my own, while having no issues with approving something a doctor ordered and put on a claim. I have to say I don’t mind the Breg too much. I know it’s early, but it has an air bladder system that’s not bad and the three wedges make it fairly easy on my ankle and tendon. The cost will be fully covered so I’ll give it a go and reevaluate the Vacoped option if necessary.

Now to fill the 2 weeks until my next appointment. I have a list of 3 recommended PT providers so I’m going to try to call or visit them to see how they’d approach rehab. More immediately, I’m going to beg someone to take me out to get a haircut as I’m 4 weeks overdue and going crazy. That was on my schedule the day of the injury but I wound up in the ER instead. The mop must be tamed! My son also has a friend’s birthday party to attend on Saturday so I’m hoping I can impress a bunch of kids with my futuristic bionic leg. :)

Six days post-op - random thoughts.

March 16, 2017

Happy to report a small bit of progress - the pain from surgery seems to have tapered off and I’ve reduced the pain meds to almost nothing. I still get some odd sensations in my calf and ankle but nothing like the first three days. I’m glad to be off the stronger stuff (oxycodone/hydrocodone) because I feel sick when I’m on those.

I’m able to get through a half-day with my son without any assistance. My parents come over for a morning or afternoon spell to give me some time to rest. I’d like to work up to a full day at some point. Now that the pain is subsiding that feels possible.

The iWalk has been great…but I’m already sooooo tired of using crutches or the iWalk to get around. I stay in bed until the last possible moment each morning because the thought of getting the day started is so frustrating. I guess I’ll get used to that at some point. Another iWalk note: this thing is so creaky and squeaky after a week of use! That would be my only complaint to date.

My first follow-up appointment is set for 3/21. Not too far to go. It’ll be fun to see what the incision and stitches look like, and to feel like I’m slowly checking off some milestones.

My neighbor is a nurse at a nearby military hospital. She said they have 26 people in boots or casts like mine at the moment. ‘Tis the season for lower leg injuries, I guess. She’d never seen the iWalk before so maybe it can help a few of those folks out, too.

Three days post-op.

March 13, 2017

It’s been three days since surgery and I’m slowly working my way through a bunch of old TV shows on Hulu. Also playing Basketball Stars and Hill Climb Racing on my phone.

My leg feels decent overall but it starts throbbing if I’m on my crutches for more than a few minutes. It’s worse in the evenings, when no matter how I’m situated my ankle and Achilles area hurt more than any other time of day. Something about that 8 to 10 p.m. timeframe makes it the worst. Fortunately I’ve been sleeping through the night without much trouble.

I might strap the iWalk back on today to at least get it re-adjusted to account for this giant cast. This thing feels about 3x heavier than the pre-operation splints. It appears to be made of the same OrthoGlass strips…they just used a bunch more. Makes sense considering the nature of the surgery and need for immobilization. I wasn’t quite prepared for that extra weight, though. I mean, I read other people’s accounts of the heavy casts but it wasn’t until I felt like my leg was encased in cement that I actually understood.

There sure are some strange feelings around the incision (or where I imagine it to be). I’m not sure what I expected, really. Sometimes there’s a burning sensation, sometimes it aches, and sometimes it feels like there’s something moving around in there - stuff twitching, pulsing up and down the surgical site, etc.

We ordered a week of dinners from a “gourmet on wheels” service in the area so that took away one worry for the next few days. I’m the primary grocery shopper and cook so it’s nice to know we’re good on dinners up until the weekend. We used the same service right after my son was born and it worked out pretty well. My wife is off today but working the rest of the week so the fun is about to begin! Thankful to have my parents nearby for some help with day-to-day stuff.

I’m not sure I have any practical advice for someone entering the same early post-op phase. I guess my one tip would be this: once you find a comfortable position, don’t move, ever! I’ve been trying to eat well and I’ve added one mid-morning protein shake and a 500 mg vitamin C dose to my routine. The doctor has me on one aspirin a day, as well, to reduce the chance of a clot. I’m slowly reducing the oxycodone and hope to be done with that stuff soon (don’t like how it makes me feel).

Crutch life.

March 9, 2017

A random conversation with my son this morning. We’d had a short walk outside and I was worn out from hobbling around.

PJ: Okay, I need to take a break now so I’ll have to take off my leg.

(we just call my iWalk crutch “my leg”)

Son: Okay

PJ: So I can take a break? You don’t mind? You can play by yourself for a minute?

Son: Yes!

(I take off the crutch and sit down at the kitchen table)

PJ: Ahh, that’s nice.

Son: I need a snack! Need a snack! NEED A SNACK!!!

It’s going to be a long few months!