Well, I've kind of had the wind taken from my sails so to speak. It seems I didn't respect "the foot enough" this week & it let me know !
So 4/5 days ago, I started walking around just using one crutch more & more often, around the house to start with & then I did venture out. I brought myself a new DSLR recently & a friend offered to take me to the Pantiles last Sunday morning. It was such a beautiful day, I took my camera & really enjoyed hobbling around (in the boot), snapping pics as & when I saw them. It wasn't a long walk or particularly challenging, I took my time & used just one crutch. I was tired when I got home but that was about it. The foot was a little sore, but after a painkiller it settled down. On Monday, I was home all day, hobbling in the boot & sometimes using one crutch, sometimes none. Well that evening, the foot really started to hurt, in fact it did feel scarily similar to the pain I had a few weeks after my 1st op. I had sharp pains in the arch & under the ball of my big toe, along with lots of prickly spasmodic type pains across the bridge/top of my foot & some pain up the back of my leg. I took pain killers & elevated it. the strange thing was, my toes didn't look particularly swollen. A little puffy but they've been alot bigger ! The next morning, it seemed OK, no lasting pain carried over.
My dog was desperate for a walk on Tuesday, I had arranged for someone to come over & take her, but it fell through. So after deliberating, I decided I could possibly manage a gentle hobble (in the boot & with one crutch) around the block with her & gave it a go.
I didn't go anywhere else yesterday, just pottered around the house, sometimes using a crutch & sometimes not. Instead limping around in the boot & using props around the house to support myself on. Last night I really suffered for it. The pain was all of the day before, but much stronger & at times nauseating ! I even had a grinding ache all along the balls of all of my toes (underneath the bases). I'm not sure if that's the right term for that area, but hopefully you'll understand from this odd description which part I mean :) I got up to use the bathroom & hopped all the way on my good foot to it, each hop I took, made "the foot" hurt, a bruised type of pain.
It stopped me going to sleep last night, I couldn't get comfortable in bed at all & I was seriously worried. I lay in bed trying to work out if this was the tendons & nerves healing following the most recent op or if I had somehow managed to damage "the foot" again. I had to go back to elevating "the foot" on a cushion outside of the bedclothes again. So after worrying & feeling pretty sick, I had a poor nights sleep & decided that today, I would hardly weight bear at all, using two crutches if I did.
I've spent the entire day on the sofa pretty much, trying to work, taking pain killers & If I'm honest still worrying. The thing is I still have all of the bandages on, so I can't actually see my foot & I have no idea if the surgeon went back in through the old scars, or if he has made new incisions (I forgot to ask). Therefore I'm not sure if the rest of the foot swelled as a result of the weight bearing & that's what caused the pain, or if it is the tendons etc healing or what, really.
I feel a bit deflated, after feeling so positive & that it really wouldn't be much longer before I could drive (it's my right foot) my car & get back to the office perhaps around the end of August, I'm now not quite so confident. I was also hoping to sail in the last couple of races of the season which are in September. I had realised I couldn't do foredeck, but in this amount of pain, to do anything except sit in the cockpit would be difficult. Not too mention dangerous really. I don't know, frustration & anxiety probably sums up how I'm feeling this evening. Since resting all day, "the foot" has calmed down & isn't hurting me quite so much, although the spasmodic prickly twinges are still happening.............
Last night I was all set to ring the hospital today, but I decided against it & thought I'd try the rest treatment first. I'm really hoping that I've just overdone it & perhaps pushed for too much too soon. I have to go back to the hospital next Tuesday which is 6 days from now, I think I'll just continue to rest it as much as possible, & see if I can gently work back up to one crutch by then. If I can't then I'll just have to make notes on how the foot feels & tell the doc.
So 4/5 days ago, I started walking around just using one crutch more & more often, around the house to start with & then I did venture out. I brought myself a new DSLR recently & a friend offered to take me to the Pantiles last Sunday morning. It was such a beautiful day, I took my camera & really enjoyed hobbling around (in the boot), snapping pics as & when I saw them. It wasn't a long walk or particularly challenging, I took my time & used just one crutch. I was tired when I got home but that was about it. The foot was a little sore, but after a painkiller it settled down. On Monday, I was home all day, hobbling in the boot & sometimes using one crutch, sometimes none. Well that evening, the foot really started to hurt, in fact it did feel scarily similar to the pain I had a few weeks after my 1st op. I had sharp pains in the arch & under the ball of my big toe, along with lots of prickly spasmodic type pains across the bridge/top of my foot & some pain up the back of my leg. I took pain killers & elevated it. the strange thing was, my toes didn't look particularly swollen. A little puffy but they've been alot bigger ! The next morning, it seemed OK, no lasting pain carried over.
My dog was desperate for a walk on Tuesday, I had arranged for someone to come over & take her, but it fell through. So after deliberating, I decided I could possibly manage a gentle hobble (in the boot & with one crutch) around the block with her & gave it a go.
I didn't go anywhere else yesterday, just pottered around the house, sometimes using a crutch & sometimes not. Instead limping around in the boot & using props around the house to support myself on. Last night I really suffered for it. The pain was all of the day before, but much stronger & at times nauseating ! I even had a grinding ache all along the balls of all of my toes (underneath the bases). I'm not sure if that's the right term for that area, but hopefully you'll understand from this odd description which part I mean :) I got up to use the bathroom & hopped all the way on my good foot to it, each hop I took, made "the foot" hurt, a bruised type of pain.
It stopped me going to sleep last night, I couldn't get comfortable in bed at all & I was seriously worried. I lay in bed trying to work out if this was the tendons & nerves healing following the most recent op or if I had somehow managed to damage "the foot" again. I had to go back to elevating "the foot" on a cushion outside of the bedclothes again. So after worrying & feeling pretty sick, I had a poor nights sleep & decided that today, I would hardly weight bear at all, using two crutches if I did.
I've spent the entire day on the sofa pretty much, trying to work, taking pain killers & If I'm honest still worrying. The thing is I still have all of the bandages on, so I can't actually see my foot & I have no idea if the surgeon went back in through the old scars, or if he has made new incisions (I forgot to ask). Therefore I'm not sure if the rest of the foot swelled as a result of the weight bearing & that's what caused the pain, or if it is the tendons etc healing or what, really.
I feel a bit deflated, after feeling so positive & that it really wouldn't be much longer before I could drive (it's my right foot) my car & get back to the office perhaps around the end of August, I'm now not quite so confident. I was also hoping to sail in the last couple of races of the season which are in September. I had realised I couldn't do foredeck, but in this amount of pain, to do anything except sit in the cockpit would be difficult. Not too mention dangerous really. I don't know, frustration & anxiety probably sums up how I'm feeling this evening. Since resting all day, "the foot" has calmed down & isn't hurting me quite so much, although the spasmodic prickly twinges are still happening.............
Last night I was all set to ring the hospital today, but I decided against it & thought I'd try the rest treatment first. I'm really hoping that I've just overdone it & perhaps pushed for too much too soon. I have to go back to the hospital next Tuesday which is 6 days from now, I think I'll just continue to rest it as much as possible, & see if I can gently work back up to one crutch by then. If I can't then I'll just have to make notes on how the foot feels & tell the doc.
Emma - That stinks! My guess is you over-did it - seems to be an all too common occurrence for us folks. My recommendation - couch time, copious amounts of red wine, Advil, and time! I would think that one needs about a week after screws come out before things start feeling better. I would also wait to see what things look like after the bandages come off. Try not to worry too much and take it easy! Glenn
ReplyDeleteHi Glenn, I'm a bit fed up. Resting in bed now, still some pain but have taken painkillers & am hoping to get a better night's sleep tonight! I'm planning to follow you'r advice over the next few days & the red wine is on order ;)
ReplyDeleteI don't know about the wine, but I would add ice to your resting. With an anti-inflammatory, ibprofen, ice, and rest helped me a lot. If the pain is between your third and fourth toe, you might have Morton's neuroma. Ice and ibp did the trick for me. But I know how you feel -- it seems like when I'm overdoing, nothing hurts, life is good. It's the next two days that are killers. Oh, yeah, elevate too. Hope you feel better real soon.
ReplyDeleteSissie
Hi Foredeck,
ReplyDeleteYou and I are really close in recovery. I just weaned off my crutches last week and still using a cane from time to time.
First my disclaimer. Like you I still worry and have a lot of anxiety about the new pains in my foot I feel everyday, so I totally understand what you are going through.
Having said that. Don't worry. When I read your post, it brought back memories of only a couple weeks ago. I had all of the same pains. Your fractures have healed. The pain you are feeling is due to tight muscles, tendons and ligaments.
Let me know if you can relate. When I was allowed to put weight on my foot, the first thing I wanted to do was follow the stupid recommended recovery schedule. Two weeks partial weight with boot and crutches, two weeks partial with boot only, then finally no boot. Throw that mentality away. I pushed myself to believe this was possible even though my foot was telling me to slow down. Finally, after a week of trying to go on one crutch, I decided enough was enough. I just went back to two crutches and put weight on my foot until it was comfortable. As time passed, I was able to put more and more weight on it. I stayed on two crutches with MBT shoes for almost 4 weeks. Then I used one crutch for one week, and finally to a cane.
What I found is that due to the immobilization, I lost more than 50% strength and mobility of ankle, toes and legs. All of this matters, because if these are not strong and supple, your foot will feel all of the stresses. Only PT will regain this back and make your foot feel better.
I know it's difficult because you want to recover fast, but try not to push it. If you need to use both crutches, then just do it and put as much weight on your injured foot as needed. Avoid the painkillers as this is impeding your body from telling you what to do. There is no "schedule". You will improve and then one day you will be confident to go to one crutch and then to no crutches.
I remember getting a serious anxiety attack (shortness of breath, lightheaded, severe panic) only a few weeks ago because of the same pains you described. I wished somebody told me then not to worry about those pains, so my wife wouldn't have to witness my emotional collapse. I am telling you now. You will improve and feel better than you do now.
Stay positive and remember the smell of the sea air because you will sail again.
Cheers,
Jim
Good morning all! Great post Jim - I will remember to re-read this in November or December when its my turn. It's raining here in CT. Working from home yet again... I hope everybody has a great weekend! Glenn
ReplyDelete"Weight bearing as Tolerated" didn't help me too much with pain management. I would overdue because I wanted to get better yesterday. I ended up injuring my knee. Fortunately a paperwork snafu denied me pt for 3 weeks. I still did my homework and the knee pain cleared up. Now I get pain different places on different days. I'm hoping that means things are getting better.
ReplyDeleteBTW on scary pain -- whenever my foot would hurt in strange places or did not hurt, I'd email my doctor in a panic. He was great in responding quickly and would tell me it was normal. Silly that I needed to hear that, glad he let me email.
How long did you all see your surgeon? It will be eight months for me at my next visit. I'm thinking it will be my last? Or is there some kind of long term follow up??
Sissie
Hi, Emma...
ReplyDeleteHere's my experience with getting weight on "the foot." Although my doctor told me I would be able to walk after 3 months, he lied! At the 3 month visit he gave me a script for two weeks of non-weight-bearing exercises and two weeks of partial. The partial turned out to mean a very light pressure on the ball of the foot.
And yes, I had those electric-shock-like sensations on the sole of the foot. My PT person told me the sole had to re-toughen up. I also had what felt like a rubber band constricting my toe.
A bit later, when the PT was more demanding, the foot started hurting again, so it makes sense to me that your foot would hurt if you are putting weight on it.
All those symptoms are gone now!
By the way, Sissie, my last MD visit was one year after the surgery. If I actually run a 5K, I will email him with the news!
Good luck with the recovery, Emma.
Hi Everyone,
ReplyDeleteFirst of all, thank you all so much for your posts & encouragement. It's been very much appreciated through a worrying 10 days or so......
Jim- Your post is excellent & yes I can relate to some of your symptoms. Although I also get alot of pain around the 4th & 5th metatarsal & toes too. A sort of pressure, grinding pain. this was the joint that was fused, I'm not sure if that would make a difference ?
I took it right back to minimal weight bearing, with the boot & both crutches for most of last week in the end & then over last weekend,I tried again with one crutch & the boot & the foot seemed to be OK. I went out for dinner on Sat evening, but took both crutches & the boot ! I wore a high heel evening shoe on the good foot & just upped the crutches by a notch. It was a classy restaurant you see & was wearing a dress, so flats just wouldn't have looked quite the same- LOL
I've been doing quite alot around the house today & have been wearing the boot, but used just the one crutch again. Although I am in pain now (on the sofa with the foot up!) it's more what I would call bearable, not as severe as last week.So I'm hopeful it's a sign of everything getting stronger.I haven't been prescribed any more physiotherapy yet other than the none weight bearing stuff I've been doing since the OP. That might happen tomorrow as I'm due to see my consultant again to have the dressings & bandages off. I'll get another look at it then, so the sensations I've been experiencing may make more sense. Anyway, I'll update my blog tomorrow once I'm home from the hospital. I hope everyone else is doing Ok & keeping their chins up :)
Hi Foredeck. Great to read you are doing better. For the first month of weight bearing, I brought two crutches with me every time I stepped out of my house. During this time, the only time I ever tried one/no crutch was inside my home and at my gym.
ReplyDeleteI am no surgeon and certainly not an expert in foot injuries. All that I know is from the last 5 months, where I have done nothing but read up on Lisfranc injuries. Based on what I learned, I am pretty sure they did _NOT_ fuse your 4th and 5th TMT joints because these joints require a lot of flexibility. It is standard practice to use K-wires to align these bones and then immobilize them to heal a fracture. The K-wires usually come out at 6-8 weeks. Your xrays seem to be consistent with this.
Also, when the surgeon opens up your foot, he usually inspects to see how damaged the cartilage and ligaments are. This is where the experience of the surgeon is most important. If there is a lot of damage, he will typically fuse the first three TMT joints (partial arthrodesis). The 1st, 2nd and 3rd TMT move very little (1.6 degrees) compared to the 4th and 5th (10 degrees). Once fused, the ligaments and cartilage no longer matter because the joint will not move. If he deems the joint is still healthy, he will just fix them with screws/plates (ORIF) and allow the ligaments and bones to heal on its own.
Of course, there is no "one" recipe for these types of injuries. However, the procedure should all aim to achieve _ONE_ main objective - a stable anatomic reduction of your Lisfranc joint.
Anyway, I don't want to sound like a smarty pants. It's always best to ask your surgeon. Good luck with your visit at the hospital tomorrow.
Hi JIm (aka smarty pants :))
ReplyDeleteWow, you certainly seem to have digested most of the available info on Lisfranc repairs that's available on the internet !
Yes, it is important to remember that often treatment is on an individual basis & is dependant upon what other damage there is. For me in my earlier comment, what I should have clarified is I have had the third joint fused & the fourth was also damaged significantly around the base, therefore I still have a compression plate & four screws in place to support it. At present there are no plans to remove this. What was removed a couple of weeks ago was the main screw which was put through the base of my 1st metatarsal & the compression plate & four screws which were supporting the second & third metatarsals. You are correct, I also had a K wire put in place in the fourth metatarsal, which was in addition to the compression plate. That was removed after 8 weeks. For me the surgeon's main objective in addition to a good stable reduction of my Lisfranc joint was to reduce the risk of impeeding arthritis, which presented a s much of a risk in reducing my mobility as the Lisfranc injury. So, I have lots of questions for my surgeon later today............... I'll update later with what I find out.
Wow -- I don't know that much about what is going on in my foot. Whenever my doctor started talking medicaleese I stopped listening. It's not that I didn't ask questions, I did. But I understood the anatomy of what was happening when my physical therapist got a model and explained things. I was ascribing to the what you don't know won't hurt you.
ReplyDeleteLooking forward to hearing your update, Emma.
Sissie