On The Mend

It's the fatigue that still gets to me, three weeks on. I'm always tired, always snoozing.

It's why I haven't written any blog posts in a week. By the time dinner is over, I just want to lie down, elevate my casted leg, and rest until bedtime.

But there is progress. I have no trouble moving around on my crutches—except for last Saturday, when I stumbled coming down our stairs and landed at the bottom on my back. Luckily, I was only four or five steps from the bottom of the stairs, and I protected my foot above everything else. Only my right shoulder blade took the brunt of the fall (or is that landing?).

I've even negotiated the snowy outdoors, attending DD15's first jazz performance of the season, and getting to and from my car to make it into the office (but only on days where the weather doesn't make crutches an even greater challenge.

If it snows, I stay home. After all, I can't exactly sweep snow off my car on crutches.

DW did some research on hands-free crutches, and I've been using an iWalk 2.0 for almost a week. It takes some extra effort to strap it onto my leg and takes some getting used to walking on, but so far I've managed a day in the office without falling: stumbling a few times, but no falling.

But the effort of spending a day at the office wears me out and raises what is already a high heart rate. On Monday, I hit a record 172 bpm, surprising even me.

I've been to follow-up appointments twice since the November 15 surgery. The first appointment was to remove the staples from my hip, from where my surgeon harvested bone. The hip still aches a bit but is no longer sensitive to the slightest movement. A nurse also removed my temporary cast to check the status of my foot and place a more stable, fibreglass cast over my foot.

It wasn't until this first followup that I learned my foot is now carrying hardware. Eight screws and a plate hold the bone graft together. My surgeon proudly showed me the x-ray, but to me it looked like the foreign objects were dropped randomly into my open wounds.

I've been partially assimilated.

On my second followup, last Friday, the cast came off so that the stitches in the two incisions in my foot could be removed, and they could look at the progress of my foot.

The same nurse cut off the fibreglass cast. As she cut away the cotton and bandages, she remarked on how clean my foot was. No oozing of blood and other fluids. Once exposed, she sniffed my foot. "It looks clean and smells good. You should see some of the feet we've had to deal with."

A doctor, not my surgeon but an intern, examined my foot. "This is coming along very well. You're healing nicely." A male nurse came in with tweezers and a scalpel, and more bandages, as the intern walked out. He explained that pulling the stitches wouldn't hurt any more than plucking the hairs from the top of my feet.

He was right: it didn't hurt more; it hurt exactly the same.

This nurse wasn't sure if we'd be using another fibreglass cast, so he left me alone with my bare foot while he consulted. When he came back, he had the best news of the day.

"I spoke with Dr. M— (my surgeon), and he said that the progress was going so well that I'm to fit you with an Aircast."

An Aircast is a soft-lined cast with two airbags on either side of the foot, from above the ankle, down, and has a hard plastic shell on the outside, held together with Velcro straps. A pump on the boot allows me to regulate how much air to place inside each bag.

The most important part of being in an Aircast is that I can remove it, allowing me to have a proper bath. The intern had returned to explain it to me. "Under no circumstances are you to bear any weight on this foot. Keep it off the ground and keep it elevated as much as possible." Putting weight on my bad foot, he explained, could undo all the work and make my foot worse.

With the stitches out, the nurse placed a bandage over each incision. He then made a long sock out of a tube of thin fabric, and fitted it from my toes to my knee. He gently set my foot in the Aircast, tightened it up, and showed me how the pump worked. "Keep the bandages on for 48 hours, after which you can have a bath," he said. Be careful getting in and out. Get help. You can put a light sock over the foot, whatever makes you comfortable."

The intern told me that my next appointment will be in four weeks, on December 28. If my foot continues to heal as it has, I may be allowed to bear weight.

Six weeks after surgery.

Originally, my surgeon said it would take three months in a cast, and then another month in a walking boot. Now, my recovery time seems to be half that.

In high school, I split my shin in two while playing soccer. It was a diagonal snap that ran more than three inches across the bone. I was placed in a full-leg cast and was told that I would be in it for at least 12 weeks. In subsequent visits, I was told 10 weeks, and then nine weeks. The doctor chalked it up to a healthy constitution. I heal quickly.

I think my surgeon stated the worst-case scenario when he estimated three months. He most like likely built in a buffer, in case my incisions became infected, in case I fell and injured the foot. On the course I seem to be on, I'll hopefully be on my feet—both feet—in no time.

For now, I take it easy, listen to my body. When it tells me to rest, I'll rest. And so, if I don't post a blog entry on a particular day, you'll know why.

It's the fatigue.