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.

foot up

Foot down 5 weeks

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

December 21^st

I am now two weeks after surgery and went back to see my consultant.  The cuts are all healing well and not much swelling so dressings now off, suture ends trimmed and back in the boot.  I am to take my foot out of the boot to do passive exercises, and will start with my physiotherapist at the 4-week point, concentrating on hydrotherapy first.

I can also start to get my foot wet.  I am sticking with the bath, which I prefer to showers anyway now that I’m not in a rush. I was able to get in safely from just a few days after surgery, and then lift my foot up over the side resting on a stool placed alongside the bath with a pillow covered by a towel to get to the right height. Luckily our bath taps are in the middle but depending on which foot is affected you might be battling with the taps. I then use the hand shower on our bath just to wash over my foot and soften the scabs without soaking the wounds, which are still pretty fresh, and then pat dry. I am using a moisturiser and some Bio-Oil to massage in around the scars.

Our shower was retro-fitted so there is a five inch hop up to get in and no grab rails. If we had a shower that was easier to get in to, then an old stool to sit on would work. I have read though that most of the early post-op accidents with people who have had foot surgery seem to be related to them slipping in a shower so I will stick to the bath for some time yet, and you don’t have to get a waterproof cover for your cast or boot, which you would need for a shower.

Its still very early days but I am feeling my progress is fine. I am not taking regular painkillers any more, usually just a couple of paracetamol last thing at night. I’ve got used to the nightly ritual of the heparin injections to reduce the risk of deep vein thrombosis but find it awkward to sleep with the boot on, no doubt I will get used to it as I guess its going to be my friend for at least a couple of months more. Trying to spend less time in bed where one of our cats has adopted me as his favourite place to be.

Muscle loss – It is frightening how much calf muscle wasting I have had. Before surgery the affected calf was about 1cm less in circumference as I had been limping for a while. Now just 2 weeks later the difference is a whopping 5cm, though the other one calf may be have got a bit bigger due to all the hopping I have been doing with my zimmer frame that I use in preference to crutches still for moving around the house.

Moving about. I have heard good things about the kneel-on scooters, which you can hire from StrideOn for about £19 per week (Other knee scooter are also available). They seem particularly good if you need a free hand to carry a drink or food, which is a major challenge using a zimmer or crutches. Luckily I have help at home and coming up to Christmas our children are around a lot more as they are now back from university. I can make a cup of tea then slide it along the worktop, hopping after it and then do a swing over to the kitchen table. Dry items I just carry in a bag slung round my neck. The knee walker is probably also invaluable if you need to get out early after surgery to the shops, but I am hoping to avoid doing this. I anticipate that I will be able to start progressive weight bearing after 4 weeks or so when I will need crutches so decided to forgo this gadget. If you think it could be right for you though details from their website below.

www.strideon.co.uk

Whilst surfing I found a great blog by Paul Gee describing his recovery from similar surgery to my own nearly 4 years ago and he was an enthusiast for the knee scooter (see entry for ‘Day 1 – The Surgery’)

mybigflatfoot.blogspot.co.uk

I will write again after Christmas and the New Year to report on progress.  I fear that I will be even more useless around the house than usual.  Managed to get the outside Christmas lights up just before my operation but the rest of the decorating and planning for the wider family invasion on Christmas Eve will be down to the others.  Anyway I should look on the bright side – no working, no driving so plenty of opportunity for some of those bottles of good claret I have in the back room.

Continue reading “Week 1” →