Snowflakes

I am always amazed at the diversity, intricacy, and beauty of individual snowflakes. We have lots of the white stuff here today. You can see more in this slideshow .

Peroneal Tendon Surgery

As of yesterday, I no longer have to elevate my foot all the time. That means I can now sit at the computer more easily. I still cannot put any weight on my right foot for another 4 weeks. Treasure your feet. Damage that takes only a moment to inflict takes months to fix, especially if surgery is required. I tore my peroneus brevis tendon on June 21st. Of course I and for that matter my doctors did not know that for sure until exploratory surgery on November 26th. The MRI did not show the damage. The foot surgeon knew his stuff though and predicted that there would be a tear in the peroneus brevis tendon. He was right. Such tears are usually longitudal, i.e., they are more like a split that goes lengthwise, not a rupture of the tendon.

 The surgery was day surgery and took only about an hour to perform. They gave me some kind of epidural, then the la-la-land juice. I was told that they would do a nerve block down near the knee and my whole right leg would be numb after surgery and for up to 18 hours afterward. Because of fibromyalgia and osteoarthritis I usually don’t have good quality sleep. When I awoke after the surgery, I felt so rested. I had been oblivious of any pain in my body. I had purchased a knee walker for my recovery period, but because of the numb leg I had to use a folding aluminum frame walker until the day after surgery. I thought it was a real waste of money, but now I think it may come in handy later when I start putting weight on my foot slowly over time. I knew I was too much of a klutz to use crutches.

Knee walker

 

The nurse who called to set up the surgery date and inform me of pre-op steps was very firm about not wearing denim or twill pants to the surgical facility. I needed something stretchy, perhaps knit workout pants. When you look at the Jones dressing/splint I had after surgery, you understand why the clothing had to fit over a bulky mass.

Jones dressing

The first week I spent mostly in bed. The first 72 hours I had an icing contraption that had to run 2 hours, then off 2 hours, then back on for 2 hours, etc. It was kind of noisy and didn’t contribute to sleeping well. I also was taking pain meds every 4 hours. The ice machine looked like a drink cooler with tubes coming out the back end which connected to tubes coming out of my dressing and an on/off switch. The ice/water combination inside had to be changed about every 6 hours to keep the temperature around 40-50 degrees. There was a temperature gauge down where the  tubes entered the Jones dressing. What was underneath the dressing was a mystery. When they took the dressing off 10 days post-op I saw that there was a little sleeve that fastened around my whole foot with velcro and the tubes attached to the sleeve. The cold water circulated around my foot.

                             You can see the tubes (actually 2 of them) that poked out of the dressing

 The pain wasn’t too bad on the hydrocodone with tylenol. I tested for feeling in my leg that first night when I would wake to take meds, turn on/off the ice machine. When I woke at 5 a.m. I realized I could wriggle my toes and feel my thigh. The numbness was mostly gone. Unfortunately, pain meds do have side effects. I had some nausea which I could control with promethazine most of the time. I also had some constipation. Sunday night (day 6) I decided not to set the alarm for the night dose of pain med, and I slept thru to the next morning with only a slight elevation of pain. I switched to extra-strength tylenol and have done well on that with the nausea and constipation going away. I also started sitting in a recliner chair in the living room. It was a good turning point.

 10 days after surgery, the dressing was removed. I had my first look at my post-op foot. I guess it is a good thing that the foot is some distance from the eyes. I thought it looked pretty good, but today I took some photos and there is a lot more bruising than I realized. However, the PA thought the foot and the incision looked very good. That was encouraging. A fiberglass cast was put on my foot which I wore for a little over 5 days. The Jones dressing and the cast could not get wet. I used a tall kitchen garbage bag with a pull cinch top over my leg to shower. My husband wrapped some clear wrapping plastic around the top to seal it. I sat on my bath bench turned sideways with my surgical leg propped on the tub ledge and covered with the shower curtain. Awkward, but it worked. I did have some sore spots from leaning on the knee walker with a cast on.

 

                      Cast; stretched a men’s large sock over the toes to try to keep them warm

 I did not have itching with my cast. I had read somewhere to use a hair dryer to blow air down a cast since you are not supposed to put anything down there to scratch. Contrary to popular thought, putting a clothes hanger down your cast is not a good idea.

Yesterday they took out the stitches. I now am wearing the CAM boot I wore prior to surgery. Since I have to wear it even to bed, I am now using my garbage bags over my boot to keep my linens clean. The only time I can take the boot off is to shower or for physical therapy which I start next Monday. Today I had my first shower with the right foot inside the tub. It was tiring to keep the foot lifted up from the tub bottom. I was sitting on the bath bench. I wonder if I should try standing with the foot lifted. I did have to take the boot off last night. I went to take my twill pants off for bedtime, and I could not get it off over the boot. The pants had fit over the cast and of course I had them on when they removed the cast and put on the boot. So my hope of diversifying my wardrobe once again has to be thought through carefully. If I have my husband help me take the boot off and back on, maybe I can wear pants inside the boot as I did previously. It is rather painful to take the boot off and put it on when I am doing it myself. My foot has a ways to go before being tender and hurting when unsupported. It also looks more swollen. I need to do more elevating again.

Incisions out; can now shower. Some of the orange glow remains from the iodine concoction they swabbed the foot with.

Not sure what this purple is on the inside of the foot. It doesn’t hurt much. Maybe they clamped the foot? The purple x is also meaningless to me. They had me write yes with a purple pen on the outside of the right foot and then the doctor was also to initialize it to make sure we were on the same page re foot to be operated on. The anesthesiologist also had to initial behind my right knee showing we were in agreement on which leg to numb.

 I am expecting some increased pain as I start physical therapy. I have 4 weeks of just up and down movements. The tendons glide when the foot is moved, and scar tissue needs to be broken up and then kept from reforming so they will glide smoothly. After I get the boot off, there will be 4 more weeks of physical therapy range-of-motion and strengthening exercises. I am not sure yet how weight-bearing takes place. From what I have read, I think I will only put partial weight, not full weight, to begin. A long journey ahead, but hopefully I will have a normal foot again.

Surgery Ahead

The post-op shoe, the cortisone shot, the boot, and the passing of time did not take away my right foot pain. No fracture re the x-rays; the MRI images were not helpful. The foot specialist says based on how I injured the foot, and the location and type of pain that I probably have tears in my short peroneal tendon that runs along the side of my foot. There may be other damage as well. The only way to find the problem and fix it is with surgery. On November 26th, I will have outpatient day surgery.

 Because I will have to keep the weight totally off of my foot for about 6 weeks and for the first two weeks even keep the foot elevated above the level of my heart, I will not be visiting the computer. This is probably my last post until the middle of December. Take a little “vacation” from From a Beggar’s Bowl. I will be able to read email on my Nook.

 I have some Janette Oke DVD movies that were donated to the retirement library that I will play on our little portable DVD player. Lots of books stocked up as well. Once I get a little better, I am going to try to teach myself to knit by making a dish cloth with these instructions. I bought some yarn already.

Have a blessed Thanksgiving. I will probably sleep most of that day because of the pain meds. I am sorry to miss out on some of the holiday season events, but for several reasons it is best to get this done now.

Still Waiting

I am still “stuck” in the Affordable Care Act website. Since October 16th, I have been told my application was processed and I am eligible to enroll in an insurance plan. The Benefits pdf file references a table that is non-existent and there is no way for me to advance to seeing actual insurance plans in my state. The phone help had me enroll via phone as well. I’ve heard nothing.

 

The state of Indiana has extended my current insurance for a month; it will now expire February 1st, instead of January 1st. According to the article, there are 6,800 Hoosiers enrolled in the state risk pool insurance. I was wrong about no funds received from the state re this article. So it will cost the state something to extend coverage. At over $1000 per month for my premium it will mean another month of very expensive insurance for me, but at least I will have insurance.

 

701  Indiana residents have successfully enrolled in Obamacare. A drop in the bucket. Indiana chose to not expand Medicaid and received a waiver. Those who enroll via healthcare.gov will be privately insured individuals in Indiana. If I ever hear that healthcare.gov is actually functional, I will probably start the application process anew. By the middle of January, I will go to an insurance broker for help if still no success via the web. There are rumors that insurance companies and brokers will be utilized more heavily if the website is not fixed. It is a sad situation.