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I haven’t blogged in awhile because I’m still trying to figure out how this blog fits in with everything else I’m tracking online but I thought it would be good to give a quick update on my post surgery status.

It’s been an up and down journey so far but I finally seem to be on the better side of healing. I’m out of the walking boot and doing quite well walking around in two shoes. It’s taken me a lot of physical therapy, including biking, to get to this point. I had a few minor set backs when transitioning out of the boot including some tendinitis and a possible ankle sprain. Those problems seem to be cleared  now though and I hope it stays that way.

I don’t see the doctor again until November 1st and I still need to go in for physical therapy some but I’m not going in at all this week which is a nice break.  I know that post strayer procedure my calf muscle isn’t the same on the left as on the right and it is a little weird. There seems to be a large build up of muscle tissue around the actual cut and the upper part of the muscle is taking its sweet time in strengthening back up. I’m having occasional massage done on the calf muscle to see if that can help smooth it out but it might be something I just learn to live with.

I wanted to make sure and post an update in case someone planning to have this surgery wanders in here looking for others in the same situation. At this point I can say that getting the surgery done was worth all the rehab because it finally seems like the original heel pain is gone now. It’s just down to finishing up the strengthening and I can handle that pretty easily.

The process has been slow and my routine has been messed up but I think I’m getting there. My foot has started feeling odd the last couple days and I think it’s due to the ligament healing.

I see the doctor Monday morning and hopefully move into the walking boot which I’ll have for another 4 weeks. I’m really hoping the staples and stitches can come out too.

I want to continue documenting my recovery, especially as I move into my rehab stage. I still don’t know for sure if the surgery fixed the problem but I am hopeful.

The last couple days I was actually able to leave the house but I’m pretty sure I overdid it yesterday. We went to Hy-Vee to get groceries and I ended up having to leave before we were finished and go sit/lay down in the car. I know it’s only been a week since surgery and I think my expectations on how quickly I’d be back to normal activity were set too high.

Today we went out and got ice cream and drove around a local park around sunset. This wasn’t so bad because I never had to get out of the car. It was nice to go see some of the animals at the park and otherwise not be in the house. Today was also my first day since surgery that I was on my own for part of the day. I had to make my own breakfast which ended up being a lot of work. It’s really hard to transport things when on crutches but I managed by using various counters to leap frog things to the table.

The leg/foot itself is probably healing but it’s hard to tell. There is still some amount of pain and I’m still taking the pain meds the doctor gave me. My discharge orders are to keep taking them until he tells me otherwise so I’m going to do that. What I can do is lengthen the amount of time between doses so I’m working out a plan. It seems the pain was better for a day or two but has now changed and seems to get worse. The leg is pretty stiff and sore from lack of use already and I can really feel it if I go from laying down for awhile to standing up.

I’m not sure what the long term plan is other than going to the doctor on the 12th and seeing if I can move into the walking boot. Once I’m in the walking boot, I’m not sure how long it will be before I can be full weight bearing. Even partial weight bearing would be helpful at this point, just to take a little pressure of my right leg.

I’m hitting the point now where I’m frustrated with being cooped up and unable to do the things I enjoy. The splint itself has been bothering me more lately just because I can’t take it off. It’s like always wearing a big wool boot all the time and it can get a bit warm. Plus, I can’t check to see how the sutures are healing so it’s all a big mystery. I’m supposed to be watching for signs of infection but that’s not really something I can do since I can’t see them. I suppose if I get a bad fever or something, that would be a sign. And one last note – itching – I knew it was going to happen but man, it’s worse than the pain!

By recent standards, I had a pretty busy day today complete with my first ventures out of the house. By the afternoon and now this evening, I’m pretty worn out and learned that crutches can quite the little workout.

Last night I was resting in bed with an ice pack on my leg and realized it was feeling a little wet and when I looked at the ice pack, it had leaked water out and some what pooled under my bandages. After some debate we finally decided to call the doctor’s office and check with the on call doctor on what we should do. The instructions said if the bandage got wet or dirty, to call for assistance. The on call doctor said it would be best to come by the office in the morning and have the bandages changed and cleaned.

So this morning I called and made a 10:00 appointment with one of the casting people. I went in and he removed the old splint and I got my first look at the wounds and they were impressive. There’s going to be some pretty nice scars when this is healed up. There’s a 3-4 inch incision down the side of my leg that’s currently being held together with staples and a long cut that basically runs from the side of my ankle, around the heel and to the bottom of my foot with at least a half dozen stitches. He removed everything, cleaned it all up and reapplied a new splint. My old splint was done with plaster but he made the new one using fiberglass so it’s a bit lighter now. He also wrapped my leg with a nice stocking first so the new splint really is a lot more comfortable.

After that errand we stopped by my house so I could pick up a few more things that I needed. I had originally planned on being home by now but it looks like it’ll be better for me to stay where I am for at least a few more days. After having my foot moved around a little by the new splint and after accidentally putting too much weight on it, I’m back up on the pain level. The accident was sad really, I was just turning on the crutches and felt like I was tipping backwards which cause my toes to just touch down long enough to shoot pain through my whole foot. It wasn’t fun at all.

For those that don’t know, this is the what the surgeon did:

  • Released 3/4 of the plantar fascia ligament from the heel of my foot
  • Removed a bit of bone spuring from my heel
  • Released (cut away) some of the tissue surrounding some nerves in my heel to relieve pressure
  • Cut and lengthened my calcaneal (achilles) tendon, I believe doing a Strayer procedure

My next follow up is July 12th and 7:30 am and should involve removing the splint and moving me into a walking boot with some additional supports, etc.

I knew that surgery wouldn’t be an enjoyable vacation but this has been rougher than I prepared for mentally. Mostly I just work on keeping the pain under control and sleeping.

I also have to make sure I get up and move around to prevent blood clots so it’s harder to get steady sleep. My follow up is on the 12th in the morning and until then I pretty much have to rest.

This surgery was a lot more invasive than the knee too. My biggest accomplishment so far has been washing my hair. I am thankful I have my parents to stay with, they have helped out a lot.

I went in to see Dr. Swanson today at Nebraska Orthopeadic and Sports Medicine to get another opinion on my foot problem – well really I saw his awesome PA, Austin Young first. We went over everything and talked about the different things I had tried, what stretches I was doing, was I wearing inserts, etc etc. He went over the MRI and the X-rays and finally brought Dr. Swanson in to try and develop a treatment plan. He, the PA, hadn’t dealt with anyone that had the issues I appear to have after a cortisone injection. Dr. Swanson examined me and we talked some too and it sounds like surgery is the next option on the table since everything else failed. Right now I am scheduled to go in on June 29th to have a few things done.

The list is as follows (all on the left side):

  • Strayer procedure – this is basically a gastrocnemius slide, or even more basic, they make the calf muscle longer
  • Partial plantar fascia release – cutting away part of the ligament on the bottom of the foot
  • Excision of calcaneal spur – shaving off some of the heel spur
  • Release baxters nerve – release one of the nerves that might be entrapped by the swelling

The procedure is outpatient and I’ll be in a non-weight bearing splint for 2 weeks before moving to a walking boot/cast for another month. He has down no PT at this time so I’m not sure what the long term recovery plan really is.

The good thing though, is that I will still be able to do Trail Trek on the 27th, which I’m really excited for – 25 mile bike ride!

This morning I went to PT and at the same time I picked up my medical records from my current foot doctor in order to shop around for a second opinion. I went and saw the same doctor that did surgery on my knee to see what he might suggest and while it’s not an area he does surgery in he did say given everything that’s gone on that foot surgery may be the only route left to try. I am going to be seeing another foot doctor on the 24th and then I suppose I have to make a decision. I’m more worried about this surgery than I was about the knee but it’s really not getting better.

The doctor today said that normally they tell people with plantar fasciitis to “stretch, stretch, stretch” and the problem generally lies in not stretching enough. I have heard this one before so I do stretch a lot – I stretch in the morning, before bed and a few times during the day at work or before/after I go for a ride.  He said that my flexibility was really good so I may have reach the limit of the benefits of stretching. He also commented that my heel spur was pretty impressive and that they don’t normal see one of that size in someone my age. He said that people come in talking about having this “big” heel spurs and normally they aren’t much but in my case it really is a huge spur. I believe he also said it was “angry” and really swollen.

I did get new shoes today, Brooks Ariels, to replace my old pair of Ariels. So far they have been pretty nice but I’m not sure they’ll be a miracle cure to my problems. One of them already has a scuff/oil mark from the bike though so that’s a little sad.

Some good news though, he went ahead and “released” me as far as my knee is concerned and I don’t need to go back. The knee is doing really well and I’m quite happy I went ahead with the surgery. Now I have to decide if the foot surgery is going to be worth it.

I wasn’t able to ride my bike in this morning because it was rainy and I don’t have fenders on my bike. I wasn’t really in the mode to ride on the weight pavement and get water up my back before getting to work so I just drove in. The problem with driving in, though, is that I have to walk about .5 mile from my car to work. This normally isn’t a problem except that I’m still trying to heal my plantar fasciitis. I made the walk and felt ok most of the morning but by afternoon I could tell something was wrong.

I did go out walk a little bit at work, nothing really high though, just around campus a little but at some point during the day I think the ligament tore again. By the time I had to walk back to my car it hurt as bad as it did after I got my cortisone shot. I was having problems putting any weight on my heel and thankfully, quite by accident, Terri pulled up in the lot next to the library and I got a ride to my car.

I ended up refilling my Vicodin prescription because that’s what the foot doctor had me on last time this happened. I think normally I would have had physical therapy today but the place was closed until Monday. Thankfully I’m going in on Monday morning but it could be a long weekend. I even get the fun of working on Sunday but hopefully we can get stuff done by noon.

I did end up going to ShopKo while waiting for my prescription to be filled. Picked up a neat neoprene water bottle wrap and a little bag thing that I think will work great on the bike. The bag should hook on nicely to the basket and will be really helpful for trail rides. It’ll also come in handy for hiking if I ever get into that again.

Multi-subject Post Warning!

Physical Therapy

So I went in for session number two of foot torture this afternoon. The first time wasn’t as bad as this time – this time it was pretty painful and I was feeling it when I left. I guess it has to be done for the long run but I had that bad, I wish I could quit, kind of vibe in my head when I left. She is doing some pretty deep massage and moving around tissues and stuff I guess and a few times she just really hit some pain spots. This really better work in the long run because it’s not fun. I have another medicated patch to wear overnight tonight and I go back for more on Wednesday and then a small break before going in three times next week. The people there are great though, everyone is nice and etc.

The Bike

Bike in the Park

When I got done at PT I decided to first stop and get a smoothie at Juice Stop and then I had planned to come home and ride my bike. During the drive home that looked like it might not happen thanks to the rainy weather. Thankfully, after dinner the sun was out and I ended up still getting in a nice ride tonight. I went down to the Rock Island trail/Billy Wolff trail area and rode around. Ended up going around the zoo a couple times, down to Calvert and out to Jim Ager Golf Course and back home. The weather was nice and lots of people were out on the trail. I’m learning how to properly pass people and while I’m certainly not the fastest bike on the trail I still hold my own. Only had to walk a little once when I hit an incline in the wrong gear coming off an underpass. Those underpass ramps can be brutal for a beginner!

Push Ups

I don’t think I have ever been able to do a proper push up so I decided it was time to change that. My new long term goal is to be able to do some real push ups. There is a program online called One Hundred Push Ups and I’ve decided to follow that. I encourage anyone reading this to join me, it could be fun! I’m currently working my way through wall push ups on week 3 to start. Once I get more comfortable with that I plan to move to bench push-ups, then “girl” push-ups and finally full push ups. I can’t do the “girl” push ups right now because my knee is, technically, still healing and kneeling on it would be bad.

The Bike

Yesterday, when I got home from work, I was really excited to get out and ride my bike. Rain was in the forecast but at that time everything was clear and nice. I happily rode the bike down to FoodPride and picked up a few groceries, it felt so great to be able to use my bike for a purpose. After my trip to get groceries I still felt like I needed more ride time, the store is only a mile from my place. So I decided to head up to the cemetery and ride around there.

Riding around the cemetery, oddly enough, is really nice. There are some nice hills mixed with flat area and lots of nice pavement – some of which was recently added. The older area is well treed so it made for some nice shaded areas to bike. I felt like I was 10 years old again, zooming around the corners and flying down the hills. It was such an awesome feeling with the wind zipping through my helmet. I am currently in love with riding my bike. I hope to get out tomorrow and hit the trails, I really want to get downtown and figure out the best route into work. I really want to bike into work a couple times a week to start. Long term, I’d like to get ride of my parking permit and just walk, bike or ride the bus.

The Foot

I think I said this before, but I have plantar fasciitis in my left foot. Plantar fasciitis is when the plantar ligament in your foot, for various reasons, becomes stretched or damaged and causes pain in the heel (or calcaneus) and can present with or without heel spurs. In my case, I have a “moderate to large” spur on the plantar side and a “moderate” one on the Achilles side of the calcaneus. This information is coming from the MRI I had done in March. So far my treatments have been icing, trying to rest (ha), stretching, night splint and finally a cortisone injection.

MRI Heel Spurs

Heel Spurs on My MRI

The cortisone injection was done prior to the MRI in hopes that it would help – instead it seems to have made things worse. The going theory now is that the injection somehow further weakened the ligament causing it to tear. This tear then created a high amount of inflammation that so far is still present. (As a side note, my right foot had plantar fasciitis also but responded quite well to stretching and hasn’t been a real problem since, never had an injection or spurs)

So today I went to a new physical therapy place, this one is located in the same building as my foot doctor. Some of the things were did were the same as I have been doing but she did a few new things. We started with ultrasound followed by some pretty deep massage. This massage, while not downright painful, was certainly not pleasant. She has to really dig in at times but I survived just fine. After that we did some exercises and stretches and that was followed by icing and something called iontophoresis.

Iontophoresis is basically an electronically charged pad that has both a positive side and a negative side. Steroid medication is placed on one of the pads and is drawn into the tissues via the electrical charge. It’s apparently similar to getting an injection without the actual injection part. This one last 14 hours and so far has been interesting – I seem to get waves of relief followed by waves of pain. I’m hoping it will work with time so I’m doing my best to leave it alone. I’m not a big fan of things stuck on my foot. I go back and see her on Monday so hopefully there will be some improvement. Our goal is to keep me from having to have surgery. I do know that prior to any surgery options, I’m getting a second opinion – it’s just the smart move.

Vital Stats

Name: Angela
Height: 5’8″
SW (2019): 475 Lbs
CW: 410 Lbs

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