Follow up #2

At my second follow up the cast came off and they took X-rays. I'll post them as soon as I can.

Everything seems to be healing well, and the staples and sutures came out. This did hurt a bit, kind of a burning sensation.

They put a tube sock on my foot and gave me a boot. I can't bend my foot enough to get it all the way in, I'm suppose to work at it though.

This particular boot has a a little push pump on it that airs everything up tight after I get it on.

I'll be able to shower without bagging up a cast. I can take the boot off. Yeah!

UPDATE...Here's the X-rays (click to enlarge):

I've duplicated one x-ray here and highlighted areas of interest. The little white "C's" up and down the back of my leg are the staples before they were removed. I'm still not weight-bearing. I'll have new x-rays then.


This is the money shot of the screw in my heel bone. Imagine sitting on the floor at the foot of my recliner and looking up through the arch of my foot at an angle. That's the angle of this x-ray.

Follow up #1

Warning! This article features graphic post-operative surgery photos.

I had my first follow-up today. One week after my surgery. I was tense as the nurse began to unwrap my leg. I hadn't seen it in a week and had no idea what I was about to see. I had felt little tingles, itches and minor pain here and there, so I had visualized in my mind what things would look like. The gauze had a lot of dried blood in it, which was a little gross. But no fresh blood was there. I left the office with cleaned wounds and a brand new orange cast. I'll have the cast for one week. Now, I apologize for the photo quality. My camera was broken, so I had to borrow my son's. Here are the pictures with a little commentary:

^ Okay, this was a little incision in my shin right below my knee that I wasn't expecting. This incision had one staple in it, which was removed. What the surgeon did here was harvest some bone marrow from the thickest part of my tibia. He mixed this marrow with the cadaverous bone graft material to create a graft that contained my own cells, thereby further encouraging bone growth.


^ This little beauty is the incision for the Cotton Osteotomy. This is the procedure that will push my big toe back down to recreate my arch. This is the first time I've ever seen an arch on my left foot. The line above the incision is just a drawing mark. The blue color around the base of my toes is where blood settled after the surgery. It looks like a bruise. This incision hurt a little bit after surgery.


^ This is the big one. This is the "outside" or lateral view of my left foot. This incision was where the talo-calcaneal coalition was broken, reset and packed with bone graft. This is also where the lateral column lengthening was done, whereby the calcaneous was elongated to straighten my foot. Again, the blue coloring below the incision is where blood settled giving a bruised appearance. This incision doesn't hurt much, but I feel a lot of pressure here whenever I stand up on my crutches. It goes away when I elevate it.


^ This is looking up at my heel. This incision gave the surgeon access to the bottom of my heel bone where he placed the screw up through the heel bone into the talus. This incision gets a little sore when my foot has set in one place for a while. You can see another incision in the lower left corner. I'll explain it next.


^ Okay, this is the last one. This is a shot of my calf. The wrinkly places are just impressions from the old gauze. The incision gave the surgeon access to the Achilles tendon, just below the calf muscle. The surgeon made a small incision into the tendon, which relaxes the tension on it. When the heel bone is repositioned it can pull the tendon tight. This helps relieve that.

Post-op: Part 2

I spent the night at the hospital. As the effects of the nerve block wore off I had a PAC machine hooked up to my IV to help with pain. The PAC machine has a big syringe inside of it full of pain killer. I was told that if I felt even a tingle I should hit the button that activated the PAC. The PAC would not allow me to overdose, so I could hit the button whenever I felt something.


While I was in the hospital I felt NO pain. Nothing. This was a real surprise for me as I was under the assumption that pain was going to be a real bear after the surgery.

We did keep ice on my foot to help with any swelling. I spent most of my time in the hospital watching TV and sleeping. I was discharged less than 24 hours after surgery.

Getting around the house
A physical therapist trained me on how to use crutches, which was a little scary. I have a friend in the medical supply business that brought me a walker. It's really great and I would recommend you get one for around the house. It comes in especially handy in the bathroom when you need the extra stability.

Bathing
I'm not allowed to shower or take a bath for a week. This is a bit tough. I've been using a wash rag and my wife washes my hair.

Pain Medicine
I'm taking two Percocet 7.5/325mg every 5 hours. The directions say every 6 hours, but I start hurting after 4. So I split the difference. I am hurting now, but not horribly. I compare the pain I'm feeling to the way my foot felt after I spent the day walking or cutting the grass. I had the surgery because my foot hurt, so I am used to foot pain. But as the Percocet wears off, I do get sharp pains and some periods of throbbing. It's all manageable though. Keeping my foot elevated helps eliminate pain as well.

Follow-up
I will have a follow-up appointment with the PA (physician assistant) in about a week. I'll take my camera with me in case the bandages come off. I think I have a total of 5 incisions.

Post-op: Part 1

It's been two days since my surgery and I'm doing fine. In this first post-op entry, I'm actually going to focus on my pre-op.

I arrived at the hospital two hours before the surgery was scheduled. I spent very little time in the waiting area (thank goodness), then my wife and I were brought to the pre-op room. This session began with several questions regarding the condition, getting my medical history up-to-date and confirming other information. They showed me a little gizmo that is used to encourage me to take deep breaths. I was to use it after the operation to help avoid pneumonia. They also started an IV.

Soon the physician assistant arrived as well as the anesthesiologist. The said they were getting ready to administer a block on my leg. Have you ever received a shot at the dentist for say, a filling? The dentist deadens a key nerve that numbs your whole face. In the case of your foot, the nerve is behind the knee. They rolled me over on my belly. Then a nurse put some medicine in my IV that she called a "six-pack." I don't know if I felt like I had just drank a six-pack, but it really relaxed me. I felt some tingling on my leg as they found the nerve and the shot really did not hurt too much. They rolled me back over and I think I received another shot in my shin. Forgive me, by this time I was feeling pretty out of it. My wife was not able to be in the room with me during this, so I don't have her to help me.

Gradually my foot fell asleep. It would stay that way for nearly 20 hours. They rolled me down the hall into the operating room and I don't remember much after that. Next thing I knew I was waking up in post-op. I felt a little groggy and my foot was still numb. The only thing that changed was now I had a big splint and wrap on my foot. Here's what I saw when I woke up, minus the ice bags:

CT Scans

My surgery is 5 days away now. The surgeon asked that I get a copy of my CT scan on a disk and bring it in before the surgery. So I have the disk, and I did a little search online for some CT scan program and found one. I downloaded the free trial version of an app called Osirix. (I use a Mac, BTW, and still found software.) I fired up the program and after messing with it a bit, I was able to grab a couple of shots of the coalition. Here's the first:

You can click the image to enlarge it. This is looking from the "front" of my left foot. The top bone is the bottom of my tibia. The little oval on the right is the bottom of the fibula. The chunk in the middle is the talus and calcaneous. I'm not a radiologist, so I didn't put any arrows on this one, it looks pretty fused to me. Here's another:


This one looks a bit more like a foot. My guess is that the bright white spot in the ankle is the fusion. I'll print these out and ask my doctor about it.

Okay, here's the fun part. The program I downloaded can take the CT scan data and build a 3D model. I can spin it around and mess with the contrast. As I adjust the contrast it gradually removes the skin and muscles and veins. Here's three views of MY foot. Freaky!




You can really see the talar beaking on this last image. I'll let you know how the surgery goes!