Sunday, May 26, 2013

A month after -- and grateful for Crocs

Last Friday makes it four weeks since surgery. I'm out of the boot and hobbling around on one and three-quarters feet; I'm still favoring the area around my big toe. Still taking Naproxen twice a day, mainly to help keep the swelling down.

I admit it -- I was rather afraid of putting my foot down at first, but my desire to get out of the boot was stronger. The first day, I wore the post-op shoe, more for the psychological comfort of wearing a "post-op shoe." But, even though it is fully adjustable, it is still too wide for my heel and ankle, which makes it uncomfortable to walk in.


As the woman in the waiting room at the doctor's office said, it felt "weird" at first. I stood up, and was completely off-balance, a testimony to how quickly we humans adapt. After two weeks of walking balanced on one heel, I felt as if I were falling forward with every step. I walked around the bedroom, holding onto the furniture, until I felt confident that I wouldn't end up flat on my face!


Despite everything I read to the contrary, I can get my foot into several different pairs of the shoes I already own -- the Skechers clogs that I've been wearing for months now, a couple of pairs of Skechers summer shoes that are well-broken in, and my athletic shoes. And the Crocs that I bought solely to work in the yard. They have now become my shoe of choice for everyday wear.

I have gone shoe shopping twice, hoping to find a pair of adjustable sandals to wear this summer, but no luck. I would describe my foot as "puffy" rather than "swollen" -- semantics, possibly, but it's my blog and my foot and I'll call it what I want! Even the $145 Clark's were not quite adjustable enough. They went on easily enough and felt great, and then I stood up, and my foot started to swell, and . . . that was that. What I was hoping for was something like the Nike Sunray sandals, but apparently they only make them in kids' sizes. The Nike slide for women puts all of the pressure across the ball of the foot, unfortunately; I need something that straps across the instep. So, it looks like the Crocs will be seeing a lot of service for the next few weeks -- or months.

As I may have mentioned, walking is not the issue. Standing is. Walking -- hobbling -- is tiring, but it keeps the blood and whatever flowing, but once I stop, whoosh! Everything expands. Then it's back to elevation and ice. I've managed to make the coffee now for three days in a row, but any cooking that requires more standing than that is . . . problematic.

Speaking of cooking -- I wish I had taken a photo of the kitchen disaster last night. We still can't understand how it happened. Mike put a pizza on the top rack of the countertop oven. When he went to take it out, it had slid off the rack -- but not onto the rack below -- not even onto the heating elements at the bottom -- but underneath the heating elements. It was upside down underneath the heating elements, completely flat. It was a struggle to get it out, and we had to scrape most of the cheese and pepperoni off of the oven and plop it back onto the pizza -- so how did it get there in the first place?

I can only think of one logical explanation -- but he says he didn't do it.

Wednesday, May 22, 2013

Advice for the bunionectomy-bound

And by bunionectomy, I mean those of you who will be having your bones broken and put back together using screws or pins or some other form of hardware. If you're just having the bunions shaved -- lucky you! You don't need advice, just common sense. And a pair of shoes with a thick sole, such as clogs, Crocs, or athletic shoes, to balance with the walking boot (everyone will need those eventually).

For the rest of us, these are things I wish I had known in advance: 

If you live alone, you must have someone come to stay with you for the first week, and preferably two, until you are out of the splint and into the walking boot. I could not have managed without my husband -- and I lived alone until I was nearly 50. There are things you cannot do while on crutches, such as carry a cup of coffee or an ice bag, but of greater concern is the danger of falling and no one there to help you get up.

If you don't have a breakfast tray, this is the time to invest in one. It not only holds food -- it holds a laptop computer at just the right height. And even the weight of the laptop will be too much for your leg at first (yes, your entire leg will hurt for a while).

Gel-pacs. At least two. You'll be given an ice bag, but gel stays colder longer. It also takes a while to freeze, so either buy two so you can trade off, or plan to use an ice bag while the gel is freezing. The ones I have came with covers and velcro straps that hold them in place. Cold is your friend. It will take the swelling down as well as numb your foot


Request a walker rather than crutches. Let me be blunt -- I don't care how young you are, unless you have grab bars installed in your bathroom, you need something to hold on to in order to get up off of the toilet. Don't believe me? Try it. Sit down, then try to get up with only one foot on the floor. Unlike the bed, the couch, an armchair, there is nothing to push against. It can be managed with crutches, but why take the risk of falling? Or install a toilet safety rail.

Even better, if you have the funds or can borrow one, a knee-walker increases your mobility and independence many times over. You may need to experiment with using it in some situations. Add a removable bicycle basket and you'll be able to carry that coffee -- in a travel mug.

Place a chair, stool, egg crate, box -- something stable in front of the bathroom sink so that you have some place to rest your knee while brushing your teeth, etc.


 Buy a shower seat. Measure your tub or shower to get one that will fit. Your doctor will tell you that you can stand, balanced on your heel, but why risk slipping and falling, if you don't have to? One with a cut-out for a hand-held shower is ideal.

Install a hand-held shower. They're also great for rinsing the tub down after scrubbing it, when you're back in action. The one I got turns off at the shower head, so it also saves water. Although, really, forget about showering or bathing the first week, at least on a daily basis. It's not worth the hassles and the risk. You're just sitting in bed anyway; how dirty can you be? Use antiseptic wipes (stock up in advance) on all of the important places as necessary and change your underwear and pajamas daily. You'll feel better, but without the risk of falling.

Buy cast covers for when you do shower. I used the Curad and they work wonderfully. You will need help to get it over the splint, unless you're very flexible. The opening is very narrow, but it will stretch to go over the splint.-

I ordered all of the above from Amazon, by the way. Got a very good price on everything and it was delivered in a few days. Read my reviews at :
http://www.amazon.com/review/R27CCEV3O2P4B6/ref=cm_cr_pr_perm?ie=UTF8&ASIN=B007HCDMJ0&linkCode=&nodeID=&tag=
http://www.amazon.com/review/RO5X7FZK0LV14/ref=cm_cr_rdp_perm
http://www.amazon.com/review/RPAZFPKT48FWY/ref=cm_cr_rdp_perm?ie=UTF8&ASIN=B005IV0DAS&linkCode=&nodeID=&tag=
http://www.amazon.com/review/R1VJY4IJ0J05JG/ref=cm_cr_rdp_perm?ie=UTF8&ASIN=B003VMAKVS&linkCode=&nodeID=&tag=


Plan to spend the first week in or on the bed, going no farther than the bathroom. I say "on" the bed because of the splint. Mine had a foam rubber cover, which caught on bedding. I discovered that the most comfortable method was to strip the bed of all but the bottom sheet, then place the pillows I was elevate my foot in the appropriate place. I used throw as a cover at night and folded it at the foot of the bed during the day. Otherwise, the bedding would bunch up.

Expect to spend at least the first three days sleeping between pain pills -- which you will probably be taking every 4 hours. As the codeine would wear off, my foot felt as if there were a tight band around the base of my toes for several days, then just around my big toe. It felt as if the band were getting tighter and tighter, and also as if there were something thin, hard and sharp between my big toe and the next one. The ball of my foot would swell until it felt as if it would pop. When the splint and bandages were removed, I discovered that the "band" was my skin.

Elastic-waisted pants -- pajama pants, sweats, gym shorts -- are much easier to deal with. Trust me. And since you'll be sleeping so much at first, invest in a few extra pairs of pajamas.

After the first two or three days, the codeine (Lortabs or Vicodin or generic) will make you feel as if you can get right up and resume at least some of your normal activities. It is lying to you, as you will discover the first time you lose your balance and fall. If you're lucky, you'll do what I did and fall onto the couch.

And it will make you constipated. According to everything I read, do not take a laxative without discussing it with your doctor; you have to take the right kind, or it can make the problem worse. Drink a lot of water; increase fiber in your diet (yep, prunes and bran cereal). If it lasts more than 3 of 4 days, call  your doctor. It pretty much clears up as soon as you stop taking the codeine every 4 hours.

Naproxen. What can I say? It will make you belch uncontrollably for the first week. Also, well, pass it in the other direction. But you must take it as directed. It is what will take down the swelling. After a while, your body adapts.

Friday, May 17, 2013

Out and About in a Boot

I mentioned my two earlier forays in my previous post, but it wasn't until Wednesday that I went out and attempted to get around on my own.

Nothing tells you that you've reached middle age more than young men running to hold doors for you as you propel yourself along on your knee walker, and call you "Ma'am."

The event was our Project Recovery final conference. For those who do not know, our program received a grant three years ago to educate 30 students and place them in libraries that were damaged by hurricanes Katrina and Rita (never preceded by "hurricane" here and frequently referred to simply as "the storm.") The students all received full tuition and full-time students received a stipend. They volunteered 20 hours per week in one of the partner libraries, while part-time students volunteered 10.

I was added to the grant two years ago when Dr. Robert Ward passed away suddenly from cancer; I did not in any way replace him. Because the grant was already underway, my role has been primarily to provide necessary support and advise the students in children's and youth services and some in public or school libraries.

The event included a panel of representatives of the partner libraries, who spoke very highly of the work that our students had done for them, (just between us, in a few cases, I had to admire the speaker's ability to say something positive without lying -- not every student was exemplary), a lunch at the Faculty Club, and brief comments by each of the students.

It was a truly inspiring event. The students who attended were among the most committed and willing, and they had all grown so much over the past two or three years. They reminded me of why I am doing what I am doing.

I am glad that I went, but it wore me out. Not only have I been sedentary for the past two and a half weeks, scooting along with one knee bent is not natural, even when it is resting on a nicely padded support.

And that is why I spent Thursday in bed and didn't even bother to shower or get dressed.

Seven Days in the Boot

We've all seen people walking around in the foam-lined Frankenstein boots that have replaced plaster walking casts for the most part. They are a true modern medical advancement, and I speak from experience. When I had the bone graft in my left ankle lo, these many years ago, I had a cast from my toes to my hip for a month, then a plaster walking cast -- it had a hard rubber bump in the center -- for another month. So, yes, the boot is better, but it isn't perfect.

Everything has become a production. The first step is to put my foot into the boot, wrap the foam liner around it, then secure it firmly but not tightly each of the six straps. Because the boot is designed to keep weight off of my toes, the center of gravity is shifted to my heel, which means that I have to make a conscious effort not to fall over when I stand up. Try it yourself -- keep your weight on your heel, your toes in the air, and stand up. It would make a great party game!

Then it's step-clump-step-clump-step-clump. "It's alive! It's alive!!"

After I learned to walk in it and not fall over, I had to reaccustom myself to being able to move from one place to another while carrying something in my hands! I felt truly liberated. Although, once I've sat down and removed the boot, it's still easier to ask Mike to do me a favor.

Oh, yes, it must be removed."Firm but not tight" becomes "tight!!" when you're not walking around. But, without a doubt, a vast improvement on a splint and crutches.

I've pretty much stopped taking the codeine, although still on naproxen twice daily, and use of ice bags is now more or less limited to evenings, when everyone's feet swell, not just those of us who paid someone to cut  it open (think about that -- I not only asked for this, I paid for it! And I'll be doing it again in a few weeks.) I'm still spending days in bed, because my foot still has to be elevated. This room needs new objets d'art.

The day after I got the boot, our neighbors, Mike and Lois, invited us to a benefit for the New Orleans Spina Bifada foundation, north of St. Francisville. Friends of theirs were providing the music and there was food -- what more could a shut-in ask for? I just kept my foot elevated on a chair, and did pretty well, although I did ask Mike for a bag of ice after a couple of hours. Always carry an ice bag with you! I had to dig a little sandwich bag out of my purse, and of course it had a hole in it, which bothered me not at all at that point.

I did find that, while walking was not a problem, standing was. My foot does not swell when I'm walking -- but once I've stopped . . . it does. Well, not foot precisely, but big toe and the space between it and the next toe.

I also got to go shopping this week and drive the motorized cart around Sam's Club. I may save the boot for future use. People are so much more polite, and move their carts out of your way.


And, then, on Monday, it happened. Mike put in a load of washing, and several minutes later, came to tell me that our 6 1/2 year-old Kenmore washer was not working. I blithely assumed that he had simply not pulled out the knob, but,he had -- and it was not agitating. It had filled with water, but would not agitate. It drained. It spun. It filled. It did not agitate. I was agitated, however, very agitated.

He was (and remains) convinced that he had somehow broken it. After I had a screaming fit, I calmed down and realized that he simply could not have -- and if he did, then there was something wrong with the machine beforehand.

Angie's List provided Mark's Maintenance, we called, and Tuesday afternoon he came out. He replaced the agitator dogs in 20 minutes, hooked it back up, started a load --- and it still wasn't agitating. He finally diagnosed it as a stuck clutch brake, which is does not fix as it is as 5-hour job and costs more than a new machine. He did not charge us for the work, as he could not fix it. His business card is next to our phone now.

So, after a crying jag and debating whether to just use a laundromat for the next 6 months, I went online and ordered a new Samsung from Lowe's. There goes my range, again. It was delivered on Wednesday evening, and we spent all day Thursday catching up on nearly 3 weeks worth of laundry -- with a few loads left for today.

It's HE, it's Energy Star, it's sleek and modern and chimes when it's finished. It does bedding (shall I tell Mike that, according to what I've been reading, doing bedding in a direct-drive machine, such as a Kenmore or Whirlpool, can lead to clutch brake damage?) and has a "no spin" option, for handwash items. It has an Eco-warm setting -- I think most of us would call that "tepid" -- which balances temperature and wash time. And a 10 year warranty. So maybe, just maybe, I'll be able to get a new range in another year. 

Wednesday, May 15, 2013

Bunionectomies and other indignities of middle age

When even the "roomy, square-toed" clogs become too tight, it's time to bow to the inevitable and go under the knife. First, though, came the custom orthotics (which, even though medically necessary to prevent further damage to feet and knees, are not covered by insurance) and three weeks of night splints
("Yes, I am Iron Man") on both feet to stretch tight calves, achilles' tendons, and arches. Then a pre-op clearance from my primary care -- EKG, blood work, etc. Finally, last Friday morning I was picked up at 6:00 by my friend and colleague, Boryung Ju, and taken to the Lake Surgical Center for surgery at 7:30. Forms were filled out and I was taken back to the prep room, given a gown to change into, and tucked into bed. There was a brief moment on panic when I revealed that I had drunk a glass of water a few hours earlier. Yes, they had told me not to drink anything after midnight, and no, I don't really have any excuse, except to say that I confused those instructions with the ones given the week before which were "nothing except water after midnight." The anaesthetist finally decided that I wouldn't vomit and choke to death, and we went ahead. The IV was inserted in the back of my hand, Dr. Le made a brief visit in his surgical scrubs to explain the procedure again and give post-op instructions (which I do remember, despite the anaesthetist saying that her magic medicine would erase my short-term memory), I was wheeled into the operating room, shifted to the operating table, felt something cold and wet, and . . .

I was telling Dr. Le that I would not accept his late paper. Struggling to wake up and stay awake. Opened my eyes long enough to see Mike's face hovering over me, Boryung behind him. It was something like 9:30. Dr. Le must have this down to both an art and a science.

I sat up, and discovered that someone had mummified my leg while I was asleep

Wiggled my way into my clothes, slid into the wheelchair, wheeled out to Boryung's car, arrived home, hobbled my way to the bed, and back to sleep. The entire weekend is a blur of sleeping, waking to take meds, and food brought on trays.




The medications -- naproxen twice a day, a codeine prescription as needed -- made the pain almost bearable, once the local anesthetic wore off, but my poor husband was sent back and forth for ice frequently. For those who are interested,  it felt as if someone had tied a rubber band across the base of my toes and was tightening it steadily. It also felt as if there were something thin and sharp between my big toe and the next toe, that was cutting into my foot. And my foot was hot -- both from the swelling and from the bandage.

Mike was off through Monday, so it wasn't until Tuesday that I had to try to manage for myself. Mike left a bowl of cereal and a small jug of milk for me on the kitchen table, and left my lunch in the bedroom on the bookcase, so I managed.

However, feeding the cats dinner was another issue. I had to emulate Ma Kettle by kneeling my left leg on a chair and clunking around the kitchen -- but feed them I did.

Personal hygiene consisted of wipe-downs with antibacterial wipes -- actually most effective, if done daily -- and a change of clothes. I quickly discovered that elastic-waisted shorts were the most practical, so my gym clothes were pressed into service, as were my sports bras. No one tells you that the underwires in your bra will catch on the padded cover on your crutches and threaten to send you over.

I now understand the purpose of grab bars in the bathroom, and will be having our retrofitted as soon as we can get the money together. And next time, I want a walker, if only for something to hold onto while I try to stand up using only one foot.

Despite Mike's protests, I insisted on getting up every day and sitting in the recliner in the living room, laptop on my lap, tray table at my side. I refused to act like an invalid. Just getting down the hall and onto the couch using the crutches left me breathless and puffing, but I was not giving in. 

By Wednesday, my hair was beyond filthy, so I knelt on a chair in front of the kitchen sink (are you sensing a theme here? Chairs are useful things) while Mike used the kitchen sprayer to help me wash it. I had already sent an order in to Amazon for a shower seat, a hand-held shower and some cast covers, but could not wait another day, as LaToya was bringing some forms for me to sign later that day and I do have an image to maintain.

Got an e-mail that morning that some packages had arrived at the office from Amazon -- what??? I had specifically selected my home address. It turns out that, if you have 1-click ordering turned on (I do not remember doing that, but possibly), then regardless of which address you select, anything coming from the marketplace goes to your 1-click address. It was too late to catch LaToya, but Tao was willing to bring them over on his way home from work.

So, Thursday I finally had a shower for the first time in 6 days -- sat on the bench, leaned forward to turn on the water -- a white paw pushed the shower curtain aside, and a big, furry black and white thing darted under my legs and the bench, and between the shower curtain liner and the side of the tub.

After I stopped laughing, I called Mike to come and get Miller out of the tub. It took some doing.


Our neighbor came over later in the day and installed the hand-held shower, which makes it all even easier. Not only can I do my back without standing up and turning around, I can turn the water off at the shower head.

I also ordered a knee-walker and a bicycle basket for it on Wednesday which arrived on Friday.


 After reading the instructions carefully, I promptly proceeded to crash my new bike. It was entirely my fault -- I had set the brakes, put some things in the basket, then pushed off, without releasing the brakes. I fell on my left side, bruising and scraping my right shin (also right shoulder and right forearm, which I did not discover for several days). I called the doctor's office, but the nurse did not seem terribly worried. I wasn't in much pain, particularly, so she suggested that I wait and go to Urgent Care later, if necessary.

At 10:00 that night, the codeine was not working, a demon was tightening a red-hot iron band around the base of my big toe, and I was getting more and more worried, so I sent Mike over to the neighbor's. He drove us to Urgent Care, where they x-rayed my foot and pronounced it undamaged. The doctor did cut the gauze away from my toes, to see if they were turning purple -- they were not, but oh the relief to get some air to them! -- and gave me a stronger codeine prescription. I can say now that the bandages are off that I had bruised that foot in several places, which was causing the pain.

So, yes, I recommend the knee walker -- and I second the instructions to be aware and go slowly.

I spent the second week in bed, getting up only in the evening for dinner and a bit of television. Oh, I showered and dressed, and sat on top of the bed, but on the bed I stayed. And, you know what? It really makes a difference. My foot is propped on a couple of pillows, but my knee has the support it needs. I'm not exhausting myself going back and forth every hour or so; I have the laptop on the breakfast tray, not resting on my lap. In other words, my husband was right.

So, last Friday, the bandages came off and I was given a walking boot. My foot is not nearly as swollen as I expected -- or as it felt! The "band" around my big toe is actually . . . skin. The screws are in place and everything is healing as expected.

You can see the famous chair -- and the bruises on my right leg. The blue wrapping was temporary, but I do have it in an ace bandage most of the time.

I still spend most of my Day on the bed, with my feet elevated, because it's just plain more comfortable. Mike picked up a couple of different types of ice bags, and one or the other is usually on my foot. I've only take codeine a couple of nights in the past week, and never in the day -- the ice is all that's needed.

I had to learn to balance myself again -- I actually needed the crutches to walk out of the doctor's office in the boot! And I admit to being scared at first to put any weight at all on that foot.  More on life in a boot next.