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Monday, February 20, 2017

Post Op from a Patient's Perspective

Hi Dr. Blake,

Today I am at exactly 6 weeks post-op for accessory navicular excision and partial post tibial tendon reattachment. My surgery was January 9th. My surgeon has cleared me to start driving, and he said I am allowed to walk without crutches or the walking boot if I want to, starting today. 

I am not ready to walk without boot/crutches yet, but I can drive short distances. I have been pretty careful/conservative with my healing, so despite being allowed to put weight on my foot in the boot the past several weeks, I have not done so frequently because it would sometimes hurt and cause swelling. I tend to worry, so I erred on the side of caution while carefully moving/stretching/building back some muscle non-weight-bearing.

I know some surgeons prohibit weight-bearing entirely the first 6 weeks. My surgeon takes the approach that it is better for me psychologically to be more mobile (which I appreciate) and he knows if I am in pain, I will stop. He has assured me that the tendon is very structurally sound and I can't do damage. It's just a matter of pain management. He only had to partially reattach the post-tibial tendon so it is probably more solid than an entire reattachment.

My Achilles' tendon is very stiff and my foot is weak. I have noticeable atrophy up to the lower thigh. I could have been using an exercise bike, but since I haven't had time to procure one yet, I've been doing light motion/pushing exercises on my roll about scooter. I'll be scheduling physical therapy today for the next few weeks.

I rarely need to ice because elevating my foot reduces the heat/swelling. I've been given some heavy duty compression stockings. I don't like them, but I should probably try to wear them when I start walking more.

I am currently able to limp with the boot only, or walk smoothly with one crutch on the opposite side of the boot. Yesterday I noticed when I did a lot of walking with one crutch I had pain/tenderness later. A good night's rest seems to reset me, and I always feel better in the mornings.

The incision looks great and is healing nicely. I decided on my own to use silicone strips to protect it and help it heal better.

I've never seen my leg like this. It's all bone and floppy fat! Even if someone didn't have surgery, I doubt they would be able to walk if they didn't use their leg for 6 weeks. 

One thing I would like to comment on is the issue of post-surgical depression, which had been a struggle. I usually beat the winter blues by going shopping and staying as active as possible in the winter. Spending the majority of the worst part of the winter on the couch is challenging. If someone has never had surgery they might not be prepared for the emotional and mental challenges of being weak, vulnerable, bored, etc. 

Plus, as I'm sure you're aware, other parts of your body become overworked after a surgery while trying to compensate. My "good" foot is aggravated, and every week I've pulled a different muscle somewhere in my body by mistake! I can't wait to get back into full body workouts! You see, the past 3 years I was more sedentary than I used to be. So I wasn't in the best shape pre-op. I would recommend to anyone undergoing foot surgery to do a lot of strengthening prior to the procedure so it's not such a big impact.

I'll keep you posted. Thanks for your support.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.