End of week 5 post surgery

The first four weeks after surgery went so well that this week kind of surprised me.  The beginning of the week my foot was hurting the worst it had since the stitches came out.  Had trouble getting into the shoes that were not a problem last week. The incision looked red and puffy and more noticeable.  Hmm. What was up with that?   The colder weather perhaps?

But then the last two days of the week my foot felt much better.  I discovered that my hiking shoes are pretty cushy and yet have a fairly flexible sole.  The extra bottom padding  seemed to really help on my longer walks and enabled me to roll through my step bending and stretching my toe as I walked.  My  3 mile walk was much better in these.  My gait was fine and was able to get my pace up considerably.  Yesterday was even able to do a short sprint.

Have been religious about doing my stretching exercises. Also have been massaging my foot with vitamin E oil.  Don't know if it really helps but it sure feels good.

So as of tonight, good progress.  But lesson of this week is that this is very much an up and down process.

Day 27--The pain returns

Maybe it's the colder, wetter weather.  Maybe I pushed a little too far on my toes in yoga or while I was out walking.  But today was not a great day for my foot recovery.  Was stiff and achy almost all day (other than for about an hour after swimming).  The affected joint throbbed even sitting down.
But I guess the ups and downs are to be expected.

So a month post surgery, here's what I can sum up:

• The exercise and movement in general are really important.  Even sitting for an hour or two can allow the joint to stiffen up.

• It's important to walk through the stiffness and pain.  It definitely gets better after about 20 minutes.

•  A pair of soft, flexible shoes that are very easy to slide your foot into will likely be needed in the few weeks following surgery.  A month post surgery, I'm still very limited in what shoes I can get on my foot.

•  Expect ups and downs.  Some days are good and then you seem to take a step backward.  But in a day or two, things generally start making progress again.

• At one month I'm getting around pretty well although probably not quite yet to where I was before surgery.  I can definitely move my toe more but the discomfort level is still a bit higher most of the time.

I'll be writing more the end of next week.

Day 26--3 mile walk

Feeling a little stiffer today than the past couple of days.  Did my standard 3 mile walk.  Was definitely feeling a pull for the first 20 minutes which made my gait feel a little off.  Fine for the rest of the walk although could feel some pull for the last 10 minutes or so. Concentrated hard on keeping my foot straight and just walking into the pull to keep working the tendons out. I know I tend to pick up the pace toward the end so maybe that's what was going on.

Still only in soft tie shoes. 

Since progress is pretty incremental at this point, I figure I'll write tomorrow and then move to a weekly update.

Day 25--Into another pair of shoes

Incremental progress today.  I was a little stiff after the treadmill walk last night but loosened up as the day wore on.  Swam for the first time since surgery.  The incision is fully healed and barely noticeable although I could definitely feel it the first couple of laps of scissor kicks.  But like with walking, as I kept swimming the discomfort went away.

Got into my Superga sneakers tonight.  Still can't get into dressier shoes or any non-tie shoes other than my slippers.  But at least I have three pairs of enclosed shoes I can wear now that the weather is getting cooler.  Am really hoping that I'll be able to wear all my shoes at some point--even the ones that were too uncomfortable over the toe joint prior to surgery.

Day 24--Back in my walking shoes

Foot a little stiff but this seems typical when I first wake up.  Did my exercises right after breakfast and headed out to yoga.  Did fine in yoga but found my foot was stiff and sore during errands afterward.  Could it be the colder weather?  I was in sandals and my foot was cold.

I was able to get into my Mephisto oxfords tonight which have been my favorite walking shoes prior to the surgery. They felt good.  Started our walk tonight but got rained out after a mile.  Again felt a little stiff and like something was pulling on the bottom of my foot under the toe joint.  But by the time we got back to the car, it was definitely feeling better.  So when we got home, I got on the treadmill.  Did 35 minutes getting up to 3.5 miles/hour for the last 10 minutes.  That was definitely pushing it for my toe but it wasn't painful.  I've found that I definitely need to push through some discomfort--my foot feels better the longer I walk.

Day 23--Back to full 3 mile walk!

Foot feeling better this morning.  I was able to get my foot into my orthoheel flip flops and they felt fine.  A first.  Enclosed shoes still problematic.

Did my toe exercises before I headed out today.  Was able to walk around our little town's car show this morning without a problem.

The incision looks better than I had expected at this point.  The area around the incision is a little red and rough looking but the scar itself is not really visible. 

Incision 23 days after surgery. The mark across my foot is from the sandals I was walking in this morning. 

Probably the first day that I went about my day without thinking about my foot.  Was able to get into my old ratty slippers to do a little painting in our hallway.  After dinner, I was able to get my foot into my regular walking/running shoes.  I got out to the car and to the start of our walk but then they will still feeling a little too uncomfortable to walk in.  So traded back to the New Balance slide ons which feel pretty good by comparison.  But the real news is that I was able to do the whole 3 mile walk that my husband and I had been doing every evening before my surgery.  My pace was a little slower than normal but not bad and my gait was about 90% normal.  I was so excited.  So this week with a little luck should be back to my normal exercise schedule.

Day 20--Yoga

Coming up on three weeks since my surgery.  I'm moving around fine although still feeling a little limited.  Main issues are stiffness in the joint (this usually eases up after some use), high sensitivity to anything pushing on the top of my foot and the ever present frustration of not being able to get into my regular shoes.  Luckily, it's been warm here so my two pairs of sandals that I can tolerate are serving me well.

I went to yoga this morning.  It's a gentle, hatha yoga class, not a power yoga kind of thing.  I was pretty much able to do everything I could do before the surgery.  Not willing to try downward dog just yet or anything requiring me to get up on my toes supporting the weight of my body but I wasn't doing that leading up to the surgery either.  It helped that I didn't need to wear shoes for this. It felt good to be back into normal activity.

Did get a mile walk in last night.  I pretty much have to be able to get into the New Balance shoes for that.  I did although the top of my foot was sore throughout the walk.  It seems a lot more sensitive since I removed the original steri strips after the stitches came out.  I've replaced with new steri strips.  Better than without them but still very tender everywhere--not just over the incision.

Day 22--Half step back

My foot seemed more swollen around the incision this morning.  My usual New Balance slide ons were not that comfortable and I really hobbled around the farmers' market this morning.  Luckily, I got a near by parking place since walking seemed even more difficult carrying a heavy basket filled with produce.

By the time I got back from the market and the grocery store, my foot couldn't wait to get out of the shoe.  And although the top of my foot felt better, my toes felt stiff.  I didn't do my toe exercises until after lunch today and I think I paid for that this morning.  Will try more diligently to do the exercises before I head out any place in the morning.  Iced my foot and propped it up for a while although can't say that it felt any better.

The incision was quite sore tonight so kept the walk to just a mile tonight.  My toe felt stiff tonight when I did the toe exercises.  Foot propped up again tonight although I'm forgoing the ice.  Guess this is just part of the ups and downs of recovery.

Day 21--Able to walk a little further

My foot seemed noticeably better today.  I could get it into my slippers and topsiders although the pressure over the incision was still too uncomfortable to actually walk in them.

Was able to do about half of my normal 3 mile evening walk and probably could have done the whole thing but didn't want to push it too far and then pay for it tomorrow.

Took off the steri strips that I had put on Tuesday.  The incision really doesn't look too bad.  The skin is a little rough looking and slightly red around the incision but the scar itself doesn't jump out.  It looks pretty well heeled so will definitely be back to swimming next Tuesday.

Started putting Mederma over the incision to hopefully minimize it even further.

Day 19--Almost normal gait, shoes still an issue

I took the steri strips off last night and slept without anything covering the incision.  It was not a restful night.  Although it wasn't painful getting the strips off, the top of my foot was extremely tender.  Even the sheet touching it made it sore enough to wake me up.

I redressed the incision with the narrower strips I was able to get at the drug store.  I was able to tolerate my fitflops this morning and headed out looking for the wider 1/2" strips that were originally on my foot.  I did finally find them at a surgical supply store.  Not inexpensive.

My gait was more normal today as long as I didn't move too fast.  Tonight I was able to get into the New Balance slide on shoes.  Got in a 30 minute walk tonight.  The joint is doing pretty well--it's the top of my foot around the incision that's sore today.  Still can't get into any kind of lace up shoes.

Day 18-- A Little More Progress

A little more progress today.  My feet were freezing this morning and since I was just hanging around the house I really didn't feel like putting on shoes and my Minnetonka moccasin slippers still won't go on.  I remembered a had a pair of down booties that I had gotten as a gift years ago.  Slipped those on and my toes were nice and toasty while I got into a good book.

I had scheduled swim time this afternoon and my doctor said it would be okay to swim as long as the incision looked healed up.  So that meant I had to take the steri strips off to check things out.  They came off easier than expected.  The incision didn't look too bad but my gut told me that a public pool with little ones in the lane next to me probably was jumping the gun a bit.  I decided to wait a couple more days.  After 2 1/2 weeks, don't want to jeopardize progress with an infection.  Things have been going pretty well so far.

Probably didn't walk as much as I should have today although I did walk around the house in the down booties which was like walking barefoot-- no cushion under my feet.  I hadn't been able to do so far but today it felt okay.  I worked my toe back and forth a lot while I was reading.  Will be heading out tonight.  I may see what other shoes I might be able to get on my foot tonight.

Day 17--A Little Better than Yesterday

Yesterday was not a good day for my foot.  I strongly suspect I way overdid it the first two days and then paid for it yesterday.  By late in the evening my whole foot and ankle was hurting.  I had to have been walking funny because of the pain in the toe and then messed everything else up.

This morning has been a bit better.  I was able to get the New Balance shoes on and walk around the house and out to the road to get the paper with them on.  The top of my foot still feels sore but I haven't got the really sharp pain on the side of my foot like yesterday.

My husband tells me that it's good that I pushed so hard.  But not sure it's good to push so hard that you're off your feet for the next couple of days or walking funny because you're in agony.  I think the key is finding that sweet spot to push hard enough to move the needle but not so hard as to set yourself back.  Unfortunately, that line is hard to find.  Maybe as time goes on it will be more discernible.

My foot is craving the warm, moist towels and the ultrasound treatment that I got at my physical therapist's for the torn tendon in my ankle.  But my doctor didn't recommend PT.  But it seems like the gentle, restorative PT like heat, ultrasound, massage, etc. would be good for healing.  Elevating, ice and tylenol didn't do anything yesterday (although maybe that's why I'm feeling better today?)

Was able to work in the garden for an hour or so later in the afternoon.  The top of my foot was still sore again the New Balance shoe but not intolerable.  Got the velcro sandals on to wear to dinner although my gait felt very stiff and unnatural.  Once I got home shifted back into the fitflops and felt much better.

Day 16--Ups and Downs

I may have overdone it yesterday.  My foot was fine during the night but once I got up was definitely not as flexible as yesterday.  It was cold and rainy this morning so that might have had something to do with it.  I've been in my fitflops all morning since the top of my foot was feeling tender and I wasn't in the mood for something pushing on it.

I've noticed that I'm getting a lot of snapping in my joint as I do my exercises.  Especially when I switch from pulling up to pushing down.  At first my toe didn't want to go down at all but with just a little pressure, I felt a snap and then it moved.  The snapping isn't so much painful as it is a little disconcerting.  I suppose that's all part of the recovery but I'll write to the doctor tomorrow night (tomorrow's a holiday) just to check and be sure.  He told me when he took the bandages off to keep it moving and that there was nothing I could do to hurt it but I still tend to associate pain and snapping with something destructive.

The new waterproof flexible tape I had put on two days ago to keep the steri strips from peeling off starting peeling off last night after my shower.  It was quite loose on the ends this morning so decided to peel it off so it doesn't stick to shoe or sock.  I may try putting more steri strips over the edges and see if that helps or just let them go as is and hope they stay on until Tuesday.  They said if they came off, I could replace with a large bandage or gauze and paper tape.  But those would add a lot more bulk and make getting in a shoe even harder. (I ended up replacing the waterproof stretchy tape with longer steri strips that I wrapped under my foot to get more grip.)

I can tell this is going to be an up and down process.  I went to head out to the mall with my husband and slipped on the New Balance shoes which were so comfy yesterday.  I took 3 steps and knew today wasn't like yesterday.  They were pushing tightly in one spot on the side of my foot just behind the affected joint and it hurt like crazy.  I couldn't even walk down the hallway.  Then tried my velcro strap sandals with the opaque socks underneath.  Not much better. The strap went over the same sore spot.  This place on my foot hasn't hurt in the last 3 days.  What's going on now?  Didn't want to just sit at home so I ended up just going barefoot with the fitflops.  They worked fine but my foot was not up to par with yesterday.  If I walked slow, I could almost keep a normal gait but the minute I picked up the pace even just a little, my gait went out of whack.  My husband claimed I wasn't bending my foot when I walked although I was consciously making an effort to.  We did cover almost the whole mall.  And then cruised around Target.  I was hoping I could find some inexpensive moccasins or something enclosed over the toes that I could get my foot into.  They had some nice furry lined moccasins but even stepping up a size, the pain was too bad to slide my foot in.

I'm now home with my foot iced and propped up.  Hopefully, tomorrow will be better.  We're going out to dinner, so it would really be nice to get back into the slide on shoes.

Day 15-Out and About

My foot was a little stiff and sore this morning and although I did my ten reps of gentle, non-assisted, stretching in bed, I was running late when I got up and didn't get a chance to do the more thorough stretching before we left.  Not my ideal situation but my husband had a deadline and we needed to get going.

It was cold this morning so I really wanted to get a pair of socks on in the New Balance slip ons.  The first pair I tried, a very lightweight cashmere made the fit too tight.  I was quite uncomfortable before I even stood up.  So I switched to some light weight knee high opaque socks and that was better although still not as comfortable as the shoe was yesterday with no socks.  Not sure if my foot is swollen or just that little room taken up by the sock makes that big of a difference.

Managed to walk several blocks from the car to the farmers' market and navigate another 4 blocks or so through the market and then back to the car.  Luckily, it was early and not too crowded so I wasn't so paranoid about someone stepping on my foot.  I wasn't walking at my normal clip but I wasn't shuffling either.  By the time we got to the car the top of my foot was pretty sore.  Kind of feeling like the skin was being pulled off.  Maybe it's the waterproof tape I added to the edge of the steri strips before I took a shower last night.  The joint was a little achy as well.  But then again probably nothing much worse than when the joint flared up before the surgery.

First shower without my foot wrapped up was uneventful.  Felt good to scrub my foot thoroughly after two weeks of not being washed. The incision didn't burn like some do when water hits them.  The warm water  felt good.  I'm finding cold feet tend to aggravate the achiness.

On a different note, I don't think I talked about how I chose my surgeon.  I'm a big chicken about surgery but also a big believer that if I have to do it, I want someone who has done thousands of exactly what I'm having done.  I also looked for someone who does a lot of work on people whose livelihoods depend on their feet getting fixed right--like professional sports players and dancers.  So instead of going with my local podiatrist, who I happen to like and who first diagnosed the condition, or a surgeon at our local hospital, I decided to go to a major orthopedic center at a major medical center in the city.  The orthopedic surgeon I chose specializes in foot and ankle surgery--in fact, I think that's all he does.  He's been in the business for some time so I figure he's seen it all.  So far, I've been quite satisfied.  I didn't really expect to be walking as far as I did today just two weeks after my surgery.  I'm hoping that's a good sign.

Went to the garden center this afternoon.  I find walking behind a shopping cart easier than walking unaided.  My gait seems almost normal.  I think it's because I know if I get a shot of pain I have something to hang on to and won't end up going down.

Worked for a couple of hours in the garden, planting and weeding.  My foot did pretty good.  Really didn't think about it too much.  Then right as I was ready to head in I stepped down and got a real intense jolt of pain through the joint.  Hobbled in and up the stairs pretty much walking on my heel since it hurt to put any pressure on the joint.  I got the ice pack out and iced the top of my foot and put it up for about 20 minutes.  It took about 10 minutes for the pain to subside but I got occasional throbs for the next hour.

Although  a little concerned about that little episode, after dinner my foot was feeling better so decided to try to do part of the usual 3 mile walk my husband and I had been doing prior to my surgery.  It was a nice evening so out we headed.  I decided my goal was to do the entire distance and back along one of the streets on our walk.  It is fairly level with a good walking surface.  Probably about a mile.  My gait wasn't perfect and I wasn't moving at my usual speed but I was able to do it!  Set a goal for doing the whole three mile walk by next week at this time.

Day 14--Much better than yesterday

Yesterday was a bit of a set back after I got the stitches out.  My foot was tender and achy and I was very hesitant in my walking.  It was a nauseous kind of pain that just made my whole body feel off.  Last night I was doing my toe bending exercises and in the middle of  a good but not overly ambitious upward stretch, a pain so sharp that it brought tears to my eyes shot through my toes and foot.  It took a good 10 minutes for me to get re-centered and for the intense pain to subside.  I took a couple of tylenols and went to bed more than a little apprehensive about what I would be met with in the morning.

I slept through the night, unaware of anything going on with my foot.  When I woke up it felt stiff but not sore.  I did my 10 reps each of up and down stretches laying in bed and using my other foot to help apply a little pressure.  I could feel a pull but it wasn't painful.  Got up and carefully slid on my fitflops since I was too tired to mess with the velcro on my other sandals.  The fitflops worked fine and provided a nice cushion under my foot.  They have a high enough cut on the strap over my foot that it didn't bother my incision any more than the other sandals.

I was still very tentative in my walking.  I did another set of stretches this time using my hands after breakfast.  Then set off to feed the neighbors' cats and go to the grocery store(s).  I put the velcro strap sandals on that I wore yesterday.  My gait was slow and off but I wasn't in pain.  I found that by walking slowly I could focus more on keeping my foot straight and not rolling outward like I had been doing before the surgery since my toe couldn't bend. Holding onto the grocery cart helped.

Got home, not feeling much like walking anymore.  The sandals were rubbing on the top of my foot and it was feeling a little irritated.  After lunch, I did  some foot massage and then more sets of toe stretches again using my hands to push a little beyond what my foot could do on its own.  Felt pretty good about the up stretches.  To my eyes it looked like I could get my toe to 45 degrees without too much pain.  Curling the toe down was much harder since that pulled on the incision on the top of my foot.  But I did the best I could and it did improve a little by the 6 or 7th rep.  Sometimes my foot is a little sore after the exercises but it is definitely more flexible.

In spite of that, I still didn't feel much like walking this afternoon.  By about e 3pm my husband lured me out to the garden saying he needed me to "supervise" what I wanted him to harvest.  I didn't want to have to walk in the dirt in my good sandals.  It did motivate though to go through my shoes and see what I could get into.  I could get my foot into my very soft, old topsiders but they felt too tight to walk comfortably which was strange since they fit so loose usually.  No luck even getting my foot into any of my shoes with ties.  But I did have a pair of New Balance slip ons. They are very soft but normally fit snugly so I was surprised when I was able to put my foot all the way in without pain.  I think the soft padding on top and the open back made them easier to get on.  I figured these would keep the incision clean and since they are black could survive a foray into the garden.  Amazingly, they worked great.  Once I got out there, I not only harvested but was able to pull out some overgrown kale and lettuce and do some clean up.  I left them on while I cooked dinner.  No problems.

What I noticed today is that when I was in the garden or cooking, my gait seemed more normal.  Maybe I was still rolling my foot outward but it didn't seem like it.

Lessons from today:  Do the exercises as often as I can.  They really help.  And get engaged in something that requires movement but also puts attention on something other than my foot.

I'm actually quite pleasantly surprised at how well my foot is doing tonight given where it was last night.

Day 13--Stitches out and boot off!

Today was the big day.  I must admit I was a little anxious about what to expect when the wrapping came off.  My doctor came and got me from the lobby and escorted me back to the examining room and took the dressing off.  I'm pretty squeamish but actually got myself to look and take a photo which I'll post at the end of this entry in case anyone else prefers not to see the incision all stitched up.  I had twelve stitches.  More than I had thought.  Other than some very mild bruising of my two middle toes and a small bruise on the side of my foot, it looked pretty good.  It didn't look swollen and the stitching was pretty neatly done.

I was very apprehensive about stepping down on my foot much less moving my toes but I was able to slowly walk down the hall to x-ray where they re-xrayed my foot to look at how things had changed.

The before xray is on the left, toe facing up.  After on the right.  You can see a distinct bump on the bone at the base of my toe on the left that is much reduced on the right. (Can't quite figure out if there is a way to rotate this photo so it is vertical.)

Back to the examining room where the doctor's assistant very gently took the stitches out (not a big deal at all) and taped up the incision with steri-strips.  No shower today (thankfully, I got up early and took one this morning) but tomorrow okay for shower.  Five days before I can immerse in water but doctor said swimming on Tuesday should be fine.

The assistant showed me how to pull my big toe back to the point of pain and hold for 10 seconds and then push it down and do the same.  10 reps for 10 seconds each in each direction.  That means a minimum of 200 opportunities for pain a day--not counting walking.  Ugh.

I had a pair of sandals that had velcro straps going over the tops of my feet which worked great.  I was able to get my foot into my Minnetonka slippers but they pushed just a little too much on the incision so the sandals seemed like a better bet to get home.

My velcro strap sandals that I wore home today,.

My joint was definitely sore as I left but I was able to walk albeit slowly and deliberately.  I don't quite trust my foot and I'm scared to death to have anyone standing near me with their back to me (like on the elevator) for fear they will accidentally step back onto my foot.

Doctor wants me back in three months and warned that it's not unusual to feel discouraged at that time that there is still some pain and swelling.  He says that's normal.  We're leaving the 23rd of October for a trip that will definitely involve some hiking and walking so I was a little disappointed although not surprised to hear that. Guess that gives me something to work for.

By the time I got home, I had a headache and uneasy stomach.  The sensation in my foot isn't exactly what I would call pain but it is most unpleasant right now which is what I think is contributing to the other symptoms.

Did my 10 reps of the upward movement of my toe.  Not comfortable but tolerable.  Downward is harder.  Feels like a tight cable running through my foot that is pulling on the ends when I try to stretch it.  Got through about 4 reps while I was on the phone.  Will challenge myself to do a full 10 more before the end of the day.

Tried walking barefoot on the tile floor in our kitchen for a bit.  The cold floor felt good but for some reason it was harder to walk barefoot than with the sandals.  Maybe because there is no cushion under the joint.  Joint is pretty achy right now although not what I would say is painful.  It's been 4 hours since my foot was released from its bondage.


Photos of stitches below.  Scroll down if you want to see.

Foot with stitches.  It's not really as bruised as it looks in the photo. 

With steri strips on.  Need to leave these on for 5 day although the first strip by my toe is already peeling off.

Days 10,11,12 Same old stuff

Tomorrow is the big day--the dressing comes off and the stitches come out.  I've been doing so well in the boot that I'm a little scared about what I'm going to experience once it comes off.  Plus I've never had stitches taken out and that doesn't sound all that pleasant.

I've been up and about a bit more this last couple of days.  Walking around in the boot hasn't really bothered me as long as I go slow and not walk too much.  Last night, however, once I got into bed the top of my foot in the center was throbbing.  That's not really where the incision is so not really sure what that was all about.  I changed the position of my foot a couple of times and then fell asleep and when I woke up it felt better.  Out for a quick run to the grocery store and to feed the neighbors' cats.  By the time I got home, the affected joint was starting to ache.  Iced up the back of my leg and have it up on pillows while I type.  I suspect I'll have a lot more to share starting tomorrow.

Planning to take several pairs of shoes and sandals tomorrow since I have no idea what shape my foot is in and what will fit and not cause pain just by being on my foot.