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Old 08-20-2011, 04:27 PM   #1
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Question Pre-Lisfranc Surgery - Seeking recovery tips

Hello everyone! I know this post is going to be long, and I apologize in advance for that.

Sorry to say, I've joined the ranks of this injury group, due to a car accident in June 2011. I THINK my injury is less serious than many -- for a few weeks, I just thought I had a bruised or sprained right foot, and was able to walk around, although with some pain and tenderness, but not too much. However, when all my other bruises and pains from the accident went away but my foot still hurt, I went to see a podiatrist who had operated on my daughter's bunions when she was in high school. He did weight-bearing xrays, diagnosed me with a "ligamentous Lisfranc injury" and put me in an orthopedic boot (because I was leaving on an overseas trip in about 10 days).

When I came back, I saw him again, and he said I did not have to wear the boot as long as my foot was not bothering me too much, but that I would need surgery to fix it. He said that I could take a while to get things set up so I could deal with the surgery. He also sent me for an MRI. The MRI diagnosis: "nondisplaced fracture through an osteophyte along the dorsal margin of the medial cuneiform. The Lisfranc ligament shows no discontinuity." Oh yes, all this plus "moderate to advanced 1st tarsometatarsal degenerative arthrosis with subchondral bone marrow edema." (Getting old is a bit*# but it beats the alternative).

I have an appointment with a foot and ankle specialist this week, mainly to get a second opinion, but I am pretty well resigned to the idea that I'm going to have to have surgery. I feel somewhat fortunate that I have some time to get ready for this. I've spent a lot of time reading blogs and health boards on the internet and feel I have a fairly good understanding of what's to come, if I don't have any complications: 2-3 months of non-weight-bearing in a cast, followed by (probably) a boot and then extensive PT and post-operative recovery. I'm looking for any suggestions and tips you could give me for how to get through what's coming.

My background: I am an active 61 year old female, married with two daughters, both away at college. I'm not employed now. About 5 years ago I was diagnosed with Type 2 diabetes, for which I have a genetic predisposition. My diabetes is very well controlled and my A1c (a 3 month average of blood glucose levels) is almost the same as a non-diabetic's. I do not have to take insulin yet, but I do use oral meds. That's my only medication. I'm well-controlled because I joined a health club, work out doing strength training 3 days a week with a trainer, and do 30-45 minutes of cardio exercise 5 days a week. Doing this allowed me to lose 30 lbs. and get to a normal weight for the first time since my mid-40s, and the weight loss and exercise keeps my diabetes under control. I'm very concerned that I'm going to gain weight and have my blood sugar levels go up due to the extended period of inactivity. In general, other than being overweight before this, I have always been in fairly good health.

As I mentioned, I'm not working now -- but my husband is, and he won't be able to stay home for more than a few days to take care of me. My daughters are away at college and I have no other family that can come and play nurse. I do have great friends, though, and I know I will get some help from them. But basically, I'll be stuck at home alone for 10-12 hours a day. I live in a suburban area with no public transportation. And since it's my right foot, I won't even be able to drive once I'm feeling better. One good thing is that our master bedroom is on the first floor of our house, as is our laundry room, and we have hardwood floors or ceramic tile throughout the first floor. So getting around with a wheelchair or crutches shouldn't be too bad. But I know I will need help with cleaning, grocery shopping, etc.

Some of my concerns:
1. Do they usually put a short leg cast on you immediately after surgery, or do you get soft bandages for a short while before getting a cast?

2. Pain control -- I usually think I'm pretty good with pain, but to be honest I've never had any real pain except for when I broke my ankle once. The one time I took some strong pain meds (don't remember what it was, it was so long ago) it made me very sick. I can't imagine having to throw up if I can't get out of bed easily to get to the bathroom. Ugh! Can they give you something to help with nausea as well as pain?

3. How long did you feel really miserable, flat on your back in bed, before you could just be mildly miserable and camping out on the sofa?

4. Even if you couldn't drive, did you feel well enough to go out, or did having to keep your foot elevated make going out difficult?

5. What did you do to keep from being totally bored? I can only watch so much mindless daytime television. Maybe I should get an iPad? Or a Netflix subnscription? I think I'll finally start using that Rosetta Stone software I got for Christmas.

6. Can I exercise (arms, shoulders, left leg) in a chair or something? (Did I mention I'm REALLY worried about gaining weight and blood sugar levels, LOL?)

7. (For the women, especially): What did you do about being able to get a shower and do your hair? We have a walk-in shower (small, but with a seat and a hand-held shower attachment) and a separate jet-tub (no hand attachment there). I could wash my hair in the kitchen sink, if I could stand long enough to do it. How hard was it to get to the bathroom? Do I need handicap hand rails there? What did you end up wearing for clothes? My normal jeans are going to be out of the question, but I don't want to live in PJs after the first few days.

8. Did you have any medical equipment or other gadgets that you found particularly helpful?

I've found all the information on this board, and on the blogs I've read, very informative. I'm hoping you can help me out with my concerns -- and any other advice you might have.

Thanks!

Tessa

 
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Old 08-20-2011, 08:31 PM   #2
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Re: Pre-Lisfranc Surgery - Seeking recovery tips

Good luck with your upcoming surgery. I had a flatfoot reconstruction on my right foot 11 weeks ago and found the first week very painful, staying in bed with foot elevated. After that, I became more mobile but tried to keep the foot elevated most of the time. I've worn shorts or capris through most of my recovery. I did a number of exercises from my bed and managed to lose 15 lbs. , continuing the food plan program I had started last year. Be sure to check out the sticky post on tips for dealing with non weight bearing. I found the kneewalker invaluable to my recovery. I used a walker with a tray table, too. A shower bench was also important as well as a toilet seat with arm rails. Again, good luck.

 
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Old 08-21-2011, 03:27 PM   #3
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Re: Pre-Lisfranc Surgery - Seeking recovery tips

Thanks for your suggestions. I didn't see the non-weight-bearing tips post until after I posted my question, but it's GREAT! Lots of good ideas. I do feel thankful that I can do a little prep work in advance.

 
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