Six Weeks Post-Op: Recap of Things I have Learned [so far] and Suggestions for Next Time

April 2017

Before surgery

• I stocked the freezer with over 10 meals, and I wish I had prepared more.
• Remember to stock the pantry, too. I had our cupboards well-stocked; however, there were a few things I did not think about. We eat mostly fresh fruits and vegetables, and we do not consume many potatoes or convenience foods. Since my husband is not going to take the time to cook like I do after working all day, I should have picked up a few convenience-type pantry products that I do not always keep on hand: canned vegetables, instant whole-grain rice and quinoa sides, and more soups for his lunches.
• Spring clean, if you can! I cleaned the entire house beforehand, yet there were still a few things I did not think about since they are not daily or even weekly tasks. If you are particular about keeping a clean house, these little things will drive you nuts six weeks later, when you are not able to reach them.
• Exercise to strengthen your toes, ankles, legs, and balance. You will be surprised how much you will need to accomplish on one leg. You will need a good amount of strength and balance in your useable leg to perform even simple tasks, like getting up from the toilet. Most handicap restrooms in public places do not have a place to rest your knee while you get your clothing back in place after standing. So, you will either be doing this with one hand, or while balancing on your good leg.

Things to clarify with your doctor

About five weeks post-op, I had questions about things I had not thought of before surgery.

• Was it okay to put mild weight or pressure on my heel? I read comments from others online who were allowed to put weight on their heel after surgery; however, I never discussed this with my doctor.
• Why was my foot wrapped or in a cast for six weeks, when I had read about many people who did not wear a cast at all after bunion surgery? My foot was wrapped tight with a firm backing the first two weeks, and then in a cast for four weeks. Most posts and photos I saw online showed patients with a soft boot immediately after surgery.

• Why was I given non-weight bearing instructions for six weeks, when I had read about others who were in a walking boot less than a week after surgery, and wearing their own shoes in six weeks? I also found post-op instructions online that said patients go home in a soft boot and begin partial weight-bearing in the boot in 2 to 10 days. 

I did find a couple of comments from others who wore a cast for a short time, or who were told to wait five weeks before any weight-bearing, and I found one person who had been given instructions similar to mine. Since wearing a cast and moving around on one leg were the most difficult parts of my experience, I suggest finding out the exact details of your recovery from your doctor, so you know what to expect. My doctor had given me the expected non-weight-bearing time; however, he did not clearly state that I would be wearing a cast during this time. I imagine the recovery regime given has just as much to do with the doctor's way of doing things, as it does with how severe the surgery is.

Comfort

• If you do end up wearing a cast like the kind I had, the material is flexible for close to an hour after it is applied. The doctor wrapped damp cast material around my foot, ankle, and leg, and then let it harden 10 minutes or so, before I was told I could go. You can see additional photos of the cast material that I wore in posts 5, 6, and 8.
• I was able to flex my ankle back and forth as soon as the doctor finished, which gave me a bit more room in this area after the material hardened. I did this after he left the room; however, the nurse did not have a problem with me doing this when she came back in. Since I thought the material felt like it shrank a bit as it dried, and my ankle and lower shin were tight problem areas for me, I plan to flex and wiggle my ankle even more next time. Since the material is flexible, be careful not to move your foot into an uncomfortable position. If the cast hardens on an angle against your foot, that could be uncomfortable, too. 
• Make sure you do not bump or rest the cast on a hard surface until after it is completely dry. Following this surgery, I usually rode in the car with my foot on the dash and my seat reclined. We kept a small towel in the car to set on the dash under my cast since the material is scratchy/rough. Even though the cast felt like it was mostly dry when I left the last time, I ended up with an indentation in the cast on the back of my heel. Next time, I plan to keep my cast from touching anything for at least an hour.

Click on the photo to enlarge it

• I did not experience many problems with itching inside the cast. One day when my foot felt like it needed to be scratched, I concentrated on doing leg exercises, and the feeling went away before I finished with the exercises.
• Have something like Aquaphor or aloe on hand for the incisions. This will help with comfort and healing.

To encourage healing

• Eat healthy, and drink plenty of water. 
• Parsley promotes bone health.
• Tumeric has many great properties that aid recovery after surgery, one of which is reducing inflammation. See my Healthy Eating blog for recipe ideas.

• Exercise, exercise, exercise! Your body, legs, toes, etc. ⎯ as much as your body can safely handle. This will, of course, depend on how flexible you are, and how much physical activity your body is accustomed to. Along with 30 minutes of yoga or other daily exercise, I suggest at least 10 minutes of leg and toe exercises, and at least one ice pack application every hour (in the beginning), as all of this helps many areas of the recovery process:
• prevents blod clots
• relieves tingling and blue skin color
• reduces inflammation 
• promotes bone healing

I had magazines and computer work lined up for the weeks following surgery because I thought I would have a lot of time on my hands. I was surprised that I did not have extra time at all. Normal activities (showering, dressing, simple household chores, etc.) were more time consuming than usual. Not only that, I lost about 20 minutes every hour to leg exercises, toe massage therapy, and getting up and down for ice packs.

Mobility

• When you adjust your crutches for height, do not forget to adjust the hand grips, if necessary. No one had explained the crutches to me, and I did not initially think about this.
• If you are shorter than 5' 3" tall, and you get a knee walker, you may want to inquire about a child walker. My knee walker is too tall on the shortest setting (I am 5' 2½"), so I plan to inquire about this next time.
• I kept a small bag on the handle of the walker to carry items like bottled water or the ice bag.
• I thought schooching up and down the carpeted stairs in our house was pretty easy. I was glad I tried this before the surgery to find the easiest way to get back on my crutches at the top and bottom. Near the end of the six weeks, I tried to hop up and down the steps using a crutch and the handrail, and I thought it was safer to sit down and schooch.

Safety

My surgery information warned about clearing the house of hazards, like loose rugs and electrical cords, and I have a few precautions to add to the list.

• Always make sure the walker is securely locked when getting on or off; even on carpet.
• Look at the walker when dropping your knee onto it.
• Be careful moving from lightness to darkness on crutches, as lack of sight sometimes causes imbalance.
• Be aware of loose clothing that may catch on something: the walker handle or seat, the crutch, or cupboard door. In the kitchen, with my knee on the walker, I would often stretch in an unusual manner to put things away, because this was easier than moving the walker back and forth. I also bent down using just one crutch for support to reach items in the lower cupboards, or to pick up things off the floor. Another reason you will need good balance and leg strength!
• Remain cautious at all times, even when you think you are far enough along in the recovery process to lessen your attention. I got overconfident a few weeks after surgery, and took a tumble on my toes (details in post #7).

I will compile another recap of my experiences in the walking boot after a few weeks. Let me know if you have any questions, or information you would like to share!