Monday, November 30, 2015

Day 13~ Stitches out!

I went to see the Physcian's Assistant, and she removed the soft cast, and I got my first look at my surgical ankle.  I already knew what to expect since I had this same surgery on my right ankle last year, but I was still anxious to see what it looked like.  Here is what I saw.
There was a lot of bruising from the tendon repair, and blood pooling that stained the bottom of the foot purple.  This can be permanent, that is one reason elevating is so important.  The stitch removal was slightly uncomfortable, felt like stinging.  I took a pain pill about an hour before my appointment, and it helped!  I then wiped down my leg with soap and water, and put lotion on the foot and around the ankle.  I picked out my fiberglass cast color.  
When putting on the cast, the PA slightly turned the ankle up and out, and raised the toes to get as close as possible without pain to a 90 degree angle.  I had to sit on the edge of the table and hang down the foot while the cast was being put on.  That causes pain, because the blood flows down, and swelling begins.  Also, the cast gets warm when being put on, so don't be alarmed.  It felt really good to get out of the splint, and get a new cast.  I was only taking about 2 pain pills a day, by this time.  One during the day, and one at bedtime.  My doctor also prescribed Vistiril to take with the pain meds to help with nausea and itching.  This helped me relax and sleep a little, then it didn't seem to help at all.  I guess my body got used to it.  Sleeping was really uncomfortable, and I did not sleep much.  When it itched, I would try to get up and move around, and this took my mind off the itching.  It is difficult being in a cast, but it won't last forever.  

Surgery Day

I arrived at the hospital at 6:30, signed in and gave them my insurance card and driver's license.  A nurse came to get us about 7:00, and showed me to my bed.  She gave me a gown and hat to put on.  I used to restroom to empty my bladder before surgery.  They put an iv in to give me fluids and antibiotics during surgery, and put a scope patch behind my ear to help with nausea, since anesthesia makes me really nauseated.  My hubby took a picture of my ankle before surgery.

The nurse wrote yes, and I asked for no smiley face, so she put a frowny face on my leg.  This helps the doctor know which ankle is being operated on.  They wheeled me off after adding a sedative to my IV.  I was awake and remember going in the Operating Room, but then fell asleep when the anesthesiologist put a mask of oxygen and gave me medicine to put me under.  They moved me onto the table after I fell asleep.  Last year, I had the same surgery, at the same place, and I had to transfer to the operating table, and then they put me to sleep.  So it can go either way.  The surgery took 90 minutes, because they had to repair and tighten tendons with a radioopaque screw.  This screw never needs removing, and can only be seen on x-ray.  My first surgery on the other ankle in 2014, only took 60 minutes, because no tendon repair was done.  Both surgeries cut into the ankle bone, and made a new groove for my peroneal tendons.  They were put in the groove, and sutured down, and tissue put on top.  I woke up in recovery, and  I was asked to rate my pain every few minutes, and then given meds, crackers, and a drink.  I was leaving about 45 minutes after waking up.  I was wheeled down to the car, and I got in the backseat, and had several pillows and a blanket ready.  I was aware enough to text some friends and family, and talk to my hubby on the way home.  It takes an hour to get home, so I definitely fell asleep on and off.  I get home, and was able to use my knee scooter to get into the house and plopped in the recliner where I fell asleep.  I woke up after a few minutes, and made it to my bedroom and finally to the bathroom. I slept a lot the first couple of days.  I took pain meds as prescribed, which kept the pain level under control.  I still felt pain, but it was bearable.  I took a baby asprin everyday for about two weeks, to help prevent blood clots.  The day after surgery was very painful, even with the pain meds, it hurt so bad to get up and go to the restroom.  I literally groaned the whole time I was on the knee walker.  I tried crutches, and it still hurt so bad.  I don't know why it hurt so bad, but day 3 was much better.  Day 3, I began to run a fever of 99.8-100.5.  I kept that fever for about 3 days.  This is normal, as long as it doesn't get above 101 degrees.  My 2014 surgery, I never ran any fever.  Each day, I began to feel a little better.  Friends came by to bring dinner and visit, and I was able to get up and move to the recliner, and stay awake for the visit.  By day 5, I was able to space pain meds out and by day 6, I was able to get off Percocet, and switch to Norco.  I was spending all day in my living room starting on day 4, which helped my mood a lot.  My 2014 surgery on the right ankle, I stayed in bed for at least a week, and I  made an effort to get up and move around to help prevent blood clots.   Love the toilet seat I bought, it was really easy to get up and down.  I got in the bed, and that is where I stayed for the next couple of days.  Here is the surgical splint that they sent me home in for the next 12 days.

I had to keep my toes above my nose 23 hours every day.  Only time I was not elevating was when showering or using the bathroom.  I wrapped it in a plastic bag, and kept it out of the shower,  propped up on my knee scooter.  I used a hand held shower head, which made showering easier.   I used yoga pants, sweats and shorts to help get around the bulky dressing.

This is all I did for the first 12 days.  I was bored, in pain, and pretty emotional.  Make sure you have plenty of movies on the dvr, Netflix, or plenty of things to do while sitting.

Preparing for my surgery

Since I had this surgery before, I knew what I needed to get around my house while not being able to put weight on my foot.  The first thing I did was find a knee scooter.  My first surgery, I used a walker with a board across to rest my knee on, and crutches.  Both worked, but I wanted something that would look good when I went out in public.  I found one brand new on Walmart.com for about $230, but after looking a while on ebay, I found one used that looked brand new for about half the price.  So, I got the Drive steerable knee scooter with a basket and split knee pad.  I love the basket, and it can carry a lot.  I also love that this one has the split knee pad, which can be useful when standing to get dressed or move around.  They sell an optional knee pad for the scooter, but I didn't get one.  I didn't need it after all.  The next thing I got was a toilet seat with handles.  When installed this raised the height of the toilet so my feet barely touched the ground, and I could get up with out struggling to put weight on my foot.  I also got a bench for the shower.  Last time, I used a folding chair, and it sat lower and slipped a little.  I also got a knee wedge to elevate my foot on that would support my knees.  My last surgery, I used pillows, and my knees and back of my thighs were hurting.  These were purchased from Amazon, because of free shipping and they had the best price.  Shop around for the best deal.
 
The next thing I did was clean my house top to bottom. and prepare the outside patio for sitting. When I sit around and can't get up, I get frustrated at things that aren't clean.   I also made a ramp out of 5/8" plywood to help me get out of my house on my knee scooter.  Getting outside was so important to help with depression that comes from sitting around so much.

I made freezer meals, so the kids and hubby wouldn't have to do so much, and I would feel like I was helping in some small way.  They are easy to make, and if you have freezer space, you can make a lot.  I also stocked up on snack food that are high in protein and fiber, and lots of fruits and veggies.  This will help with the constipation that can happen after surgery and while on pain meds.  You should always eat a little something when taking pain meds to prevent stomach upset.

A week before surgery I went to complete my pre-op testing.  This was an ekg, and blood work.   The day before surgery they called to give me an arrival time of 6:30.  I ate a small snack before bed, and tried to go to sleep early.

Finding out I need Peroneal Tendon Subluxation surgery again!

I had this surgery in September 2014, on my right ankle.  I read every post and blog I could get my hands on, and I still was not prepared for this difficult surgery.  I found out that I was born with no grooves in my ankles, and my tendons had nothing to hold them in place.  My right ankle started out of nowhere, no injury, just pain.  I went to several doctors before learning that my tendons were subluxing.  After recovering from the first surgery, the doctor said to be careful with the left one, since I have no grooves it could happen to the left ankle.  Well, in June 2015, I felt the same thing happen again in my left ankle.  I did not want to have the surgery again, so I tried everything possible to avoid the surgery.  I wish now that I had not waited,  because I have been in a boot and off my foot for so long.  The doctor examined my ankle, and then asked what took me so long to come in?  I told I didn't want to go through the surgery again.  He said that it was necessary, or it would shred the tendons.  I scheduled the surgery for a month later to give me time to prepare mentally, and get things needed to help me while nonweight bearing.  In my next post, I will talk about the things I did to get ready, and purchases I made that made my life easier.