2 weeks post op: first check up!

   Today I had my first follow-up with my podiatric surgeon. I had X-rays done and my doctor said they looked great, healing is on target. I'm relieved about that. I've been doing everything they told me to. But now that I have seen my foot and my poor sad little excuse for a left calf muscle, I have bigger concerns:

• When can I start physical therapy (my own exercises at home)
• When can I take the boot off?
• When can I bear weight on the affected left foot?
• When will my toes come back together

   I have a huge space between my big toe and the rest of my toes. It was disheartening to see. However, the doctor assured me that the other toes will float back over by about 6 months or so. I checked other bunionectomy blogs and have seen that this does in fact happen. All of the dressings have also shoved my toes over and away from my big toe. Also, it's hard to see but my four little toes are pretty swollen. Surprisingly my foot was not swollen at all. I'll put a side by side of my foot before. So putting my embarrassment aside, here is the picture so far:

I apologize I have no good picures of "before". Wasn't thinking ahead!

   Now about my left calf. It has pretty much atrophied. This is quite normal. It only takes muscle about 2 weeks to atrophy. Luckily we are getting close to winter so I can hide it with pants. I'm sitting in a chair so it's hard to tell just how much muscle I lost but when I stand there is almost no definition in the calf. I was told I could start doing some exercises that don't jostle around my foot too much. Unfortunately I didn't get really any advice as the appointment was a blur. Oh well. I looked to other bunion blogs and orthopaedic surgery sites for some good exercises. The other issue is that you don't want your big toe to get too stiff. I've read about people that have permanent decreased range of motion in the toe. I've decided to go with this website for physical therapy suggestions. Given what I know about post-op rehab and fractures and what I've read about other peoples' experiences this seems appropriate: 

http://www.davidgordonortho.co.uk/patient-info/rehabilitation-after-injury-or-surgery/foot-rehabilitation/hallux-valgus-surgery-rehabilitation/

   I am told I can take my boot off when I am resting at home, changing clothes, showering, and sleeping. I am excited because I'm so tired of having my foot at a 90 degree angle. It is constantly making my foot feel a "pins and needles" sensation. I've still been icing my foot about every 2 hours (it feels amazing and it's my favorite part of the day). I've pretty much stopped narcotic pain meds and moved over to Motrin. I take 600 to 800 mg twice a day. I also still keep my foot propped up on 3 pillows at night. The doctor said I should keep doing this to help reduce swelling and help the wound heal. I try not to walk around or have my leg down for too long. After about an hour it gets sore from being down. I actually feel the pain more once I prop it up again. If I am going to be up a lot I use the knee rider. I have nurse practitioner clinicals tomorrow and plan on taking full advantage of my knee rider!

   Yay! My pedicure is still intact. It's the only nice thing about my left foot right now so I'm pretty psyched:) This picture also shows the difference between my edematous left 4 small toes and my normal right four small toes. The new dressing my doc put on is much lighter so my foot doesn't feel so cramped in my boot. I still wanted the ace bandage on to help with compression and moving fluid upward. It's also a nice barrier between the ice and my foot. 

   

   Up next is my 4 week follow up. Unless something interesting happens I will be posting then!

Keeping your boot and bed clean

    After 5 weeks I realized that I wanted to go back in time and make this little post. Luckily the magic of "scheduling" my blogs allows me to do this! When I was released from the research unit I was told to put a pillowcase over my boot at night to sleep so I don't get my sheets dirty. That just sounded kind of unsanitary to me and a lot of work. What if it comes off in my sleep? So I bought Clorox wipes. If I walk around anywhere except my bedroom I wipe my boot down before getting back in bed. Yes it takes some extra work but it also means my bed is clean:) I also bought 3 pillows that I dedicate to elevating my foot and which I plan to throw away when I am done with this boot.

   I don't want to go all RN-paranoid on you but when you wipe the boot down you should wait 30 seconds for it to dry and work it's magic. Otherwise, you aren't going to kill that flu virus on your boot;) 

1 week post-op

   I am finally at one week post-op. Yay! Pain is definitely been improving. I am only taking pain meds in the morning and evening. I've also been able to tolerate a little more walking/standing. I decided to actually make myself dinner today, stove and all. By about 20 minutes or so my foot started to get sore and throb. Had to sit back down and ice it. But it just felt good to get up and do something.

   I am looking forward to week 2 when I have my first follow-up where my bandages are changed. Finally get to see my surgeon's handy work! From here on out I will be posting every time I have a follow up so I can post progress pictures. There won't be much to report in between. If something significant should happen I will be posting:)

   I have no interesting pictures to post so I thought this would be enjoyable....

Day 5 - First day out of the house!

   It is Saturday night and I have just been so stir crazy I decided to go out with my husband. We went to a movie and dinner. I brought my knee rider and a few pillows to prop up my foot (no shame here). Turns out there is no comfortable way to prop your foot up when you are in a movie seat. It was pretty uncomfortable throughout the movie. Mostly because the blood was rushing down into my foot and pulsating. I assume it was also swelling. I barely made it through the movie. Probably a mistake.

   By dinner I was pretty pooped. At least I was able to prop my foot up in the booth. Had a lackluster conversation with my poor hubby and then headed on home. I was so happy to see my bed again. I immediately propped up my foot and iced it. Whenever I get up and walk I ice my foot when I come back.

   The pain is definitely still there. It is much worse at night and in the morning when I get up. It also flares if I walk around too much (i.e. go to the bathroom, wash my face, then change my clothes). Sadly, this amount of activity exhausts me. Pain meds are still working very well.

   I am starting to get tired of eating pre-made frozen food or processed food. But I have trouble keeping my leg down for too long. So I'll look forward to the day that blood rushing down towards my foot doesn't cause immense discomfort.

Day 4 - First Bath!

   I have been using my Percocet consistently and the pain has been pretty well controlled. I wouldn't say that I am ever pain free but it is manageable. When my foot swells the boot starts to put pressure on the edges of my foot, causing quite a bit of pain. Icing has really helped. I ice it every 1-2 hours while I am awake. Thank goodness my husband has been nice enough to run to the fridge every time I want to ice my foot. My husband found these really great ice/heat packs from Target. Here is a picture below.   

   Walking is a little painful, but it feels so good to get up! However, every time I walk, afterwards I do have pain. So I make sure to ice after every walking session. I think the most unpleasant thing for me right now is sleeping. I have to sleep with my leg propped up on 2-3 pillows and I can't sleep on my sides. I am a major side-sleeper. So it's been tough. Good news is the pain meds knock me out so well I don't usually get up at all during the night. 

One thing I am so glad I bought is this armchair pillow.

So comfortable and versatile. Especially laying in bed a lot. It is way more comfy than regular pillows. The arm rests allow me to work on my laptop more comfortably. It also has more support than pillows. I got one at Target for about $20. 

   I've never been so excited about bathing. I've also never taken so long to bathe. I made my makeshift boot cover with my trashbag and medical supply tape and it worked really well. I set my foot outside the tub on top of a laundry basket. I would recommend switching your shower head to the kind that you can retract into a handheld device. 

   
   Each day is a little better than the last. I'm surprised how manageable the pain has become after 4 days post-op. I hope that my pain is under control by the time the pills run out. Will have to cross that bridge when I get there. 

3 DAYS POST-OP

   At home and given a prescription for Percocet. The percocet has worked fairly well for me, decreasing my pain from an 8/10 to a 5/10. I have been elevating my foot whenever I am in bed. I have been instructed to "use it but don't abuse it" (referring to my left foot of course). So essentially this means to rest and elevate foot as much as possible but still get up every couple of hours to go to the bathroom/get food. Only doing what is essential. Also important at this time, continuing to ICE liberally, 20 min. on 20 min. off. It really does make a difference with pain and discomfort. The swelling of the foot plus all of the wrapping you saw in the picture I posted yesterday can make the affected foot pretty uncomfortable. Walking has gotten easier with each time I have done it.

   I've been doing assigned leg exercises every hour I am in bed to help prevent clots. Let me tell you friends, I've seen lots of clots in the hospital and they suck. Don't skimp on the exercises! The other thing I have been very careful about is tightening my boot properly when I get up to walk. The boot has a large heel so you cannot walk around barefoot or in a flip flop on your good foot. If you are a guy, an athletic running shoe will do the trick. If you are a girl and you want more options besides a running shoe, You can try a small wedge or a clog.

   This is the boot!

 I bought these comfy Teva sandals and they ended up being the perfect height for my boot. I hate shoes so this is great.

2 DAYS POST-OP

   Surgery went really well. I was given a nerve block starting at my left knee. I was also given an IV medication to help relax me during surgery. I was awake for the whole thing, which I had initially dreaded. However, maybe it was the medication given or just me surprising myself but I was strangely peaceful and chilled out during the surgery. It only lasted about 25 minutes. Each surgeon has different methods so you may not have this exact treatment plan for your surgery. Here is a picture of the popliteal nerve block in the back of my left knee. Was not painful when they put it in.

   I am just going to skip day 1 post-op because I participated in a research study in which I was given a nerve block for the first 20 hours. So post-op pain started on day 2 for me. Let me tell you - it was pretty bad. I would say 9/10. On day 2 I was still participating in the study so I was given an experimental drug. A certain amount of participants are given a placebo. I'm pretty sure I ended up being one of those participants. I was allowed to have two "rescue" drugs every 6 hrs - Tylenol and Toradol (an NSAID on steroids basically, and much more powerful than Ibuprofen). Neither really helped. So day 2 was basically me having 8/10 pain all day. I was bedbound except for using the restroom. 

   This will not be your experience, assuming you are going in for routine bunionectomy. However, I mentioned it because I did gain something valuable and relatable out of the experience. I know exactly how much raw pain the surgery causes. Some of the pain is caused by swelling of the foot itself. As I've learned as an RN, everybody experiences pain differently. Some patients have more pain post-op then others.

   Last thing I did on day 2 was take a short 45 foot walk. And oh boy, initially it was extremely sensitive and painful getting up and bearing weight on my left foot. But as I started walking I realized it just felt very good to be getting up out of bed. Warning, when you sit back down again your foot will be throbbing. I recommend taking your pain medication 30 minutes prior to getting up.

Day before surgery

   I decided it might be helpful to blog about my bunionectomy experience since it seems to be one of those procedures where some people tell you it hurts like hell and they would never do it again and other people say "meh, it was fine". I found reading other people's blogs about their surgery experiences to be very helpful. 

   I will be undergoing a bunionectomy surgery known as the Chevron procedure. I have moderate bilateral bunions. I am having surgery only on my left foot right now as I do not want to be in two boots! After surgery I am expected to be in a surgical boot for 6-8 weeks while my foot heels. Essentially the surgeon is fracturing the foot in order to fix the problem so think of it as a healing fracture. Normally you would have a cast so I think it's not a bad deal:) 

   I did a lot of shopping before hand (food, supplies, etc.) so that when I come back from surgery I can have everything within arm's reach. I also bought some medium sized trash bags to tape over my booted leg so I don't get it wet with baths. 

   Here is a before picture of both of my feet. I've had bunions since grade school. I am 28 years old and am a nurse in a hospital. My feet are always sore at the end of the day, particularly around my bunions. One thing I have been thinking about especially this past week is how nervous I seem to have gotten. I feel silly because I am a nurse so I'm around this stuff all the time. But I've never had a surgery before and I have to admit I am scared! I'm also kind of sad about my foot changing. I know the bunion is a deformity and a pain in my butt but I'm so used to seeing my feet like this. It will be weird when it's straight...