The first week I spent longer in bed than I had probably done for the previous month.
I felt completely wiped out, my leg ached though not too much as I was taking regular codeine and paracetamol. Every trip to the bathroom was a major effort and I was glad to get back to bed and get my leg back up again. We hadn’t been a family with enough time to watch much TV so didn’t have any of the streaming services or SKY but they got me onto Netflix and I spent many hours watching the visually stunning The Crown, all 20 episodes of the two series, Suits and many more.
The day after I got home it snowed, the only snow of the year so far. Two kids made a snowman, the chickens refused to leave their house and the 2 ducks we have couldn’t understand what this ice stuff was on top of their paddling pool.
Lack of outside commitments have given more time to read, I do like books with a medical theme and have found so much to empathise with in “Being Mortal” by Atul Gawande. This is a beautifully written, insightful and thought-provoking book looking at mortality, the only certainty we have in life besides taxes (Benjamin Franklin, 1789). It explores how patients and their relatives often have a rather different perspective from their doctors on what is most important for them as they face a limited life expectancy. Often these are not predictable or indeed consistent but the book is illustrated with powerful personal experiences and those from Gawande’s long career as a surgeon. Anyone working with elderly people or with those facing life shortening disease will get a lot from this book and I thoroughly recommend it. I’m planning on reading one of his other books soon and will post comments in due course.
This week my wife had planned to be on holiday, indeed so had I originally, but hers got messed up by jury service. She had done her 2 week stint but the trial she was attached to went on for another 3 days into this third week but luckily two of our children are just back from university so had to do Dad-care duties, we coped. I got a sense of the issues involved if you are self-employed and have to arrange locum cover for your jury service, the reimbursement doesn’t even begin to cover the costs; thats the price of civic duty.
I went back at 1 week to see my consultant, and have the dressings changed. The padded bandage around the heel had got a bit bloodstained and as that had dried out it was rather hard and rubbing on the inside of my boot. Pictures here show the outside incision (for the calcaneal osteotomy) and the inside incision for the FDL transfer and spring ligament repair. The steristrips up along the back are from the percutaneous achilles tendon lengthening. Not much swelling and Mr Malik seemed pleased with the appearance after all his hard work. Starting to come off painkillers now except at night and back for another review next week.
I was given a written plan for what to expect to achieve over the first weeks and months after surgery. This is the template to measure my progress over the next 5 weeks
Initial Rehabilitation Phase (0-6 weeks)
Goals:
- To be safely and independently mobile with appropriate walking aid, adhering to weight bearing status
- To be independent with home exercise program as appropriate
- To understand self-management/monitoring eg. skin sensation, colour, swelling, temperature etc.
Restrictions:
- Ensure that weight bearing restrictions are adhered to:
- Non weight bearing for 4 to 6 weeks in VACOped Boot, at 6 weeks referred to physiotherapy.
- Weight bear as tolerate to full weight bearing in VACOped boot after 4 to 6 weeks
- Elevation 50 to 55 minutes in an hour
- If sedentary employment, may be able to return to work from 6 weeks post- operatively, as long as provisions to elevate leg, and no complications
Treatment:
- Pain-relief: ensure adequate analgesia
- Elevation: ensure elevating leg with foot higher than waist
- Exercises: teach circulatory & early ROM exercises toes, hallux and knee
- Education: teach how to monitor sensation, colour, circulation, temperature, swelling, and advise what to do if concerned
- Mobility: ensure patient independent with transfers and mobility, including stairs if necessary
My Flatfoot Surgery Recovery 