Hey guys! So got the cast off! Felt SO good! The RN cleaned my whole leg, foot, toes with alcohol and got all the betadine off! That felt fantastic! I can't wait to bath, shave, exfoliate, and moisturize my leg! No baths or submersion in water for at least another 2 weeks so no full pedicures yet! Ankle looked good! All 8 steri-strips still intact and look just as they did the day they were put on. I will just let them come off themselves in the shower in the next couple of days. Incision looks good. Still swollen around the ankle although not terribly and there is generalized swelling in my toes and the 4th and 5th toes are still with that sensory disruption thing!
Doctor said that I am weight bearing as tolerated, but that I wouldn't be able to do that today. Said it would take a while to work up to FWB. No kidding! I can put my toes down and I put the foot down when I'm on both crutches, but not much weight. Hurts in my ankle and my heel. Had electric shocks in my heel. Gave me an order for PT for 2x/wk for 3 wks to start with. Didn't want to give me a long drawn out order at first. Wants me to follow up with him in 2 wks to see how PT is going and then if it's going well, he'll extend it. That way we don't waste PT sessions that insurance is covering. Smart! He asked if I needed any more pain medication and the conversation was interesting.
MD: Do you need more pain meds?
Me: Well, how painful is PT going to be?
MD: Yeah, I'll just give you another Rx for Percocet
Me: Greeaaattt!! I guess that's a yes?
MD: Most patients say it's really painful, some say no.
Later on, when I get home and tell my husband this conversation, he said oh yeah, he said you'd hurt. I said huh? You didn't tell me this! He said well the day was long and hectic and parts are coming back to me as we talk about them. He said as soon as I came out of surgery and my doctor went to talk to him, first question my husband asked after finding out I was okay and it went well was "Will she be out of pain after this?" He said my doctor said, "After she gets through PT she will!" Yay!
So with PT to start, I can only move my ankle up and down, no side to side or inversion/eversion right now and no BAPS board (wobble board) obviously. Just slight ROM up and down, modalities to control pain and swelling and weight bearing. So I took the order down to the place in the front of my neighborhood and asked for the guy my friend recommended (she just had knee surgery in Feb too). He was great and made me laugh 3 times right then! I have my first PT session on Wed 4/4 at 1pm!
I forgot to ask my doctor how often I can take the boot off. I know I can shower without it obviously and 3 wks ago if I had gotten the boot then, he said I could sleep without it, but even if I had gone with the boot and not another cast, I wouldn't have been comfortable with that then. Now, I want to try it. The boot is so bulky and hot and SNUG! My cast wasn't this snug so my foot is aching a lot from the manipulation the doctor did to check the work. He also checked my good ankle to show me how much tighter my repaired ankle is now. So I guess I'm ok to sleep without it? I called my doc's assistant and left him a voicemail but I haven't heard back from him yet. I just want to be able to take it off while sitting on the couch some and while sleeping. Boot in the bed will be yucky!
All in all a good day! I took percocet before I went so the manipulation wouldn't hurt as bad and it didn't hurt as bad, but it still hurt! Can't imagine what it would've been like had I NOT taken it! He didn't make me stand on it at all! In fact, he told me don't expect to be FWB right away! Yeah, no kidding! So I have it elevated and going to ice and take some more pain meds before bed!
Re: Cast off! Back from my 3rd post-op visit-Update!
Sounds like you have a pretty fantastic doc. Glad to hear everything went so well.
I'm not quite positive but I'm pretty sure I was able to take my boot off for sleeping once I got out of my cast (7 weeks). I do know that I was back on round the clock meds for the first week of PT but then it dropped off pretty quick. I was also able to bathe right away.
Re: Cast off! Back from my 3rd post-op visit-Update!
Hollywood!!!
So happy that all went well for you today!!
Your doc sounds awesome and very attentive to your needs. Your foot is "in good hands"!
Don't we wish all dr/patient relationships were like that?!
I would imagine you can have the boot off in bed. I think it's most important when you're up and about. No sleepwalking then! LOL! I had a dream last night I was walking around on both feet! In my dream I was recovering from surgery, but I was walking around anyway.
Weird!
Hope you have a good night's sleep!
I'll talk to you soon!
__________________ Left Calcaneal osteotomy w/flexor tendon transfer 2/29/12.
Re: Cast off! Back from my 3rd post-op visit-Update!
LURCHY--Yeah, I have a great doc! Really fantastic! I think I'm good to sleep without the boot too! I also imagine that come Wed, I will be taking more pain medication to accommodate for PT. I'm already having to take more today after manipulation and the boot. The boot hurts right now!
LORI--I think I'm good sleeping without the boot too. Just scared I will turn my foot side to side like I'm NOT supposed to do! Might try to wear my lace up brace and see if that helps! Yes, we wish all dr/patient relationships were like this! But this is why I chose my doctor. I worked with him in the SICU when I was there as an RN and he was a resident. I knew then that he had a great bedside manner with his patients and the nurses and he also knew his stuff! Surgery didn't "change" him as it does a lot of them, but he was older when he started (3rd career so he had to REALLY want to do this!). He and my husband had a few rotations together too. He didn't remember me as it has been a few years and as residents they have so much on their minds, but nurses remember just about all the residents b/c we have to call them a lot and we remember who's nice to us and who isn't! So that helps! But it wouldn't matter if it was me or someone he'd never met before, he treats everyone like that! He's fantastic!!
Re: Cast off! Back from my 3rd post-op visit-Update!
Sounds like you really have a good Doc. I wish I could find one like that! And your recovery is going so well. I definitely can attest to PT HURTING... after surgery. It was always a minor setback having PT for me each day I went after I had shoulder surgery. So, keep the meds close on those nights. And, wearing the boot to bed, stinks. But, we were talking about the covers they have for them or using a giant pillow case to keep sheets clean and stuff... so that might help if you do have to wear it to bed. Maybe you could wrap in an ace to give you some support rather than the boot? My aircast boot is so big and bulky. I cannot wear that to bed. I much rather have the cast for bedtime. But, getting the shower and cleaning up the leg is awesome too! It's comical how gnarly the leg can look after being in a cast for several weeks. Scary!
Re: Cast off! Back from my 3rd post-op visit-Update!
Hollywood, I've got a meds question for you (or anyone else that wants to chime in). When I first had my surgery last year, 2 5 mg Oxy were not as effective as 2 Norco 10/325 so I transitioned pretty quick to the Norco only. Since I continued to have problems with my foot and ankle, I was on and off Norco for the last year (1 dose a day every 2 - 4 days). As expected, I built up a bit of a tolerance for the Norco but I've never taken more than 2 at one time. I'm now two weeks out of my surgery and have tried to transition to Norco only. It has not been nearly as effective for pain and taking the two pills at once really makes me spacey (especially compared to the Oxy). I called my doctor's office and explained my situation. They said that they do not want to give me any more Oxy. In your experience, is my doctor's office being unreasonable? I've only been on the Oxy for 2 weeks. I mostly take it at night. I took the 2 Norco last night and had the worst nights sleep yet and woke up with horrible pain for the first time in about 10 days. I'm unemployed but am getting my MBA and it is almost impossible for me to complete any schoolwork once I take the Norco. I've taken 2 already this morning so half of my day is going to waste. Any suggestions?
Re: Cast off! Back from my 3rd post-op visit-Update!
I finally had a chance to read this! I am soooo glad your appointment went well and that you have such an amazing doc! Yay for a clean leg and no cast!!
I can't wait to hear how you do with PT... Did you end up sleeping without a boot? That would make me nervous too...
__________________ Peroneal brevis debridement; peroneal longus transfer to brevis: tenosynovectomy, 11/20/12
Re: Cast off! Back from my 3rd post-op visit-Update!
LURCHY--It really depends on a lot of things. Different patients respond differently to pain meds. Factually speaking, oxycodone is much stronger and a different schedule or class of controlled drugs than Norco. Norco is hydrocodone. Same thing that is in Lortab or Vicodin. They have different trade names depending on the company that makes them or the combo ingredients in them. So 2 5mg oxycodone tabs would still be stronger than 2 Norco 10s. Since you had gotten off these for a while and then tried to go back on them, it's not surprising that they make you spacey. Your body's tolerance went back down if that makes sense. However, *usually* (not always) if the hydrocodone or Norco makes you spacey, the oxy might too, but you said you've been taking oxy for 2 weeks since this surgery, so maybe not. How many oxys did the doctor send you home on? I don't think longer than 2 weeks is unreasonable, no, but I will say that a LOT of doctors don't want to keep dispensing oxy b/c it is a highly addictive drug and most surgeries can be managed after a while on hydrocodone. However, there are some that can't and different people with different tolerances. That being said, doctors usually still don't want to keep giving oxy and a lot of times refer the patient to pain management and let them handle it from then on. I will say I am surprised that my doctor keeps refilling oxycodone for me in some ways (and I don't ask for it), but all doctors are different. So I would think they would refill it again for you unless they gave you a high quantity of them to begin with. But I'm not surprised they didn't refill it either. I know that's not much of an answer for you, but there are so many variables as well as individual surgeries, pain tolerances, etc that goes into those decisions! I do hope you get it sorted out though! A lot of people on here have been using Ultram or Tramadol for breakthrough pain, so maybe they could give you that? You'd just have to try and see if it doesn't anything for you. It doesn't for me, but a LOT of people on here like it!
KARATEMOM and PZNATTI--I slept without the boot last night! BUT, there was still NO way I could sleep with just an ace wrap or nothing b/c of pain and b/c my doctor still doesn't want me to do side to side movement and I can't guarantee I wouldn't do that in my sleep. I might only do it once as the pain from it would probably wake me up, but still! I put a sock on and put on my lace up brace that I was told to wear prior to surgery. It laces up and then have figure 8 straps for added stability. It worked really well! When I got up this morning, I took it off and put my boot on! I didn't pull it as tight as the tech did yesterday when I was being fitted for it! He had it too tight and it hurt! So I loosened it and I realized that it's a medium boot so he had to pull it tighter than usual for it to fit snug. I probably could've used a small boot, but oh well! I'd rather have room than no room!
So PT is tomorrow at 1pm. I still had a good amount of pain today from yesterday's manipulation and boot being tight. So I had to take meds in the middle of the day and that helped a lot. I've had it elevated and iced too. It felt SO good to sleep IN my bed rather than on TOP of it with my own comforter to cover up with. I couldn't really do that well with the cast, but now that I'm in the boot during the day and the lace up brace at night to sleep, I can get between the sheets again! That along with the pain meds and I slept better than I have since before surgery! I've tried more weight on the ankle and it doesn't like it. So I put some on it for a while with the crutches (not much) and then backed off. I still get the electric shocks in my heel and the ball of my foot when I put weight on them. So we'll see! Hope the PT has a lot to say about all this tomorrow! I also hope he can work out the knots in my peroneal muscles. They are still SO knotted and sore and they radiate pain into my ankle over the tendon and ligaments! Ouch! Anyone else with that? It was that way for me before surgery too, but now that my tendon has been repaired, I want the knots gone so they won't keep causing me pain down in my ankle!
Re: Cast off! Back from my 3rd post-op visit-Update!
Thanks for the feedback. It turns out, the surgical nurse I was working with was not the sharpest tool in the shed and had called in extra medication for me on Friday that I didn't even need (or ask for) so the pharmacy flagged my account. It all got sorted out in the end and the on-call doc prescribed me a few more until my doc gets back from vacation.
Sounds like you're making progress. Good luck at PT tomorrow!
Re: Cast off! Back from my 3rd post-op visit-Update!
LURCHY--That's great! I'm not sure what the surgical RN called in b/c you can't call in oxycodone. Maybe she called in more Norco? But I'm glad it all got worked out!!
Re: Cast off! Back from my 3rd post-op visit-Update!
Thanks so much! Had first PT session today and it went well. It does hurt though!!! Loved my PT. We had a lot in common and he's very outgoing. He got a history from me and then looked at my ankle/foot. He had 2 students with him so he gave them a chance to ask questions. He took my steri-strips off which was fine with me b/c more dead skin came off with it! Then he started with me lying down and my legs up on a wedge with a pillow under my injured ankle. Oh first, he measured my ankles to see how swollen the surgical one was and then he measured my calves. My left one is 20cm SMALLER than the right! OMG! He said it would take about a year to get that completely back, but that I'd feel normal way before then. He took this grease like stuff (not lotion really) and started massage with long strokes starting with my toes and moving up towards my leg. Did all my toes, the foot, inside of ankle and lower leg. Felt AMAZING!! He did it to get the swelling out of my toes/foot and then starting passive ROM on my toes. They are very stiff and sore, more than I realized!! Then he did up and down exercises and then he did leg lifts with my foot pulled back and my quad tightened to help my quad. I also had to roll a ball back and further under the sole of my foot lifting my heel when it was at my toes and lifting my toes when it was at my heel. When all this was done, he put my leg back up on the wedge with me lying down, and put e-stim pads on my foot, ankle, and leg and turned it on and then put my whole foot/ankle in a game ready boot. It's a boot that has ice water going through it and compresses as it does it. Helps with swelling. I will say that my swelling was much better afterwards and my foot felt much better after it had been touched for so long. It is sensitive and not used to that! However, those exercises were NOT without pain! It hurts a good bit now b/c it just isn't used to that! I can really feel my tendon. It is fully awake now! OUCH!! So we'll see. He gave me exercises to do at home 2-3x/day and I go back on Friday and then Tues/Thurs of next week! Tonight though, elevating and resting with ice and pain meds!
Re: Cast off! Back from my 3rd post-op visit-Update!
Wow! That is so awesome... I have 1 PT appt per week set up starting May 4th because I really cannot take more time off... The doc said 1 or 2, but yeesh... I've already missed so much of my kinder classroom...
Your PT guy sounds amazing...
__________________ Peroneal brevis debridement; peroneal longus transfer to brevis: tenosynovectomy, 11/20/12
Re: Cast off! Back from my 3rd post-op visit-Update!
Quote:
Originally Posted by Hollywood48
Thanks so much! Had first PT session today and it went well. It does hurt though!!! Loved my PT. We had a lot in common and he's very outgoing. He got a history from me and then looked at my ankle/foot. He had 2 students with him so he gave them a chance to ask questions. He took my steri-strips off which was fine with me b/c more dead skin came off with it! Then he started with me lying down and my legs up on a wedge with a pillow under my injured ankle. Oh first, he measured my ankles to see how swollen the surgical one was and then he measured my calves. My left one is 20cm SMALLER than the right! OMG! He said it would take about a year to get that completely back, but that I'd feel normal way before then. He took this grease like stuff (not lotion really) and started massage with long strokes starting with my toes and moving up towards my leg. Did all my toes, the foot, inside of ankle and lower leg. Felt AMAZING!! He did it to get the swelling out of my toes/foot and then starting passive ROM on my toes. They are very stiff and sore, more than I realized!! Then he did up and down exercises and then he did leg lifts with my foot pulled back and my quad tightened to help my quad. I also had to roll a ball back and further under the sole of my foot lifting my heel when it was at my toes and lifting my toes when it was at my heel. When all this was done, he put my leg back up on the wedge with me lying down, and put e-stim pads on my foot, ankle, and leg and turned it on and then put my whole foot/ankle in a game ready boot. It's a boot that has ice water going through it and compresses as it does it. Helps with swelling. I will say that my swelling was much better afterwards and my foot felt much better after it had been touched for so long. It is sensitive and not used to that! However, those exercises were NOT without pain! It hurts a good bit now b/c it just isn't used to that! I can really feel my tendon. It is fully awake now! OUCH!! So we'll see. He gave me exercises to do at home 2-3x/day and I go back on Friday and then Tues/Thurs of next week! Tonight though, elevating and resting with ice and pain meds!
I'm so glad your apt went so well! I'm getting anxious to start rehab, but I still have to wait til at least 5/8/12 when I see the doctor again! I do have range of motion as far as up and down, but that's it. Still painful to walk on, but as long as I use the one crutch I am good. I'm hoping to be off the crutches by next week. I am thrilled you had a great appointment today!
Re: Cast off! Back from my 3rd post-op visit-Update!
Hey guys! Thanks! I did have a great visit and yes, PZNATTI, my PT guy rocks! He's awesome! Said he loved my doctor and wished he got more of his patients because he did really good work. So gonna tell my doc that next visit in 2 wks! He and I just clicked! He was recommended to me by a friend and since he's a DPT (doctor of physical therapy) and has students under him and board certified in sports injuries, I thought why not? Great choice! Really caring! Told him about the painful knots in my peroneal muscles and he said we will def work on those!
However, must say I'm in pain tonight. Percocet to the rescue! I didn't do exercises at home today. Will start tomorrow since this was the first day and it hurt! I am putting my foot down with both crutches but still not much weight. Still hurts and is sensitive and get shocks.
JOYFUL--I know you are ready for PT! I hope you are able to be off churches next week too, but don't overdo it!!
Re: Cast off! Back from my 3rd post-op visit-Update!
Hi Hollywood,
How are you feeling today? Has been a rough day for me. I think I mentioned that I was getting in my dad's car yesterday and slammed my foot onto the brake pedal and saw stars. I'm so incredibly sore today, hurts to walk again. Have been taking tramadol all day and now I'm icing it again. So discouraged with this process and yet I know I've made pretty big strides....just sick of the pain I guess. Sigh....keep telling myself how much better it has gotten in the past few weeks, just a rough day I guess. Hope you are feeling better today after the rehab!
Re: Cast off! Back from my 3rd post-op visit-Update!
JOYFUL--So sorry you smacked your foot! I KNOW that hurt! Keep elevating, icing and taking your meds! That's why we have them all! This whole process has ups and downs, but yes, try to concentrate on the overall big picture here that you have made a LOT of strides!
As for me--I am still having some pain, but 2 things have contributed to that on top of the PT. Last night, I took the boot off to show my sister my ankle and how much smaller my left calf was than my right. I set the boot down and lifted my leg and showed her and then I set my leg down again and turned to get something. When I turned, I knocked the boot over and it hit my ankle! OUCH!!! It really hurt! Then today, I was trying to get ready to meet a friend for a movie and I don't really know what happened b/c it happened so fast, but I had opened the door, let the dogs downstairs, on my crutches, edge of a rug, bag in my hand, bunch of things that can cause disaster, but I fell all the way over to my right side (not forward or backward) and landed on the floor. Now it's my left ankle, but it hit the ground too in the boot. I was okay, but it's been more painful since that. Then I did some PT home exercises. I hope he does a lot of pain and swelling control in tomorrow's session! My toes are KILLING me! Didn't realize how stiff and tender they were till PT!
Re: Cast off! Back from my 3rd post-op visit-Update!
Had my 2nd PT session today and oh my goodness!!! I had been hurting a little more than usual anyway due to doing the exercises at home so I told my PT that. We went a little easier because of it. I did the recumbent bike for 10 min which a 61 rpm = 1.3 miles. That wasn't too bad because there was no resistance and I never bent my ankle. Then the towel doing toe scrunches! Ouch, ouch, ouch!! My toes are so sore and stiff and swollen! Then I did the ankle pumps up and down, the both ways with resistance, the leg lifts with my quad tightened and my foot pulled up as much as possible, then leaving my leg flat and tightening my quad and squeezing my knee into the mat. Really working on strengthening my quad. Then my favorite time-retrograde massage, where they start at my toes with lotion and rub from toes up my leg to move swelling out. Then they do the e-stim while I'm in the ice water compression boot. That thing feels awesome! I wanna take it home! But tonight? SO sore! I saw a movie with my husband and am hurting. Taking Percocet and going night night. Supposed to go with my sister to see our University compete at the NCAA gymnastics regionals! Our University is hosting 6 teams. So I'm excited, but really hope the pain is better tomorrow!!
And your recovery is going so well. I definitely can attest to PT HURTING... after surgery. It was always a minor setback having PT for me each day I went after I had shoulder surgery. So, keep the meds close on those nights. And, wearing the boot to bed, stinks. But, we were talking about the covers they have for them or using a giant pillow case to keep sheets clean and stuff... so that might help if you do have to wear it to bed. Maybe you could wrap in an ace to give you some support rather than the boot? My aircast boot is so big and bulky. I cannot wear that to bed. I much rather have the cast for bedtime. But, getting the shower and cleaning up the leg is awesome too! It's comical how gnarly the leg can look after being in a cast for several weeks. Scary! 
