7 weeks post-op - fastest checkup yet.

April 27, 2017

It’s hard to believe I had surgery seven weeks ago. And the injury itself happened two months ago!

My doctor erased my PWB timeline concerns by declaring I could go PWB as tolerated, and then on up to FWB when I feel ready, so that’s nice. I’d already tested out standing and bearing some weight in the boot; now I’ll make it official and see how I do. I was only in the office for 10 minutes or so. It’s such a change from my first visits when I’d get light-headed at the thought of going in there and getting evaluated, talking about surgery, getting stitches out, etc.

For boot aficionados or shoppers, the Breg boot (Genesis Walker), though a welcome change from the cast four weeks ago, doesn’t feel particularly well-suited to this injury or at least the PWB/FWB phase. I’m eyeing those VACOcasts with envy now. But hey, the Breg and I have come this far so I’ll give it a go. I added an orange SuperFeet insole that provides a better feel when I practice shifting weight around. Without it my foot moves around in there (the liner also slides against the outer shell), and that kind of movement doesn’t give me confidence as I try to re-learn this whole walking thing.

I thought the doc would be impressed with my range of motion but he rightly pointed out that moving my toes doesn’t count. :) It feels like I’m moving my foot a lot more than I actually am. With three weeks of PT between now and my next checkup, I should be able to show him some more progress.

My goal is to have everything looking good enough to get an all-clear for driving at week 10. Even though I know some folks have started earlier, I didn’t even ask about it today. I don’t think I’d want to try at the moment - the stiffness and weakness make me think I’m simply not ready. I’ll be happy working on my PWB-FWB work and going from there.

Onward we go! Here’s to PT twice a week, exercises at home, and with any luck a lonely iWalk gathering dust in the corner soon.

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.

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. :)