January 2024

 Wow, it has been a very long time since I last posted. My life has changed quite a bit. I got married, bought a house with my wife, and a father to a beautiful 6-year-old. I still face challenges with my feet and the medications have since caused other problems with my body. Overall though, I'm doing the best I can.

My wife and I would like to have another child but my body is not cooperating. The doctors believe the methadone has somehow impacted my pituitary and that's why I have to get testosterone injections every two weeks. The injections help my energy and mood however they also degrade the body's ability to be fertile. I've tried going off of the injections to see if things will return to normal but nothing changed. It is extremely frustrating. 

I haven't had any additional surgeries to my feet however I had abdominal pain which led to a biopsy of a mass on my pancreas that fortunately was negative. After the biopsy, I had terrible abdominal pain that was a result of the pancreas bleeding and I ended up in the hospital for a 3 days. The following week, I started having pain again and almost didn't go into the hospital but fortunately, I did. The ER did a CT scan and detected a pseudo aneurysm of the artery by my spleen. It could have ruptured at any time. Unless in a hospital, the chances of survival are practically zero. I ended up having a procedure to clip the aneurysm but the result was killing off part of my spleen. I have to get extra inoculations now to protect against some viruses. It was a pretty miserable experience but I was very very lucky that I went to the hospital otherwise I wouldn't be here today.

Recently, I knocked my foot on the stairs. And ended up in urgent care because of swelling and my foot turning blue and purple. X-ray didn't really show anything but I'm still having problems now. It's been 2 weeks. I'm really hoping it's something that resolves on its own because I just can't go under the knife anymore. There's just no way to control my pain. This leads to another concern. The mass that I had biopsied on my pancreas could become malignant. Apparently that's a wonderful trick that your pancreas can pull off. I have an MRI scheduled for next week to get a better look at it. A friend of mine believes it is probably scar tissue. He's a doctor and does this kind of stuff for a living so I'm hoping he's correct. If it is anything else, they might have to go in and cut out part of my pancreas. It's a very serious surgery and I would probably be in the hospital for over a week. I don't know if there would be any options to help me from being in agony. I'm hoping they could give me a sedative or some type of amnesiac to get me through the first few days. Just going to think positive that it's just scar tissue and nothing else will need to be done.

March 2020 - ER, Surgery, Fiance

A year has passed since my last update. My world has changed significantly. I met an amazing woman from my home town that does not judge me and my situation. We are engaged to get married in August. She has had a taste of my terrible luck with medical and is still with me. When we were moving into our apartment, my back went out. I tried to push through but the following Tuesday, I couldn't keep going so I went to see a chiropractor who immediately sent me to the ER. I was hesitant because the hospital that used to be so wonderful is now part of Spectrum Health - a massive group of hospitals and medical care. They took one look at my chart and immediately assumed I was a junkie. Gave me a shot of Tordal and sent me on my way. God forbid they have compassion and make you comfortable so you can try to manage the pain going forward.  Anyway, I had an appointment with my pain doctor the following day to get my monthly lumbar sympathetic injections to help manage my CRPS. He uses fluoroscopy to guide the needles into my spinal area to inject the medication. Later that day, I was at my apartment moving something and I started getting a horrible pain on the left side middle of my back.  Excruciating. I was almost to tears when my fiance took me to the same hospital as the day before (as much as I hate the place, I figured it was best to be consistent). The pain was so bad tears were running down my face.  My blood pressure was through the roof.  None of that mattered to the doctor and they refused to give me meds.  I laid there for 7 hours until someone remembered me.  The doc then checked the results of my CT scan, came to my room and says "wow, I was wrong, you have a massive hematoma in your back. They admit me, I wait in the room for over an hour for the doctor to come up and she will only give me a baby dose of dilaudid.  With my tolerance to medications, this is like fighting a fire with a squirt gun. I suffered for 5 days in agony before it finally started to settle down and I could go home.  I will never go to Spectrum Health Blodgett or Butterworth hospitals again. 

In January of this year, I had the clawed toes on my right foot fixed.  Unfortunately, it is now at the point where hospitals are too scared to provide the amount of pain medication I need.  My tolerance to ketamine is too high and they will not provide more than 2 mg of dilaudid.  I had another 5 days of burning misery in the hospital followed by 2 days of withdrawals from the ketamine afterwards.  My toes got infected and the antibiotic helped but didn't completely kill off the infection.  The wounds smelled and took over a month to heal.  It was quite a journey. 

It's March and I am hoping to start taking less pain medicine if I can.  Go down 1/2 a pill every week or two.  I don't know if I'll be able to do it but I need to try.  I want to get back to having normal feelings/emotions.  My fiance deserves me being 100%. 

March 2019 - More health problems, disability update

I'm sorry to be negative but my life is so miserable. I try to be a positive person and make the best of things but I just can't catch a break. The last few months have been horrible and I finally got a date for my disability appeal and but it looks like the judge that was assigned has a record of approving fewer request then the state and national average. By nearly 10%. I'm sure he will look at me, my education, and my age and just make a decision there. I'm under 50 and used to be intelligent. Now I can't keep my thoughts straight half the time, my memory is garbage, I barely have relationships left with anyone, and spend my life miserable laying in bed. I had everything going for me before and I was on such a positive upward trajectory in my career and then the original injury happened in 2010 and you can pretty much see just from my resume that my work and career hit the toilet. Believe me, I would much rather be able to do any kind of work and add value to the world if I could. That's enough of me feeling sorry for myself as there are people out there that suffer a lot wo then I am. Unless, of course, my disability gets denied and I end up homeless laying on the ground somewhere.

As far as what's happened the last couple months, I ended up having an infection from the surgery and the wound wouldn't close but after antibiotics and such, it finally did. I started getting infusions again from a local clinic because it is less expensive but still beyond what I can really afford. On top of that, they don't use versed so they are unable to actually achieve a high enough dosage of ketamine to be helpful. The other option is to go through my pain clinic where they can do that however they refused to prescribed the nasal ketamine spray. There's just no winning.

I'm not sure if my body is shutting down or all the side effects from the medications are growing too severe but I ended up in the emergency room twice due to insanely bad stomach pain and again, compliments of people that abused opiates, the emergency room wouldn't even show the compassion to make me comfortable. They did the absolute basics with a blood test and kicked me out the door. I felt like I was going to die. We ended up doing all sorts of tests and everything came back negative so who knows. This month, my problems are more related to prostatitis or my urinary system and some sort because it feels like I have a UTI but also have terrible cold sweats and all I can do is lay in a ball in my bed. That part is nothing really new but it's just more misery in addition to my feet. This is also setting off the coccydynia which is the horrible aching pain in my tailbone.

Hopefully things get better and I can at least try to distract myself with TV or something.

With all my posts, please disregard typos or words that come across weird because I use voice to text. I do my best reviewing everything before I post but it all takes so long. I do hope the information is helpful for others as they make their decisions regarding surgery and such. Best of luck.

Here's how my feet look today. You can see how bad my toes are clawing on my right foot.

January 2019 - More surgeries, disability pursuit, new stimulator

It's been a long time since I last posted so figure I'm overdue for an update.

I had a really big surgery on my right foot in September of 2017. Took about four hours in the OR. The doctor ended up doing four or five different osteotomies throughout my foot and ankle. Pins, screws, plates, etc. The surgery was quite successful as my foot no longer flops over to the side and is relatively stable. On the flip side, my mobility of the joints has become quite limited and my big toe can move even less after losing another tendon. I was in the hospital for about 10 days after the surgery for pain control. Regular opiates just don't have much benefit so they had to put me on a ketamine drip in order to hopefully control the pain. They had me on 14 milliliters or whatever the unit of measurement is but it wasn't helping and the next level would be 21 and they said I would have to go into the ICU if they went that high. I was afraid of what that cost would be so I just suffered instead. As with my other times in the hospital, since they no longer allow your own pain doctors to come in and they don't have a team available to help people in my kind of position, there were hours and hours between any changes in medications or any potential health. It is so ridiculous.

Had additional ketamine infusions but unfortunately, they are not very effective anymore. The only thing that really helps is the nasal ketamine spray but due to easy way for it to be abused, fewer doctors are prescribing it so now people like myself that really need it can't get it. Wonderful.

My disability request was denied. my attorney said it was the blanket denial that they send everybody and due to my age and such, they probably didn't even really look at everything. I have run out of money and now and pulling from my 401k trying to survive. We filed an appeal immediately in may of 2018 and are still waiting to get a trial date assigned. Even if I do win my case, it will take months for any type of payment so I don't know if I will be able to survive. Great system we have going on here.

While waiting for social security disability, I was able to secure help through the state and county bridge card system - food stamps. We also requested financial assistance and was denied because they say I am not disabled. This is very concerning as anyone that looks at my charts or meets me realizes that I am indeed disabled.

I was finally able to get the new dorsal root ganglion stimulator put in. In line with my usual luck, one of the leads migrated within the first month and when the doctor went in to fix it, he encountered too much scar tissue and was not able to get the lead in position. Now we are waiting for the FDA to approve paddle leads that provide better coverage over the nerve. Nobody has a clue of how long it will take to get approved.

Although the last big surgery on my right foot was successful, I started to get a lot of pain in the back of the heel, the bottom of the Achilles, and on the right side of the heel. This is almost identical to what happened with my other foot. Surgery was scheduled at University of Michigan metro health in Grand Rapids. This is the first time I've had surgery there and I was absolutely floored by how much better it is than the other hospitals. You could tell that the nurses actually care as opposed to just doing their job and whenever an issue arose with my pain control, they would have someone from anesthesia come up with in 20 minutes as opposed to 24 hours at the other hospitals. I will never have surgery anywhere else again. Anyway, I got the usual nerve block but it was only partial effective and it turns out they only blocked one of the two nerves which covers the outside of my foot and my heel. Had medication strength issues because they always have to start at the smallest dosage and work up. Half a milligram of Dilaudid does nothing for me. I finally was able to get them to increase it to 2 mg the second day but even this was ineffective. I need at least 3 mg it's not four but they won't go that high. They did put me on a ketamine drip and it was on level 14. I'm guessing that's milliliters or something. It was not effective at all because of all the infusions I had before I have developed a tolerance to ketamine now. They eventually increased it to 21 and that still wasn't effective so they put it up to 42 and then I finally started getting relief. The difference here verses when I was at the other hospital is they didn't require me to go to ICU at such a high dosage. I was in the hospital from Friday until Tuesday and now home and even though it's been almost two weeks, still having a lot of pain and I looked at the wound and it's still bleeding.

I've probably missed out on some problems or surgeries that I don't remember because there's been so many. I'm sure I will need to have my toes on my right foot fixed at some point because they continue to claw but I'm really not looking forward to that surgery.

One last thing, all of this crap with junkies od'ing on heroin and the news and people bundling people like myself into the same group as people doing heroin is making it incredibly difficult to get medications. I don't know why the insurance company feels like they should be able to regulate what my doctor has prescribed. I am having a constant battle with them over the level of pain medications I am on and trying to get them to pay for stuff. I have never abused my pain medicine and should not be punished because of other people doing stupid things. it is not the only tool to help control pain but it is an important piece of the puzzle.

July 2017 - disability, toes amputated, another stimulator & surgery

Life has been rough since my last post. The CRPS has been getting worse in both legs. I got a Nevro stimulator put in and thought it was working but turns out to not help much at all.  I don't even have it turned on anymore.

I finally figured out why I haven't had any interest in trying to date. The meds reduced my testosterone to almost zero. I'm now getting shots and it does help a little. Considering I can barely retain a social life anymore is now the biggest problem. I have a theory that the disease and drugs are what tanked my career. The timeline lines up.

The toes on my left foot that had the knuckles removed began to twist a little and developed ulcers on the bottom that wouldn't heal. The options were to redo the surgery (cutting knuckles, etc.) or just amputate. Since it was originally just the middle toe and wouldn't affect balance, I went with the doc's recommendation and chopped it off.  30 minute surgery and weight bearing immediately. Had to have the pinkie toe removed two months later.

The CRPS has continue to progress so I decided to try Ketamine infusions. Ketamine has emerged as an incredibly effective drug for treating nerve pain, depression, and other problems. It's not covered by insurance due to it being an older medication and not technically approved to treat CRPS. Cost me $1,500 per infusion, six infusions initially with boosters in the future. I get amazing relief anywhere for a few weeks to 8 weeks. Theoretically, people can eventually get complete relief after boosters. This is pretty rare though. In Europe, they are actually putting people in ketamine induced comas for 7-10 days and they are coming out with their nervous systems completely reset. A bit risky though.

A new stimulator has been approved in the US that focuses on the dorsal root ganglion. It is the first to show continuous positive results for patients with CRPS. As high as 70%. I am scheduled for a trial in August.

Been missing the best part of summer as I'm stuck in bed with horrible pain. Epidural shots have not helped but a peripheral nerve block seems to have some effect. Got the left leg done Monday and it's helping a little. Right leg will be done Monday.

The last surgery on my right leg (osteotomy, brostrom, tendon transfer) failed and is scheduled to be redone in September. Can't imagine dealing with that and CRPS. Not sure if I can.  That would mean I have an ankle that flops over and can't stand on anything other than solid ground.  After about 20 minutes it gets too painful, regardless.

Lastly, I've finally decided to pursue disability. I've really tried to not do it as I see it as giving up but I need some income while I fight this disease. I hoped to be able to work but now I'm losing hope. It is really scary. The disease is going up my legs into my knees. I've never been in agony without anything helping before. I'm so tired of laying in bed all day with no relief. I can barely manage going to the kitchen for coffee or food.

October 2016 - Surgery, CRPS, Spinal Cord Stimulator, Steroids

A lot has happened since my last post. The surgery was pretty much as expected. The tendons were completely severed and were trashed so the Doc transferred one from the inside of my foot. He took the one that would normally cause my big toe to flex at the knuckle. He performed the calcaneal osteotomy and also the gastrocnemius recession. Our biggest fear was realized and the all the surgeries have caused CRPS in this foot. It has gotten bad enough that I now need to get a spinal cord stimulator. I'm waiting for a surgery date.

One of the big side effects I experience from the Methadone is a major drop in testosterone. It's bad enough that I'm going to start taking a steroid soon.

April 2016 - Another surgery....and it's the big one.

So, I need to look and see the last time I updated this site. We seem to have come full circle and I now need to have the nasty calcaneal osteotomy on my right foot. I'm very worried about it. If I didn't mention it before, I've had two other surgeries on that foot over the last 12 months. I'll be posting again soon with more info and then updates throughout my recovery. Surgery is scheduled for May 20th.

*I just looked back and my last post was before the surgery in October. The doctor did a 4 hour surgery, fixed all the ligaments, two tendons (including using a cadaver tendon), and lengthened my achilles. He couldn't do the osteotomy because he felt the soft tissue wouldn't hold. Now, after no weight bearing for all of November and December, three months of PT, I have retorn it all because my alignment is off. Turns out is probably congenital as both of my old siblings have torn their peroneal tendons.

October 2015 - More Surgeries

In a cruel twist of fate, when my bad foot and ankle (left) finally healed enough for me to enjoy being mobile again, I split the peroneal tendon in my right ankle.  Seriously, it happened.  And, because I don't do anything normal, the surgery to fix it failed and has since turned into all of my ligaments being torn in that ankle and the doctor wanting to perform a calcaneal osteotomy.  Miserable.  I'm sure I'll update this blog while I'm laid up.

September 2014

It has been a long time since I've updated.  Quite a bit has happened since then.

The nerve damage caused my toes to curl (claw toes) and I had to have them straightened.  That involved cutting out the middle knuckle of each toe, releasing the capsule at the bottom of the toe where it hits the foot, transferring tendons, and putting pins in so my toes heal straight.  I knew going into it that the surgery would be tough but it was compounded by my pain doctor not showing up to manage my after surgery care at the hospital.  I was in severe agony for about 5 hours before a different pain management group stepped in because they couldn't watch me suffer any longer.  Needless to say, I changed pain management doctors immediately.  Recovery was two months on crutches.  Getting the pins out wasn't painful at all, I was really surprised.  Barely felt it.  I didn't realize that there aren't nerves in the bones so there really wasn't anything to cause it to hurt.  My doctor told me to just slowly begin to walk again and everything will stretch out.  Everything was going well for a few days and then my RSD went crazy.  The pain was off the charts, my foot was bright red all the time and swollen.  I ended up having to go on Methadone for a while.  It was really effective but had some odd side effects.  For me, the sex drive was completely gone.  Anyway, after a few weeks,  I was able to taper back down to my usual meds.  Everything was going okay until I noticed a bump in the arch of my foot that was getting sore.  More bad news.

The lump in my arch turns out to be a fibroma.  Kind of like a tumor but it is a mass that is in the plantar fascia.  For some people, they get really bad and have to be surgically removed.  The risk there is an arch collapse and for me, upsetting my CRPS/RSD.  The doc said we have two options.  We can be conservative, redo the gastroc recession, and see if the additional mobility keeps it from getting worse.  The other option is to cut it out.  I chose the former which was a simple procedure followed by a few days in the hospital for pain control because of my condition.  I spent two weeks recovering and then had to travel to Vegas for work.  Swelling was pretty bad and so was pain but that was to be expected.  The doctor said it was fine to try and walk normal.  Well, a last minute trip came up and I had to go to Italy.  While I was there, the pain and swelling were still bad but nothing crazy.  Unfortunately, a few days after I got home, my ankle and heel became extremely painful and swollen.  Completely out of control.  I had to drive across the country for a new job and I thought this would allow it to calm down.  I was wrong.  Just having it down made it miserable.  Since then, I have seen an orthopaedic surgeon, been to the ER, and scheduled a new pain doctor out here in San Francisco.  If I keep my foot immobilized in a lace up brace and minimize movement when I walk, the swelling and pain stay within reason.  If I don't wear the brace, all it takes is having my foot down and the pain goes crazy.  So, now I'm waiting for an MRI and for all of my records to get transferred.  I'm hoping that I will have better luck out here than I did in Michigan.  

29 months (August 2013)

Saga continues....

I went to China in June and three days after getting back, I started getting nauseas and having terrible abdomen and groin pain.  After two trips to urgent care, two rides in ambulance, three ER visits, one CT scan, three ultrasounds, and one MRI, we still don't have answers.  The doctor isn't sure if it is the spreading of the CRPS or a nerve injury from sitting crammed in a plane for 14 hours.  I'm now on the fentanyl patch with norco for break through. The pain had localized to my groin and privates.  Feels like they are constantly being squeezed.  Miserable.  Getting a nerve block next week.  Hope it helps.  Doc really wants me to consider having a neuro stimulator implanted but I'm not sold.  Definitely mixed results to read about.  There is a new treatment that has been very successful.  It involves high doses of a ketamine injection for a few days.  Going to research.

On a side note, I am now taking Gralise instead of Gabapentin (neurontin).  It is incredibly helpful.  It is extended release version and is amazing.  Only down side is that most insurance won't cover it.

This whole episode is now impacting my ability to work.  Haven't put in a full day since June.  Scared to think about what the future may hold.

21 Months (January 14)

Had a few comments posted so I think it's time for an update.

Since my last post, I've moved half way across the country for a job.  It is awesome except for my stupid foot. I've developed hammer toes and am working on stretching the tendons again.  I will start pt soon. The pain comes and goes, no big change there. I do live in a mountainess area and it is pretty depressing not being able to fully enjoy. Hikes are limited and skiing is out of the question. I am still on the same meds and my norco dose is up to 5 a day. I've also been prescribed clonidine for breakthrough relief but it doesn't really do anything. My new pain doc had me try Nucynta. It's the first new opioid developed in a long time. Supposed to work as a regular opioid and have the same effect as tramadol. Some people love it. Didn't do much for me and gave me anxiety. I was on the 100 mg pills.

My doc warned me a while back that I may develop back problems due to limping for so long.  Well, that has happened. I have a pinched nerve in my neck that sends electric shocks down my arm and into my face when really bad. I can barely sleep because my back hurts so bad. I'm getting an MRI of my neck soon.

The really scary news is that when the doc administered the versed to knock me out for my most recent injection, he had to give me 12 mg. the normal dose is 2 mg! That means that if I ever have an injury and need pain relief, it will be very difficult to achieve it. Not good.

Lastly, I've had flare ups since I've been in Colorado. I've gone to the ER and they completely blew me off. I guess that's the difference between a hospital in a medium size town and a major metro area.   They just assume here that you're a junky. Even though I brought in all my files. Terrible and scary.

16 Months (August 21st)

Quite a bit has happened since my last post.  The pain in my ankle continued to escalate and I ended up in the emergency room in June.  The pain meds were not getting it done and I woke up at around 4 in the morning and couldn't take it any more.  The hospital did the usual tests and had to shoot me up with three rounds of dilauded and put me on oxy.  Fortunately, I had an appointment with my surgeon scheduled for the next day.  When I went in to see him, he said that he can't see any reason for the continued pain and recommended that I see a pain specialist.  He wanted tor rule out RSD.  I went to the pain clinic the next week and discussed my symptoms with the doctor.  At this point, I could barely walk around the house without significant discomfort.  Extended walks were completely out of the question.  The ache in my heel and ankle were non-stop and worse after activity.  The doc suggested an injection in my back to calm the sympathetic nerve.  He also put me on the gabapentin, an anti-depressant (effexor), and 4 norco per day.  The procedure for the injection was interesting.  I went in and they put an iv in my arm.  Then they gave me something for pain and to calm me down.  The next thing I know, I'm in the recovery room.  I guess they don't really knock you out put just make you really loopy and amnesiac.  The pain in my ankle/foot got worse over the next 6 days and was to the point where I could barely get out of bed.  I was taking 2 norco at at time every four hours and was miserable.  Then, out of nowhere, I woke up on the 7th day and the pain was reduced about 80%.  It was incredible!

I continued on the meds throughout June and July.  For the most part, my foot would ache a little when not doing anything and get quite sore when I walked a lot.  What is strange is that the ends of my toes became very sensitive to walking and would really hurt if I was on a tile floor.  The same thing was happening with the bottom of my foot on the lateral side.  I went back to the pain clinic around August 6th and the doc said he does believe that I have mild RSD (I can't imagine what major would be like!) and wants to continue with injections and treatment.  I did explain that the 4 norco a day are not enough if I am active.  He then switched me over to extended release ms contin.  Apparently, this is morphine.  Unfortunately, whenever I got morphine in the hospital in the past, it hasn't worked. It just makes me warm.  So, I am now on the ms contin, gabapentin, and effexor.  I really do not like the ms contin as it is not very effective for me and it makes me really out of it.  I honestly don't know if I could maintain a difficult job while on this.  I am constantly searching for the right words and my memory is affected.  I am going to request that they take me off of it immediately.  I really don't like it.

I'm scheduled to see the pain specialist again in September as well as my surgeon for an update.

13 Months (May 2)

Has been a while since I've posted.  Things are good and bad.  I've definitely made progress regarding the amount of weight I can put on my foot.  However, I'm having a lot of pain in my achilles, heel, and bottom of my foot.  The doctors office has put me on Gabapentin.  They think it may help calm the nerves that are upset.  I started taking it yesterday (1 dose), have taken 2 today, and will take 3 tomorrow.  No benefit yet.  I got a script for 40 Norco Tuesday last week and am down to 3 already.  The docs office doesn't want to give me more.  I'm really hoping my foot calms down otherwise I'll be calling them on Friday and telling them I need more.  Not good.

1 Year + (April 16)

Not much new to report.  Still have burning on the back and side of my foot if any pressure is on it.  Guess the bone is still healing.  If I try to put too much weight on my leg, I still get the weird pain in my achilles.  I have been spending a little more time with the boot off and the front of my ankle really aches.  Hope that gets better soon.  I have been getting quite a bit of spotting in my sock.  Just little blood spots every now an then.  I've started covering one area with a banage with Neosporin on it just to make sure it doesn't get infected.  Here's a pic....

1 Year + (April 10)

Okay, this is scary. As noted earlier, I saw the MA to get my stitches out 2 weeks post op. She told me I could transition to FWB between 2nd and 3rd week, sleep with boot off at night, and that it wouldn't be a problem to fly for my interview next week (5 weeks post op). I just spoke with the surgical nurse to confirm if I could sleep with my boot off. She checked with the doc and:

a) I am only allowed to pwb since the bone is still healing.
b) I can not sleep with my boot off and need to keep my leg elevated.
c) I am not allowed to fly or have my leg down for extended periods of time.

No wonder I'm having so much pain and my leg is swelling so much. Now I need to find an alternate way to get some place 12 hours distant by car in order to interview.

1 Year + (April 6)

I was making great progress towards walking without the crutches until yesterday afternoon.  I was using only one crutch and putting nearly all of my weight on my foot when I felt a horrible pull in the achilles.  It dulled down but kept happening every time I would put any weight on my foot.  I ended up not putting much weight on it at all today and am hoping it is improved by tomorrow.  I am getting a burning pain in my heel that is similar to what I felt after the original osteotomy.  It comes and goes and seems to depend on the position of my foot.  I did just look and I do have bruising on the back medial portion so that may have something to do with it.  I'm still averaging about two doses of meds per day.  

Here are some updated pictures.

1 Year + (April 3)

The last few days have been up and down.  The pain definitely comes every night though and requires meds.  I stopped taking the valium on Saturday and switched from Oxy to Norco yesterday.  I had the worst night of sleep yet last night and woke up in terrible pain.  I had to take more Norco first thing this morning.  The worst part about that is the Norco makes it impossible to study or do any type of thinking.  I called my doctors office and requested a refill of the Oxy this morning but they are saying they don't want to give me any more.  It has only been two weeks since surgery so this is a bit surprising.  The nurse said she will check with the on-call doc since everyone else is on vacation.

I did begin transitioning off of the crutches on Sunday and it has not been easy.  I'm trying to put more weight on my foot in the boot which results in pain in my heel and achilles.  So far, it hasn't been overly miserable but I think that I need to go slow this.  I'm also continuing to get pain in the front of my ankle which is very strange.

1 Year + (March 31)

Got my stitches out yesterday and everything looked great (exact same as pictures posted last weekend).  I saw the medical assistant and not the doc.  I have to keep wearing the boot 24 hours a day for 1 more week (except for showering) and then I can start taking it off for sleep.  Really looking forward to that.  Will be in the boot for a total of 6 more weeks but can begin transitioning away from crutches shortly.  The MA did say that she will check with the doc to see if I can go without the boot for my interview in 3 weeks.  I mentioned that the pain has actually been getting worse, especially at night.  She said that is completely normal as things are healing and I'm moving around more.  She said to expect to be on and off pain meds for another 4 to 6 weeks.    

Although we didn't do much with my foot yesterday, it was the most painful it has been since surgery.  I was told to take my meds before the appointment and I am glad I did.  I took two oxy at 9:20 and my appointment was at 10:30.  The MA used that brilliant magic spray to numb my skin so I didn't even feel her take the stitches out. She then put me in a new Cam walker and I was on my way.  Everything was fine until 1 pm when my foot started to hurt.  By 1:10, I was in the most pain I have been in yet.  Wow, it was bad.  Guess the Oxy really had been working and was wearing of.  I took another dose and it kicked in about 20 minutes later.  Definitely dampened the pain but didn't eliminate it.  It was like that all day so I spent the rest of the day on pain meds.

1 Year + (March 26)

Well, I have some good news and some bad news.  My doctor's office called today to follow-up regarding the potential infection of my foot.  After I filled the nurse in on what happened, I was able to ask her some questions about my recovery.  The good news is that she was very impressed with how few pain killers I have been taking.  She said most people are calling for refills by the second week and the fact that I've been down to as little as one dose a day is really impressive.  Now the bad news.  Because the doc split my achilles tendon, I have to wear the Cam walker boot for an additional 6 weeks after I get the stitches out Friday.  Really bummed about that.  I was still under the impression that I was going to be able to transition to a normal shoe shortly after getting the stitches out.  Of course, now is the time when potential employers are calling and I may have to wear my gimp boot to an interview which I'm sure wont benefit me in any way.  Oh well.

As far as the foot is concerned, I had a rough day yesterday and took a dose of Oxy followed up by 1 Lortab.  It seemed to settle things down.  My foot still does seem to get very achy at night.  Feels like there is a lot of pressure built up inside.  So, before I bed I took my valium and 1 Oxy (instead of the full dose of 2).  Slept like a baby.  I do have phone interviews coming up this week so I'm going to try and go the whole day tomorrow without taking anything.  Night time is my biggest concern but I have to give it a shot.  I want my head to be as clear as possible.  

My boot still smells like the plague.  I did order a new liner that I can pick up anytime but I'm going to wait until I get my stitches out Friday so I can fully wash my leg and start out fresh.  I just can't be in enclosed spaces too long.  Gross.

1 Year + (March 24 & 25)

Well, had an interesting 28 hours.  I took my meds at 11:30 pm Friday (23rd) and slept through the night without waking up once!  Was really pleased.  Pain seemed much less all day on Saturday (24th).  My little bro came by in the morning and ended up having my leg down for about 30 minutes or so.  Pain wasn't bad but I did take some oxy after he left.  Overall though, barely any pain all day (compared to before).

Now the crazy part.  Yesterday, I noticed that my leg was really beginning to smell.  I've worn the CAM boot before during the summer and it does tend to stink a bit after a few weeks but nothing too bad.  Well, last night it really smelled.  Then today, it was even worse.  I'm talking 10 times worse than really bad foot odor.  Someone mentioned that I should check my leg as the smell could be indicative of an infection.  I'm not supposed to remove the cam boot and especially not the ace wrap and gauze.  I did take off the boot and noticed some dried blood and a bit of a fluid outline on the ace wrap.  And the smell.....was even worse.  I wrote on the Healthboards forum asking for advice and a nurse said I should call my doctors office as they will have an after hours service.  I called, gave my info, and was told a doc will call me within 30 minutes.  The on-call doc was one of the partners but he sounded either drunk or like he had just woken up.  It was only 9:30 or so.  Anyway, he told me to either take off the dressings and visually inspect the wounds or go directly to the ER.  If I inspect them myself, I need to be able to rewrap them.  Well, I don't have the supplies or anything.  I decided to wait a bit and asked the nurse on the forum and she said she recommends not screwing around and going to the ER.  A few other people also recommended the same.  I decided to take off the ace wrap and there was quite a bit of dried blood on the gauze and some yellow staining.  Once again, it smelled horrible.  I tried to look and see the wounds but the gauze was stuck and I was very nervous.  I decided that I better just go get it checked out.

Got to the hospital at 12:30, was triaged and in a room at 12:35, saw the doc at 12:38, and was out of there by 1:20.  I love this town!  Anyway, when the nurse first came in, she said "wow, that smells like a really bad infection".  Crap, not what I wanted to hear.  Doc then unwrapped everything and my wounds looked great!  Not even any staining on the skin!  Such a relief.  They said the smell is from all the fluids that had been collected in the gauze and ace wrap.  I asked if I did the right thing by coming in and they said absolutely.  If it had been an infection, it could get really nasty really fast, especially because of the screw removal.

For anyone that has the same worries, here is what the nurse told (which I searched all over the internet but couldn't find).  The primary indicator of infection is red or aggravated area around the wound.  The next is any drainage.  Third is fever and last is odor.  Everything I found online gave each symptom the same weight.  Oh well.

So, here are pics of my foot.  Pretty sweet.  Only 8 days out from surgery!  Can't believe how big the incision is over my achilles.  The pic of the lateral side isn't that much different than the one from last year when they did the osteotomy.  I do have to like that there isn't all the crusted nasty blood on them like last year.