Posted in BODY, LIFE'S JOURNEYS

Joint Fusion Surgery-My Journey to Walking Pain Free-Part 1

Three years ago, I felt a sharp pain in my ankle. It gave way and wouldn’t hold any weight. I managed to keep myself from falling and hobbled to a chair where I massaged my ankle until it felt better. Later on that day, my ankle gave out again and then again later that evening. I realized I had a problem and bought a sports brace to stabilize my ankle. I thought maybe I had sprained my ankle. I wore the brace for a few days and my ankle felt better.

Weeks later, it happened again …a sharp piercing pain in my ankle. I reached for the sports ankle brace again. This time I knew something was really wrong so, I headed to urgent care where I had x-rays done. The conclusion was I didn’t have a broken ankle so they treated it like a sprain and gave me an air brace. My ankle got better and I went on living life. That’s until my ankle went out again. This time I went to my doctor and he ordered a MRI and referred me to an orthopedic specialist.

The specialist examined me and determined that my arches had fallen, and I now had flat feet. This was caused by the fact that I have tight calf muscles which is a genetic disorder. Tight calf muscles often lead to problems as you grow older. I had developed plantar fasciitis, which is a painful inflammation in the feet. I’d actually been feeling pain in both ankles which were stiff in the morning and prone to swelling. They’d both given out at times but the left ankle was by far in the worst shape.

My plantar fasciitis was treated with physical therapy along with shock wave therapy. After several sessions of the shock wave therapy, we stopped because it was simply too painful for me. The physical therapy worked and I was back to walking with few problems. This lasted about a year. Periodically, I’d feel some pain, but the stretching exercises I’d learned in physical therapy kept everything in check.

About a year ago, I had  my first real issue. My left ankle went out and I had to wear the sports brace for two weeks. I went back to doing my exercises. The pain would go away but reappear in a couple of weeks. Sometimes it was a minor flare up and other times I couldn’t walk without the sports brace for two to three weeks at a time.  After months of doing this, I finally gave in and went back to my orthopedic doctor.  He took x-rays and put me in a walking boot with orthopedic soles for thirty days.

After a month, my ankle was still weak, and it was clear I couldn’t walk pain-free with or without the walking boot, so he ordered a MRI on my left ankle. (This was two years after my first MRI.) The new MRI showed that I had a damaged joint which was caused either by rheumatoid arthritis or trauma to the joint since I’d sprained my ankle several times in the past. My ankle was so unstable that I would not be able to walk pain-free without surgery.

I agreed surgery was the best option. Over the last three years, my quality of life had declined. I’d resorted to keeping a brace in my totebag at work and one in my car for the weekends. I wore sensible shoes because I never knew when my ankle would go out. I didn’t go anyplace that required too much walking such as: festivals, outdoor events, or even shopping at a big mall. Worst of all, I’d gained weight because I couldn’t do  cardiovascular exercises without pain. In return, the additional weight was putting more stress on my foot and I was increasing my chances of heart disease, high cholesterol, and diabetes which all run in my family. I was trapped in a vicious cycle that would only get worse.

What happened to your foot?

I ended up having to wear the walking boot for three and half months before I finally had surgery on June 22nd. I was constantly asked about my foot by strangers. Many people had suffered a similar fate. They described their surgeries and gave me advice on the long road to recovery that I had ahead of me. I used these conversations, my doctor’s information, and good ole Google to work out what exactly was going on with my foot and what needed to be done to heal it. I’ll break it down with the hope of helping someone else with the same issues.

Surgical Procedures:

I had three surgical procedures done at once.

  1. Gastrocnemius recession. 

gastroThis is the release of the Gastrocnemius muscle which is connected to the Achilles tendon. This basically relieves the pain associated with plantar fasciitis since it releases/cuts the tight calf muscles. It sounds horrible but this was the easiest part of the surgery, causing little pain and healing quickly.

2. Subtalar Joint Fusion

 subtular pix 3My doctor originally thought my ankle joint was causing the pain, but the MRI showed it was my subtalar joint which is between the ankle joint and the heel bone. The subtalar joint fusion procedure removes any damaged areas and fuses two bones as one.

subtular pix 1These bones are held together with screws which will stay in the foot even after the bones fuse together.  I will have some limited movement in my foot but the pain will be gone. The screws never need to be removed unless they become uncomfortable.

3. Lateral ankle stabilizationBasically, the doctor goes in and repairs any damaged tendons or tissue that may be cause instability in the ankle.

Preparing for Surgery

Your doctor will give you a whole list of things to do to prepare for the surgery. You’ll need to get a work-up done by your primary physician to make sure you can handle surgery. This will require blood work. You will also need to stop taking any supplements and ibuprofen ten days before surgery. Most importantly, remove any and all stress from your life. You need to be as healthy as possible to tolerate the surgery and heal.

There are other things you need to do as well.

  1. Stockpile your home, especially if you live alone. Buy at least a two-month supply of toilet tissue, paper towels, laundry detergent, dishwashing liquid, dishwasher detergent, trash bags, bath soap, and lotion. You will not be able to walk for at least eight weeks which will make grocery shopping challenging. Pick up lots of frozen dinners, snacks, beverages, and other non-perishable items. You’ll still need someone to get you fresh fruit, vegetables, and perhaps dairy products; but the more you buy ahead of time, the easier it is on everyone while you’re recovering.
  2. Designate a notebook to your surgery. You will use this notebook to document any information related to the surgery. Jot down your orthopedic surgeon and primary physician’s, name, address, phone number, and fax number; your company’s contact name and number for disability; rental medical equipment information, and any other numbers related to the surgery. You will be given specific information that you’ll need to follow and having one place to store it all helps. Also dedicate a pocket folder to all bills, receipts, and handouts you receive related to the surgery.
  3. Just a warning, your surgeon and/or the medical facility may require a down payment before the surgery. If the cost is expensive, see if they will work with you and set up a payment plan.
  4. Make plans before the surgery to get any medical supplies you might need. My doctor ordered a knee roller. knee walkerMy insurance pays for it but only from certain companies. I wasn’t able to obtain the knee roller from them so I rented it from my doctor’s office. The cost is $25 a week. I plan to use the knee roller for eight weeks which comes to $200. Hopefully, I can get reimbursed. My insurance company paid for my crutches which I get to keep.
  5. I ordered a few things I thought I might need from Amazon such as this grabber. This was a major life saver.20160617_212553
  6. I also got this cast and walking boot cover.20160617_212505
  7. I’d suggest making sure you have plenty of clean fresh sheets, pajamas, lounge pants that can fit over a cast and/or walking boot. If you prefer, you can buy a stool for showering and many doctors prefer you use Dial anti-bacterial soap.

Surgery Day

My surgery was done as an outpatient service. The whole procedure generally takes about 90 minutes. Mine took longer because my potassium level was low, so I had to have an IV with potassium pumped in me. General anesthesia was used during my surgery.  The anesthesiologist gave me a nerve blocker which numbed me from my hip to my toes, so I didn’t feel any pain. Once I woke in the recovery room,  I was given some juice and wheeled out the door, clutching an ice pack. (I guess that’s how they do it nowadays.)

Once home, I was still numb. My leg had a brace with ace bandages on it.20160706_153001[1]

I had been instructed to keep my leg elevated at least six inches above my heart. This is imperative to avoid blood clots. I also had to take a Bayer aspirin every twelve hours to help avoid blood clots. Keeping the leg elevated helps with swelling and reduces pain.

I went a whole day and a half with little pain due to the nerve blocker. However, swelling was an issue so I had to ice my foot frequently. During the first two weeks, I relied heavily on medication. I was given Oxycodone for pain and Flexeril for muscle spasms. I limited how much Oxycodone I took and used a lot of Tylenol Extra Strength for break through pain. I only had a couple of incidents of really bad pain, generally when I woke up in the morning, but other than that it was manageable… very uncomfortable at times but tolerable for the most part…I guess.

During the first few weeks, I’d advise you to do as little as possible no matter how “normal” you feel. I got overzealous a few times on my knee walker and almost tipped over, landing on my recovering foot. I even feel on the ground while using crutches and earned myself a few bad bruises. Just relax and only do what you have to do. You will be very tired and sleepy during this period. The meds will make you sleep a lot. Enjoy the rest because this will help you heal quicker.

Bathing is a big challenge. I advised taking really good sponge baths until you feel comfortable getting in the shower. The shower is a slippery and dangerous place so be careful. I bought one of those handles that supposedly cling to the wall. Bad idea. It fell off, thank goodness I wasn’t desperately clinging to it. My waterproof cast cover was invaluable. It kept my cast dry while I showered.

After two weeks, I returned to my doctor’s office to have my cast and staples removed and get x-rays.  I was told to wear a walking boot twenty-four hours a day (except for when showering) for the next six weeks. I was instructed not to put any weight on my foot. My medication was down-graded from Oxycodone to Norco. I still had plenty of Oxycodone tablets left and chose to keep taking them for a few more days due to my pain. By this time, it had moved to the bottom of my foot and toes. It was a very hot intense pain that didn’t seem to respond to the Norco, so I used the Oxycodone.

Word of advice, make sure the nurse gets all of your staples out. I found one wedged in my skin nearly a week and a half after my follow-up visit. I had to go back to have it removed. Also make sure, you’re clear on how to care for your incisions once the cast is removed. Steri-strips skin closures will be put on the incisions and you can shower and gently wash the incision. This will help the steri-strips come off.

I hadn’t been told that. I was still wearing my leg cover in the shower and then I would get out and hand wash my incisions separately. It took more than a week for some of the steri-strips to come off and that’s when I discovered the staple still imbedded in my skin. When I went to the doctor, he was shocked to see that most of steri-strips were still on. The nurse immediately removed them along with the miscellaneous staple left in my incision. I was told that my incisions were healing well and now we needed to wait for the internal healing which is the fusing of the subtalar joint. Once again, I was warned NOT to put any weight on this foot.

Here’s where it gets graphic. I thought it was important to show what my foot looks like after the staples were moved. It has been two weeks since the cast came off and one month since the surgery.

*******WARNING GRAPHIC PICTURES****

These pictures were taken the day the sutures were removed. You can still see where the nurse wrote my initials on my leg and the surgeon put his initials BEFORE the surgery. Initials are BAF  for me and NC for my surgeon towards the bottom of the leg. It’s still on my leg because it was in a sterile cast. The other marks on my leg was bruising. I bruise easily. My ankle felt like a dead limb at this point. I could barely wiggle my toes.

 

This picture shows the back of my leg. The three steri-strips up top is where the gastro release was done. You can see my leg was heavily bruised from the surgery.

20160709_120837[1]

Here’s where the screws were put into the bone.

Progress. Here is a shot of the back of my leg a week later. Bruising is slowly going away. The front looks good as well.

20160719_115137[1]

This is a shot of my leg after I went to the doctor to have the extra staple removed. The nurse took the steri-strips off which should have fallen off days before, but I was not cleaning the area correctly. This picture looks super gross, the doctor was impressed with the way it was healing.

Here’s that incision four days later–two weeks after the cast was removed. The lighting has improved but you can definitely see where my incisions are healing and the bruising is diminishing.

 

The front and back are looking good. I should also mention that once the cast is removed you will have a large amount of dry skin on your leg. It was actually quite gross. I used pure shea butter and coconut oil on my leg and feet, avoiding the incisions, and it healed the dry skin.

Now that the incisions are healing, the focus is on the internal healing. I still need to use the prescription pain reliever. One day I feel great and the next day my foot is tender or straight out painful. I still have to elevate my foot for the next four weeks. I mostly use my knee walker to get around the house and stay calm and relaxed as much as possible. I’ve spending time on blogging and my adult coloring books, since both of these things relax me. So now the plan is to hurry up and wait and stay off my foot.

wp-1469255742574.jpg

I will posts updates on my journey as I move forward, including my testing for rheumatoid arthritis and the journey from there. If you’d like to learn more about orthopedic issues, check out my surgeon’s website Dr. Nick Cheney . I can’t say enough about the wonderful job he did before, during and after my surgery.

Stay Blessed,

Barbie

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Preparation for Surgery

It turn

 

 

Author:

I'm a Midwesterner who explores the world via the Internet, books, and movies. I share what I learn whether its beauty tips, health advice, recipes or literature. I'd call this blog a melting pot. I named it Barbie's Bookmarks because I love literature, and I love documenting things I find important in my life.. big and small. Thus, these are my life's bookmarks. I look forward to sharing them with you and learning about your bookmarks as well.

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