Day 38 & 39 (April 27 & 28)

Back to needing a pain killer in the afternoon.  Pain moves from one spot to the next.  Today my foot feels way to big for the cast.  Hope for an improvement tomorrow.

Day 37 (April 26)

Made it through the day without pain killers!  My leg was the best it has been.  Had occasional discomfort but nothing like it has been.  I did take valium today which I think helped.  Just really pleased that I didn't have to take pain meds.  Hope the trend continues!

Two weeks until I get the cast off.  Can't wait.

Day 36 (April 25)

Had a pretty good day.  Took my mother to lunch and propped my leg up while at restaurant.  I took a valium before I left and it seemed to help.  By the time I got home, I did have to take a Norco.

Day 35 (April 24)

Same story as before.  Leg uncomfortable when I first wake up but gets a bit better.  This morning it was burning heel pain.  Was uncomfortable for most of the day though.  By 330 pm, I had to take a norco.  It didn't do much so I took another half a pill at 430.  It helped for a few hours but pretty uncomfortable again.  Left side of foot is really tingling and I'm getting shooting nerve pain.  Heel is still burning a bit.  Feels like my foot is really hot.  Going to try not to take anything.  I feel like I'm moving backwards as far as pain.

Day 34 (April 23)

Leg was a bit sore when I woke up but that seems common.  It calmed down after about 15 minutes.  Was fine for most of the day until about 5:30 pm when I started getting a horrible burning where the modified brostrom procedure was done and shooting pains throughout the ankle.  I really wanted to make it through the day without any pain meds but gave up and took 1.5 Norco.  Hope it kicks in soon as I am really uncomfortable.

Goal for tomorrow is to not take any meds.

Day 33 (April 22)

Woke up in a lot of pain today.  Not sure what is going on.  Called docs office to ask whether I should take the oxy instead of the norco as it doesn't give me the euphoric effect that norco does.  They said they prefer that I take the norco as it is less addictive.  Oh well.  Figured the oxy would be better as it works on pain and that's it, doesn't even seem like a drug.

Did have a new sensation today.  I got up to use restroom and it felt like a spot on the bottom of my foot was wet and cold.  Lasted about 20 seconds and then moved to my toes.  Then back to the bottom of my foot off and on.  Went away for an hour and then came back after I went into my bedroom.  Strange.  I did take norco earlier today.  Not sure if it has anything to do with it.

Day 32 (April 21)

Slept pretty well but woke up pretty groggy from the pills.  Still getting shooting nerve/bone pain in my calf area and on top of my foot.  I've discovered that if I sit with my foot down for a bit, it's not quite as painful when I'm up on crutches afterwards.

Kept having pain today and ended up taking 2 norco at 330 pm.  It is helping so far.  It's been almost 72 hours since I last took a norco so I'm hoping that alternating in the oxy will help me avoid any dependence.

On a side note, I started posting on the healthboards forum and there are some great people on there with advice and feedback about their experience with similar procedures.  As with anything on the internet, have to take it with a grain of salt.  Just nice to know that my pain is actually ahead of schedule compared to others.

Day 31 (April 20)

Had the worst night since I can remember being home from the hospital.  That valium I took at 1030 pm didn't do anything so I took an oxy at 1220.  It kicked in pretty quick and I was asleep by 1.  Pill wore off after 3 hours and I woke up at 345 in a lot of pain.  Took an oxy and then tossed and turned for 3 hours.  Pain was coming back so I took an oxy 10 mg extended release at 630 and slept until 9.  Have been okay so far today.  Really hope tonight is better.  I don't want to take any meds as I've been on them more or less for a month (with the occasional day without).

Update: had to leave the house for a few hours and take my mother to the doc.  25 minutes in car each way and 40 minutes in office with leg elevated to waist level.  Tolerated it pretty well.  Leg really started hurting in the evening again.  I didn't mess around and took a 12 hour oxy and a valium.

Day 30 (April 19)

Took my usual dose of aspirin in the morning followed by a 600 mg ibuprofen at 2 pm.  Ibuprofen really didn't seem to do anything.  I wasn't as active as the previous few days and had leg elevated to waist level or higher most of the day.  Around 9 pm, leg really started hurting.  I took a valium at 1030 and it really didn't do anything.

Day 29 (April 18)

Had a pretty rough night again.  My foot stayed swollen so I tried to elevate it a bit higher.  Makes it more difficult for sleeping.  I did go into the office for a few hours this afternoon.  Foot tolerated it okay but it's just difficult to get comfortable.  I also didn't want to push it too much as I had a little trouble with swelling yesterday.

Here's a pic of my toes after being up for a few minutes.

They will stay slightly red when I elevate to waist level and are almost normal if I elevate above my heart.

Day 28 (April 17)

Foot was still a bit swollen when I woke up this morning.  It's odd how the swelling really seems to be in the foot and not as much in the ankle.  May just be perception though (although I can tell when my foot is being squeezed).

Having a hard time finding the right balance between keeping it down and elevating.  Swelling doesn't go down as quickly as I would like it to.  I had my foot down for about 40 minutes this morning and then elevated for a few hours.  Had it down while I bathed (20 minutes), then again while I was in the car for about 15 minutes, then at waist level on couch for 3 hours before 15 minute drive home.  It's swollen and aching this evening.  I can even see the swelling in my toes.  Was planning to attempt a few hours in the office tomorrow but will have to wait and see if the swelling is down in the morning.

Today is 4 weeks since the surgery.  Tomorrow is 3 weeks until I get the cast off, get boot, and can start partial weight bearing.  Can't wait to put this whole experience behind me.  

Day 27 (April 16)

Foot still felt a bit swollen today.  Seems to swell in the actual foot, not sure if it's happening in the ankle as well.  The bottom of my foot feels like it's on fire.  I took 1.5 norco at 12:30 pm as it was getting a bit uncomfortable.  Then left house and went to niece's birthday party.  Was able to spend most of the time on couch with my foot at waist level.  Could tell after a few hours that my foot was swelling a bit and I was also having a hard time getting comfortable.  Got home about 4:00 and put leg up immediately.  6:45 now and had to take an oxy.  Going to keep it elevated in hope that the swelling and pain go back down.  On a positive note, my toes didn't seem to be as purple today when I was standing and moving around.  

Day 26 (April 15)

Continue sleeping with leg elevated.  Figured that it's a good way to keep swelling down as I'm going to continue increasing amount of time my leg is down during the day.  It also ensures that I move around a lot at night as it's not very comfortable. 

Toes continue to turn pretty purple but not as bad as yesterday.  Have family coming in from out of town so I will be on my feet more today.  I consider it another good test.  Will update later. 

Day 25 (April 14)

Woke up today with my leg really aching.  This cast just feels too tight.  When I get up, my toes still turn dark purple and my leg above me knee even hurts like it isn't getting enough blood.  I also can't move my toes nearly as much.  I decided to call the doc's office and let them know.  I spoke with the surgical nurse and she said it may be too tight.  I was little worried about calling in again but she said to always call if there's a concern.  Makes sense.  So, I went in and had a new cast put on.  The med assistant even spoke with my doc before applying the new cast.  He said to go ahead and make it a bit more loose and put in some extra padding.  Wow, what a huge difference.  My toes are still turning purple but my leg feels a million times better.  One thing to mention, my calf muscle just hangs off my leg except for the area where the doc made the incision. That spot is still pretty hard and not sagging at all.  Very sore to the touch. 

I asked the nurse about alternating ibuprofen and aspirin to make sure I understood the benefits.  Said it would be fine to switch completely to ibuprofen or I can continue taking aspirin in the morning and evening and add ibuprofen in the middle of the day.  Any combination is fine as long as they are not within 6 hours of each other.  I also asked about the meds preventing clots and she said there are studies that have shown aspirin doesn't even help prevent clots.  I guess it's not clear.  She even said that they used to give patients a blood thinning shot but it didn't reduce the occurance of blood clots in those patients.  Guess there isn't an answer.  Most important is to balance moving around as much as possible while keeping the swelling under control. 

Throughout the whole process, my leg was down for over 2 hours.  Very pleased as it didn't even swell (very much). 

Here are some pics of the ankle, old, and new cast.

Old cast:

Ankle

New cast

Day 24 (April 13)

Slept pretty well but moved around a lot.  Not a deep sleep.  I ended up taking a valium last night so I think it helped.  Didn't have too much pain today.  The purple toe/pain/pressure when standing seems to have gone backwards about a week+.  Can only assume it has to do with the new cast and how tight it is.  I did have my leg down for 45 minutes without much swelling or pain.  I did put it up immediately after for about 30 minutes.  Good sign overall.  Think I have a bit of a pill hangover today.  Been absolutely exhausted.  Must be the 12 hour oxy extended release that does it.  Going to avoid those as much as possible going forward.  

Day 23 (April 12)

Slept okay last night considering I had to keep the CAM walker on.  Took another oxy extended release before heading to docs office to get new cast.  New cast feels very tight, not very comfortable at all.  Once cast was on, I asked if I could speak with a nurse about expectations going forward.  Was advised that I should keep my foot down more and more each day and should be able to keep it down for 4+ hours at a time in a few weeks.  The nurse said it's good to get the leg used to being down again and I should only need to elevate it for 20 minutes 3 or 4 times a day.  Said I no longer need to elevate at night.  What's interesting/concerning is that these instructions are different from the ones I received last week (from a different nurse).  She also said I can take ibuprofen as long as its not within 6 hours of the aspirin as both thin the blood.  I did not know that ibuprofen thinned the blood.  Oh well.  Leg has been really sore all day and I'm going to take another oxy extended before bed.  Plan to not take meds tomorrow unless it's absolutely necessary.

Day 22 (April 11)

Had a terrible nights sleep and woke up pretty sore.  Noticed an ache in my calf muscle around 10 am that just kept increasing.  I tried to move around or shift to see if it would subside.  The most it would go away would be for 30 seconds after moving into certain positions.  I decided to call the doctors office and left a message for nurse at 11:50 am.  My pain kept escalating and at 1 pm I took a couple oxycontin.  Called doctors office again at 2 pm and they said I should get checked for a blood clot.  Went to docs office where they cut off my cast and put me in CAM walker.  Went to the hospital where they did an ultra-sound.  Fortunately, it was negative.  Have fluid and bruise where the incision is in my calf.  Was very painful when tech pushed on there with machine.

Leg is very sore after being manipulated and I ended up taking an Oxy extended release for the first time since coming back from hospital a few weeks ago.  Painful but it's tolerable.  I head back to docs office tomorrow morning to get a new cast.  Going to stay medicated.

Day 21 (April 10)

Slept through the night but couldn't get comfortable.  Still having problems now but it's nearly noon and I haven't had to take a pk.  Will really try to avoid them today as I had to take so many yesterday.  On a positive note, the swelling is down to where it was before I went to class on Friday.  Will update again later.

Update: Had an amazing day until 4 pm.  Very little pain or swelling.  Unfortunately, out of no where, pain got really bad at 3:30 and ended up taking 1.5 norco at 4:30.  They seemed to help but pain started coming back at 9.  Took a valium and really hope it helps.  Aspirin now and then bed, hopefully.

Day 20 (April 9)

Only 30 more days in cast!

Had a horrible night.  Couldn't get comfortable and leg was aching pretty bad.  Woke up and it's still pretty swollen.  My toes feel numb like they did last week (they aren't, except for pinkie toe).  Glad I went last night as it was a good test.  Definitely shows improvement and hope to be able to do 4 hours by next weekend.  Quite a bit of pain today and will probably end up taking pk's.  Took my aspirin and hoping it helps.  Going to give it another 30 minutes.

Update:  Today was the worst day since I got back from the hospital.  Can't understand the way the pain works with this surgery.  About 10 am I had to take an oxycodone.  At 11, I was still miserable and took another.  Pain was just a horrible ache throughout my ankle and foot with the random shooting nerve pain.  The pills seemed to help a bit but the pain came right back at 3:30 pm and had to take 2 more oxy. These numbed it but I still felt a horrible pressure on the bottom of my foot, almost like something was boring into my arch.  That was new.  Pain didn't come back as bad in the evening and I was able to get by with a diazepam (valium) before bed.

Day 19 (April 8)

Had a horrible night.  Couldn't get pain under control.  Can't believe how up and down it is - tolerable one day and then miserable the next.  Feel like I've gone back to the 2nd week.  I did sleep with leg elevated and woke up with it still swollen, feeling very hot, and painful.  Keeping it up as much as possible.  Going to try going to class tonight.  If I can get in and get my leg propped up, I may be okay.  This will be a good test.  Driving will take me 10-15 minutes to get there and then 10 minutes to get up to room.  Really going to be pushing the limits.

Update: ended up taking a Norco around noon.  At 2, I decided I couldn't go to class but changed my mind and went.  Made it from 6 to 8 and then started getting worried about swelling.  Had leg down/partially elevated for about 3 hours total.  Elevated as soon as I got home but by 11, the bottom of my foot had swollen out of the cast and was pushing on my toes.

Day 18 (April 7)

Best nights sleep so far.  Didn't even take any meds.  I was so exhausted after leaving the house for an hour that I fell asleep at 10:30 and didn't wake up until 8 am.

I started off the day pretty well.  Went out to living room, sat on couch, and had leg down for 30 minutes.  Put it up afterwards and didn't have any major swelling or pain.  Great.  Then, 3 hours later while sitting with leg up on couch, my foot, ankle, and leg light up something terrible.  My heel is feels really hot, not the searing poker pain like immediately after surgery but just really hot.  Getting the random crippling shooting pains and foot is aching.  Ended up putting ice behind knee and taking an Oxy IR.  Going to give it a half hour and see what happens.  It's actually bad enough where I"m contemplating taking another.  Would be first time since day 8.

Ended up having to take another Oxy at 8 pm.  Didn't do anything for me.  Took my aspirin, didn't help.  Had one of those crazy shooting nerve spams that made my whole foot flex.  Can't explain the pain. Finally took a valium at 11.

Day 17 (April 6)

Slept great last night.  Didn't wake up covered in sweat.  Really beginning to think it's bc of the pain killers.  Not good.

Calf was a bit more swollen this morning than last night.  I must not have my leg up high enough when I'm sleeping.

I went out to living room and spent about 20 minutes sitting on couch with my leg on the floor.  Darn thing blew right up again and feels like it's way too big for cast.  Hurts like crazy.  This is really frustrating.

Update: After elevating leg above heart for 40 minutes, the swelling has reduced to a tolerable level.

I spoke with nurse at doctor's office and asked about timeline for recovery.  She advised at least one more week with leg raised above heart as much as possible.  She said the more we control the swelling now, the faster it will heal.  She recommends continuing pain killers as necessary and continuing to test the leg.  Wants me to try 20 minutes again tomorrow and then elevate.  Try 25 the next day and so on.  I did ask about the risk of DVT and she said as long as I am wiggling my toes for 5 minutes at a time a few times a day and getting up every few hours during day, it shouldn't be an issue.

I did go out to a local restaurant for 1.5 hours.  I brought a pillow and put leg on chair.  My foot and ankle are swollen but within tolerance.  I did take 1.5 norco before leaving.

Day 16 (April 5)

Had a terrible nights sleep, just can't seem to get comfortable.  Woke up at 4 am and my bed was soaked with sweat.  Really annoying.

Made it until about 2 and then took Oxy IR.  Helped a bit.  Getting very frustrated about not being able to keep leg down for more than 20 minutes.  Also nervous about circulation.

Took Oxy SR (extended release) at 10 pm.  Have noticed I can get three fingers into top of cast now so that's a good sign of decreased swelling.

Day 15 (April 4)

Finally fell asleep around 1 am.  Woke up at 1:30 with pillow soaked with sweat.  Was told this is body expunging all the synthetics left over from meds.  Not fun.  Slept until 8 and woke up less groggy than the last few days.  That's progress.  I called doctors office to tell nurse about cast getting wet.  She said that if it doesn't feel wet anymore or like there are blisters forming, it isn't a problem.  No idea if it's wet (where I can't get my fingers) or if blisters are forming as the whole thing hurts.  Oh well, guess I'll wait it out.  One thing to note, when I saw the horrible b-grade doctor on Friday, she told me I no longer needed to take aspirin.  I reconfirmed with nurse today who checked with another doctor and said that is 100% wrong and I need to stay on aspirin regimen the entire time I have the cast on to reduce a risk of clot.

Took a bath today and leg really lit up afterwards.  That feeling of the cast being too tight is back with a tremendous ache throughout foot and ankle.  Tried a diazepam instead of a Norco and it seems to have helped a bit.

Day 14 (April 3)

Didn't wake up as groggy today.  Definitely getting over some of the meds.  Trying to move around a bit and take care of myself more.  Still trying to get the brain more engaged.  Need to get back to where I was.

As with the last few days, the foot really starts to hurt around 1 pm.  Held off on pk until 3:30.

Appetite is finally back and I was able to eat a whole steak again.  Thank God.  I need steak at least twice a week to survive.

Update:  had to take Norco at 10 pm.

Day 13 (April 2)

Still really groggy when first waking up and can't seem to get warm.  Very strange for me as I don't usually like too many covers.  Took my temp and I'm fine.

Slept decently.  I stack 2 sets of pillows, one for my bad leg and one for my other leg so I can sleep on my side.  

Used cast protector from docs office and took shower.  Water went down back of leg so had to call docs office.  As it's a Saturday, the on call doc just said to either go to ER/Urgent care or deal until Monday.  Wow, very helpful.  I used a blow dryer on cool for about a 1/2 hour and it seems to have helped a bit.

Toes are back to tingling and pinkie toe partially numb.  Feels like cast is too tight on foot.

Took a norco at 2 pm and another at 10 pm.  Not getting the searing hot pain as much anymore.  Mostly shooting electric pain that causes whole body to cringe.  Been using ice behind knee and it helps a little.    

Day 12 (April 1)

Had my stitches out today, x-rays taken, and fiberglass cast set.  Overall, not a bad experience.  I had read on a number of posts that it can be rather painful, especially when they set your foot at 90 degrees.  I took a daizepam (valium) at 7:30 this morning as well as a Norco.  Just in case, I put a few Oxycodone IR's in my pocket.  I arrived at doctors office and was back in the room within 10 minutes.  Unfortunately, my doctor is on holiday so I was seeing all his partner's team members.

The medical assistant removed my surgical dressing and splint.  She was very gentle.  She then called in the doc to take a look at stitches and make sure everything was okay.  Temp doc was horrible.  Zero personality, one word answers to questions, just very unhelpful overall.  Anyway, I got the all-clear and was taken to get x-rays.  I asked the tech about pain and told her what I'd read online.  She asked what meds I was on and suggested I take the Oxy IR.  I complied.  X-rays weren't very painful, just difficult when maneuvering foot and placing it on hard surface.  X-rays looked good so I was sent back to room for stitches removal.  One thing that is different from all the other times I've had stitches taken out is that they now spray the stitches with some crazy cold solution that kind of numbs the area.  Very nice perk.  Not that it hurts to get them out usually (and I've had stitches and staples removed many times), just stings sometimes so it was nice to not have that happen.

Next step was going to casting room.  Tech was very friendly and walked me through the process.  They used a crazy upside down L shaped contraption that you rest your foot on to ensure a 90 degree angle.  It wasn't easy to get my foot in position and I could really feel the achilles stretching.  Overall, not very painful.  Not sure if that was due to pain killers or my foot being set pretty well in the original surgical cast.

I was then instructed to come back in 6 weeks.  Absolutely no weight bearing.  If I get the cast wet at all, I need to come in for a new one.  She suggested I keep my leg elevated one more week if possible but that I can go to work if I can tolerate pain.  The real kicker was when she said my ankle will be swollen for a year.  That's going to make work difficult considering I'm in international sales and flying with swelling is not recommended due to increased chance of thrombosis.

They recommended one of those knee scooter things that you see old people on.  I did ask if many younger guys get them and they said almost all of them do.  It's being delivered tonight.  Also purchased one of those specially designed bags for my cast so I can take a shower with much less risk of water getting through.

So, got home and rested leg.  Took a 2 hour nap.  Leg aches a bit but overall I just feel relieved to know everything is okay down there.  I'm still getting random shooting pains anywhere from the calf muscle to the bottom or side of my feet.  Guess that will happen for a while.  Pain is darn-near intolerable when I first get up after laying down.  Also, if I need to stand in one place, my leg begins to spasm.  I did ask doc for some more diazepam as that helps to settle the muscles.

Update:  My foot really ached in the evening and I took a Norco at 11 which seemed to help.  Feels like cast is too small around end of foot and my toes are tingling/partially numb.  I know they said to call if they go numb but I'm not sure if it's due to cast or just the procedure.  I'll call on Monday.

So, here's the good stuff.  Pics of the foot.

Top set of stitches is where doc went into for the ligament repair (modified brostrom procedure), removal of bone fragments, and overall inspection of tendons, etc.).  Middle set is from the calcaneal osteotomy.  Where he went in to cut the bone.  The third set that you can barely see on the back of heel is where the screws went in.

Here's another view where you can see back of heel.

Here is where the doc went in for the gastrocnemius slide.  Assistant was a bit surprised there weren't any stitches.

And here are x-rays showing the screws.

(Had to remove pic of xray as it showed personal information.  You can search for a similar pic online)

Not sure how often I will update blog going forward.  Will do so occasionally when reaching milestones.  Main purpose of this blog was so people can know how bad it can be (and I'm sure it could be even worse than what I experienced).