Friday 2nd February: My first day back at work, though I have gone into the hospital 2 or 3 times in the last week for meetings and visits. Today is outpatient clinic only, so hopefully an easy introduction and tomorrow’s the weekend! One stick and partially weight bearing and the first time I have worn a tie for 8 weeks.
Most doctors even the senior ones don’t wear a tie any more, under the guise of infection control though I suggest that the creeping chest hair a tie keeps covered up is more an aesthetic and microbiological hazard than the tie any day. Also it’s a difficult habit to break and I used to think that patients may have more confidence in a doctor who looked smart, rather than if he/she had just got back from taking the dog for a walk. As for the patients now it is usually only the older ones who make an ‘effort’ to dress up a bit when coming up to a hospital clinic, a bit like going to church. Perhaps it makes consultants more approachable if they look as if they can’t afford a decent suit, it was to make us more approachable that white coats went, first for paediatrics so as not to frighten the children though they were very useful at keeping their vomit off your clothes, and then for everyone else as hospitals realised that they could save a chunk of money by dumping uniform and laundry facilities. The only place you will find a white-coated person in a hospital now is either in a path lab or the pharmacy. Somewhat odd that this dumming down has not caught on in most of Europe or the States, you would expect us to have the lowest hospital infections rates in the world now, funny that.
Back to the task in hand though – a staged return to work. Everyone was very welcoming and seemed genuinely pleased for me to be coming back. I even got a hug from one of the nurses. This was a multidisciplinary team clinic for prostate cancer patients, a couple newly diagnosed and the rest on treatment or monitoring. Patients have the benefit of being seen by both myself as a surgeon, my oncologist colleague who is an expert in radiotherapy and also getting support and practical advice from one of our specialist cancer nurses. In addition we also had a couple of medical students for part of the clinic so the consulting room was full. It was nice to be back.
Walking around is getting easier, partially weight bearing with one crutch enables me to carry things and open doors. That is a huge practical benefit over needing two crutches though for any distance I would still prefer two crutches at the moment. I have taken 3 short video clips to show my progress from none to partially weight bearing, first with 2 and then only with 1 crutch. This transition has really taken little over two weeks. Eight weeks after surgery it is unlikely that I will now damage the tendon transfer, except perhaps by vigorous resistance exercises, so progress with gradually putting more weight through my foot is just determined by how it feels. I was a bit worried by this to start with but it just seems to come along in its own good time.
Non weight bearing
Partial weight bearing with 2 crutches. Can limit the weight taken on your foot, increasing it with time.
Hint: Try standing on bathroom scales with your crutches either side to get a feel for how much of your weight is going through your leg.
Partial weight bearing with one crutch. More weight now being taken through the VACOped boot with one crutch held in the opposite arm and moving with the boot.
I am continuing with the physio in the pool at the moment but after another week or so expect to have moved out of the water and into the gym. I do find the pool exercises (walking forwards, sideways and backwards in various combinations with and without floats), very helpful for my whole leg in general, as well as the foot. With the water buoyancy I can walk comfortably without my boot on and getting up a bit of speed swimming is the only cardio exercise I have had since surgery.
My balance is still useless. When I try to stand in the pool on my bad foot only, I start to topple over very soon despite trying to keep steady and flapping the floats in the water to try and keep still. My aim is to manage one minute of one-leg standing by next week. Owen has also given me exercises to try and build up core strength that should help with balance and posture. I just have to make the effort to do them often enough. My right shoulder, which I dislocated many years ago, has been starting to hurt a bit now, no doubt due to the extra work this arm is doing with the single crutch. Owen’s advice about that also has been helpful.
Next week I will be going into work every day for the first time, again clinics only and more meetings, as I don’t have as many of my usual excuses about workload to avoid them.
My Flatfoot Surgery Recovery 