Four Weeks Post-Op [second foot] and Third Checkup

March 2018

Pain and swelling

My swelling remained minimal. My foot mainly just swelled up from the weight of the boot, when I used the crutches instead of the knee scooter. I kept my foot elevated when seated, and I applied ice several times during the day. During week 2, the cold ice had made my veins feel painful, and then during week 3, the ice made my foot pain lessen. I looked forward to applying the ice bag, because it made my foot feel so good. You can see in the photo below that I still had quite a bit of bruising on both my feet at 3 weeks post-op. My right big toe is also bruised, although that is not very visible in the photo.

Both feet at 3 weeks

After 3 weeks, the only pain in my left foot occurred when I touched the top of my foot, or when exercising the foot. When I exercised that foot, the skin felt tight and tender across the top. The top of my foot was tender enough that I had to wear loose shoes, or shoes that did not touch the top of my foot.

The pain on top of my right foot remained; it felt like a heavy, rough, hard surface was pressing down on my foot. When exercising, I felt tingling, rough/ripping type pain along the top of my foot and through the inside to the toe. Occasionally, my right foot felt painful or throbbed when I went to bed, although the pain was not enough that it kept me awake. My big toe knuckle was quite sore, and I wondered if more bone had been shaved off this foot than the other one. When I had asked my doctor about any differences, he said the two procedures had been pretty much the same. He said that even if I had had both my feet done at the same time, I would probably still have different feelings between my two feet.

By week 4, the pain in my right foot had lessened to just the big toe and knuckle area, except when I was exercising. The shooting, tingling, scraping pain was worst when I stretched and bent my toes backward toward my body, or when I tried to point my toes.

Exercises

My doctor had told me that it is best to bend my toes even if it is painful (after I asked him, of course, since he never offered any information on his own), so I did this every hour or two throughout the day. After 5 days, I noticed fresh blood around the incision on my right toe. I cleaned the area, and applied Neosporin and a bandaid. I then discontinued toe exercises on that foot for a few days.

Along with flexing my toes and ankles while seated, I did floor exercises every couple of hours; about 5 to 8 times per day. This was extremely painful when I started the following routine 2-weeks post-op. I gently stretched, flexed, etc., and most of the pain lessened as time went on. I think the leg exercises are especially beneficial in getting the oxygen and blood flowing throughout the body. I found that some of these exercises eliminated the tingling, scratchy pain in my foot and toe knuckle. The pain did not stay gone, although it did dissipate during movement.

For informational purposes, I am sharing the exercises I did, and my results below. Please remember: I am not a doctor. Readers should always consult with his or her physician about matters relating to ones own health.

• Knee bends/bicycling: I did these on my back for 1 to 3 minutes at a time. Sometimes, I did more than one set of these per session.
• Tip-toe stretches: Laying on my back, I gently stretched and pointed my toes as far as I could, and held the position for several seconds. Pointing and stretching my toes was painful; I cut back on these stretches after I called my doctor during week 3, and he said he did not want me doing any of the exercises while not wearing my boot. He had told me it was okay to do this stretch; however, this exercise is impossible while wearing a boot! After my 4-week checkup, I gently resumed this stretch, even though it was painful.
• Toe bends: Using just my toe strength, without the aid of my hands, I bent my toes back and forth several times as far as I could. I could hardly move my toes when I started this at 2-weeks, and it was extremely painful, causing shooting pain from my toe down the top of my foot. This is the exercise I had to quit for several days after my incision started bleeding.
• Ankle bends: I alternated between pointing my toes, and flexing my ankles. Again, this caused tingling, rough pain through my foot when I started, and I could not do very many. The pain was most severe at the base of the big toe by the knuckle. This is another exercise that is impossible to do while wearing the boot or a cast, so I cut back on these, and the ankle rotations (next), after I called my doctor during week 3. After my 4-week checkup, I resumed them again.
• Ankle rotations: I made several circles inward with my feet, and then in the opposite direction. I was only able to do about 5 of these in each direction when I started. 
• Leg lifts. 
• Side leg raises. 
• Side knee pulls: While laying on my side, I bent the knee of my top leg, and pulled it in toward my chest. At the same time, I pulled my top elbow toward my knee. Next, I stretched my top leg behind me, while stretching my arm forward over my head. This was one of my favorite exercises, as it relieved the tingling in my foot after about 20 repetitions.
• One-leg kickbacks: Starting on my hands and knees, I lifted my leg up behind me, keeping the knee bent. I then brought my knee back toward the starting position without touching the floor. I repeated this about 25 times. This exercise rejuvenated me; however, I do not recommend it unless you have the strength and stability to support yourself without falling over.
• Shoulder stand: I usually did this for about 1 minute while gently bending my legs back and forth at the knees.
• Seated forward bend (if you are flexible): Sitting on the floor with my legs outstretched, I reached for my toes, bending at the hips. I gently grasped my toes and bent them toward me. 

Another view of the boot showing how large it is,
and how impossible it is to exercise while wearing!

Activity with the boot

Although it was extremely difficult to do anything with the boot on, because of its weight and bulkiness, I was able to do basic household chores: laundry, dishes, minimal food prep, vacuuming, floor cleaning, etc. The most difficult chore at home while wearing a boot instead of a cast, was cleaning the floors on my hands and knees. I usually used the knee scooter to get around at home, and I was able to get around with the boot and crutches when we went out: for meals (4 times), overnight stay, shopping (5 times), haircut, etc. I used the store scooters when we went grocery shopping, and some stores had wheelchairs.

We have a seat in our shower, so I removed the boot to shower a few times a week. Last year, I had not been able to stand on my foot after it had been in a cast for 6 weeks; the pain when I tried to stand was excruciating (I assume from not using my foot). In an effort to prevent that this time, I tried to stimulate the nerves and bottom of my feet during the 6-week non-weight bearing period. I brushed the bottom of my foot in a circular motion with a bristle brush (like a dry exfoliator) a few times a day. I will let you know if this works when I start walking at 6 weeks.

4 weeks post-op

Third checkup

My third visit to the doctor was just over 4 weeks after my surgery. The day before my visit, I noticed a bulge on the inside of my right ankle that looked odd. This did not hurt, so I hoped it was just from swelling or something similar. It felt more like the bone than swelling, so I was a tad worried. I thought the incisions on my right foot looked like they might be pulling apart (I had read stories from people whose incisions did split), so I wrapped my foot somewhat tightly after taking this photo.

At the doctor's office, they took X-rays of my right foot, and the doctor said everything looked good. He attributed the bulge in my foot to swelling. After I requested a smaller boot, he conceded to letting me wear a surgical shoe instead. He still warned me not to put any weight on my foot. He said I could do the ankle rotations and stretches I had started to do without the boot, so I resumed those after my visit.

Wearing surgical shoe instead of boot a 4 weeks post-op

Effects of wearing the knee-high boot

I want to share a photo showing what wearing the knee heigh boot did to my leg in two weeks time. Some of you may be familiar with body wrap treatments that claim to take inches off your body. I have never had one, and I have no idea where the inches go; however, I lost almost 2" around my leg after it was wrapped in the boot for two weeks! You can probably see this better, if you click on the photo to enlarge it. My bone sticks out more on my right leg, and the skin is droopier. I measured my legs after I noticed this, and my right leg measured 1½" smaller than my left leg. It felt to me like I had lost muscle in that leg.

If all goes well, my next post will be in 2 weeks at 6 weeks post-op. After my next X-ray, I hope to begin walking again!