Tuesday 28 June 2011

Day 80 Weight bearing- Woohoo !!

I had a really good appointment at the hospital today, for the first time in this recovery process, I finally received some real positive news !
My AP & Lateral X rays looked as good as the consultant would expect at this stage, his words were "You're making a good process in line with what I would expect at this stage".  The fusion (with bone graft) of the 3rd TMT joint is healing well & the plate & screws that are also holding it & the 4th metatarsal will remain permanently in my foot. The 2nd metatarsal which was treated with an open reduction & fixation look like it's healing well, the screw that was put in in place will hopefully be removed along with the fixation plates & screws in the 1st metatarsal. If I continue to make progress at the same rate, I can expect this to happen in about 17 days (July 15th).
After examination of the foot, he was encouraged with the low level of swelling that it presented with.  He wasn't concerned by the swelling I described & the purple appearance "the foot" sometimes adopts he said it was quite normal to experience this after exertion at this stage & I should take it as a sign that I need to rest it whenever it happens. The swelling should always subside after resting, which mostly it does.
I explained to him the problems that I was having with the boot, it was loose & hung awkwardly on my foot rather than supporting or cushioning it. This was causing the bridge of my mid foot to become sore, pins & needles in my toes & irritation of the operation scar.  He explained that he was hoping to get me to start weight bearing using the boot, so we needed to resolve this other wise it would mean transferring back to a cast, which would be a slight regression. So we hopped along to the physiotherapists office to see what her verdict was. After having a look, she explained that the boot was far to loose, following the reduction in swelling over the past 3 weeks. I also still cannot get my ankle & heel to bend into the normal 90 degree position due to stiffness & swelling within the ankle joint. This is also affecting the positioning of my foot within the boot. The physio suggested that we try to inflate the air cushions more to hold my foot in a better position, although it would mean discomfort short term, the long term benefits would be important. After doing this, the boot was a lot tighter, all around my foot & calf, apparently this is how it should have been all along :( I also need to continue with the ankle exercises at home.
Then came the "moment"................. after another nurse was called in for support, I was asked to stand up slowly.............. on both feet ! After much coaching from the physio & lots of instructions I then began to walk, just putting 50% of my weight into my heel. Crikey it felt alien, completely abnormal ! I painstakingly slowly put my crutches out in front of me, then brought my bad foot through, parallel with my crutches, put my weight down into it's heel & then brought my good foot through to meet it. The smile on my face after the first couple of steps was immense ! I even felt emotional, my bottom lip wobbled a bit, I don't mind admitting. The relief was over whelming, at last a real tangible step forward in my recovery process. I also had a lesson in staircase techniques, so hopefully after a bit more practice, I may be able to leave the days of bum shuffling behind me- Yay !
I asked my consultant if I had actually displaced the Lisfranc alignment when I fractured all of the bones that I did, he confirmed that in deed I had & it was by a serious measurement. However If I continue to make the recovery that I currently am, he felt confident that the ligament & tarsometatarsals should heal well. I asked about my prognosis, he confirmed that subject to the good recovery continuing I stand a relatively low chance of developing a debilitating level of arthritis. The good news is that I stand no chance of developing arthritis in my 3rd TMT as I've already had the treatment by having it fused. If I were to present with painful arthritis in the future then he would treat it my fusing the rest of my TMT joints. I feel reassured that it would be treatable & actually if it came to this, well at least I'd still be able to stay relatively active. I have lost some feeling on the inside of my 3rd & 4th toes, my consultant said he couldn't say for sure if this would be permanent, but it shouldn't affect me too much. I also asked if I would be left with a permanent limp, he said that I would have a slightly displaced gait, but after 6 months or so I shouldn't have an obvious limp & should be able to walk relatively normally. It will take a full 12 months or so, before I will reach my full recovery. I should be able to sail again next year, OK so no pirouetting on the foredeck but I WILL be able to balance well enough on both feet to be able to sail.

So I can hopefully look towards the op in July, then around a month later walking in a normal shoe, a few weeks later discarding the crutches & being able to drive sometime in August.
Happy, happy, happy of Royal Tunbridge Wells !!!

18 comments:

  1. Way to go, girl!! I'm happy for you.

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  2. Hi Sissie, I was very relieved ! Although this is probably where the hard work starts huh ?
    If you want to stay in touch through email instead of on here, feel free to email me direct....
    Anyway, how are you today ?
    Did you know that in the US the protocol for removing the metalwork is normally 18 wks but in the UK it's 12 ?
    I looked up your condition with your toes, did you have it before do you think ? Or was it something you developed as a result of the Lisfranc ? I have lost feeling in my 2nd & third toes, don't know if I'll get it back, but I think it may be linked to the swelling post surgery.How are you getting on with your work ? Are you able to at the moment ?
    Emma.

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  3. Hi Emma,

    I just found your blog from fractal foot's site. I am glad you have positive news. Lord knows we need it. I posted a summary of my story on http://fractralfoot.wordpress.com/2011/06/07/this-is-the-hardest-time-for-recovery/#comments. I hope you continue to do well. I have found that the recovery process is a daily struggle of ups and downs. Please continue to post how you are doing.

    Nucklehead

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  4. Hi, I posted a link to my blog...I am glad to read that you are now putting weight on the foot. Way to go!

    Fractralfoot

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  5. Hi there - Just stumbled across your blog - I am happy to see that there is life at the end of the tunnel. My boating accident just happened 2 weeks ago Sat - stepped off the swim platform of my boat just before bed to get something off the dock, tripped on the dock cleat and you know the rest - Trip to the ER, fully displaced injury, Surgery within hours and now on week two of sitting wondering when this gets better. Would love to share my story and journey with all that are interested.

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  6. Hey Justchillin. This is a frustrating injury, but try to stay positive. Accidents unfortunately do happen. We have to live our lives right? Your ER found the injury and you had surgery right away. This is already really good news for a recovery. Most people are mis-diagnosed and left untreated for a long time. Good luck and please share your story. Feel free to email me with any questions at nuckleheads@hotmail.com.

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  7. Hi Justchillin,
    I agree with Nucklehead, it is frustrating & I remember how I felt in the beginning. To do it in such a trivial way for me was difficult to comprehend. As a fellow sailor, I'm sure you must be gutted about the time you'll now have off of the water. I'm about 11 weeks ahead of you in my recovery, I still have to have another op to remove some of the metalwork (currently waiting for a date)& then the recovery process will continue with "weaning" my foot off of the boot & into a shoe. You have probably already looked into dietary info for bones, but if you haven't it's well worth doing so & adjusting your diet to include the foods containing the right nutrients. Also start taking an osteo care vitamin supplement. It can't make you any worse can it ? My attitude was to do everything I could to help myself, despite the dperessed & feeling sorry for myself moments. I also started none resistance & none weight bearing physio exercises around week 3, initially prescribed by my physio following the surgery, I then added some of my own to extend the exercise routine. I'm sure doing this has helped me to retain some of the muscle groups & made the transition to partial weight bearing alot easier. As well as helping me to feel better in myself. If you want to ask me any questions, feel free to email me at emmadavidso@gmail.com.
    I will continue to update my blog, there is still a long way to go in the recovery process for me.

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  8. Hi Nucklehead and Foredeck Wannabie! THANK YOU THANK YOU for posting. I was feeling sorry for myself yesterday as I had a slow work day (technically I am on holiday) but answering email and reviewing reports etc. from my staff has been keeping me sane. I started looking at some of the blogs out there and REALLY started to get depressed. A pep talk from the wife, a few glasses of Chardonney and reading your blogs made me feel much better! Feeling much better this am. So as the day goes on today I'll start to post my story on my blog. I would love to keep in touch with you all thru our shared journies. Misery loves company ;-).

    Regards, Glenn - AKA - Just Chillin is my 38ft Meridian MY.

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  9. Glenn ............ cool, glad to hear you are feeling better. Stay positive & let me have the link to your blog, I'll add it to my blog roll on here. Motor yacht huh ? I should've been racing this year on SCream, 37ft Santa Cruz. She did see 21 knots down wind during this years Round the island race, I had to follow her progress on the live race blog ;( Still, I'm hopeful for taking part next year !

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  10. Yea Yea - I am a "stinkpotter" BUT - I have owned 3 sailboats in my life - the last was a CAL 28. Only have raced once... You will be racing no doubt next year - even if you are not on the foredeck - perhaps tactician? :-) People always need crew. Not sure how to pass you my blog link - I think if you click on my name you can get to my blog. Let me know if you can't. Cheers - Happy hour here in New England - time for a Chard. G -- PS - What town are you in? I have been to London and Bournmouth in my past on business. I thought Bournmouth was great!

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  11. Hey Justchllin. I wouldn't say misery loves company - it's more like nobody understands it unless they are living it, and any positive group support is good. To be able to touch somebody else's life just by posting on a blog is well worth the effort. I know I felt better after some of the positive comments that came my way from Sissie, Foredeck and Fractal Foot. I was working out, and doing physio and pool therapy for 4-5 hours a day. I was physically and mentally drained, but their comments helped me carry on. Hopefully, you will get to help somebody else in a similar way (could even be us). Keep positive and enjoy the little wins (ala Sissie).

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  12. Nucklehead - You bet! I am overall a very positive guy - so please take my misery comment as tongue in cheek :-) 2 weeks in for me - so this is all new.... Keep the comments coming - I appreciate the company. G

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  13. No worries Justchillin. I just didn't want you to be miserable. Since you are a positive guy, you have half the battle won. Staying positive was one of my biggest challenges. Today I parked from the front of a medical building to my physio's office without my crutches. I also walked from the parking lot to the back of the drug store to pick up my prescription. Aside from some pain in my foot which scared the crap out of me, and walking a bit slower than my normal pace, I guess I should feel pretty good about it.

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  14. Just think, we are going forward -- maybe slowly, but forward nonetheless. I love hearing how everyone is moving. Justchillin' two weeks is the beginning of the journey. Stay off your foot like your doctor says, it's worth it. My last xray showed great bone fusion. My doctor is not taking out my hardware unless it bothers me. Interestingly enough, I met someone who has the exact hardware in miniature. He told both of us the same thing. I'm at a teaching hospital, USC, so it was like Grey's Anatomy at surgery time. :) We are all different and will heal on our own schedule. I'm always happy to learn from you all.

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  15. THAT is the hardest part folks - looking forward and not backwards. I realize this is a journey now - and reading all of your comments has helped me prepare for what is to come. I am very happy that you all are mid-way to seeing light at the end of the tunnel. My stitches come out the week after next - then I settle into I assume another 4 weeks in a cast. My goal for now is to get thru that and then look towards 'the boot'. To me - that is the light at the end of the tunnel moment - out of the cast and into therapy.

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  16. Great to hear how well you are doing Nucklehead, Sissie that sounds like good news for you too :)

    I think you are doing really well Glenn, in my first month, I suffered terribly with anxiety, tearfulness & feeling very down. In fact I think it just overwhelmed me, so along with a good dose of pain I struggled to keep my chin up ! Keep hold of the PMA you've got, it will stand you in good stead.
    I think they way you have already broken down your recovery into 'steps' is excellent too ! It is definitely the best way to get your head around it.
    I'm managing to hold on to the positive feeling that I got from my last appointment & just love the way that we have our own 'lisfranc' community chat going on here. It's great to be in contact with other people who are actually going through this too, albeit across the pond ! Although friends & family are supportive, it's hard for them to comprehend the frustration & fear involved in the recovery from Lisfranc injuries...

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  17. Interesting comments all
    they mirror what I believe is a common experience amongst Lisfranc-ers:-

    that recovery from this injury is as much about the mind as it is about the body
    and that we all struggle because the injury is so abnormal and not understood (by many in the medical professions, never mind the public!!)
    I guess we all only 'discovered' that Lisfranc existed once we'd already joined the club...

    I believe there is a need for a help and support network to help people progress through this 'journey'
    and that such a group is as essential as good medical care in getting people through this

    Emma's blog has a good store of useful info and experiences as a result of her posts and those of the commenters
    - great resources like these need to be pulled together, IMO

    If this resonates with you then please visit and join the 'Lisfranc Fracture Club' on Facebook and help build the community with your experiences

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