Tuesday, September 29, 2009
Thursday, September 17, 2009
Surgery and Recovery
I guess there were options other than surgery. In fact, the doctor said if I was a smoker or diabetic, he wouldn't have operated. The calcaneus is just such a poor bone to heal. But this was such a bad break, I don't know what the outcome would've been. To me, the bone is shaped like a potato. When I landed with all my force on the bottom of the potato on concrete, it was driven up into my leg bones. The bone kind of splayed out in several pieces. So the plan was to open up the outside of my foot by the heel, and put the pieces together with plates and screws. Any space left would be filled in with bone matrix. The surgery itself generally went according to plan, although the fracture was very complex, and very difficult to manipulate and put all the pieces together.
Before the operation, I was given a nerve block in my lower leg. This was apparently a somewhat new procedure, as I was called by the hospital to let me know that was recommended and sort of asked if that's what I wanted. Well, sure, why not? As I look back on the whole thing, it was a good thing to have. Basically my lower leg was numbed.
I woke up from surgery from the one of the best sleeps I ever had. I think I even recall a dream of standing in a corridor wearing office attire. Anyway, I didn't want to be awakened. My main discomfort was my throat was sore (more than likely I had a tube down my throat). They put me in recovery in a semi-recumbant position. I was wide awake and had no pain at all. My leg was wrapped in huge ace bandage type stuff. They let my husband come in and see for a few minutes, then he left. I just lay there. I thought I should sleep because there wasn't any TV, and I didn't have my glasses to read, and anyway, there wasn't anything to read, but I was so well rested I couldn't sleep. I think I was there for 2 or 3 hours watching the screensaver on the computer monitors which just kept scrolling sentences about hospital safety tips, like "Don't block doors."
I should have mentioned the plan was for me to stay at least one night in the hospital after the operation. I learned why the doctor recommended this - the pain! The nerve block stopped the pain until about 10 am the next morning. I had a pain pump with the nerve block which I had not used, but then the pain started and I started using the pump. It really didn't seem to make a difference at that point. I told the nurses my foot was starting to hurt, they gave me some sort of IV pain med, probably morphine, which didn't really seem to help. I e-mailed the doctor, not expecting he would really respond, but he did, and the nurse gave me Percocet. I was then transferred to the orthopedic floor and given oxycontin, which settled the pain. The doctor decided I should spend another night in the hospital, and that turned out to be a wise decision.
I was told by the nurse I would get more percocet at 7:30. So before my husband left at the end of visiting hours, I asked for pain medication. When he left at 8, I asked him to remind the nurses on his way out, but by 8:30 I hadn't gotten any meds and I started getting the worst pain I have ever had in my life. Nurse then gave me daravan? iv, which slowed my respiration and made me feel like I was being weighed down on the bed, but the pain in my foot was excruciating. I was counting down the hours all night long until I thought I could take more pain medication. Nurse gave me another iv around midnight which helped but I still had very sharp, burning pain in heel. I told her, why is there that sharp pain still there? The pain on the scale of 1 to 10 was 11. I finally got another dose of percocet. The nurse figurged out the iv's didn't work and came in with a benadryl. I thought that was an allergy medication, and was slightly confused, but I finally was able to sleep. And when I sleep, I don't feel pain. I got an oxycontin dose at 4:30, woke at 6am asked for pain med, percocet. The pain was still there but somewhat settled down.
From that point on, I didn't dink around. I kept track of the time, and the time for medicine. I didn't want that pain to get a hold again. When the doctor suggested maybe I should spend another night in the hospital, I figured if I had pain prescriptions, I could probably monitor what I needed when better on my own at home.
I spent the weekend taking various pain medications within the prescribed parameters, like 1 or 2 pills, every 4 to 6 hours, trying to find the best combination, and I kept close track of how much acetaminophen I was taking so I wouldn't overdose. It was so weird. The pain was so changeable, and while I was sure to be taking at least some pain medication, nothing really made a huge difference.
After the weekend, I went back to the doctor. Everything looked stable, and I was placed in my first cast. The pain never went away. I mainly used the pain medication Vicodin, which pretty much just settled the pain down. My analogy is that when the pain was bad, it felt like my foot was in a steel leg trap. Taking Vicodin made my foot feel like it was in a vise grip instead. The next time I saw the doctor, he changed the prescription to a higher dose per tablet. I asked him why, and he said it didn't matter, so I thought maybe I had been cheating myself and not taking enough. I then took the maximum dose of the higher concentrated medicine, but you know what - it didn't make much difference. So I asked the doctor, "Am I doing something wrong here?" He told me, no, the only way to make the pain go away completely is to give me so much medicine I'd be knocked out!
I was also very naive when it came to how long the pain would last. I thought after two weeks, I'd have to take an occasional Percocet or something, and there would be no more pain. I was kind of waiting for that two week period. That was not true at all. The pain continued about the same, more or less, sometimes I could take less medicine, sometimes I had to take more. The pain really didn't substantially improve until I had the cast taken off, nine weeks later. And six months, later, there is still a level of pain.
Before the operation, I was given a nerve block in my lower leg. This was apparently a somewhat new procedure, as I was called by the hospital to let me know that was recommended and sort of asked if that's what I wanted. Well, sure, why not? As I look back on the whole thing, it was a good thing to have. Basically my lower leg was numbed.
I woke up from surgery from the one of the best sleeps I ever had. I think I even recall a dream of standing in a corridor wearing office attire. Anyway, I didn't want to be awakened. My main discomfort was my throat was sore (more than likely I had a tube down my throat). They put me in recovery in a semi-recumbant position. I was wide awake and had no pain at all. My leg was wrapped in huge ace bandage type stuff. They let my husband come in and see for a few minutes, then he left. I just lay there. I thought I should sleep because there wasn't any TV, and I didn't have my glasses to read, and anyway, there wasn't anything to read, but I was so well rested I couldn't sleep. I think I was there for 2 or 3 hours watching the screensaver on the computer monitors which just kept scrolling sentences about hospital safety tips, like "Don't block doors."
I should have mentioned the plan was for me to stay at least one night in the hospital after the operation. I learned why the doctor recommended this - the pain! The nerve block stopped the pain until about 10 am the next morning. I had a pain pump with the nerve block which I had not used, but then the pain started and I started using the pump. It really didn't seem to make a difference at that point. I told the nurses my foot was starting to hurt, they gave me some sort of IV pain med, probably morphine, which didn't really seem to help. I e-mailed the doctor, not expecting he would really respond, but he did, and the nurse gave me Percocet. I was then transferred to the orthopedic floor and given oxycontin, which settled the pain. The doctor decided I should spend another night in the hospital, and that turned out to be a wise decision.
I was told by the nurse I would get more percocet at 7:30. So before my husband left at the end of visiting hours, I asked for pain medication. When he left at 8, I asked him to remind the nurses on his way out, but by 8:30 I hadn't gotten any meds and I started getting the worst pain I have ever had in my life. Nurse then gave me daravan? iv, which slowed my respiration and made me feel like I was being weighed down on the bed, but the pain in my foot was excruciating. I was counting down the hours all night long until I thought I could take more pain medication. Nurse gave me another iv around midnight which helped but I still had very sharp, burning pain in heel. I told her, why is there that sharp pain still there? The pain on the scale of 1 to 10 was 11. I finally got another dose of percocet. The nurse figurged out the iv's didn't work and came in with a benadryl. I thought that was an allergy medication, and was slightly confused, but I finally was able to sleep. And when I sleep, I don't feel pain. I got an oxycontin dose at 4:30, woke at 6am asked for pain med, percocet. The pain was still there but somewhat settled down.
From that point on, I didn't dink around. I kept track of the time, and the time for medicine. I didn't want that pain to get a hold again. When the doctor suggested maybe I should spend another night in the hospital, I figured if I had pain prescriptions, I could probably monitor what I needed when better on my own at home.
I spent the weekend taking various pain medications within the prescribed parameters, like 1 or 2 pills, every 4 to 6 hours, trying to find the best combination, and I kept close track of how much acetaminophen I was taking so I wouldn't overdose. It was so weird. The pain was so changeable, and while I was sure to be taking at least some pain medication, nothing really made a huge difference.
After the weekend, I went back to the doctor. Everything looked stable, and I was placed in my first cast. The pain never went away. I mainly used the pain medication Vicodin, which pretty much just settled the pain down. My analogy is that when the pain was bad, it felt like my foot was in a steel leg trap. Taking Vicodin made my foot feel like it was in a vise grip instead. The next time I saw the doctor, he changed the prescription to a higher dose per tablet. I asked him why, and he said it didn't matter, so I thought maybe I had been cheating myself and not taking enough. I then took the maximum dose of the higher concentrated medicine, but you know what - it didn't make much difference. So I asked the doctor, "Am I doing something wrong here?" He told me, no, the only way to make the pain go away completely is to give me so much medicine I'd be knocked out!
I was also very naive when it came to how long the pain would last. I thought after two weeks, I'd have to take an occasional Percocet or something, and there would be no more pain. I was kind of waiting for that two week period. That was not true at all. The pain continued about the same, more or less, sometimes I could take less medicine, sometimes I had to take more. The pain really didn't substantially improve until I had the cast taken off, nine weeks later. And six months, later, there is still a level of pain.
Thursday, September 10, 2009
At First...
I thought the splint was put on wrong. The girl who put it on didn't seem too assured in what she was doing, and she put these two very hard "things" right next to the bones of my foot and a ton of cotton padding. It hurt like hell. I had to take a two hour car trip to get home, and I just couldn't wait to get home and take it off, even though the ER doctors told me not to touch it, and don't take a shower.
I did take it off, but thought I'd better leave some of the padding on, and wrapped it with an ACE bandage. The next day I realized it wasn't the splint that was causing the pain - it just hurt. I put most of the splinting back on.
Since I was dirty because I was ready to do some painting before I fell, I HAD to take a shower! I decided to keep the splint on, and my husband wrapped my leg really well, we put a stool in the shower for me to sit on, and somehow I crawled over the rim of the tub. Nothing got wet. Now the second time I took a shower, about one week later before surgery, I poo-pooed to my husband that he was putting entirely too much duct tape on the garbage bag on my leg. What a dummy. A little water got inside. A wet splint is miserable. Fortunately I didn't have to endure it too long because I went into surgery. I subsequently sponge bathed, until I ordered a dry-cast wrap. It worked well, but since I never wanted to experience a wet cast again, even with the wrap on, I sat in the tub to take a shower with my leg draped outside the tub!
After my first visit with the surgeon, I was determined to get the swelling down. I seriously made sure my leg was above my heart. I waited to get up to go to the bathroom. Before I propped my leg up, I made sure I had everything within reach. I'm a private practice doctor of chiropractic, so I had to go to the office at least a few times that week, but my husband drove, and when I was in the car, my leg was still propped up for the ride. When I got to the office, I mostly let my staff do therapy, while I charted with my let propped up on the desk, above my heart.
The pain was bad, but it seemed like it was easing somewhat during that week. I remember during the second visit to the surgeon, I hadn't taken Vicodin that morning, and asked him if I should continue to be stoic and only take it when I couldn't stand the pain anymore, but he told me for crying out loud, you broke a bone - take it when you need it!
The assistant in the cast room took the splint off. My foot was all purple and looked swollen to me, but not near as bad as the week before. I didn't know if it was good enough. The doctor came in and immediately remarked on how much better it was, and we were ready to go! Of course, scheduling for surgery is not immediate. There are CAT scans to obtain, surgery suites to be available, pre-op screening/testing, etc.
All requirements were met, the date was set, I was good to go.
I did take it off, but thought I'd better leave some of the padding on, and wrapped it with an ACE bandage. The next day I realized it wasn't the splint that was causing the pain - it just hurt. I put most of the splinting back on.
Since I was dirty because I was ready to do some painting before I fell, I HAD to take a shower! I decided to keep the splint on, and my husband wrapped my leg really well, we put a stool in the shower for me to sit on, and somehow I crawled over the rim of the tub. Nothing got wet. Now the second time I took a shower, about one week later before surgery, I poo-pooed to my husband that he was putting entirely too much duct tape on the garbage bag on my leg. What a dummy. A little water got inside. A wet splint is miserable. Fortunately I didn't have to endure it too long because I went into surgery. I subsequently sponge bathed, until I ordered a dry-cast wrap. It worked well, but since I never wanted to experience a wet cast again, even with the wrap on, I sat in the tub to take a shower with my leg draped outside the tub!
After my first visit with the surgeon, I was determined to get the swelling down. I seriously made sure my leg was above my heart. I waited to get up to go to the bathroom. Before I propped my leg up, I made sure I had everything within reach. I'm a private practice doctor of chiropractic, so I had to go to the office at least a few times that week, but my husband drove, and when I was in the car, my leg was still propped up for the ride. When I got to the office, I mostly let my staff do therapy, while I charted with my let propped up on the desk, above my heart.
The pain was bad, but it seemed like it was easing somewhat during that week. I remember during the second visit to the surgeon, I hadn't taken Vicodin that morning, and asked him if I should continue to be stoic and only take it when I couldn't stand the pain anymore, but he told me for crying out loud, you broke a bone - take it when you need it!
The assistant in the cast room took the splint off. My foot was all purple and looked swollen to me, but not near as bad as the week before. I didn't know if it was good enough. The doctor came in and immediately remarked on how much better it was, and we were ready to go! Of course, scheduling for surgery is not immediate. There are CAT scans to obtain, surgery suites to be available, pre-op screening/testing, etc.
All requirements were met, the date was set, I was good to go.
Tuesday, September 8, 2009
Fall From Normal
It's been a long time since I relived the fall. I used to go through it in my mind at least once per day. I was on a simple stepladder, on the third or fourth step, about 4 or 5 feet off the ground. I just needed to get up on the next step. But when I lifted my foot, the ladder started to tip and threw me off of it. I threw my arm out trying to find something to grip onto, and then landed on the concrete on my right heel. My foot/ankle hurt, but I've sprained an ankle before. I sat on the ground hoping against hope nothing was broken. I had felt the force on my heel so I felt around it and it felt intact, but it hurt a lot.
My husband and stepson came over, and wanted to get me up. I thought my ankle was hurt pretty bad, so I told them we better get to urgent care or emergency for an x-ray, cause you just never know without an x-ray. Man did my foot hurt!
After x-ray, the orthopedic doctors on call came in. They said it was a broken heel bone, I'd need surgery, and have to stay off of it for 12 weeks, but they didn't really know for sure because they weren't foot specialists. For now, go home (because it happened out of town), keep the foot above my heart, make an appointment for Monday with either an orthopedic surgeon or a podiatrist. In the end, I sure was glad I called a foot surgeon. This break was so bad there was no way...anyway
I didn't believe it. I went home and hoped it wasn't that bad. Yeah, I spent the rest of the weekend with my foot up on a few pillows with the splint on. I got up as little as possible, used the crutches of course. I usually don't get hurt. I do things, but if anything happens, it's usually minor and I recover very fast.
By the time I got to the foot surgeon's office Monday afternoon, my foot was very swollen. It was the worst case scenario. Smashed heel bone, surgery as soon as possible, then absolutely no weight bearing for 12 weeks afterward. But the swelling would have to come down. If it didn't, surgery would be delayed. Wow, was this ever hard to accept. First of all, my life would have to stop. When they said foot above heart level, they meant it. No getting up, no walking, much less driving. And thank God we have a house without steps. Ah, yes steps - I never knew how daunting they could be with only one foot/leg.
My heart just sank. I looked down, I looked at my husband, I just thought and probably said, well I'll do what I have to do.
Thus began a journey longer than I ever thought was going to be necessary. A journey of healing, rehabbing, trying to get my life, ME, back. A journey I'm still taking...
My husband and stepson came over, and wanted to get me up. I thought my ankle was hurt pretty bad, so I told them we better get to urgent care or emergency for an x-ray, cause you just never know without an x-ray. Man did my foot hurt!
After x-ray, the orthopedic doctors on call came in. They said it was a broken heel bone, I'd need surgery, and have to stay off of it for 12 weeks, but they didn't really know for sure because they weren't foot specialists. For now, go home (because it happened out of town), keep the foot above my heart, make an appointment for Monday with either an orthopedic surgeon or a podiatrist. In the end, I sure was glad I called a foot surgeon. This break was so bad there was no way...anyway
I didn't believe it. I went home and hoped it wasn't that bad. Yeah, I spent the rest of the weekend with my foot up on a few pillows with the splint on. I got up as little as possible, used the crutches of course. I usually don't get hurt. I do things, but if anything happens, it's usually minor and I recover very fast.
By the time I got to the foot surgeon's office Monday afternoon, my foot was very swollen. It was the worst case scenario. Smashed heel bone, surgery as soon as possible, then absolutely no weight bearing for 12 weeks afterward. But the swelling would have to come down. If it didn't, surgery would be delayed. Wow, was this ever hard to accept. First of all, my life would have to stop. When they said foot above heart level, they meant it. No getting up, no walking, much less driving. And thank God we have a house without steps. Ah, yes steps - I never knew how daunting they could be with only one foot/leg.
My heart just sank. I looked down, I looked at my husband, I just thought and probably said, well I'll do what I have to do.
Thus began a journey longer than I ever thought was going to be necessary. A journey of healing, rehabbing, trying to get my life, ME, back. A journey I'm still taking...
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