#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.

#10 ~ First Week with Walking Boot

April 2017

I had heard that bunion surgery is painful, and before this week I felt like comments I had read were overstated. I had quit taking my meds within four days of surgery, and I did not experience a lot of pain immediately following surgery. Yes, I had swelling and discomfort; however, I did not have extreme pain. I did not realize the more intense pain would be during the recovery when I started walking again; not the surgery itself. 

Activity and exercise

My doctor had not given me very detailed instructions about what activities I should be resuming, and he had not really discussed any exercises to assist with the healing. He basically told me to wear the walking boot when I was putting weight on my foot, to walk/do what I could tolerate, and continue bending my toes. I mentioned in my last post how severe the pain was when I tried to stand up, and this did not lessen any in the first week.

Although walking was painful, it was easier to do things around the house. I went up and down the stairs (walking, rather than schooching), vacuumed, washed the floors, prepared meals, etc; pretty much all of the typical household chores. I did yoga, toe bends, and ankle stretches daily. I always felt better after gently stretching my body. 

#9 ~ Week Six Checkup and Walking Boot!

April 2017

Cast comfort

I am providing a brief recap of the cast comfort first, as I think some of the pain I experienced this week was a result of the way the cast fit. The cast was tight around my ankle and front of my leg (just like the first one had been), and around my entire foot just above the toes. By the time I returned for my checkup, I had cut off a couple of layers of cast wrapping, and I had made a couple of cuts in the material above my toes. The wrapping ended at the top, so removing a bit of material relieved that area; however, it did not do anything for the area above my toes where the wrapping started.

The shorter cast had a few good points: less weight, and because it ended just above my ankle, I did not need to worry about where it hit the pad on the walker. It hung off the end of the walker, whereas the taller cast had rested partially on the pad. If the cast had not been so tight, it probably would have been quite tolerable.

Pain, tingling, blue toes

The tingling in my first two toes started to decrease after five weeks post-op. I could gently squeeze, massage, and bend the ends of these toes with my fingers. Before this, I had not been able to even clasp my toes between my fingers because the tingling pain had been so severe. I had frequent tingling from my big toe and up the top of my foot that was quite bothersome. I think my cast being tight aggravated this, since my toe knuckle rubbed tightly against the cast when I bent my toes forward. I also experienced mild pressure on other areas of my foot from the cast when I exercised or moved. This felt similar to the way your body feels when it starts to "fall asleep" from pressure on a nerve. Areas that was especially bothersome were the ball of my foot below my big toe, and the top of my foot.

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.

#8 ~ Week Five and Extra Checkup

March 2017

Recap of my injuries [from post #7] after surgery

The first time I fell was at home about 3½ weeks after surgery: my toes hit the floor with force. The second time I fell was on concrete porch steps a few days later: the bottom of my cast thudded down on the cement. I had become quite active on one leg before my falls: vacuuming, cleaning the floors with a Swiffer mop, going up and down the stairs, showering at least twice a week with a bag over my cast, yoga, and more. Both times that I fell were a result of being careless, rather than from doing too much. Neither fall happened when I was performing any type of feat; I was standing in the living room next to the knee walker the first time, and I was going up two porch steps the second time. I had done both of these things numerous times before.

Pain

The pain and tingling in my foot was much worse after my second fall. The fall itself did not hurt as much the second time; however, the pain got worse as time went on, rather than better. In fact, a few days after this, I took a couple of Norco pills I'd had leftover after surgery, since I had not taken them all then. My foot throbbed when I first got up in the morning, and it throbbed within five minutes anytime I got up to move around. I could no longer bend my big toe without using my fingers, and I had been able to do so before my falls. 

Initially, I thought the pain and tingling was just a setback in my recovery because of the trauma to my foot. After the third day, I thought the pain felt worse than it had after surgery. It was actually difficult to judge the pain for sure, since I had been taking Norco for three days following the surgery, which dulled the pain. I called the doctor's office five days after my second fall, and they scheduled an appointment for two days later.

#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. 😓

#6 ~ Week Three After Second Checkup and Cast On

March 2017

Pain, swelling, and comfort

The minimal pain I had been experiencing did not change much. Since I could now move my toes, and the doctor had told me I should, I started toe exercises. I must have overdone it the first day, because in the late afternoon I had a lot of pain and tingling along the top of all of my toes, which also extended up the top of my foot from my big toe. The pain lasted for about an hour. I had thought about putting ice on my toes, but then the pain subsided before I did. I had a similar feeling the next day or so, although not as severe, since I cut back on the exercises a bit. After this, the only pain I felt when exercising my toes, was with my big toe. The entire end/tip of my big toe hurt when I bent it, along with the area where my big toe connects to my foot. It looked like a cut had been made almost all the way around my big toe in this area. This is visible in the last photo in this post, and in previous pictures of my foot with the bandage removed.

The cast was initially uncomfortable around the ankle area, and on the second evening with the cast I noticed a new problem. I loved that my toes were exposed so I could move them; however, I had not thought about the comfort of where my cast ended until I experienced the discomfort 24-hours later. The cast ended at the start of the ball of my foot, when it seems like it would have been more natural to extend to where my toes connect to my foot. The purple in the photo below is the cast. A full cast photo is visible in previous post #5. The cast was made by the doctor hand-rolling the cast wrapping around my foot, so it seems like it could have been made to fit my foot. You would not think having something rest on the edge of the ball of your foot would be bothersome; however, after a length of time it is! In fact, I considered going back to the doctor a couple of days later, as I was not sure I would be able to stand it for two weeks. Even though I was not standing on my foot, this end of the cast pressed against my foot at all times, even when my leg was elevated.

Underside of my cast

My ankle no longer felt swollen at the end of the third week, and this area was not bothersome. The top of my foot was uncomfortable instead. Even though there was soft gauze around my foot under the cast, the top of my foot was sore. It felt raw, as though the tender stitched area was rubbing against the rough cast. The ball of my foot where the cast hit underneath was also sore, as if this area around my foot was now swollen instead of my ankle. I did not understand why my podiatrist had chosen to fully cast my foot when I saw many more comfortable looking foot wrappings online. If you do an online search for "foot cast after bunion surgery," you will see many options. I thought the type of covering in the photo below looked the most comfortable. This would not be as protective as the cast; however, I would have preferred it. I was extremely diligent about the care I gave my foot, and about not putting any weight on it. I had not thought to research foot coverings, and I had not specifically asked my doctor about what kind of foot cast I would have before I had the surgery.

Photo from Margaret River Correspondent blog

Exercise

I continued the same yoga and leg raise routines, along with the added toe bends. I did the leg raises more frequently, and I added a few more leg exercises after my toes turned blueish gray in color (more about this under the next heading). I did about 10 minutes of leg exercises every hour or so. After my toe pain the first day, I initially cut back on the toe exercises, and then I gradually increased the amount I did. I did not stretch my big toe as much as the others; not only because it was painful, but I also wondered if the activity might increase scarring from the cut around this toe.