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2 days after lisfranc hardware removal surgery

 
 

 

 

 2 days after my lisfranc hardware removal surgery I was told to remove the dressing and ace bandage.  I wasn’t sure what my foot would look like, and I was surprised it wasn’t more swollen.

 
 
2 days after lisfranc hardware removal surgery

You can still see where my surgeon placed his initials and where I signed “yes!” indicating my right foot was the correct foot to be operating on.  My surgeon used the exact same incision for removing the hardware as he did for my original lisfranc surgery repair.

 
 
lisfranc hardware removal incision
 
 
 

After a shower I had to let my incision air dry and I needed to elevate and ice, something I know how to do!  My nurse told me the ice doesn’t have to be over the incision, and that icing the ankle will help just as much.  That knowledge came in handy since the incision area is very tender!

I have been keeping the incision covered with a large band-aid which protects the area from germs.  I remove the bandage daily to make sure the area around my stitches is not turning red with infection.

Lisfranc hardware removal surgical site

I have been meticulous about staying off my foot as much as possible and have been icing and elevating most of the time.  This has been hard, psychologically, for me because it seems like I have gone backwards in my lisfranc journey.  But I know, that in a little more than a week, my surgeon will remove my stitches and I will be able to resume walking again, and this time, I hope it will be pain free !

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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.

Today was my first physical therapy session without my beloved  therapist.  When we first met, my therapist and I made a “pinky promise” that I would be done with therapy around the time she was due to have her baby. Unfortunately, I had to break that promise because she delivered her new baby girl yesterday morning.  I am absolutely thrilled for her and her family! (Her new daughter is absolutely adorable and has a full head of black hair!) 

My therapist taught me to walk again and I am mourning the loss of a trusted caregiver. Being with her twice a week for the last 4 months, made for a powerful bond, which I will greatly miss . 

I am lucky, though, because my new therapist is also one my surgeon recommends for lisfranc surgery recovery. In fact, I found out today that he has actually worked with a lisfranc patient before! Ironically, his wife is also pregnant and today WE made a promise that I would be done with physical therapy around the time his wife is due, which happens to coincide with my next appointment with my surgeon.  I fully intend to keep this promise which gives me until the end of October to be back at 90%.

Because today was my 20th physical therapy visit my insurance company says I am at a juncture in my recovery.  When my new therapist told me  my insurance company requires “proof” that I am not back to 80-90 % of my normal daily activities in order for them to keep paying for my therapy I felt the first waves of anxiety.  I wondered if today I not only lost my cherished therapist, but was being let go from therapy all together.  I can’t even walk down my driveway yet to get the mail!!!

After talking things through with my new therapist, he agreed that I probably need 8 more therapy sessions and will keep me with twice a week for a few weeks and then decrease my sessions to once a week.  I filled out the necessary paperwork which involved a lot of questions about my ability to do everyday activities.

My new therapist took a lot of time with me today to really get to know not only where I was physically, but psychologically as well.  I told him about my bout of foot envy, fully expecting him not to really get the whole cute shoe thing.  After all, he is a guy!  But he surprised me and not only understood, but gave me a new perspective on only being able to wear sneakers.  He said to think of this sneaker period as the most comfortable period in my recovery.  After all, who wouldn’t want to wear sneakers all day and have their feet comfortable all the time?  He also pointed out that this 6 months of lisfranc therapy is really just a blip when looking at my life as a whole.  So my sneaker period, is even smaller than that.  So I have decided to embrace my lisfranc sneaker recovery period and enjoy the comfort of my sneakers.

 

 
 
 

                       That’s right!  
                                  It is official!! 
              My physical therapist has asked me to 
                      retire my boot!!! 

 

Bejeweled lisfranc recovery boot

 For the last 2 weeks, we have slowly been weaning me off the boot (when away from my home) by using the boot only when I had to be on my feet for 20 minutes or more.  

Lisfranc recovery boot

I am now officially in the next stage of recovery from lisfranc surgery………I am bootless and wearing sneakers full time!

Making your lisfranc recovery boot a work of art 

It is a little weird to think I might actually miss my beloved boot, not because I enjoyed wearing it, (NOT!) but because every time I looked at it, I saw the signatures of all the people who cared enough about me to take part in my lisfranc recovery journey. Each signature represents a person who shared some of their life moments with me and participated directly in my care.  

My lisfranc recovery boot is a reminder of people who care
 about me

I may even miss being stopped by strangers who commented on how pretty my boot was decorated with signatures of my family, friends and caregivers…….

 

 
Last evening was a tough night for me psychologically.  I had such high hopes that my lisfranc surgery recovery was almost over. After being so limited, mobility – wise, for such a long time,  I was really looking forward to resuming my normal routines.   

 
Mentally I had already started planning for what is left of summer with maybe a pool party or hosting a large family Labor Day party.  I  wanted to throw myself fully into fall life starting out with a fall vacation followed by long walks around our lakes looking at the fall colors.  I couldn’t wait to be “out there” among the living once again.
 
After meeting with my surgeon and finding out that realistically I will not be walking comfortably for another 3 months,  my dreams crumbled.  I tried really hard to talk myself into the whole glass is half full thing which sounded very much like blah blah blah.  But no matter how many “it could be worse” scenarios I could envision,  I had to come to grips that I was overwhelmed by disappointment.

When my husband walked through the door, I burst into tears which had been building all day.  I asked him not to “fix” my pain, but to just hold me and let me share my disappointment with him.  I think the amount of tears stunned him into doing the guy thing complete with a pep talk and telling me I was going to prove my surgeon wrong etc.  He was trying to help, but it made me feel worse.  I felt very alone in my grief.

This morning I woke up and knew that in order to survive the next 12 weeks, I was going to have to  re-enter my Zen mode of survival which I used during my 6 weeks of complete non weight bearing recovery period.  During that time, I can remember pulling into myself and learning to listen to my thoughts and emotions.  I was in my own little world since I had no power to enter the world of moving, active people.  My personal thoughts and emotions became more real to me than the outside world that I watched from my windows.  I was completely dependent on others for all of my needs, even my basic needs.

To try to achieve a partial Zen like sate I started out my day with a 90 minute massage and a good conversation with my massage therapist.  Turns out that she is also a psychologist and understood exactly what I was trying to accomplish with my massage.

I have now re-entered my Zen mode, slowing my life down once again.  It won’t be as intense as it was during my complete non weight bearing period, but this peaceful state of mind will prove to be just as useful.

I am slowly letting go of my fall plans and tonight I was even able to deal with the fact that I will be missing quite a few of the Vikings home games.  Our season tickets are 8 rows off the field and there is no way I can handle the steps or the amount of walking it would take to attend.  I have already started planning on who to give the tickets to, and have even enjoyed thinking about how the different people might find joy in attending a Vikings game.

12 weeks post lisfranc surgery repair X-ray

 

 

 

Yesterday I met with  my surgeon for my three month post lisfranc surgery appointment.  It was depressing to learn that I have 3 more months of recovery until I can walk comfortably again.

 

The good news is that the current X-rays show that I don’t have any stress fractures.

 

 

 

 

 

12 weeks post lisfranc surgery X-ray outside left side view

 

 

The X-rays also show that my joints are starting to fuse the way they are supposed to at this point in recovery.  My surgeon showed me my current X-rays and compared them to the ones taken 6 weeks ago:

 

 

 

 

 

 

 

12 Weeks post lisfranc repair X-Ray.  You can clearly see the joints around the prosthetic starting to fuse.

 

6 weeks post lisfranc surgery repair X-ray.  Joints have not started to fuse.

 

 

 
I was really looking forward to seeing my surgeon yesterday for my 12 week post lisfranc surgery follow up.  Armed with my list of questions and notes from my HydroWorx therapist, I was well prepared for my appointment.  I even went as far as to have a fresh pedicure with hot pink toe nail polish to match my sneakers.  

I was fully expecting my surgeon to be extremely pleased with my progress and tell me I was way ahead of schedule.  After all, I have been attending either HydroWorx therapy or physical land therapy 6 days a week, plus performing my at home exercises given to me by my physical therapist.  I knew I had worked hard these last 6 weeks and was well on my way to pain free walking again. I expected my surgeons  full endorsement and recognition of my progress.

After I arrived, I was escorted into my patient room where I removed my boot and headed to the X-ray room in my stocking feet.  I was in more pain than other days, so I did have to use my cane, but I kept up with the X-ray technicians gait which made me smile proudly to myself.

I was able to step up easily on the X-ray pad without difficulty and even mentioned to the technician how much easier it was for me this time as compared to 6 weeks ago.

Shortly after returning to my room, my surgeon walked in.  He sat in his chair and said, “you are still limping quite a bit.”  I was surprised he knew.  After all, I fully intended to demonstrate walking without a limp so that my surgeon could see my gait during the times I am not experiencing pain.  BUSTED!!!
 Apparently, he had observed me walking to his X-ray room.  (I guess that is the best time to asses a patient is when he or she does not know he/she is being watched. )

I then admitted I was experiencing pain when walking and asked him realistically when I could expect to be able to walk down our driveway, which is a steep hill, and pick up my mail pain free.  Not running or jumping or anything fancy, just pain free walking doing everyday activities.

My surgeon said realistically it will be 3 more months until I can walk comfortably.  I was stunned and I started to feel my world shatter once again. I had to try hard not to burst into tears, which most certainly would have embarrassed us both. 

I sat quietly with this information for a few moments, not wanting to meet his gaze.  When I collected myself I looked up at him and repeated quietly   “three more months???”  He nodded slowly maintaing eye contact.  (My surgeon is quite, gentle and a man of few words.)

Desperate for my surgeon to revise the remaining three months of recovery to something shorter, I asked him if he had a chance to read my physical therapist report and the report from the HydroWorx therapist.  I thought certainly he must not have had time to read the glowing endorsements from both modes of therapy.  

(Hint to my surgeon,  this the part where you are  supposed to “pat me on the head” and tell me what a good girl I’ve been!!! )  My surgeon didn’t get the hint.  Instead he nodded quickly and asked me why I was in such a hurry?   I said, I was determined to walk like a normal person again and that I was tired of the lisfranc recovery.  

We briefly discussed stress fractures and I found out it would not be uncommon for that to happen during this period, especially if I am pushing myself too hard.  My surgeon said I needed to cut down on the amount of therapy and just relax and give my body a chance to heal.  “Healing takes time and cannot be rushed,” he said.   He looked at me long enough to make sure I understood and then he smiled and said, “look at it this way, you are half way there.”

I slowly nodded still trying to comprehend that I am not almost at the finish line but am only halfway through this journey. 

 
 

 

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