Wednesday, July 29, 2015

4 Weeks Post Surgery

Woot! A Month out -- things are going well. I went in this afternoon to have the stitches taken out (finally!)

OW OW OW OW OW! Seriously, that HURT. I wasn't expecting it to; the only other time I've had stitches that needed to be removed, they were old-fashioned, single-stitch silk. Taking those out was simple: clip the stitch and tug the 1/4" or so of thread out.

Not so much with my heel. I hadn't taken a really good look at it (since stitches in general make me a bit queasy), but it was stitched subcutaneously with one long length of prolene (a sort of non-absorbable polypropolene thread). So, pulling out the stitches was really pulling out this really long length of fishing line that was spiralled into the incision. Hurt like hell and lit up all the nerve endings in my foot.  I only cried a little bit.

But everything looks good (although my left calf is skinny and atrophied because I'm 100% non-weight-bearing. It's going to be funny looking when I finally take off the boot. I have another follow-up in two weeks -- and still no walking on my left foot. Hopefully I'll get the go-ahead to start toe-touching and putting a bit of weight on the foot and starting the process to work my way down from the four wedges in the boot (to keep my foot at a neutral, to-pointing angle) to a normal flat-footed step.

Slow progress, but progress! That is good!

I am really getting tired of the view of my living room from the recliner. Poor Mark is met at the door with "where are we going OUT OUT OUT tonight? Get me OUT of the house!"

Wednesday, July 22, 2015

Three Week post-op

Follow-up appointment today, ostensibly to remove the stitches (which, I must admit, are beginning to itch a little bit --worse now that I had the initial thought "ooh, that itches just a little..." now it's all I can think about).  But my surgeon decided to leave them in place for another week. Heels (and feet in general) don't have a ton of blood-flow to the skin and so any incisions are very slow to heal and need much babying and care.  Everything looks good -- incision is clean, heel is pink, not too much swelling.

So, Mark got to review the MRI from last week (which is pretty cool, I must say), and we both got to look at the "after" xrays and see just how much bone he removed from my heel to get the bone spurs and Haglund's deformity removed.  I should have copies of them soon, I'll post them when we get the CDs.

But -- and here's the fabulous news! -- after much begging and reassuring him that I promise to wear The Boot every other moment of the day, I have been cleared to sleep without the boot! He figures that if my fall didn't do any damage, what could I possibly do while sleeping? If I try to move it in a way that is not good, it will wake me up.

Slightly less gruesome pictures this week -- things are less purple-y and freaky. I still have strings of stitches (which I must admit make me very queasy and barfy. I hate stitches. And my foot is still vaguely orange-ish from the betadine, since I haven't been able to get my foot wet at all. I'm  just a little bruised.

And, three weeks in the cast and boot and my left leg is all skinny and atrophied. But I don't have a lot of swelling in my foot, which is good. Back into the elastic bandage and into the boot we go!

Monday, July 20, 2015

Good New for a Change!

Good news!  My MRI results look good -- evidence of healing, and NO TEARS in the achilles. When I fell, I apparently did not step down on the foot (or if I did, nothing bad happened except pain).

No second surgery to repair things and I'm on track. Woot!!

Next appointment is on Wednesday, 3 weeks post-surgery. I'm still no-weight-bearing (and assume I will be for another week or two at least). But things are ok! Yeah!

Sunday, July 19, 2015

No incidents today!

I managed to successfully take a shower without falling, slipping, banging, or otherwise damaging myself. Yeah!!

Of course, the Adorable Husband was there the whole time and it took 45 minutes, but I feel. so much better! Whoever tells you that 'bathing' with a washcloth and washing your hair in the sink is good enough---lies. It's not. After a few days you feel awful and grimy and disgusting.

I cannot wait until I have the stitches out (Wednesday this week) and I can take a shower without the waterproof baggie thing, or even soak in the bathtub. The problem with a bath is that I don't think I can lever myself out of the's one of those huge soaker affairs and it's hard enough to get out of on a good day!

Friday, July 17, 2015

OK, Universe, enough!

I surrender. The universe obviously has it in for me. No more.

I'm doing ok, still waiting for results from my MRI, but otherwise same-old, same-old. Things hurt a bit, I'm annoyed an uncomfortable, but all is going ok.

The Adorable Husband, however, called me at three o'clock yesterday to tell me that he was on the way to the ER because he was in A-Fib (Atrial Fibrilliation) and needed to be cardioverted. This is the first time he's had an issue in almost 9 years, and the fourth time he's had to be shocked back into a normal rhythm.  Aaargh! Seriously? We need another thing wrong this week?

He's fine -- they do it under general anesthesia and he was home by seven and looking and feeling fine. My nerves are shot, but other than being a bit tired, he is ok and back to work this morning.

So, that's it. Nothing else can happen. One person having issues is enough!

Wednesday, July 15, 2015

Day 14 - Insurance Annoyance

I've been icing and elevating, and my heel is feeling ok -- no more painful than it was before, mostly.A twinge now and then, but doing ok. I'm hoping that this is a good sign; that this means I didn't rupture or tear anything off my heel.

At any rate, when we called the surgeon on Saturday night, he said he wanted an MRI. So, the order went in on Monday and the lovely dance with the insurance company starts. The scheduler at the office calls to tell me that insurance denied the MRI and would not give pre-approval for it. Ookay. Apparently it went to them, then to their physician review process, andtheir physician decided that it wasn't necessary and an xray would do.

Um. no. We know I have bones in my foot, but an xray will not show the surgeon if the reconnected tendon is still attached. It won't tell anyone anything except to reconfirm that my foot isn't broken. We know that. So, reconsideration after trying, again, to explain that I'm 10 days post-op and had an accident and stepped on the foot and possibly ripped loose all the tendon attachment points. I talked to them, Mark talked to them, and the scheduler talked to them. Nope! Not medically necessary, an xray shoudl be just fine for diagnosing issues with a sprain/strain.

Wait, what? No, not a strain, you idiots. A post-op accident where I may have torn the freaking tendon loose from the repair. We're trying to determine the patency of the Achilles re-fastening. Back to the drawing board with the insurance company and the medical review group. Seriously, it was like a bad game of Telephone. How the ICD-9 code for 'achilles rupture' became 'strain/sprain' is not quite clear. Well, obviously, the insurance company doesn't want to pay for an MRI if they don't have to. SO they come back with "needs to have a physician evaluation and xray first".

Sure, now I have an appointment for an xray and time for the surgeon to look at me, unwrap my foot, and then note "needs MRI" in the chart. Oh, taht was useful! Dr Leonard dutifully prodded my ankle, noted that the tendon seemed to have the same tension in both heels, and didn't have any obvious injury. And then laughed and said, "But I can't tell anything at all until I see the MRI".

This time, the scheduler called and walked down the hallway with her headphone on to grab the doc when she got the review company on the phone. "Here! I have my physicians, get yours on the phone". It took a total of three minutes for my surgeon to explain just why the other guy was wrong and this was required. Voila, MRI scheduled for that afternoon. Seriously, that was way to complicated for a necessary test (with a pretty hard time limit).

I will say that of course, even if the insurance had denied it yet again, I woudl have had the MRI today. It's not something I"m going to skip just because they want to be pissy. It's necessary and I don't want to repeat this all in six months if we discover that the tendon attached improperly or healed badly.

THe doc said he had a patient last year who did the same thing and never told him. ONce you rupture the tendon, there isn't any actual pain -- like cutting a phone cord: sound one second, then nothing. So the repair shifted, healed badly and too high on the heel and took several hours to fix later on. I really don't want that. I really don't want ANY re-op, and I'm hoping that this doesn't need it. But I am going to do everything to be sure before we write this off as "Robin is a Klutz, please note that in her chart."

The MRI was uneventful. Took longer than I thought it would, with my foot in a very awkward position. You have to be utterly still, so they pretty much strap whichever part of you they need to scan into a brace with foam and velcro.  They have a standard foot/heel brace; nope - can't actually flex my foot far enough to get it into the brace and still scan it all. He tried a round frame that they use for whole foot or knee or hand; nope -- my foot doesn't quite fit without bending it down, can't do that either. It's neutral position or nothing. One last try, a big foam envelope thing that he could pout my foot in  on its side and then fasten it down with another layer and velcro. Felt like putting it in a waffle maker.  The scan of my heel/ankle took about 25 minutes once we got things  velcroed in and me slid halfway into the MRI machine. I had though it was faster, but Mark said that I must have been thinking of the CAT scan machine, which is super fast. This is slow and loud, but turns out pretty 3d images. We notified the radiologist and the surgeon and headed off to  have a burger.

I should hear about the results in the next day or so, and have a default follow up set for next week (it can take 3-5 days to get things read normally, but my surgeon is pretty antsy to figure this out, since if it needs to be re-done, doing it sooner rather than later is a big deal.) If I do need the repair re-done, I assume we'll schedule it for next Tuesday. Oh, fun. Start from square one. I sincerely hope not.

So, think good thoughts that my MRI is clear and that I aggravated this, not damaged it. Every time I slightly twist, or slip and tense my foot, or accidentally touch my foot down, it hurts, so I'm ready for this to be resolved!

Sunday, July 12, 2015

Not the worst news

Well,  my wrist isn't broken, or at least nothing obvious is - there are so many little bones taht something could be bashed, but it was proclaimed a significant sprain and they sent me home from the ER with a splint and more pain meds.

It still feels broken, so I apparently did a really good job bashing it when I fell.  My foot still hurts a lot, we're just waiting for the MRI appointment tomorrow to see if I did any real damage. Slept most of the day, after a really awful night.

I am Queen of the Klutzes! All Hail!


I finally got situated to take a shower tonight -- can take off the boot, have a waterproof leg thing to keep my foot dry, shower chair, etc. Great! Clean!

I was done, half-dressed, and leaned to open the door to call Mark to help me get the boot back on...and slipped and fell. I don't know if I stepped flat, just hit my foot, or what happened. I don't really remember what happened. I just remember that it just might be the most pain I've ever been in.

I didn't rupture the tendon -- it's still attached, at least partially and it's not rolled up into my calf, I may have torn something loose, I'm not sure. Mark got me on ice, in the chair, and calmed down enough take pain meds and then called the on-call for the orthopedist. My own surgeon called back -- there isn't much to to immediately, so he wants an MRI on Monday morning to see if I've effed up everything in my heel. I hope not. I'm on two Vicodin (twice as much as I have had to take at all, even right after surgery) and it still hurts like hell. Even the slightest movement is bad.

I am NOT happy. Freaked out, more like it. I hope things are ok, probably a set back, not something taht requires surgery again, but @%^^!@.

And, I may have broken something in my wrist. Mark thinks it's just jammed/sprained, but if it doesn't feel better in the morning, we're heading in for xrays. I can't grab/push anything, which makes it very freaking hard to use the bathroom or do anything other than sit here. I'm typing one-handed. And it's one in the morning and things hurts enough that I can't even lie down and try to sleep.

Well, even if I had planned on going to work on Monday, I think I will be off for a bit more time, it seems. 

Saturday, July 11, 2015

My constant companion

This is how I have spent my day -- in the recliner (complaining about the stupid boot), with Rowan camped out as close as possible and periodically staring up at me expectantly.

Amazed...or scared

We finally bought a Dyson vacuum, after years of being told that we needed to have the "Animal" version, what with the dogs and all.

It arrived today, The Adorable Husband immediately unboxed it, put it together, and gleefully went into my office to vacuum. My office is where the dogs spend a lot of their time, I spend most of my time there, and it's vacuumed a lot less than the rest of the house since I'm almost always home when the cleaning people come, and I hate to vacuum.

Well, enough mitigation.

He was in there for less than two minutes and started laughing -- and then emerged with the bin from the vacuum cleaner...looking like this:

Ninety seconds. Seriously.

I swear, the carpet looked a bit dingy, but it wasn't awful. There weren't drifts of dog hair all over. It was even cleaned not that long ago!

So I'm sort of terrified to use it on the rest of the carpet. I don't think I want to know just how much fluff and dirt is in the carpet that looks perfectly clean to me! 

I totally understand why my sister called me up in tears when she bought one years ago -- she vacuumed every day, and this still happened to her. I sympathize!

Friday, July 10, 2015

10 days and I hate the freaking boot

First followup appointment today -- the doc removed the splint and about forty yards of fluffy cotton batting and peeled off the steri-strips and pronounced things "looking good".  Not quite ready to remove the stitches yet (that will be next week).

Of course, now I have The Boot. I hate The Boot. It is heavy, unwieldy, uncomfortable, and I'm pretty much turning into a whiny monster now that I'm home. I can't fine a position that's comfortable and no matter what I do my foot is squished. Frankly, things hurt more now that they have all week. Waaaah!  I'm half-tempted to go back and ask for a splint again for the next few weeks. I can't put it down anyway -- not even toe-touching --  this is going to make my cranky.

Otherwise, though, things look good. He's not going to take out the stitches until next week. My foot looks gruesome (well, at least to me), but I'm told that it's just fine.

Me, in the ginormous boot with four wedges in it so I don't flex my foot:

Even the pillow isn't helping.

My mom sent me a care-package yesterday with four glittery pins that say "Queen", "Princess", "Bitch" and OhShit!"...and a tiara. My sister Jenna sent a light-up sparkly Princess Fairy wand. I'm set. I'm going to pick the Princess pin today, wave the Princess wand, and sulk.

I should be far enough down to post the icky pictures, for anyone who is remotely interested. Otherwise, scroll now!

First, the less-gross picture -- bruised, but not terribly swollen, really. That was surprising.

And now for those who like watching the Surgery Channel -- here's the back of my heel:

Wednesday, July 08, 2015

Day 8: Tylenol is my friend

Well, things have fallen into a pattern here at Chez Phouka -- get up, slither down the stairs to sit in the chair, and get waited on hand and foot. I feel like royalty.

Oh, wait -- not quite. The Adorable Husband had to go back to work yesterday and I've been whining about how hard this is by myself. I didn't realize how much he was doing for me -- just the random fetching of ice, tylenol, diet coke and the rest is a big deal. I have to plan head more and make one trip. Luckily my fabulous scooter has a basket!

I'm not really in much pain any more -- just random zrrrps! along the back of my heel and a dull ache. It's more annoying/uncomfortable than actually painful as long as I don't put any pressure on it. I was taking only a half a pain pill every four to six hours and that seemed fine, and now tylenol seems to be handling things well enough. I get a bit uncomfortable, sort of twitchy and achy, but nothing bad at all. I still keep my foot elevated as much as possible. Having the recliner and a pillow are just the trick!

I think this has really gone a lot better than I thought it was going to. A lot less pain. The annoyance factor of not being able to put my foot down at all is pretty high, though. Another 3-4 weeks of that, I think. Hopefully at my appointment on Friday they will take off the cast/splint and put me in the boot. That is more secure and I'll feel less worried about whacking things -- although, I will also probably feel less paranoid about resting my foot on the floor, which will still be a no-no.

The hardest part is really just doing the normal daily stuff -- getting up and going to the bathroom, getting more diet coke, answering the door, all of those things take a long time and are tiring. I sort of took for granted that I could just go up and down stairs..not at the moment. Up = crawling, and down = scooting. I could try using crutches, but I'm such a remarkable klutz I'd probably kill myself. I've never been good at crutches.

I did buy an iWalk crutch on the recommendation of another achilles-surgery blogger -- it's sort of a pirate peg-leg affair that is supposed to replace a pair of crutches and be more stable/easier to walk on. I've tried it out a few times, but the scooter is way easier, to be honest. The girl in the promo picture makes it look so easy, right? Not quite.  I did practice with it a bit before surgery,and I think once I'm in a boot isntead of just this splint thing, I may try it for longer distances. If I can stomp upstairs in the thing instead of crawling up on my knees, that will be a big win! Plus, I get to practive my pirate 'yaaaaaar!'. I might even have an eyepatch around her somewhere.

So, not much to report. More --probably including gruesome stitch pictures - -after my appointment on Friday!

Sunday, July 05, 2015

A bit optimistic

Oy. I got a bit too enthusiastic about not taking the narcs last night, figuring that tylenol would be fine and I was past the worst of it.

Nope. Feels like my foot is on fire this morning, and the barest movement makes my whole leg hurt. 

I must have overdone it yesterday, but today is back in the recliner with ICE and lots of whining and tenseness and bags of frozen peas. Ow! I'm afraid to move. Serves me right for being cocky.

Saturday, July 04, 2015

Day 4: We're Rollin', rollin', rollin'

Both yesterday and today have been pretty quiet -- same schedule as before: get up, shimmy down the stairs on my butt, and trundle over to the recliner, where I spend most of the day. I've been trying to make sure to get up every two hours or so and move around, but mostly my days have been spent in the chair napping or watching movies.

I've been weaning back from the Percoset during the day, and it's been mostly ok. I have prickles of nerve pain taht shoot through my foot when I move things, but it's minor, and at least I can move my toes now. There was a period on Thursday where I was absolutely obsessed with the thought that I couldn't move my toes -- couldn't move any of my foot, even if I tried. Nothing happened. It's a really strange sensation and it freaked me out a little. I was really grateful when I started having little zaps of feeling in my toes and my foot, even if it hurt.

Mark would walk by every few hours and touch my toes -- to check that they were warm and not too swollen, and to see if I felt anything. I had to tell him to stop (or at least let me cover my eyes first) because it was very disturbing to having him poke at my toes and not feel a thing. It was creepy. And then came the time when he ran his fingers under my toes and it felt like he'd lit them on fire. Ouch.

Well, my toes and the rest of my foot seem to be doing fine -- occasionally there is a numb spot or a weird tingling but I'm attributing taht to swelling and the bandages, really. Nothing too strange. Mostly what I'm feeling now is pressure and heat, and a deep, dull ache in the hell and along my tendon from where he sawed off bone.  It's actually quite tolerable when I'm awake -- an ice pack usually does the trick to keep things from feeling creepy-crawly.  I can tell my foot is pretty swollen just by the pressure of the splint on my foot and the pressure on the ball of my foot.

As far as I can tell, my foot didn't swell up too terribly much -- no sausage toes or throbbing and too-tight bandages. I had it elevated from the moment I got home for at last 48 hours, and I'm still putting it up on a pillow or two when I'm in the recliner. At night, I just prop my whole leg up on a thick pillow. That has really helped -- ice and elevation are recommended for 48 hours and I can't stress enough how important that is. It's hard to find a comfortable position sometimes, since I shouldn't set my foot down so it rests all on the incision, but with the thick splint, I haven't worried too much. I imagine it's a rather kaleidescopic range of blues and purples, though. I tend to bruise really spectacularly. But we aren't supposed to pull off any of the dressing or wrappings until we see the doc next Friday. It's making Mark a bit crazy -- I mean, he's a nurse, why can't he change the dressing and make sure it's ok? But the argument is that it was sterile when they wrapped it, and should remain that way.

I'm down to Tylenol during the day, as I noted. It is enough to take the edge off and is just fine as long as I don't spend too much time with my foot down.  I seem to be ok on the scooter for a while -- we went on a short walk outside today! -- but it's particularly aggravated by trying to sit on the toilet. Go ahead, try it -- try to sit there without resting your foot on the floor! It's hard. One thing that really helps is keeping the walker in the bathroom to help stand up and rest your foot on.

I made the mistake of putting just a teensy bit of pressure on my foot (while sitting) and it  made me yelp. It's definitely very painful and it a good deterrent to even trying that again. I'm noticing a bunch of little twinges today that I'm sure will be showing up with more frequency as I start moving around more. Leaning down without bending my knee is a no-no -- feels like someone is pulling all the skin up over my heel, a very strange prickling sort of thing. Twisting isn't really possible with the splint, but I can feel things shifting about a little. I woke myself up this morning with one of those midde-of-the-night spasms, you know the sort? Where you dream you miss a step or fall or something and your whole body jerks? Yeah, that woke me right up!

A few of the blogs referenced charley-horses and muscles spasms as being pretty common. You can't move from a toe-pointed position, and that tends to cause things to seize up randomly.  My surgeon mentioned it, and they can give me Valium or something to make it less likely, but we decided to wait and see. I haven't had any real issues, other than some random crawling in my calf, so I hope that's it.  I'm sure I'll feel that way until I get the first one and then it'll be all 'bring on the drugs!'.

The one thing that I wish I had thought more about is the rather well-known tendency of narcotic pain killers to stop you up like Hoover Dam. Oh, yeah. Not fun. Definitely take the doc up on the Colace or whatever other options they offer. And take them religiously. And get up and move around more.

I'm still napping at odd intervals -- just dozing off for an hour or so in the chair. I originally told work and the FMLA coordinator that I thought I'd be back after a week, but I think I was being far too optimistic about my ability to concentrate and actually work. Sure, I can sit here, but I get spurts of a few hours being "on", and then I'm exhausted. I'm going to call them and tell them that I'll plan on coming back after my first followup appointment -which is July 10.

The Adorable Husband just went out to get Dairy Queen. He's been so patient and nice about all of this. I've been trying to limit the whinging, but I'm sure I've been demanding and cranky. 

Thursday, July 02, 2015

Day 2...and the nerve block has ended

Ow ow ow! The nerve block wore off some time in the middle of the night (well, mostly, my toes still feel a little electrified and stiff), but my heel has definitely started to throb and hurt. There's no real comfortable way to sit and I've morphed into a crabby whiny person.

Mark stayed home again today. He was going to go to work, but he said he realized this morning just how much he's been doing for me and that I'd be stuck if he wasn't here. He would have been home by noon, but they had enough people in the lab that he could stay home. He's been up in his office playing computer games and checking in on me every hour or so. 

Definitely taking the lovely little pain pills, although I have to rely on Mark to dole them out because I can't remember when I took the last one. I made it downstairs, in time to nap in the chair all afternoon. My life is so exciting, I tell you.

I accidentally touched my heel down on the floor -- I won't be doing that again if I can help it. Right now I'm in a hard splint wrapped up to my knee. The doc doesn't want us to mess with it until we see him on the 10th, which is my first scheduled followup. At that point, he should remove the stitches and put me in a boot.

Ok, back to sleep. That's about all I'm managing today.

Wednesday, July 01, 2015

Day 1: Still Numb

Slept like a rock last night -- no pain whatsoever, mostly just awkward with the splint and wrapping, so once I got settled, I was out for the count. Mark strongly suggested taking the pain pills, just on the of chance that things might start hurting overnight, but things were still totally numb this morning when I got up (at the lovely early hour of 10am!).

Getting up and down the stairs is a bit of a trial -- scoot up on my butt is the only real option. I haven't really used the crutches much, and since I'm not very good at them, I really don't want to try them on stairs while I'm still so wobbly. Mark carries the scooter up the stairs for me.

The knee scooter has been a lifesaver; even at this early date, it means I can get around the house and I'm not worried about putting my foot down or slipping or anything. I've got just about every assistive device we could think of (wheelchair, crutches, on-legged-peg-leg crutch, walker, scooter) and I'm whizzing about on the scooter with ease. I have to be careful backing up, since I can't feel if my foot gets whapped on things.

Fabulous scooter, though, isn't it? Unfortunately, I couldn't find a red one. The basket comes in handy, though. And it has a handbrake.

So, I spent the day in the recliner watching movies and reading (and napping), and thinking that this isn't really too bad, I'm beginning to get a few twitches in my foot and leg, but my toes are still numb and swollen, I'm figuring that things will be better tomorrow.