Wednesday, October 14, 2009

Steve's Foot & Ankle Surgery ~ October 13, 2009

On the morning of October 13th, Stephen underwent surgery on his right foot and ankle. As a result of his Stage II posterior tibial tendon dysfunction (PTTD), he had to undergo a calcaneal displacement osteotomy with flexor digitorum longus (FDL) transfer. In laymen terms, PTTD is considered adult-acquired flatfoot where the tendon (posterior tibial) that holds the arch of his foot into position essentially tears or collapses.

There are several reasons for the injury. Steve already has flat feet; add that to the misalignment of his ankle and heel bones & over-usage (specifically during Cavalier gamedays) and you have PTTD! The surgery included the cutting of his ankle bone and then realigning it with the heel bone. In addition, they replaced the torn tendon with another tendon from the same area.

We arrived at the hospital just before 8:30 am on Tuesday morning. After getting checked-in, meeting with doctors, nurses, anesthesiologists, etc., etc. he finally went into surgery at approximately 10:30 am. Meanwhile, Rich and I went to a nearby Bob Evans and ate breakfast; we picked up Stephen’s prescriptions and then returned to the hospital and waited. The surgery took about two hours. Steve’s surgeon met me in the waiting room and reported that everything had gone well and he was in recovery. It was another 1½ hours before I was able to see him and at about 3:30, we left for home.

Prior to surgery

Just before he left to go into surgery.

Steve at home and resting.

Steve's foot at home and resting.

Week 1

Soon after we arrived home, we realized that this would be an adjustment for both of us. Personally, I think we’ve managed very well. We both agree that the most difficult adjustment has been going up and down the stairs. Unfortunately, our bathroom is on the second floor so Steve has to head upstairs a few minutes earlier than he used to :) We had a home care nurse come to the house on Wednesday to show us how to inject the blood thinning medication; a simple procedure that we’ll have to do once a day for about three weeks.

On Tuesday, Steve was still pretty numb from the Novocaine, but Wednesday was a different story...he was in quite a bit of pain. He anxiously awaited for the four hours to pass until he could take his pain medication again, but he'll be even more excited when he doesn't have to take it at all! We are both very thankful for our DVR's as watching TV makes the time pass very quickly.

I headed back to work on Thursday, but Stephen managed fine. Between drinking lots of fluids, icing 20 minutes every hour, dangling his feet 5-10 minutes every hour, pain medication every 4 hours, a blood thinning injection once a day, DVT exercises throughout, sleeping, and a few video games…he remained busy and was exhausted by the time I got home :)

He is out of work for three weeks and then goes back on restricted duty for the next 8 weeks. Overall, he will be non-weight bearing on his right foot and on crutches for 8-10 weeks. During that time, he is unable to drive so we need to coordinate our work schedules so that he can drive to and from work with my mom and me. Let’s just say we have a long road ahead of us, but are confidant that after this is over, Stephen will be able to walk pain-free and resume physical activity…both of which he had been unable to do for several months. Who knows? Maybe he can actually run with me some day :)

Week 2

It's been a week already and Stephen has made a lot of progress. He is almost entirely off of his pain medication...he takes one pill before he goes to sleep at night and that's it! I'm still getting used to his immobility. Each morning I wake up a little earlier for work so I can get Steve's "stuff" ready, including his medication, ice packs, water, remote control, and cell phone. I also adminster his blood thinning shot. We haven't really done much of anything and we've been pretty bored. We've watched a few movies and a lot of TV. Stephen has had a lot of well wishes sent his way as well. Sean & Alex were kind enough to give us the first 2 seasons of the British version of The Office, while Karen & Andrew gave us the first season of The Wire. Paul & Sue also gave Stephen the new NBA 2K 10 video game...something that I know has been keeping him busy during the day. On Sunday, we had a very normal day...lots and lots and lots of football. It was really nice. Tuesday night my dad, Berneda & Sean stopped to visit my patient and brought us dinner (Angelo's pizza!!) As always, it was nice to visit with them.

On Wednesday (10/21), we had Steve's first follow-up appointment. It was his first time out of the house since his surgery and we had amazing weather. It's too bad he was only able to enjoy it in between the house and car. Oh well. Everything with the appointment went pefect...until I fainted!! It was really weird. I was watching the doctor unwrap all of the bandages from his foot and then saw the stiches and incisions. I thought, wow that must really hurt! The next thing I knew, I was dreaming happy thoughts and the doctor was shaking me awake. He called for the nurses who took me into another room and gave me ice packs and elevated my feet. I've never fainted before and I've never had issues with blood or cuts or anything. I'm usually the tough one! I'll just blame it on my enduring love for my husband and the thought of him in pain makes me pass out :) Anyway, I was quite embarrassed and apologized to everyone who was there to help Stephen (and not me!)

The rest of the appointment really did go perfect. There was very little swelling, which the doctor was very happy with (it must be his exceptional care at home...) He had his foot & ankle put in another splint and then wrapped over and over and over again. He has another appointment next Wednesday where he'll receive his boot. The following Monday (11/2) is when he returns to work where he'll be sedentary until January 2, 2010.

Thursday night was quite memorable...Elizabeth, Sean & Alex brought us take-out from Players. It's our absolute favorite restaurant and we have missed the people and food dearly. We had a carblicious smorgasbord. That way we could are share! Isn't that cute? Along with a few bottles of wine (sorry, none for Stephen...), we had Butternut Squash Ravioli, Macaroni and Cheese, Cavatelli Rustica & Quatro Formaggio Pizza. Mmmmm...So good and such a great night. Thank you!!!

Week 3

On Wednesday, Stephen had his second follow-up appointment where he had X-rays taken, his splint, soft cast and stitches removed. He also received the boot he'll be in for the next two months.

Waiting to get his stiches taken out. I left the room when they started...I didn't want to pass out again :)

Stiches are out!

We had fun pushing him around in the wheelchair. It was a whole lot faster than crutches!

The new boot!

Below are the before and after x-rays of his foot and ankle. The most noticable changes are to his arch (both the top & bottom of the foot).



The screws in the heel are due to the realignment of the heel and ankle.

Steve really likes this commercial because it reminds him of his life right his recliner, leg elevated, watching all the other kids having fun. I guess I should stock up on some more popcorn.

On Friday, we had our first night out since his surgery. It was a big day :) We went to the Melting Pot with Sean, Alex, Mom & Rich to celebrate Sean & Alex's new house as well as Steve's progressing recovery.

We followed dinner up with a nightcap at Players. It was a long day for Stephen, but even he'd have to admit that it was a really great time and a nice change from staying at home...

Halloween at Sean & Alex's & Sunday football is on the agenda for the rest of the weekend and then Monday is when Steve heads back to work. I feel like I'm sending him off to his first day of school :) He has his new laptop backpack and we were also happy to find out that his pants fit over his boot so we don't have to invest in any new clothes! Ahhh...the little things in life.

Week 5

After another follow-up appointment on 11/18, it appears that Stephen is progressing nicely. He has been authorized to put some weight on his foot while he walks as long as his leg remains straight. It took some getting used to, but he seems to be managing well. His next appointment is on 12/9, where he hopes to have the boot replaced by a large split. We’ll keep our fingers crossed!

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