Surgery/Ankle Block March 9 2017

My surgery was scheduled for 9 days after the rupture.  In the days leading up to the surgery I was in a dorsi flexion cast and on crutches.  It was certainly very uncomfortable to leave my foot down at all, as the pressure and throbbing from the injury would make the cast very uncomfortable, but not necessarily painful.  I had said no to any pain relief in the ER, so was only taking Ibuprofen as needed.  In hind sight, I was wishing I at least had another option especially at night.  I slept with my leg elevated on two pillows and didn’t struggle too much to get comfortable and sleep.

My job is partially at a desk, and partially showing future families around our campus at school.  (My job is also 45 minutes away from my house, and not driving is going to be a challenge.)  Clearly the tour part won’t be happening for a few months, but am still able to be in my office and do everything except the tours.  I went to work for the two days before my surgery, but because the plaster was on the front of my leg and where the injury is obviously on the back, it made it difficult to comfortably elevate my leg while sitting at my desk.  It was a long two days, and my back and hips were very sore afterwards, but I knew that getting out and about was important, both mentally and physically.

I had discovered the knee scooter in my research and sent my husband on the hunt to find one (not a lot of them available here in sleepy little Perth).  We managed to hire one, and I am very happy to have it.  It was a little uncomfortable in the plaster, but was much better once I progressed to “the boot”.  I use it a lot everyday, but also use the crutches as well.  All though the crutches make me sore, I think of it as “gaining strength” every time I use them, and remind myself that not sitting around being sedentary is a good thing.

Anyway…the surgery.  I was originally scheduled to be there at 7:00 am, and got a phone call the afternoon before to say don’t arrive until 12 instead.  The anesthetist called me about 8 pm the night before to chat, and suggested that I think about an ankle block as pain relief since a repair close to the heel can be quite painful.  He said I could decide once I got to the hospital.  I got to the hospital at 12, and wasn’t actually wheeled down for surgery until 4, where I sat in the little room (with lots of other people…strange) for 30 minutes and was finally taken to theatre at 4:30.   No drama with the surgery.  Once the iv was in, the meds kicked in quickly, and I comfortably went to sleep about 2 minutes later!

The surgery took 73 minutes.  I didn’t realise that I would be lying on my front for the surgery, as I was on my back when I went to sleep.  I did opt for the ankle block, but there was about a 45 minute window of time where I was without any pain relief at all after the surgery.  This was the time it took for the ankle block to kick in.  I was in a lot of pain as I woke up in the recovery room, but opted not to take any pain relief as I didn’t want to be looped up and thought the ankle block would be kicking in any minute.  I should have taken the pain relief…it was a long and painful 45 minutes.

I was scheduled for one night in the hospital, with discharge around 12 the next day.

They figured the ankle block would last approximately 12 hours, give or take an hour, and would likely be wearing off around 5:00 am the next morning.  Once the ankle block kicked in, all was good…until the next day.  At 12:00 the next day the ankle block was still working full force.  At the beginning of the block I was able to move my toes, and about 6 hours in had no feeling in my foot and could not move my toes.  Since the block had hung on for so long there was the question of possible nerve damage, however the block started to wear off around 1:00 pm.  The transition from no block to the reality of the pain was AWFUL!!  So much so that I probably would reconsider having had the block in the first place…it was great while it lasted, but it took a lot of meds to get things under control in the transition.  The pain was excruciating and intolerable for around two hours.  I would say that was the worst part of the journey so far.  I was discharged finally around 4:30 that afternoon and went home with the 12 hour slow release oxycodone which I used for the next two days.  I was able to switch to panadol osteo on the third day, and then went to only “as needed” from that point on.

I was in a back slab cast with my foot in a relatively comfortable position.  The cast would get really tight on and off throughout the following days if I did not keep my foot elevated.

I considered going to work for two days the following week, but decided that I would take the extra couple of days to recover.  I returned to work for the first time on the 11th day after the surgery.  I worked Monday and Tuesday, then from home on Wednesday, and then back to the office for Thursday Friday.  The hardest part was not being able to leave my foot down at all, as doing so was instant swelling and throbbing.   It was tolerable, but exhausting to be back in the office.

Next post will be my first post op visit, two weeks after surgery.

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