Tuesday, November 6, 2012
Surgery Day
Disclaimer: I'm still groggy from anethisia and taking lortabs as I write this post. Hopefully I don't write as scattered as my brain feels right now! :p
I'm up from sleeping most of the afternoon away. I wanted to makes sure I tried to post today, while I still remember some of what happened.
So, today was surgery day!
Starting last night, I was not allowed to eat/drink past midnight, the usual. I certainly obeyed the instructions as I have a history of getting sick from anesthesia and know how important this really is.
Of course I woke up super early. I'm still not adjusted to the time change. I think I woke up around 5am which is much better than the 4am I woke up the last two days. This was good because it gave me some time to putter this morning. The girls stayed at my parents house last night, since we had to be up and out fairly early.
The first thing we made sure to do on our way to the hospital was VOTE! I was number 30-something at 7am and proud of it :)
The surgery was being conducted at Erie County Medical Center (ECMC), in Buffalo, NY. While this hospital is on the other side of town, it is very cool because it is actually the ONLY level 1 trauma center in New York State! It is a huge hospital and there is tons of stuff going on. It feels a bit like a factor but everything was managed very well.
We arrived at the hospital a little before 8. It was nice to get there early because I was finally able to see the office where Brian works and some of his co-workers. It was great to have the surgery where Brian works because he knows all the Drs. and a residents, so he was comfortably knowing who was who and what was going on.
At 8am we had to check into the Ambulatory Surgery Center. I waited no longer than 10 minutes before they had me all checked in and into the back.
The first thing they had me to was a pregnancy test. I found this ironic because I had to pee in a cup when I wasn't allowed to even drink a sip of water since the day before. Anyways, I managed to make it happen, probably because I was a little nervous/anxious.
After that, I was given the usual hospital gown and told (my favorite quote of the day) to "get naked like the day I was born!" Ha ha ha :) It was super cold in the room so I was bundled up in blankets. That is when we took the picture I posted earlier.
They immediately started an IV with a sedative. It was very, very slow (I think they just wanted it started but surgery was still nearly 2 hours away, so they kept it slow). During this time there were lots of questions on my medical history.
I saw both the Resident Anethesialogist and Anesthesiologist. I can't say enough of how amazing they were. This surgery was my BEST experience ever in terms of anesthesia. After my first foot surgery, I woke up nauseous and shaking. During both my c-sections I was very nauseous and with Nora, vomiting the entire time. They took this into consideration and made sure they had drugs lined up in advanced. If I ever have to come back for another surgery, I really hope I get the same Dr. He was just so open and understanding and really talked things through with me. He also kept visiting me while we waited which was nice.
My Dr. and his team performing the surgery were also amazing. Although I didn't see my favorite PA, Karen, I did get to meet a new PA Jeff. Jeff and Dr. Ritter both came by multiple times to discuss what the definitely knew they had to do, and then what they might potentially have to do. They examined and talked about my foot again and made sure I understood everything before signing off. As I said before, they "got my foot" more than previous Drs. I had seen. There is no greater feeling that to be able to totally trust your entire surgical team prior to going under!!!
So, my last memory is around 9:45. In my IV I was giving something that made me feel like I had a few drinks of wine... really fast! After about 10 minutes, my mind goes blank. Brian says that I was still totally awake and chatting away, when I was wheeled off at 10, but I don't remember anything at all! (Last surgery I remember getting wheeled into the OR and breathing in the mask... this time, it's a blank!)
Apparently I was in surgery for nearly two hours. They thought it would only take about 1 hour, so I was very surprised to hear this. I have yet to see the Op report, so I will find out the details when I can get ahold of that.
The next thing I remember was waking up around 1:30. Wow, and I just woke up like I woke up from a nap! It was the greatest thing ever. I wasn't cold, nauseous or anything! I was so excited and I think I kept telling the nurse how happy I was about this. She let me have two big glasses of water right away.
The next thing that I was surprised about was that I had a cast! The plan was that I would have a splint after surgery for two weeks and then get a cast. Again, I'm surprised but very happy about this. Having a cast gives it much more protection from some unruly toddlers that I know...
Before I woke up, I had already been out of surgery for and hour and a half. Brian was then able to come in and visit. He had spoken to the Drs. and got the report. At this point, they were ready to get me out. I wore stretchy/comfortable clothing so it was easy to get dressed and they wheeled me out to the car.
So, what did they do?
When they got in there, they learned that my tendon was in a much worse state than they had thought. This is probably because of my past issues and the fact that this is my second tear. A good portion of my tendon had to be removed. They also found a cyst on the tendon that had to be removed.
So, the decision was made that they would "transfer" an existing tendon in my foot (the on that connects to my baby toes) and help stabilize the posterior tibial tendon that was left. In order to do this, they drill a hole in one of the bones and thread the tendon through, in order to run them parallel together. This helps give the existing tendon support, since it will likely never heal to how I need it to be.
As a result, I'm probably going to be loosing some mobility in my toes. My future activities will be limited - I can no longer climb trees and I definitely will have to retire from any kind of running.
The good news? They did NOT have to take the bone from my heal and rebuild my arch. Although I was showing some symptoms of this, they decided not to perform the procedure. I'll find out why in my post op appointment. I'm thrilled about this since that procedure would probably have added another few weeks to my "non-weight bearing" timeframe.
This is about all I know at this point, in my special, non-medical explanation.
Overall, I'm feeling pretty good. I'm happy with how things went. My foot is hurting ALOT and I'm maximizing on the painkillers right now. Hopefully within a few days I can go down to just Ibuprofen, since I hate feeling out of things. This afternoon I slept, at homemade mac 'n cheese my mom made, slept and ate again.
Thank you to everyone who has left me such nice messages on Facebook and sent me Texts. I really appreciate all of your kind thoughts!
I'm up from sleeping most of the afternoon away. I wanted to makes sure I tried to post today, while I still remember some of what happened.
So, today was surgery day!
Starting last night, I was not allowed to eat/drink past midnight, the usual. I certainly obeyed the instructions as I have a history of getting sick from anesthesia and know how important this really is.
Of course I woke up super early. I'm still not adjusted to the time change. I think I woke up around 5am which is much better than the 4am I woke up the last two days. This was good because it gave me some time to putter this morning. The girls stayed at my parents house last night, since we had to be up and out fairly early.
The first thing we made sure to do on our way to the hospital was VOTE! I was number 30-something at 7am and proud of it :)
The surgery was being conducted at Erie County Medical Center (ECMC), in Buffalo, NY. While this hospital is on the other side of town, it is very cool because it is actually the ONLY level 1 trauma center in New York State! It is a huge hospital and there is tons of stuff going on. It feels a bit like a factor but everything was managed very well.
We arrived at the hospital a little before 8. It was nice to get there early because I was finally able to see the office where Brian works and some of his co-workers. It was great to have the surgery where Brian works because he knows all the Drs. and a residents, so he was comfortably knowing who was who and what was going on.
At 8am we had to check into the Ambulatory Surgery Center. I waited no longer than 10 minutes before they had me all checked in and into the back.
The first thing they had me to was a pregnancy test. I found this ironic because I had to pee in a cup when I wasn't allowed to even drink a sip of water since the day before. Anyways, I managed to make it happen, probably because I was a little nervous/anxious.
After that, I was given the usual hospital gown and told (my favorite quote of the day) to "get naked like the day I was born!" Ha ha ha :) It was super cold in the room so I was bundled up in blankets. That is when we took the picture I posted earlier.
They immediately started an IV with a sedative. It was very, very slow (I think they just wanted it started but surgery was still nearly 2 hours away, so they kept it slow). During this time there were lots of questions on my medical history.
I saw both the Resident Anethesialogist and Anesthesiologist. I can't say enough of how amazing they were. This surgery was my BEST experience ever in terms of anesthesia. After my first foot surgery, I woke up nauseous and shaking. During both my c-sections I was very nauseous and with Nora, vomiting the entire time. They took this into consideration and made sure they had drugs lined up in advanced. If I ever have to come back for another surgery, I really hope I get the same Dr. He was just so open and understanding and really talked things through with me. He also kept visiting me while we waited which was nice.
My Dr. and his team performing the surgery were also amazing. Although I didn't see my favorite PA, Karen, I did get to meet a new PA Jeff. Jeff and Dr. Ritter both came by multiple times to discuss what the definitely knew they had to do, and then what they might potentially have to do. They examined and talked about my foot again and made sure I understood everything before signing off. As I said before, they "got my foot" more than previous Drs. I had seen. There is no greater feeling that to be able to totally trust your entire surgical team prior to going under!!!
So, my last memory is around 9:45. In my IV I was giving something that made me feel like I had a few drinks of wine... really fast! After about 10 minutes, my mind goes blank. Brian says that I was still totally awake and chatting away, when I was wheeled off at 10, but I don't remember anything at all! (Last surgery I remember getting wheeled into the OR and breathing in the mask... this time, it's a blank!)
Apparently I was in surgery for nearly two hours. They thought it would only take about 1 hour, so I was very surprised to hear this. I have yet to see the Op report, so I will find out the details when I can get ahold of that.
The next thing I remember was waking up around 1:30. Wow, and I just woke up like I woke up from a nap! It was the greatest thing ever. I wasn't cold, nauseous or anything! I was so excited and I think I kept telling the nurse how happy I was about this. She let me have two big glasses of water right away.
The next thing that I was surprised about was that I had a cast! The plan was that I would have a splint after surgery for two weeks and then get a cast. Again, I'm surprised but very happy about this. Having a cast gives it much more protection from some unruly toddlers that I know...
Before I woke up, I had already been out of surgery for and hour and a half. Brian was then able to come in and visit. He had spoken to the Drs. and got the report. At this point, they were ready to get me out. I wore stretchy/comfortable clothing so it was easy to get dressed and they wheeled me out to the car.
So, what did they do?
When they got in there, they learned that my tendon was in a much worse state than they had thought. This is probably because of my past issues and the fact that this is my second tear. A good portion of my tendon had to be removed. They also found a cyst on the tendon that had to be removed.
So, the decision was made that they would "transfer" an existing tendon in my foot (the on that connects to my baby toes) and help stabilize the posterior tibial tendon that was left. In order to do this, they drill a hole in one of the bones and thread the tendon through, in order to run them parallel together. This helps give the existing tendon support, since it will likely never heal to how I need it to be.
As a result, I'm probably going to be loosing some mobility in my toes. My future activities will be limited - I can no longer climb trees and I definitely will have to retire from any kind of running.
The good news? They did NOT have to take the bone from my heal and rebuild my arch. Although I was showing some symptoms of this, they decided not to perform the procedure. I'll find out why in my post op appointment. I'm thrilled about this since that procedure would probably have added another few weeks to my "non-weight bearing" timeframe.
This is about all I know at this point, in my special, non-medical explanation.
Overall, I'm feeling pretty good. I'm happy with how things went. My foot is hurting ALOT and I'm maximizing on the painkillers right now. Hopefully within a few days I can go down to just Ibuprofen, since I hate feeling out of things. This afternoon I slept, at homemade mac 'n cheese my mom made, slept and ate again.
Thank you to everyone who has left me such nice messages on Facebook and sent me Texts. I really appreciate all of your kind thoughts!
Monday, November 5, 2012
Preparation
I've had about 3 weeks notice of my surgery date, in this time, I have been frantic to prepare. Some of the things I have done:
- Purchased/made somewhere around 47 meals and packed them into the deep freezer. I also made an inventory of the meals so that we know what remains.
- Hired someone to come and clean my house once/week.
- Created a schedule for the grandparents/babysitters of when the girls need to be picked-up/dropped-off, taken to activities.
- Picked up/borrowed a FREE shower chair from the church near my house.
- Purchased a Sealtight Cast Protector (I hope I look as sexy as the woman on the box when I use it!)
- Borrowed over 10 books from friends and the library.
- Moved my home office from the basement to the front hall of our house (less than 5 feet from the couch and ~25 from the bathroom/kitchen!)
- Talked with the girls about how mommy is going to have a cast like Abi on Bubble Guppies did when he fell of his bike and broke his tale.
- Chopped 5 inches off my hair.
- Made sure I have pillows both upstairs and downstairs to use for propping (so I don't have to carry them around).
- Put gel polish on my nails (toes and hands!)
- Purchased a few extra pairs of comfy, stretchy pants to go over the splint and cast.
- Cleaned, cleaned, cleaned and organized, organized, organized!
- Started this blog!
The Surgery
We are up to the point of surgery! The plan is...
Because I'm so functional, they aren't sure if they will need to the osteotomy or not. They will see when they get in there. If they do have to do it, the healing time is significantly increased. I've also read that many people have to have an additional procedure done to remove the screws once everything is healed.
My plan is to be off of work for one week, then start working form the couch part time. I plan on being back to work full-time within 2 weeks, from my couch. I'm not sure when I'll be returning to the office (after Thanksgiving?) - that will depend on the swelling and comfort level.
- Repair the tendon (duh).
- Potentially perform a procedure where part of my heel is removed and then screwed into my foot to reform the arch - this might be called an Osteotomy based on my research.
- Potentially lengthen another muscle, a different one than before.
Because I'm so functional, they aren't sure if they will need to the osteotomy or not. They will see when they get in there. If they do have to do it, the healing time is significantly increased. I've also read that many people have to have an additional procedure done to remove the screws once everything is healed.
My plan is to be off of work for one week, then start working form the couch part time. I plan on being back to work full-time within 2 weeks, from my couch. I'm not sure when I'll be returning to the office (after Thanksgiving?) - that will depend on the swelling and comfort level.
History - Part II
Life after my first surgery was amazing. As long as I wore my orthos, I had no pain. It was the first time in my life I was able to wear cute dress shoes (orthos velcroed in!), heels, etc. I was lucky they were able to give me two styles of orthos - one short, for dress shoes and another longer pair, for sneakers.
It took a long time (at least a year) but I was able to run, walk, workout just like I used too... maybe even better/harder than before. We eventually moved back to Buffalo, popped out two beautiful girls, and then...
I had post-childbirth-I-need-to-workout-again syndrome.
After having kids I did what any mom wants to do. Loose weight, feel confident and buy cute shoes (not necessarily in that order). I started wearing even more styles, including flats (with my orthos, I swear!) AND I started running... alot.
It was my own fault. I remember the beautiful day in early May 2012, about 1.5 miles from my house, on lunch hour, when I felt it. It wasn't good, but I kept going (because that's what gymnasts do!)
I ran a few more times that week and things went from "I might have done something," to bad words.
I knew it, I knew it, I knew it... I did something bad so I halted all activity and went to see my primary in Buffalo who immediately sent me to a podiatrist again.
It took over a month to get an appointment. In this timeframe, I went to extreme pain on a daily basis (5-7) and couldn't do a lot of my daily activities, like walk the girls, walk to the beach, etc.
I won't say the podiatrists name, but I did not like him. From the first day, he did not get what my issue was. He read my op report from the first surgery, but he just didn't get it. He kept having me try new braces (I spend around $400 on them) and nothing even improved the situation. He didn't think I needed PT (diagnosis=tendonitis) and did not feel an MRI was warranted. After three appointments and another $300 in new orthos, I switched to UB Orthopaedics.
Of course, it took me another month or so to get an appointment there. It was now nearly September. Thank goodness Brian works in the same hospital as the office - he was able to get me in on someone's cancellation.
My summer was not fun. I had to get rides down to the beach, I was in constant pain so I couldn't chase the girls around... it really just was not good timing.
My first visit with PA Karen Thomas was wonderful. Right from the start she understood my foot and I. She had a feeling right from the start that I re-torn the tendon, but we both agreed that before scheduling anything drastic, I should try some PT.
One month into PT there was no improvement, so an MRI was scheduled. The MRI showed a 2" split tear in the posterior tibial tendon (I KNEW IT!). Surgery was immediately scheduled for November 5 (tomorrow!!!)
It took a long time (at least a year) but I was able to run, walk, workout just like I used too... maybe even better/harder than before. We eventually moved back to Buffalo, popped out two beautiful girls, and then...
I had post-childbirth-I-need-to-workout-again syndrome.
After having kids I did what any mom wants to do. Loose weight, feel confident and buy cute shoes (not necessarily in that order). I started wearing even more styles, including flats (with my orthos, I swear!) AND I started running... alot.
It was my own fault. I remember the beautiful day in early May 2012, about 1.5 miles from my house, on lunch hour, when I felt it. It wasn't good, but I kept going (because that's what gymnasts do!)
I ran a few more times that week and things went from "I might have done something," to bad words.
I knew it, I knew it, I knew it... I did something bad so I halted all activity and went to see my primary in Buffalo who immediately sent me to a podiatrist again.
It took over a month to get an appointment. In this timeframe, I went to extreme pain on a daily basis (5-7) and couldn't do a lot of my daily activities, like walk the girls, walk to the beach, etc.
I won't say the podiatrists name, but I did not like him. From the first day, he did not get what my issue was. He read my op report from the first surgery, but he just didn't get it. He kept having me try new braces (I spend around $400 on them) and nothing even improved the situation. He didn't think I needed PT (diagnosis=tendonitis) and did not feel an MRI was warranted. After three appointments and another $300 in new orthos, I switched to UB Orthopaedics.
Of course, it took me another month or so to get an appointment there. It was now nearly September. Thank goodness Brian works in the same hospital as the office - he was able to get me in on someone's cancellation.
My summer was not fun. I had to get rides down to the beach, I was in constant pain so I couldn't chase the girls around... it really just was not good timing.
My first visit with PA Karen Thomas was wonderful. Right from the start she understood my foot and I. She had a feeling right from the start that I re-torn the tendon, but we both agreed that before scheduling anything drastic, I should try some PT.
One month into PT there was no improvement, so an MRI was scheduled. The MRI showed a 2" split tear in the posterior tibial tendon (I KNEW IT!). Surgery was immediately scheduled for November 5 (tomorrow!!!)
History - Part I
From a young age, I was always involved in competitive gymnastics. I believe I started competing when I was around 8 and continued until I was a senior in high school.
My earliest memory of a problem with my foot was when I was about 12 years old. I was constantly spraining my ankle and having trouble with it. To the point where I always had to be taped and was usually in PT. I used to have this peculiar problem that when I did straddle kips on bars, and brought my feet back together, that I would have a ton of SHOOTING pain up my leg. It was weird and funny at the same time... I remember the coaches and I laughing about it because I used to put foam on the inside of my foot when I did bars to prevent this.
Eventually I went to a foot Dr. (I believe at the time it was a podiatrist) and he determined that I had an "extra" bone in my foot. Basically, the bone on the inside arch of my foot was much larger than it should be and put much more pressure on my foot than there should be, causing it to be weak and unstable. The only solution would be to surgically remove it.
Surgery was not an option for me at this age, while still growing. There was hope that I would "grow out of it" as I was older and eventually left the sport. So, as typically gymnasts do, I dealt with my foot and a plethora of other injuries that came my way until I was done.
Sometime around when I was 20-ish, and now coaching competitive gymnasts, I was having problems with my foot again. Although they had never stopped entirely, it sort of flared up on my activity level. It was summertime, I was working multiple jobs, including coaching, where I was on my feet all day. One morning, I woke up, and the entire top of my foot was black and blue.
It was sore, but as in my usual fashion, I just ignored it. Within a week it wasn't better and I went back to the Dr. I broke 4 bones in my foot and was casted. Again, the pressure in my foot, along with my activity just caused the bones to randomly break.
It stunk - I was in a cast for almost the entire summer. As I was coaching and it was the year routines were being changed, I got to travel to Reno to learn the new compulsory routines for my girls. In Reno, I must have been too into the routines, because I cracked my cast! The other coach and I ducked taped it until I we were home and I could be re-casted! After that, I broke my cast AGAIN!. I was then moved into a boot (I think the Dr. gave up on me).
Eventually I healed for the time being. We moved to Altanta, I stopped coaching and was much easier on my foot (aka, desk job). In Atlanta, I started working out quite a bit including lots of running, biking and weight lifting. Alas, my foot problems began again.
In Atlanta I went through a period of time where each morning, when I woke up, I wouldn't be able to straighten my left left. I had to hobble around, getting ready as it would slowly stretch out and then "be normal." It eventually got worse and worse and I went to see a Dr.
Lucky for me I found Resurgeons Orthopedics in Atlanta. They were WONDERFUL. The first Dr. I went to was a lower body Dr. and he recommended I see a foot specialist in the group. Dr. Womack. He was amazing. I can't remember what we did exactly (I'm sure we tried a boot, a brace, cortisone, PT, etc.) but eventually it was determined that it was time for surgery. Oh yes, they also discovered I had partially torn my posterior tibial tendon.
In the summer of 2006 (I was right around 23) I had surgery. It was a very interesting time in my life - my surgery was scheduled within 1 week of Brian and I closing on our first home and three months away from our wedding! It wasn't good timing but it was time to have it done.
In my non-technical terms, this is what they did:
After the surgery I had a splint for 2 weeks, cast/crutches for around 2 months and an aircast/boot for another few. Of course I had PT for a long, long time. I believe it took close to 8-10 months to feel normal, and after almost a year, I could finally wear "normal" shoes, including HEELS which I had never previously been able to wear in my life!
My first surgery was a huge success.
My earliest memory of a problem with my foot was when I was about 12 years old. I was constantly spraining my ankle and having trouble with it. To the point where I always had to be taped and was usually in PT. I used to have this peculiar problem that when I did straddle kips on bars, and brought my feet back together, that I would have a ton of SHOOTING pain up my leg. It was weird and funny at the same time... I remember the coaches and I laughing about it because I used to put foam on the inside of my foot when I did bars to prevent this.
Eventually I went to a foot Dr. (I believe at the time it was a podiatrist) and he determined that I had an "extra" bone in my foot. Basically, the bone on the inside arch of my foot was much larger than it should be and put much more pressure on my foot than there should be, causing it to be weak and unstable. The only solution would be to surgically remove it.
Surgery was not an option for me at this age, while still growing. There was hope that I would "grow out of it" as I was older and eventually left the sport. So, as typically gymnasts do, I dealt with my foot and a plethora of other injuries that came my way until I was done.
Sometime around when I was 20-ish, and now coaching competitive gymnasts, I was having problems with my foot again. Although they had never stopped entirely, it sort of flared up on my activity level. It was summertime, I was working multiple jobs, including coaching, where I was on my feet all day. One morning, I woke up, and the entire top of my foot was black and blue.
It was sore, but as in my usual fashion, I just ignored it. Within a week it wasn't better and I went back to the Dr. I broke 4 bones in my foot and was casted. Again, the pressure in my foot, along with my activity just caused the bones to randomly break.
It stunk - I was in a cast for almost the entire summer. As I was coaching and it was the year routines were being changed, I got to travel to Reno to learn the new compulsory routines for my girls. In Reno, I must have been too into the routines, because I cracked my cast! The other coach and I ducked taped it until I we were home and I could be re-casted! After that, I broke my cast AGAIN!. I was then moved into a boot (I think the Dr. gave up on me).
Eventually I healed for the time being. We moved to Altanta, I stopped coaching and was much easier on my foot (aka, desk job). In Atlanta, I started working out quite a bit including lots of running, biking and weight lifting. Alas, my foot problems began again.
In Atlanta I went through a period of time where each morning, when I woke up, I wouldn't be able to straighten my left left. I had to hobble around, getting ready as it would slowly stretch out and then "be normal." It eventually got worse and worse and I went to see a Dr.
Lucky for me I found Resurgeons Orthopedics in Atlanta. They were WONDERFUL. The first Dr. I went to was a lower body Dr. and he recommended I see a foot specialist in the group. Dr. Womack. He was amazing. I can't remember what we did exactly (I'm sure we tried a boot, a brace, cortisone, PT, etc.) but eventually it was determined that it was time for surgery. Oh yes, they also discovered I had partially torn my posterior tibial tendon.
In the summer of 2006 (I was right around 23) I had surgery. It was a very interesting time in my life - my surgery was scheduled within 1 week of Brian and I closing on our first home and three months away from our wedding! It wasn't good timing but it was time to have it done.
In my non-technical terms, this is what they did:
- Removed extra bone on the inside of my foot.
- Repaired the torn tendon.
- Lengthened my calf muscle.
After the surgery I had a splint for 2 weeks, cast/crutches for around 2 months and an aircast/boot for another few. Of course I had PT for a long, long time. I believe it took close to 8-10 months to feel normal, and after almost a year, I could finally wear "normal" shoes, including HEELS which I had never previously been able to wear in my life!
My first surgery was a huge success.
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