POST-SURGERY PHOTOGRAPHS BELOW.
My second PT session added partial weight bearing using crutches. Although faster to deploy than the iWalk, I move slower. And with crutches you lose the use of your hands to open doors and carry items. So the rebel in me is going to keep the iWalk handy for longer walks and when I need my hands. The walk from my desk at work to the lunch cafeteria can take a good 20 minutes if I check out the offerings in both buildings. I can’t imagine what the same trip would take on crutches. On the positive side, the crutches let me navigate our steep driveway and visit our mailbox.
The therapist also added five more exercises to my daily repertoire. Two of them were leg lifts that were already in my bodyweight routine. Their version adds the weight of the boot and a longer five-second hold, making the 20 reps challenging. I’ve been doing the stretches and exercises at home and choosing the maximum number of repetitions prescribed. Consequently, I had hoped that my strength and range-of-motion had improved, so I asked about swimming. I did not ask about driving after I heard the answer. The therapist said I would have to wait until after the next doctor visit (week 8). Originally, I’d been told I could resume swimming after my first post-op review (week 4). But when I brought it up during the post-op and I was told I’d have to wait until after the Steri-strips™ were no longer needed on the incision (week 5). Then when I got home from the post-op and read their instruction sheet it said not to swim until week 6. So you can imagine all these conflicting timelines are frustrating and I sent a query to the doctor (via the patient portal) to get clarification.
No folding chairs were needed for today’s shower and I got by with just one crutch. That left one hand free to get ready this morning. Aluminum crutches may be stronger than wood, but they are very noisy in the dead of night. There is so little discomfort I feel like I could put my full weight on it if that were allowed. The post-op instructions said PWB (partial weight bearing) “as tolerated.” Since I’ve been told PWB is only for a week, I’m not going to push my luck and continue to follow instructions.
Speaking of timelines, I found that my query to the doctor about the conflicting timelines had been answered: both driving and swimming are prohibited before the next doctor’s visit (i.e., a minimum of 8 weeks from the date of the surgery). That should have been clearly communicated before the surgery, because I made transportation and work arrangements based on an extremely faulty timeline. And this error makes me doubt the accuracy of the other milestones I’ve been quoted, such as when I will begin full weight bearing or discontinue boot usage. I made travel and vacation plans based on those quotes.
Only yesterday I’d replaced the Steri-strips™. And after my morning shower they were already in need of replacement. This time I cut the strips in half as the full length promoted peeling. I also added extra strips to tack down the ends. Even though today is the last day I’m required to use the strips, I want them to last until my scar therapy arrives (the shipment from Amazon is scheduled for tomorrow night). Then I’ll replace the strips with silicone sheets.
My doctor only prescribed a lotion vitamin E, Cocoa butter, or aloe for scar therapy. But I found some medical studies showing that vitamin E caused skin irritation for some test subjects. Therefore, I chose a scar serum that used Cocoa butter . The probability for an observable improvement is about the same chance as vitamin E, but lessens the chance for irritation. Also, I will supplement the that scar serum with silicone sheets, which act as a type of compression bandage. While researching scar serums, I found that these sheets were recommended by dermatologists.
Today was also the first time since the surgery that I was able to retrieve our massive (96 gallon) trash and recycling cans from the curb. Each can required its own trip up our inclined driveway. I’d push the can to my left arm’s length and then hobble up on a crutch and repeat the process. The retrieval was also an excuse to get out into the sunshine. I get a bit stir crazy being confined to the house so much this past month.
Today marks several minor milestones: I begin scar therapy, I can ditch the Steri-strips™, and I can wear my normal compression sleeves. I have vascular reflux and had to wear compression even before my operation. After surgery the right leg has been in various “disposable” compression materials to prevent deep vein thrombosis or blood clots. The first device was elastic bandage wraps, which I wore until the staples were removed (4 weeks). Then they supplied cut lengths of compression “tubes.” These sleeves use a latex that quickly becomes brittle and generated a tan dust. Even with gentle hand washing these sleeves did not hold up well. Thankfully, they provided two, each with a life expectancy of five days. The reason I had to use these sleeves was they aren’t as tight and are easier to get over the incisions without disturbing the wound-care strips.
My favorite style of leg compression is the open-toe sleeves (30mmHg). My second-favorite, calf compression length. But they don’t pair well with socks if too high above the ankle. And if they’re a tad too long they bunch up uncomfortably on top of the foot. The sock style would be my first choice if ever I find a pair that fits. Every brand I’ve tried so far left a whole lot of material hanging off the the toes! This excess has to be folded over on top of the foot and then a normal sock has to be put over that to hold it in place. Not only does this lump look ugly, but the extra material can cause chafing. So for now I only buy open-toe sleeves. And my favorite brand of this style is Doc Miller, which I get through Amazon. The Doc Miller company is only a few miles away, but they don’t have a storefront.
Since I could now wear standard compression, I showed up at PT with both legs matching. I did some crutch-free weight bearing for the first time. And I’m now allowed to get around with only a single crutch. However, I have to use the crutch on my left side, which feels unnatural and awkward. The purpose is to shift my weight away from the recovering foot (i.e., to the left). It’s only a few days away from full weight bearing (Monday), so I think I can manage the left-crutch until after the next PT appointment. The therapist also added exercises to my routine, but none of them were hard. But it does make the daily routine take longer to complete.
My weight bearing confidence was crushed overnight. The PT from the day before came back to haunt later that night. My foot experienced sharp stabs of pain between a distracting ache. This only happened when I was resting or sleeping. I guess without any other sensations to distract my foot, it decide to go into complain mode. I was afraid to touch it in case that made the pain more severe. But later in the day when I was feeling braver I found that when the foot was back in the boot or if I was touching it, that there was no tenderness. I guess when the nerves are idle they sense they’ve been sliced and throw a temper tantrum. I took my pain medication out of the safe and carried it with me thinking I might need a dose. But the pain went away by afternoon when I was in the boot hobbling about. I will have the prescription bedside if I have another difficult night (last night’s thunderstorms didn’t help matters either). Although I have doubts because ice didn’t seem to alleviate the stabbing or aching pain. Let’s hope a quick massage will do the trick instead, although that’s not a real solution to the sleep problem.
The pain (when I rest my right foot) continues. Now that I’ve been partial-weight-bearing for several days now, the foot seems to frequently be in a low grade ache at minimum. The PT exercises force the right foot to carry full weight at times, so it seems natural that there would be some repercussions. And the feedback (I’ve gotten and given during my PT appointments) confirms that minor pins-and-needles, tendon tightness, and scar tenderness are normal discomforts. I’ll confirm with the therapist tomorrow, if the night spasm/stabs are also a normal consequence of working the injury through the recovery process.