#7 ~ Week Four, Injuries, Second X-ray (third checkup)

March 2017

Blue-gray toe color and exercises

My fourth week started out great. I had increased my toe exercises, and I was keeping the blue-gray color in my toes under control. My toes still got discolored after I had been on my feet for over 30 minutes, and the color returned to normal after I did the leg and toe exercises. After I whacked my toes (details under next heading), my toes turned purple within 5 minutes every time I got up. The color still returned to normal after the exercises. Before my [first] injury, I had started to wash my big toe area as best I could around the stitched area with a cotton ball, and I was applying petroleum jelly or aloe to the toe. This helped with the cracked skin feeling I had when I exercised that toe (part of the reason I was afraid of scarring). I also continued yoga daily, except for two days following my toe injuries. I was afraid to do much of anything after my falls.

Injuries ~ twice this week!

I felt like I was doing very well, and then I got overconfident and careless. One morning, I misjudged the location of the knee walker, and was not able to catch my balance in time. My toes hit the floor with tremendous pressure and all of my weight before the rest of me then hit the floor. Even though I was on carpet, I should have had the walker locked, and I should have been looking down at it before attempting to drop my knee onto it. The fall was painful, however, the pain was overshadowed by the extreme fear I had about whether I had done any damage inside my foot. I stayed on the floor about 20 or 30 minutes - gingerly checking my toes and foot as best I could, and praying. I was not uncomfortable on the living room carpet, and I was not unable to get up. I was just afraid to move. The most pain I felt when it happened was in the arch of my foot, except when I tried to move my toes. My big toe was very painful when I tried to move it back and forth. I also felt mild pain in the ball of my foot (more than just the discomfort I had been feeling), and in the knuckle of my big toe. This fall/toe stubbing happened only a couple of days after my last post, when I expressed how carefully I had been taking care of my foot! I guess it was a good thing I had a cast on after all. 😓

After a few hours, I figured I probably had not done any serious damage, since I did not have severe pain. Because of the pain I felt when bending my big toe, I decided to call my doctor's office to ask a few questions. I told the receptionist who answered, that I had hit my toes, and that I wanted to talk with the nurse or doctor. The receptionist did not put anyone else on the phone, and I was not asked any questions. After placing the call on a brief hold, she returned and said they wanted me to come in, so I went in the next day. Details of my second fall are below, after the office visit.

Second X-ray and third office visit

This unscheduled visit occurred about 3½ weeks after my surgery. My second X-ray and third checkup had originally been scheduled for 4 weeks after surgery. After looking at the X-rays the aide had taken of my foot, the doctor came in and told me everything looked fine. I am not crazy about the communication skills of the doctor I have been seeing: he does not explain anything, he never asks me any questions [about my situation], and he never asks if I have any questions. I have to remember everything I want to talk about and initiate the conversation myself. I asked if he could tell how my bone growth was doing, and he said it was good. I asked if it was good enough for weight yet, and he said 6 weeks. I took this as a good sign, because he had been saying 6 to 8 weeks. I also told him I had pain on the ball of my foot, and I told him about the discomfort on the top of my foot from the cast. He left the room, and then sent in the aide to saw my cast down the sides. This was my first experience with a cast saw, and I thought this was very scary! I could feel the saw hitting my leg with only the gauze between the saw and my skin. Afterward, I learned that the cast saw only vibrates and does not spin, so it could not cut me. When the doctor came back in, he wrapped more cast wrapping around my cast, so now it weighed even more! Their attempt to relieve pressure on my foot from the cast did not work. My foot was not more comfortable than it had been before my visit.

The doctor said it was okay to exercise my toes again, and he said I did not need to come back for my 4-week visit the next week. I wish I had thought to talk with him about the incisions around my toe. I presume I should be washing the area, and applying moisture like I have been, although it would have been nice to confirm this. I was never given any instructions about how to care for the incisions, and no one in the office ever cleaned this during any of my checkups.

Activity - St. Paddy's Day outing, and second fall

I had my first extended evening out on St. Patrick's Day. We visited a country club for dinner and music, and then we spent the night away from home. I figured out what I could wear that night a few days ahead of time (I could not wear normal slacks, and I wanted to wear something festive). I was glad I scrutinized my wardrobe ahead of time, because the green top I initially wanted to wear did not look good with any of the bottoms I could get on. It still took a lot of energy to dress and undress!

The evening out went fine. I did not have any difficulty getting around on my crutches, and I was able to sit comfortably with my leg on an extra chair. When we arrived back at the house where we were staying for the night, I started to walk up the porch steps with my crutches. This probably would not have been a problem, if we had turned the porch light on before we went out. In the dark and cold, my crutch fell off the step, and the bottom of my cast thudded against the cement before I fell. I was surprised this was much more painful than when I had fallen on my toes. As I am getting ready to publish this post, I am still undecided about whether I need to see the doctor again. My first two toes, the ball of my foot, the arch of my foot, and the top of my foot are more painful since the second fall. Today is exactly 4 weeks since my surgery, and the 3rd day since my second fall. If I had not gone for X-rays early, between the two falls, my third checkup would have been today. I am reluctant to call the doctor, because when I called to talk with someone last time, I was merely told to come in. Then, when I got there, I was asked why I had come in. Not only that, they had not been helpful about finding me an appointment time that was convenient. In hindsight, I wished I had not gone in after my first fall, and that I was going in on my regularly scheduled day. My foot is much more painful from the second fall when my cast hit the cement. Before my experiences, I would have guessed that a fall hitting my toes would have been more painful and harmful than a fall where the bottom of my cast hit the ground with force. Based on my two experiences, that is not the case. Another reason I am hesitant to go in, is because I have not found any conversations by others whose foot was injured after a fall like this. All the posts I have read online stated that the person went in for an X-ray and all was well. I wish I knew if there was something specific to look for!

Pain and comfort ~ before and after toe injuries

I had eased off on most of my toe exercises until after my visit to the doctor. I began them again, after my checkup, except I did not exercise the big toe as vigorously, as it looked like the skin was cracking when I bent my toe. For a couple of days after my first fall, my toes started to throb anytime I got up, or when they were not elevated. On the third day, it felt like things were getting back to where I had been before, and then that was the day I fell on the concrete. After that, my toe again throbbed and became discolored when I was up. Along with the injury pain I already mentioned, the skin around my big toe also felt stiff and tighter than before. I always elevated my leg when I was sitting. I used ice off and on behind my knee, which did not feel like it really made any difference.

I continued to have the same discomfort that I previously wrote about from the cast on my foot and leg: rough/scratchy feeling on the top of my foot, and pressure on the ball of my foot. The pressure on the ball of my foot felt worse after my falls. During week four, the cast also started to feel like it was pressing against the front of my leg above the ankle. My ankle area did not feel swollen; the cast just felt tight on my leg in this area. This pressure felt the same before and after my fall, and before and after the cast was cut.

I have two more weeks until my next checkup. If I do not end up calling my doctor or going in early, my next post will be:

Weeks 5 and 6, third X-ray, and walking cast.

Please let me know if you have any questions, advice, or personal experiences to share ~ thank you!