Fractured forefoot

My consultant was quite concerned when I arrived this evening. The CT reported a fractured forefoot which apparently is the part from the bottom of my metatarsals to the tips of my toes.
I just need to fracture my ankle & I've done the full set !

Thankfully it's not displaced & my mid foot reconstruction is still intact with no misalignment. Therefore as long as it stays that way I won't require surgery. It just needs lots of TLC.
So I feel some sense of relief but am upset & frustrated to be back in the aircast boot & on crutches for the next six weeks. The Osteopaenia is partially to blame apparently making my bones more brittle than normal, but the good news is it doesn't slow down the bone recovery rate.
I developed Ostepaenia as a result of the time spent none weight bearing, it should resolve itself in time I've been told. I am continuing with the vitamin supplements & will try to eat a diet to encourage the mineral density in my bones to improve.
It hurts, but the drugs are good, it's very swollen too, ice packs & elevation here I come!

So, on Monday 3/10 it is the six month anniversary of my Lisfranc fracture & on Friday 7/10 it will be my birthday. On Thursday 6/10 I am supposed to be flying to NYC to celebrate :-(
My consultants advice was I could travel but he wouldn't if it was him in this situation. I will have a higher risk of developing DVT being pro coagulant at the moment due to the fracture. He did say he would put me back on the Clexane injections if I went ahead with my trip to try to prevent a possible DVT.
I'll need to restrict what I do in NYC though & will need to put my foot up as much as possible (De Ja Vu !). I will need to sit in the back of the car with my leg up for the road trip in the Smokies as well .........  However I don't think we can get a refund on the airline tickets now. So, I don't know what to do really. I was so looking forward to seeing the Smokies in the Autumn, I bet the colours are stunning this year. But I'll be able to do very little in NYC, my planned cycle ride in Central Park on my birthday can't go ahead.......... Hold on, do they have tandems ??? Hehe I could just sit on the back & get my chap to pedal.

Travel insurance could be a problem too, getting cover for the foot !

With this unlucky streak, I don't think it's worth my while buying any lottery tickets.

Yes......... I panicked !

Last weekend, after managing fairly well for 3 weeks without the boot & using my crutches less & less I had planned a sailing reunion with my crew down in Southampton. Unfortunately I hurt my foot! I stepped up with my good foot, wobbled backwards & lost balance with my entire weight dropping back onto the ball & toes of my injured foot. The pain was immediate & severe. I felt a horrible crunching in the base of my toes, followed by a searing pain through the bottom arch.
It swelled pretty much straight away, a band of swelling all the way across the bottom of my forefoot & base of my toes. The pain was scarily similar in sensations to the pain I'd experienced following my 1st surgery. I took a hefty dose of ibuprofen & hoped that it would settle down & that perhaps I'd just jarred the joints & ligaments or something. The fear, just kept rising up inside though, managing that whilst being with my sailing crew was difficult. A couple of times the fear & panic overwhelmed me to the point that I shed a few tears. Sure I felt run down due to the pain, but the panic & fear overtook.

48 Hrs later I gave in, walking was incredibly difficult, the ball of my foot & underneath the forefoot felt horribly tender, my 2nd & 3rd toes were pretty swollen too with some bluish bruising starting to materialise. So on Sunday evening I found myself in the A & E department of a nearby hospital. After waiting for a couple of hours I was seen & lateral & AP Xrays were taken. To my immense relief no significant fractures were evident on either Xray !
But the consultant was concerned enough about my inability to weight bear & the swelling to give me another pair of crutches (my 3rd !) & prescribe very strong pain killers before discharging me with strict instructions not to weight bear until I had visited my own consultant.

So I saw my own consultant last night & after reviewing the Xrays again he agreed there are no significant fractures evident & my midfoot reconstruction still looked intact which was great news. He was slightly concerned over the swelling & tenderness in my forefoot & toes, with my planned holiday to the US due to happen in a week he has requested a CT scan before confirming that I'm OK to travel.

So it's been a pretty eventful few days, & here I am waiting to go back to hospital this afternoon for the CT. I feel so relieved I can't tell you, the thoughts of having to go back into surgery or back into cast were enough to make my stomach lurch & my heart sink. So I'm keeping everything crossed & thinking positive thoughts that the scan results are good, I'll get them during my follow up with Mr Ritchie on Saturday. In the meantime resting the foot & only partial weight bearing with crutches allowed.

Breaking the silence .......

Well ! Where have I been ?
Apologies first of all, I know I've been a bit quiet, it's been a very tough couple of months........
So after my second operation on the 15th July, I got an infection in the wounds. Which set me back a few weeks. Innitially after the op I felt great. It turned out to be more complicated than planned, I needed some tendon repair & cleaning up which meant another 2 1/2 hrs under anaesthetic. But I felt good and after a couple of days & was looking forward to walking without my crutches relatively quickly. What actually happened was the two weeks planned holiday following the op were spent with me feeling quite ill & eventually not being able to walk at all.
It put me back,but all in all I got over it quite quickly,
What was harder was the walking & weaning out of the boot. I'm no wimp, but when I started to walk I couldn't believe how painful or difficult it was going to be, or was. I knew it wouldn't be straightforward but no body explained to me or prepared me for just how hard it would be. The initial disappointment was so hard..............
I tried to stand up, but I just couldn't. Taking the first few steps out of cast were petrifying. People just do not prepare you for it.
Dealing with my weakness, limp & the pain have been a huge problem. I suppose that maybe I've been hoping that when I came out of the boot I would walk normally. in fact I think I've been in some sort of denial for the last 5 months & was pinning my hopes on it all being fine once I got out of cast.
So when it happened, that is the failure & pain when trying to walk normally, I really struggled with facing up to just how serious this injury is. I didn't deal with it, I cried lots & pushed more & more, hoping for a breakthrough, it didn't happen.

Physiotherapy, shoes & all that follows Lisfranc Surgery

2 1/2 wks post op removal of compression plates, fixing screws & arthroscopy.

I saw my surgeon last night for my post op check & all things considered I didn't think the foot looked too bad .............. I now have one more incision, on the inside of my foot following the arthroscopy but he used the same scar for the metalwork removal & I have to say, I think he did a better job of closing it this time then after the original surgery. What was encouraging was the lack of significant swelling, this is a positive sign apparently & is as a result of all of the elevating & rest it has been given. So there we are, the Lisfranc mantra of "keep your foot up" obviously works !
I still have internal stitches which will dissolve in time, but I can go back to bathing with "my foot"- heaven ! I looked down after the dressings were removed & thought there were a couple of blonde hairs that were perhaps stuck to the sticky residue left behind, but after a gentle tug & a bit more scrutiny, I discovered that they were in fact attached ! They were the 'tails' for the internal stitches- LOL
I will start with an intensive moisturising regime & will buy some "Bio Oil" to rub into the scar. My surgeon says that this stuff really helps with scar healing.......... time will tell !


I explained how I'd tried to build up the weight bearing last week & the amount of pain that I experienced afterwards.............. After an examination, there was some tenderness around the 3rd & 4th metatarsals. My surgeon commented that it is possible the bones haven't fully fused yet, which would explain the discomfort. He was hoping that I would start full weight bearing in a shoe yesterday, but in view of the pain etc, he has asked me to continue with trying to build up the weight bearing whilst wearing the (now stinking !) boot & I will see him again in two weeks time for another examination & X ray. But the good news was I am now ready to meet with the physio terrorists as I fondly call them & they can now be let loose on "the foot".
I must say, my ankle & foot are so painful & stiff at the moment it is hard for me to believe that I will manage to walk in a shoe in a couple of weeks time, but I'm hopeful that along with targeted physiotherapy exercises & a focused effort from me, it can happen. I'm sitting at the moment on my sofa with my laptop on my knees & both feet flat on the floor. Not really weight bearing, but bending the ankle joint & flattening the foot on the floor. My ankle joint has been in a rather odd position pretty much since I had my accident & although I do try to bend the joint & rotate it from time to time, it still will not reach the 90 degree angle which is normal.The pain has been gradually building whilst I've been writing this post & I know I will have to elevate it again shortly.
It's all very well, but when does this need stop ? Does anyone know if this need to elevate gradually lessens & "the foot" will build up enough strength to become strong enough not to need it so often ? I'd be grateful for an indication of how long from where I am now this will begin to happen too.

I have been thinking that swimming would be a good thing to do, but there are no facilities close enough to me to be able to get to without a lift or taxi. Maybe I might just have to stomach the bills & overcome the diminished self confidence & just go ! Quite frankly I think I'd do anything at the moment to help reduce the pain & accelerate the recovery process if I could.

1 step forward......... 2 steps back

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.

Removal of my compression plates & screws Day 103

On July 15th I was re admitted to hospital for the removal of one of the compression plates & five of the screws that were holding this plate in place & supporting the Lisfranc ligament.

I arrived at 12.30pm, in my boyfriends Porsche, with the roof down of course! Peter Gabriel's Solsbury Hill was blasting out from the stereo, the sun was shining beautifully & well, arriving in style seemed like fun. A sort of ironic celebration I guess, but either way it took my mind off of the surgery for a while & I arrived at the hospital in good spirits.
I met with my surgeon who talked me through the process, it didn't seem to be complicated, but I was advised to have another sciatic nerve block from the knee down in addition to the GA. This was instead of Morphine, which the anaesthetist thought I may need in post op recovery otherwise. So the waiting began................

After a few hours of flicking through the daytime TV, fiddling with my Ipad, photographing the foot pre op & planning a possible holiday in October my boyfriend & I were pretty fed up with waiting & were beginning to wonder if I'd be able to go home after the op as I'd wanted to.

Eventually, just before 6pm, the porters came & got me !
Although I was a little anxious, with sweaty palms, i was relieved to finally go. Everyone was really friendly, I cracked a few jokes about needing a glass of Merlot & celebrating the end of "the foot" which now felt like it's not too far away. My lovely anesthetist gave me a little something via my canula to make me feel fantastic (I have no idea what it was, but it worked!) I'd agreed to have the nerve block administered while I was conscious, so I was asked to roll over onto my belly, I watched them do it over my shoulder. My sciatic nerve looked like a ball of wool really, a white mass on the ultrasound screen, to numb it, they injected anaesthetic around the outside edge of it, through the back of my knee, at equal distances, like the 12, 3, 6 & 9 points on a clock face. After rolling back onto my back, I can't remember much more really, the GA was given but I think i may have drifted off before then...........

So what actually happened to "the foot" whilst I was under was, my surgeon removed the plate which was bridging my 1st cuneiform & 2nd metatarsal articulation & also the 2nd metatarsal joint. he discovered that these joints were stiff & some of my tendons had become attached to the plate. So he also carried out a formal arthroscopy (examination & flushing out/cleaning of the joint to re mobilise it) & then an open release of the extensor contracture ( releasing the large tendons from the surface of the plate by laser). It all went smoothly apparently & I had a 'smooth uneventful flight' according to my anaesthetist.

I woke up at about 8.30 in recovery, feeling pretty groggy but already relieved & happy. After some oxygen, I was taken back to my room, where lovely boyfriend was waiting with a gorgeous smile for me :)
I peered under the duvet, to see "the foot" well wrapped, looking almost ball like in shape, with the familiar Iodine staining on my toes & around my ankle.

So the deal was, I had to eat, pee & walk convincingly on my crutches in order to gain my release from the hospital that night by the "physioterrorists" ! After half an hour or so, I began to munch the sandwich proffered to me & drink the tea in earnest, so as to satisfy the release criteria- ha ha !
We tried at 9.30 pm, then again at 10.00pm, I was given one last attempt at 10.30pm.

I could feel nothing in the foot at all, it just flopped about, & my head felt strangely separate from my body, but after forcing the foot back into the aircast boot & a few deep breaths, Voila ! I achieved the necessary few steps around the room on the crutches & the tea had performed it's magic too. Home I went, much more appealing to sleep it all off in my own bed than stay another night in hospital. I took Co codamol & Diclofenac home, just in case.

Saturday night, I was determined to take out BF for dinner, to say thank you for all of his support & to celebrate ! So we did, I managed to put on a high heel (hitched my crutches up a notch) & a dress & off we went. It was lovely, Chinese with a bottle of bubbly, foot still numb & although I was still a bit tired it was worth it.
So the nerve block worked fantastically, it finally wore off about 3 am on the Sunday, over 30 hours after the op, I'd recommend having one to anyone, much nicer than the groggy mess that Morphine can you leave you in sometimes.

But on Sunday I paid for not obeying my body, I was sooo tired, sore & groggy I slept most of the day. I took the Diclofenac & a couple of doses of Co codamol to take the edge off. Monday was spent dozing on the sofa too.

It's now 4 days since the op & I don't feel too bad. the foot is still a bit sore, but that's too be expected, but the swelling isn't too bad & the pain is bearable. I've been told to try to start fully weight bearing in the boot over the next 2-3 weeks, building it up gradually, but stopping if "the foot" protests too much.
I'm back to see my surgeon on the 2nd August........

3 mths since my Lisfranc surgery .........

Tomorrow will be the 14 week anniversary of my Lisfranc fracture, I thought I'd update you all on how I'm doing. ....
I've been home alone for two weeks, just me, my foot & my dog rattling around in my flat & finding ways to overcome some of the obstacles I now face when trying to do some of the simplest tasks.
My dog, Hannah is almost completely blind now from degenerative retinal disease, so trying to negotiate around the flat on my crutches & avoid banging into her has been a challenge !
Hannah lives to eat, food is her greatest pleasure in life, so every time I got to the kitchen, so does she. Hannah has cunningly worked out that if she sits in between me & the kitchen work surface, then she's in a prime position to catch any food I drop, before I can stop her. Although this has worked well for her for food, the downside is she regularly nudges my crutches that are resting against the work surface & as such has received several bumps on the head from them as they clatter to the floor.  She walks hopefully alongside me with her head in the air, nose twitching, as I trundle slowly along on one crutch, whilst precariously balancing a plate of food in the other hand. My cutlery & anything else I need in one of my pockets. I do it this way because the only other alternative would be eating in the kitchen whilst standing. Hannah's also bumped into my crutches when trotting up to me for a stroke, the poor thing has had to try to adapt to her mistress's extra two legs by touch & smell only. I look at her & can't help but think that this must be very confusing for her. Walks only happen if someone visits who doesn't mind taking Hannah for a quick stroll around the block, the rest of the time she has to make do with the garden, but she never complains.................. treats & strokes work wonderfully.

So I've been continuing with my physiotherapy exercise since being home, the plus is I can now do them in the living room in front of the TV. I've worked out a way to do my laundry too. I have a big bag with a long strap. So upstairs in the bathroom, I load my laundry into the bag, then I put the bag on diagonally & swing it around to the front, like a kangaroo pouch. After bum shuffling down the stairs, I then use my downstairs crutches to get to the washing machine in the kitchen & unload. To dry it I do the same thing but in reverse & sit on the loo (lid down of course , it's just a handy place to sit!) whilst I unpack the bag & hang the laundry onto my clothes horse.
Thermos vacuum mugs have been a god send. I make a cup of tea, put the lid on & then manage to hobble back into the living room carrying it without slopping it all over the floor- fantastic !
I had a go at hoovering the living room last weekend. Mmmn not my most sensible idea. I worked out how I could use the hoover as one of my crutches & shuffle around the room, hoovering as I went. Balancing was tricky & I did overbalance onto 'the foot' several times......
I've discovered the power of home shopping too ! I place my orders for my food & groceries online, a very friendly chap delivers it & carries it into my kitchen for me. I can even order magazines, newspapers & alcohol :) The next delivery is tomorrow & I can't wait, I've ordered an Indian takeaway, the highlight of this weekend- hoho
My sofa is a huge corner style one, which has now become my main base. I have the TV remotes, my handbag, Blackberry, Iphone & all that I need set up in the corner seat. Lots of cushions to prop me up & both laptops to hand. This is where I currently rest, work & spend most of my time.
I've been working from home for the past couple of weeks which has been difficult to concentrate on. But perseverance will help I think, I mostly just answer emails, phone calls write reports & co ordinate the team in the office remotely. But after being in this very insular environment for so long, it's tough now to snap out of it & stay focused on any singular task for any length of time I find.

This week however I went to two day sales meeting & met with the rest of my team. It was the first time I'd seen them all since I'd had my accident. So I had one chair for me & one for 'the foot'. I sat at the end of the boardroom table & gave my presentation, to my surprise it was well received, I finished with the last slide being my X-rays with the caption "any questions?" & gave everyone a wry smile.
The hotel room booked for me was an accessible one, with a walk in shower. This was novel, I've been lifting myself in & out of the bath for three months. So in I hobbled on my crutches & switched it on, the shower head squirted water everywhere, not just on me, but up the walls, all over the wash basin, all over the towels & mirror. It was broken & there I was naked, on crutches & powerless to do anything other than watch the water spray uncontrollably anywhere it wanted to !
I gave up, washed as best I could & switched it off. the bathroom was a scene of soggy chaos !
I think I'll stick to baths.......


So I received a letter from my consultant yesterday, I am to go back into hospital on Friday (15th) for the operation to remove one of the plates & approx 6 screws from my 1st, 2nd & 3rd metatarsals. It may mean an overnight stay due to the general anaesthetic, I'm hoping this op won't be a big deal though. I'm sure I'll feel a little bit sore afterwards but I have plenty of pain killers left over which should see me through. I'm guessing that they'll go back in through the same scar from the previous op, pity as it's healed quite well.
I've put boyfriend on standby for some TLC & to ensure they'll let me out as quickly as possible (apparently they have rules about discharging people after GA without people to look after them) & I've warned work that I'll be uncontactable for a few days. But this op is another step forward, after I've recovered I should then be able to begin walking using all of 'the foot' albeit still in my boot & on crutches. The thing to look forward to though, is I'll be another step closer to SHOES- Yay !