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Removing stitches after lisfranc hardware removal surgery

 
 
 
The morning after we arrived in Cabo, the swelling had gone down in my foot and my husband was ready to try and remove my stitches.
 
I could not wait!!
 
 
3 weeks post op after lisfranc hardware removal surgery

I thought I could do it on my own, but my hands were shaking too hard, so my husband took over.  The top of my foot was very sensitive, so he had to be very gentle.

 
Removing stitches after lisfranc hardware removal surgery

My husband took his time and made sure each thread of my 8 stitches was accounted for.

 
Removing stitches after lisfranc hardware removal surgery

After we were sure everything was done correctly, he adhered steri-strips to my incision to help hold it together.

3 weeks post op from lisfranc hardware removal surgery

I was now ready to do the “homework” my surgeon gave me.  He asked me to walk several times a day in the resort pools in order to begin to regain the proper movements for walking once again.

 
Relaxing by the pool after lisfranc hardware removal surgery

I was surprised to find that I had to once again, re-learn how to walk by repeating the mantra “heel, toe, follow through.”

 
 I was not able to swim at all, and was actually content walking around the pool smiling to myself because I was walking again without pain!!!!!!
 
My homework assignment after lisfranc hardware removal surgery

As you can see, the pool was large enough to really get in a lot of walking!  Once I was able to walk without concentrating, I pushed my husband on a float around the pool while he read a book. Other guests asked me if they could hire me to do the same thing for them!

 
Recovering from lisfranc hardware removal surgery

I decided that recovering from lisfranc hardware removal surgery is best done in Cabo at the Esperanza resort!!!

 
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33 weeks after lisfranc surgery

 
I cannot believe it was 33 weeks ago today that I had my lisfranc surgery!  I apologize for not keeping up with my blog these past few weeks.  
 
I had my lisfranc hardware removal surgery on Nov 20th (5 1/2 weeks ago) followed by entertaining for both Thanksgiving and Christmas plus my husband and I took a  “lisfranc hardware removal recovery trip to Cabo.  So things have been hectic.
 
I will try and pick up where I left off from my last blog.  
 
One week after my lisfranc hardware removal surgery was Thanksgiving and we were having 14 people over for Thanksgiving dinner.  I was told I could not lift a finger and had to stay off my foot as much as possible icing and elevating, so my husband and I had to get creative.  (As you can see, at Thanksgiving, my foot was really swollen, black and blue and extremely painful)

1 week after lisfranc hardware removal surgery

My husband hired a chief to prepare the food so the only thing my husband  had to do was warm up all the food.    Our guests were mostly family members and all understood that I had to play the princess once again.

1 week after lisfranc hardware removal surgery
lisfranc hardware removal surgery
 
Last Wednesday I went in for my lisfranc hardware removal surgery.  I requested the same nurse that I had for my lisfranc surgery and was thrilled when she came to get me from the waiting room.   Nurse “Emily” is the perfect combination of humor and empathy with the ability to convey information in a way I can hear.   
In preparation for my surgery, nurse Emily got me into a heated gown, and covered me with heated blankets, which made me feel like I was at a spa.  As she started my IV and explained exactly what was going to take place, I shared that I  wasn’t nervous about the surgery itself, but was really anxious about the pain and recovery period.  As we were talking, Emily took my blood pressure and it was 168!!!!
 
Nurse Emily immediately started re-assuring me that it would be nothing at all like my last surgery and that I would be feeling “normal” in a few weeks.  Then my surgeon walked in, calm as ever, and with a reassuring smile asked me how I was doing. Since it was nearing the end of his surgery day, I immediately asked him if I could buy him a cup of coffee.  He laughed and said he was plenty alert for me.
 
 He reassured me that this surgery would be nothing at all like the last one and then talked with me in depth about the kind of anesthesia I would be having.  The biggest question I had was whether I would have to go another 6 months with my big toe and the top of my foot being numb.  We decided together that I would not have a nerve block unless I absolutely needed one which would cut down on the likelihood of lingering big toe numbness.
 
After he signed my right foot and turned to leave, I told him that the anesthesiologist said I couldn’t watch the surgery.  He smiled and said, “bummer.”  
 
When he left, I was a lot more at ease with what was about to happen.  Emily shut my curtains and told me to rest until it was my time, which turned out to be 1 1/2 hours!  I have never sat in a room, with nothing to read and nothing to do for that length of time. Unrestrained thoughts can be a dangerous thing!
 
Finally, my surgical nurse, Sarah, came to get me and she and the nurse anesthetist  wheeled me into the operating room.  The operating room was quite cold and when I mentioned the cool temperature, I was asked to transfer to the operating table with the promise of more warm blankets.  The operating room table was really narrow and did not have space to put my arms by my sides. While I was still trying to decide where to put my arms, someone took my arms and placed on side tables located on either side of the operating room table while someone else secured a thick strap over my stomach.  I asked why the strap and was told it was so I wouldnt fall off the operating room table during surgery.  About  now I was starting to get a little creeped out, and as I was staring up at the ceiling at the many bright white lights that looked a lot like  spider’s legs, a mask was placed over my mouth and nose.  I was very happy to succumb to the anesthesia!!!!!
 
It felt like only a few minutes when I woke up in recovery with my nurse Sarah asking me if I had any pain.  As I slowly came to, I felt a searing red hot pain in the top of my right foot and noticed tears starting to stream down my face.  I told nurse Sarah I was quite uncomfortable and she said I did not have a nerve block and that they needed to control my pain with meds instead.  She immediately gave me a couple of opiates and some crackers.  After about 20 minutes my pain level decreased from a 7 to a 3 for which I was grateful.  After getting my pain under control I was offered ice water and I can honestly say, no ice water has ever tasted so good!!
 
My surgeon came in smiling widely and told me everything went extremely well and asked me if I wanted to keep the hardware he removed from my foot.  I told him I planned to take pictures of it and post it on my blog and keep it next to my boot.  He laughed and  said they would sanitize it and mail it to me.  Eventually, my pain remained under control and I was told I could return home, where I have been mostly in bed, sleeping and occasionally visiting with family and friends who have been care taking me and my husband.
 

lisfranc hardware removal surgery ice and elevation and a cute new surgical boot
 
 
 

27 weeks post lisfranc surgery with more surgery tomorrow

After recovering from lisfranc surgery for 27 weeks, my husband and I took a quick trip to Florida before I head back into surgery tomorrow.
I was not able to walk barefoot on the beach, and sandals were still uncomfortable, but that didn’t stop me from being able to enjoy the feeling of sand on my toes!
27 weeks after lisfranc surgery

I decided to be really adventuresome and try walking through Sea World.  We took it slow, and I was able to manage walking around the entire park and enjoy several of the shows!

After visiting Sea World, I even managed to walk through the airport to catch our plane. When we got home last night, all it took to be pain free was a little ice, elevation and tylenol!!

Tomorrow I am having the hardware removed from my foot.  I am not at all nervous about the surgery itself, but am apprehensive about the recovery.  I have been assured by both my surgeon and his nurses that recovery will be much easier this time, but I still wonder how long it will take to recover to the exact point I am now.  I have worked hard to regain almost normal walking and I dread going backward.

I know, though, for a positive long term outcome, hardware removal is necessary

Today marks another milestone in my lisfranc recovery journey!  While shopping at the grocery store, perusing isle after isle of items, I suddenly became aware that I hadn’t thought about my foot since I walked into the store!  The realization hit me after walking halfway through the entire store without one ounce of pain or stiffness.

 

26 weeks post lisfranc surgery scar

 I couldn’t stop smiling at feeling so “normal” and greeted everyone I saw with a huge grin.  I did resist the urge to tell complete strangers to notice that I was just a normal walking shopper, once again.

 

  After checking out, another shopper bumped into me and I didn’t fall apart in a panic worrying she would step on my recovering foot.  In fact, my first reflex was no longer to pick up my right foot and hide it behind my left for protection.  Instead I managed to smile and say, “hello.”  WOW!!!!!

 

I am now able to walk about 3/4 the speed of other people and I can keep that gait without a limp!

26 weeks post lisfranc surgery wardrobe

 

I still am much more comfortable in sneakers and decided to buy matching jackets.  I girl needs choices of what to wear in  the cold Minnesota fall weather!!!

Finally, after 25 weeks of healing from lisfranc surgery, I am able to do 2 full hours of regular housework, including being able to vacuum!!  I never thought I would say I enjoyed doing laundry, cleaning the kitchen, picking up, getting out Thanksgiving decorations etc!!!  My foot told me I need to stop, but that’s OK. I can honestly say, I am thrilled to be able to take back another part of my life!!! 

I also decided to move up my hardware removal surgery to Nov 20th.  This decision was based on my insurance, who will pay for the entire surgery if I have it done by the end of 2013.

I traded a couple of e-mails with my physical therapist (whose wife has still not had their baby boy yet) and he wants to come and observe my operation! (My surgeon and my PT have a good relationship.) I am absolutely thrilled!!!!!  How cool is it that he wants to follow my case even after I have graduated from PT!!!!

plates and screws after lisfranc surgery
24 weeks post op

So, in a few weeks I will be saying “good-bye” to the plates and screws that were imperative to my healing bones!!

 
 

Fantastic news!

 
Today I had my 24 week surgical follow up and my surgeon’s exact words were:

“The bones in your foot are completely healed and fused together, exactly like they should be.”

x-ray showing complete healing 24 weeks after lisfranc surgery

All of my fractures are healed, my joints are aligned and my lisfranc joint is fused.  I couldn’t be happier with my healing and progress!!!

lisfranc healing 24 weeks after surgery

He went on to review with me my x-rays from before my surgery, at my 2 week check, 6 week check, 12 week check and today’s 24 week check. 

 
Lisfranc injury before surgery
lisfranc joint completely healed 24 weeks after surgery

 

My surgeon noted that my foot still has some slight swelling and discoloration and I filled him in on my continued pain when walking, especially when I try to walk fast.  I also told him I was unable to run, jog or jump and he said that was normal at this stage, and realistically it would take another 6 months to fully and completely recover. 

He also said that if I was an athlete it was time to have the discussion about hardware removal, and I laughed and told him my goal has always been to walk down our steep driveway and get the mail, and I can do that now!   He smiled, and continued to say that a lot of women want the hardware removed in order to be able to wear cute shoes again.  Of course that got my attention, especially after wearing neon green and pink sneakers for the last couple of months! 

I showed him the top of my foot and traced the area with my finger where I thought the hardware was and he affirmed that it was indeed the plates I was feeling under my skin.  I also asked if hardware removal would help with the itching in that same area and he said it definitely would stop the irritation.  Removing the plates and screws may even help with the cramping I have been getting in the arch of my foot.  (Although the cramping most likely is related to my muscles re-building.)

Removing the plates and screws is a simple procedure, and the incision would be along the same line as my lisfranc incision.  I would be full weight bearing right after the surgery with stitches removed at 2 weeks and full recovery at 3 weeks.  So, I decided to have my plates and screws removed and scheduled surgery for Jan 8th 2014.  (Hardware removal should be done within 1 year of original surgery.)

I am not at all discouraged, though, since I know my bones are healed, my muscles are continuing to develop properly  and my lisfranc recovery journey is on the right path.

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