Thursday, April 20, 2017

#11 ~ After Two Weeks with Walking Shoe / Eight+ Weeks After Surgery

April 2017

Yay! My pain and condition has improved considerably two weeks after walking with the surgical shoe. I still have a long ways to go; however, the healing process feels like it is improving tremendously. I was even able to grasp my foot this week to trim my toenails and scruff off some of the dead skin. I had used a dry brush to get rid of the skin on the outside edges of my foot after the cast was removed; however, I had not used a dry brush or exfoliator near the inside edge of my foot until this week. You can see in the photo below that my foot still needs some TLC. Since touching my foot is becoming less painful, I should be able to get it back into shape before summer sandal weather! 😊

Pain and swelling

I am not feeling hardly any pain along the underside of my foot like I did when I first started walking. I still feel some pain; however, it is not excruciating, and I am no longer using the cane. Most of the pain happens when I first stand up, or if I put too much pressure on the bottom of my foot.

The incisions are still tender, and the top of my foot closest to the ankle is extremely sore and tender. I have begun to wonder where the second screw in my foot is located, and whether this area being so sore has anything to do with that. The sore spot is where I placed the circle in the photograph below. The top of my foot is swollen, although not as much as it had been a week ago. I am continuing to use Aquaphor on the incisions. There are four incisions on my foot: two straight line ones on top, one around the inside of my big toe, and a small curved one along the side next to where the bunion had been located. The incision that had not been closed all of the way when my cast was removed (top of my foot closest to the big toe) looks nasty and jagged rough compared to the scar farther up on top of my foot. This is the area that was aggravated by the cast when I exercised my toes, and I hope I did not damage the scar tissue so that it heals less smooth. My husband seems to think it looks worse because it is not as far along in the healing process as the other longer incision.

8 weeks post-op

The swelling in my ankle has gone down in the last week, although you can tell by the photo that it is still swollen. I am continuing to elevate it, and I put ice on it several times a day. The ankle pain I am experiencing feels like the kind of pain one would have after twisting or spraining the ankle. I am no longer experiencing pain rising up my leg from my ankle.

I still have tingling pain along the top of my foot that starts at my big toe. This is not constant pain; it occurs when I take a shower, after icing, and during some movements. It seems like the heat from the water must be causing this in the shower, as I am not standing on my foot yet, other than when it is in the surgical shoe. I hope this tingling goes away soon, because I am planning to try exercising in a hotel pool in a couple of weeks. 

I am no longer having pain in the arch of my foot. After my last post, I spoke with the medical assistant at my doctor's office about this, and she gave me a few exercises/stretches to try. I had already been doing the stretches she gave me except one; she said to roll my foot on the top of something like a rolling pin or frozen water bottle for one minute three times a day. The other stretches (like runner's lunge) made my foot feel better than the rolling pin exercise. I tend to think the arch pain came about from walking on uneven ground in the non-flexible walking shoe.

Exercise and activity 

Just like previous weeks, I feel better after I do yoga, so I try to do at least 30 minutes a day. I am no longer doing leg lifts every hour, although I am doing toe and ankle exercises a few times a day.

I try to walk on my foot as much as I can (while wearing the surgical shoe). For example, rather than walk/hobble in a manner that produces less pain and allows me to walk faster, I walk at a gentle pace that allows me to tolerate the pain while pressing my entire foot on the floor with each step. I also made a deliberate attempt to go up and down the stairs in a normal fashion with one foot on each step, even though I had to take the stairs slower. I can now go up and down steps with only one foot per step! This is a big accomplishment, because two weeks ago the pain was so intense, I could not do this. I had to move one foot to a step, and then the other, and so on.

I rode my bicycle a short distance a few days ago. I found that I could not take off pedaling uphill because it put too much pressure on the front part of my foot. I was able to pedal up mild inclines; I just could not start on one. Stopping was the most intense part, because no matter which foot you place down first, both feet end up having pressure exerted on them. We are planning to try and pedal a few miles on a flat paved trail at the end of the week.

We went camping over the weekend, and I hiked one of the trails wearing the surgical shoe! Yes, it was an uneven surface and it was tricky. It took us about 40 minutes to go one mile. This experience showed me how much my condition had improved. A week earlier, my foot was in pain the entire next day after I walked outside at the birthday party. This time, I did not experience any additional pain the next day.

Range of motion 

Neither my toes nor my ankle bends like it should. I initially had to start out bending my toes with my fingers after my cast was removed. Now I am doing this on my own (although not very well), and with my fingers. Hopefully, this will improve even more after another week.

I noticed a couple of other body movement ranges that have changed since this surgery:
➤ For some reason, I cannot lift my right leg (non-surgical side) as far straight up as I can my left leg (when doing leg lifts while on my back). When I was doing leg lifts with the cast on, I had to leave my left/cast leg flat on the floor when I lifted my right leg, whereas, when I lifted my left leg, I did it with my right leg bent and my foot on the floor. It is easier to lift your leg farther when the opposite leg is bent rather than straight, so I initially thought I was able to lift my left leg higher because the right leg was bent. Now that the cast is off, I am lifting both legs the same way, and I still cannot lift my right leg as high as my left.
➤ When I sit in easy pose or butterfly pose, my surgical leg is not as flexible, and does not touch the floor like the other leg.
➤When I do any kind of bow type pose where I am grabbing my leg(s) behind my back, my surgical leg and that side of my back is not as flexible as the other side.

Some additional thoughts

I wish I better understood the purpose of the surgical shoe. I would like to try placing my foot lightly on the floor for some yoga poses; however, I do not know if there is any danger to pressing on any area of my foot with too much pressure without the shoe. So far, I have only done poses with my bare foot on the floor (carpet) when I am laying down. I have not tried to do any standing poses without the shoe.

My next checkup is in a couple of weeks, which will be 10 weeks after surgery. Hopefully, the swelling in my ankle will be down by then, and the doctor will say I can start wearing shoes!

Let me know if you have any questions.