January 4th 2018. Now 4 weeks after surgery and got through Christmas and New Year. Mine was rather different this year as you will have guessed. We have a 3 seater sofa where both the outside seats recline and my 90 year-old mother in law and myself occupied these for post-prandial recovery each day over the 3 days all the family came to stay. I felt she was the more spritely and at least didn’t need my zimmer frame.
I increased my stock of books and list of films to watch and and least didn’t have to worry about the odd drink or three as I wasn’t driving anywhere. I had some cards and flowers from work colleagues, which were very sweet. Pleased that they seem to be managing fine without me.
First physio appointment. This was the highlight this week, to meet Owen who is to supervise and encourage my recovery over the next 3 months or so. The first session was just an assessment and massage and I will start off in the hydrotherapy pool next week.
He went over proper crutch usage again as I was tending to overswing and not have the best posture so hopefully will improve here. Scared him a bit I guess with a bit of a stumble coming down the stairs after our session but no harm done. My right shoulder has not been quite right since I dislocated it more than two decades ago and it has come out with more minor injuries on a few occasions since, but not for at least ten years now. Starting to ache rather more with using the crutches, hope not starting my next orthopaedic condition quite yet. Got some strengthening exercises to do.
Week 5 – In the Pool
This was a great confidence boost. The pool is at a local retirement village in Chalfont St. Peter and part of a small gym/spa complex. It has a full-length bar (to hold onto!) down one side, constant 1.2m depth throughout and quite warm. I have not more than momentarily touched the ground with my foot without the boot so far, and after the first session was able to walk along the pool sideways, and backwards as well as forward. I was using a bit more flotation that just the water with some polystyrene dumbells pushed down into the water, but at least I was walking on both feet unaided! It did feel strange, my foot feels pretty numb especially the heel, and my balance on that leg only was hopeless but I really started to feel that I was making progress.
After the second session I could do the same without holding onto the bar, was swimming and doing some quads and calf exercises in water against resistance. Probably another couple of weeks in the pool and then moving onto the gym if I am able to weight bear fairly well by then. I must not give up on the static exercises which although a bit boring are helping. My calf muscle wasting has stopped and perhaps just a bit of an increase now. I started getting some aching after the physio along the calf muscles, not in my foot, that FDL is starting to wake up.
Purple foot sign. Another strange thing I have noticed is that if I let my foot down just for a few minutes it goes a dark colour, almost purple and start to ache but these changes reverse quickly when I elevate it again. I guess that a similar though less pronounced process is occurring even in my boot, as I get a bit of aching if I don’t have my lower leg at least horizontal most of the time. I have tried to capture this in photos shown below. These changes are because the muscle pump system in the calf pushing blood back to the heart against gravity is pretty useless at the moment, fits with all the muscle wasting I have mentioned despite the static exercises as I am not walking on it. Also there will be some reflex sympathetic nervous system changes also allowing the skin blood vessels to dilate excessively.
Well Mr Soleus, you are just going to have to buck your ideas up a bit and on advice of my physio I am going to wear a TED stocking on this leg when up on crutches to help you work a bit harder and reduce blood pooling.
My incisions are continuing to heal nicely, all the scabs have come away with a bit of gentle soaking, oiling and moisturising. All quite comfortable now though still rather numb. This is to be expected as the tiny sensory nerves under the skin will have been cut and take many weeks to re-establish connections. Two photos here of my scars at the 5 week point.
The aim for next couple of weeks will be to progress with physio enough to start to weight bear, back to driving, and planning a phased return to work at about 8 weeks. Lets see how it goes
My Flatfoot Surgery Recovery 