Flat Foot Surgery recovery - what it looked like & how things felt

 After coming home from my hospitalization for pulmonary embolisms, I quickly became adept at using my knee scooter. It was way easier on my lungs/chest than trying to hobble around on the walker, and I discovered I could do more tasks independently or efficiently (like washing my hands and face) when I could park and brake the scooter. Using the bathroom was also more efficient because I can park the scooter in front of the toilet and prop my leg up on the seat of the scooter, rather than using a different stool to prop my foot. Most foot doctors prescribe a knee scooter for this type of surgery, from what I understand, but I highly recommend it. I rented mine from a local medical-supply store instead of purchasing one and being stuck with it.

When I first talked to my doctor about surgery in June, here's what he laid out to me:

- 12 week recovery

- 8 weeks of cast on my foot

- 4 weeks of boot and physical therapy immediately following cast removal

I didn't realize that the 8 weeks of the cast on my foot meant that it would be switched out every two weeks - I just assumed it would be there the whole time. It turns out that every two weeks, I had to go in for a follow up appointment, where my foot doctor took X-rays and checked my incisions. This means that each time I go to the office, the nurses remove my cast and then my leg has about fifteen minutes to breathe before they put a new one on. 

The most pain I felt at the beginning was in my heel, where the screws are - I think psychologically knowing they were there didn't help, and also since my foot was mostly resting on my heel, it made things very uncomfortable and painful. Throughout the rest of the recovery, most of my pain has- interestingly - been in my toes. They tingle, they burn, they have phantom movements. My foot doctor reassured me that's not unusual, but it has been very weird.

My first cast was purple. When I went in for my second follow up, the cast removal process was a little more nerve-wracking for me because I was now on a blood thinner (Eliquis) because of the PEs. I trusted the nurse with her little saw to cut my cast off, but it still made me anxious! The X-ray process was way easier the second time than it was the first time, although the swelling still made it uncomfortable fairly quickly. My doctor removed the sutures for my incisions at that visit, which I could NOT watch because it made me queasy.

 My daughter requested that I get a pink cast for my second round, which I complied with to make her happy (even though pink isn't my thing, really). She LOVED my pink cast, which made it worth it. However, the wrapping on the pink cast was much bulkier and heavier, which took a lot of getting used to and I found very uncomfortable. Also, by that point my leg was itching like crazy because of all of the dry skin (and hair growth) underneath. 

I was beyond thankful when I went to my next appointment and got that giant pink thing hacked off my leg. I also managed to get some pictures of my foot without the cast on. You can see it's still a little bruised and swollen, but my foot doctor was very pleased with the healing taking place. 

I know, the dry skin and leg hair on top of the suture and everything is super cute.😜

I also got a quick picture of my X-rays:

Clearly you can see my foot is raised a bit in the "now" X-ray because the padding is still on the bottom of my foot and I didn't lay it completely flat on the X-ray platform. But you can see the screws and wedge, and you can also tell that my bone structure has shifted to create the new arch in my foot. 

At my third follow up, I got a blue cast. I was happy because my toes got more breathing room and the cast didn't go as close to my knee. However, it was wrapped by my foot doctor and a new assistant who hadn't had much experience... not the nurses who have typically done all of the casts. On my way out of the office, the nurse saw my cast and said to call if I needed it redone. I tried to tough it out, but after about five days I had to call and ask for them to re-wrap the cast, because the batting was fraying and the plaster on the back was cutting into my calf. 

When I went in to get it rewrapped, they cut the poorly formed cast off and the doctor checked my incisions again. He said they were completely healed (this was at 5 weeks post-surgery). Then they put a new cast on. HOWEVER, when I tried to stand up and leave on the scooter, I couldn't bend my leg at 90 degrees because they had wrapped the cast too high in the back! So I had to sit back down while they removed that cast, and tried again... luckily the third time was a charm and my third blue cast fit nicely and comfortably against the top of my calf. 

Blue cast, pink compression sock. : )

Because of the way scheduling panned out, my foot doctor decided that this blue cast could stay on until week 8 instead of applying another one for just a week. So now I have only 8 days left until my cast comes off for good! I am excited, but also know that this journey isn't over yet, because my muscle has wasted away so much that I will have to start physical therapy immediately in order to be able to walk with my boot once they take the cast off. Mostly I'm relieved that it's healed so well, and my goal for the next 8 days is to be as careful as possible to keep my foot safe and sound in its cast!

Flat Foot Surgery PLUS Pulmonary Embolisms

 My surgery on my right foot was on a Wednesday, my follow up appointment with my foot doctor was on a Friday, and on Tuesday morning I woke up with an awful stabbing sensation under the left side of my ribcage. It hurt to breathe. We knew something was wrong. My husband helped me get down to the car, and we were at the emergency room at 7 AM. 

After IVs, blood tests, an EKG, a COVID test, and a CT scan... I found out I was still COVID negative, but unfortunately I had developed dangerous blood clots in both of my lungs. As I lay in the ER waiting to be admitted, I had tears running down my face and soaking the ear loops of my face mask. The entire left side of my chest was on fire. If I tried to take a deep breath, the pain radiated from my hip the whole way up to my ear. I COULD NOT believe that this was happening to me, and I was terrified.

It was the second time in three years that I was told I almost died. The last time was when my daughter was born in 2018- at 32 weeks via emergency C-section, because I had severe pre-eclampsia. My oxygen levels were low, my heart rate was dropping, my lungs filling up with fluid. I was hospitalized for 10 days, my daughter in the NICU for 41 days. It was a traumatic experience, but luckily I fully recovered and my daughter hasn't had any lasting complications from being born prematurely. 

I was admitted to the hospital in the INCU and put on blood thinners immediately. Fortunately, my breathing never deteriorated enough that I had to be put on oxygen this time around.

Prior to my foot surgery, I had to get a chest Xray, EKG, bloodwork, and a COVID test done. Everything came back completely normal. I also had to have a pre-op physical. My PCP was confused why I was there, because all of my tests had been normal and I was an otherwise healthy 34 year old. Maybe overweight and with a potassium level that was a little low, but nothing to indicate that I would have any issues with this surgery or the recovery following it. Because of this, I wasn't put on a blood thinner in the hospital. I didn't wear any compression socks. 

Getting up and moving around following a foot surgery is painful and awkward and uncomfortable, but YOU HAVE TO DO IT. Get up at least once an hour. Don't be like me. I would not wish this condition and the recovery I've been through on anyone. Please, please, please. Buy yourself some compression socks before you have the surgery and wear one home from the hospital on your non-surgical leg. Force yourself to get up and move around. 

The blood clots I had formed in my surgical leg. I had felt something like a Charley-horse under my cast a couple times, but didn't really think anything of it- I was just frustrated that I couldn't stretch it out to relieve the pain like I had before. I took a muscle relaxer and went back to sleep. I had no idea that these blood clots were forming and then traveling to my lungs. 

I was in the hospital for three days. The pain I felt when I tried to get a deep breath was intense. The first night I was there, the pain traveled from my left side up into my shoulders, and the second day the pain traveled to my right side, where it started causing muscle spasms in my lower back. The entire second morning of my hospital stay - at least five hours - were spent trying to relieve the intense pain I felt in my back and chest, while also keeping my foot elevated and managing THAT pain. Finally the nurse was able to get permission to give me anti-inflammatory meds on top of the other drugs I was already on, and those combined with pure exhaustion allowed me to sleep for a few hours.

Like I said. Do your research, request blood thinners post surgery if that's right for you, get some compression socks, and move around. Do everything you can to avoid blood clots. I am now six weeks post-hospitalization for the PEs, and seven weeks post foot surgery, and I am still experiencing pain in my chest, while my foot is basically healed. 

Flat Foot Surgery - the days after

 At this point, the days following my surgery are a blur. Eventually I did make it up the stairs the morning after by scooting on my butt, and using the handrail to help lift me from stair to stair. That was much easier than putting both of my hands on the stair and trying to push myself up. I have reasonably good upper arm strength, but it was too exhausting to do it that way. I wound up using a walker (zimmer frame) a lot the first few days, because until the nerve blocks wore off (around noon the day after surgery) I felt too unsteady on the scooter. 

Going to the bathroom was an adventure at first. My kids both have bathroom step stools for brushing teeth and handwashing, and those came in handy for propping up my foot when I was using the walker. Handwashing was very difficult with the walker, however. I couldn't balance on one foot and use both hands. I remember reading that everything would take twice as long as it did before, and handwashing safely was a great example. 

I bought a stellar elevation pillow from Amazon after reading recommendations in other blogs. (I don't get anything from sharing the link, but it really was a saving grace.) I loved the handles on the pillow because they made it so easy to adjust it myself. Keeping my foot elevated was so important, and not having to mess around with a pile of pillows made it so much easier. 

My daughter also enjoyed propping her feet up on the elevation pillow. : )

Cast #1: Purple (wrapped with an ace bandage on top - this was a couple weeks after surgery and my muscle had already wasted so much/swelling gone down, and I was trying to keep things from going into the gap in my cast)

I have been sleeping on our recliner in the living room pretty much ever since the surgery. I tried sleeping in our bed one night a few days post-surgery, and it just wasn't very comfortable. I didn't feel secure. The recliner keeps me from moving around, and it was easy to set the elevation pillow up and keep my foot where it needed to be. 

I had a follow up appointment with my doctor two days after my surgery (surgery on Wednesday, follow up on Friday). My husband had to use a wheelchair from the office to get me in, since I was still uncomfortable with the scooter and it was too much with the walker. Between getting down the stairs and in and out of the car, by the time we got to the office I was already sweaty and exhausted. Having to hang my leg down for X-rays was extremely painful. The nurses at the foot doctor's office have been extraordinary from the start, and they were so compassionate in trying to get my X-rays done as quickly and comfortably as possible. Then it was time to remove the initial wrappings from the hospital and put on a cast. I've never had a cast before, so the process was interesting, but I was honestly so tired and in pain that I just wanted to cry. With strict instructions to keep ahead of my pain using my meds, I was sent home. Luckily the doctor was happy with the X-rays and incisions. 

My parents were kind enough to take our kids the day before the surgery and keep them for about a week and a half after for a stay at their house. They kept them very busy and happy, which was a relief for me and my husband because the days after surgery got a bit more complicated than we had expected or hoped they would. 

Flat Foot Surgery - The Big Day

 When the day came for my surgery, I was supposed to arrive at the hospital by 8:30 for a 9:45 estimated starting time. We got there in plenty of time, got my IV in, and watched some HGTV while we were waiting... and waiting... and waiting. I didn't end up going into surgery until closer to 11. After reading more accounts of foot surgeries, I had begun to panic a little about what type of screws would be used for my surgery. I've always had issues with nickel jewelry. The nurse noticed my hesitation when she asked about allergies, and she simply added a nickel allergy to my chart. The anesthesiologist came to visit us, asked some questions, talked a lot, and left. I've never had any problems with anesthesia, nor has anyone in my family, so that was pretty standard. 

When the anesthesiologist went on his way, my foot doctor popped into autograph my right foot and review the surgery procedures. My nurses all morning were phenomenal and they stuck around to hear about my surgery so that they would know exactly what they were dealing with afterward. Dr. P. showed me exactly where each incision would be made and reviewed that he would be putting two titanium (not nickel) screws in my heel and a wedge in the bone on the outside of my foot to help build the arch. He also went over what would be happening with my tendon. Then it was time for me to say goodbye to my husband and I was wheeled into the OR for surgery.

The last time I was wheeled into an OR while I was conscious, it was in a big rush and everything about it was stressful. I had been pretty chill leading up to that, but once I was in the cold, bright OR, I started panicking a bit. My nurse was tremendous in helping me to calm down. Then anesthesia kicked in and I woke up... over four hours later?!

The surgery was supposed to take 2 to 2.5 hours, but it wound up taking four. My husband said that when my doctor finally came out to talk to him, he looked like he was wiped out. It turned out that when they went into my foot, they discovered the problematic tendon was beyond repair, and the inside of my foot was basically a mess. The surgical assistant told me later that they weren't sure how I had still been walking prior to the surgery (I mean, it hurt really bad, so at least that was justified). They wound up removing the tendon and then connecting other tendons so that I'll still be able to walk. We were warned that was a possibility, but that was part of the reason the surgery took so long. Additionally, my nerve blocks took a little longer than anticipated because my legs are "thicker" (the anesthesiologist's words - I am aware my legs are not skinny. LOL)

In the meantime, a huge mess was taking place with my prescriptions and pharmacies. (Yes, it turned into PLURAL pharmacies.) My husband was running all over the country trying to track down the different medicines I was going to need - an antibiotic and a painkiller. 

All that aside, after I was sufficiently conscious and settled, the nurse helped me get dressed and wheeled me down to our car, which my husband drove to the door. She helped him figure out how to best situate me in the car to keep my leg straight and elevated comfortably, which wound up being the seat behind the driver's seat with my foot propped up on the center console. Then she demonstrated to me how I would stand up from the wheelchair and move into the car. Then it was my turn! She did a great job teaching me, because I have had to get in and out of the car many times since, and the way she showed me has worked out great.

When we got home, I had to take the knee scooter inside. I was exhausted, hungry, and in pain- so there was no way I was making it up our stairs in our split-level house. I had (foolishly) not taken that into account beforehand. Also, the nerve blocks made balancing my knee on the scooter extremely difficult - it felt like my leg was asleep. I cried the whole way into the house but I made it to the guest bedroom on our lower level, where my husband was able to situate me for the night. 

Flat Foot Surgery: Pre-operation

 In a way I was fortunate because I had plenty of heads up about my surgery to repair my tendon and fix my flat feet. We had a family beach vacation planned the week after my appointment with the foot doctor, and I refused to cancel it because we had to cancel our vacation last year due to COVID-19. I wasn't going to do that to our kids. My doctor had his vacation scheduled directly following ours. So we landed on the date of Wednesday, July 14 for my surgery. 

Dr. P. could clearly sense that I was panicking about the recovery timeline of the surgery, so he left me time to gather myself and visited another patient. I texted my husband, whose immediate response was "You have to get it done. Better sooner rather than later. I don't want you to be in pain." I pointed out that he is going to be carrying a heavy load with caring for me, and driving once school starts - we just signed our son up for fall soccer, so that will be a lot of chauffeuring for him. He said we will make it through, and we will- it just caused me a lot of panic at first.

I had a pretty traumatic experience when our daughter was born- she was delivered via emergency C-section after I was diagnosed with severe pre-eclampsia, and I have been going to therapy the past two years to help deal with the anxiety and medical PTSD I developed after that event. In order to handle my anxiety about this upcoming foot surgery and recovery, I dove headfirst into finding out every possible thing I could. I found the following blogs and blog entries extremely helpful while doing my research:

- https://flatfootsurgery.blog/

- https://www.themomcafe.com/20-truths-about-life-after-foot-and-ankle-surgery/

- https://www.healthboards.com/boards/foot-ankle-problems/737812-tactics-coping-while-non-weight-bearing-after-foot-surgery.html

- I also saved specific articles to a Pinterest board, here: https://pin.it/5hEx3GH

Another helpful thing was reading post-op recovery documents from various foot and ankle doctors and services that I came across on the web. My own doctor gave me a very interesting lecture - complete with illustrations - on the anatomy of my foot. I made dozens of lists and did whatever I could to overprepare my home and brain for this surgery.

One of the things that caused me extreme stress was that I will not be able to start the school year- our first student day is slated for 8/19, and the earliest day I'll be able to teach - strictly according to timeline, which will flex according to how well I recover - is 9/8. Luckily, I was able to get into both of my classrooms (I teach in two buildings) and set them up enough that a substitute can cover for me at the beginning of the year, and I can navigate around when I am able to return. I also took pictures all around my classroom, including with cupboard doors open, so that if anyone sent me a message asking where something was, I would be able to help them locate it. Once that was done I felt a lot better.

I also took pictures around the lower level of my house. We live in a split level, and I knew the stairs would be a challenge. So I took pictures of bookshelves downstairs, and the front panels of our washer and dryer - that way I could help with laundry from afar as well. : ) Also - lots of cleaning, trying to do as much fun stuff with the kids while I can, putting some freezer meals together for the crockpot, taking clothes for consignment, taking the dog to the vet and the kids to their well checks to get that all in. Cleared pathways in my home, secured a knee scooter, set up a "nest" in our recliner with my things within reach. 

Then... surgery time finally arrived. 

Flat Foot Surgery - The Prequel

 Hello there! As I prepared for my own surgery this past week, I found it helpful to read blogs others had written about their own experiences. I figured I would pay it forward by recording my own, and hoping that it will help others who are experiencing similar foot and ankle problems.

I am a 34 year old music teacher in rural PA. Last fall, I began experiencing dull aches and pains in my right foot- something not completely out of the ordinary, as I have had completely flat feet my entire life and a diagnosis of tendinitis for both of my feet when I was a kid. Because of anxieties related to COVID-19 and visiting the doctor's office, I put off making a call until April of 2021, when one day I was having difficulty walking without pain. I figured it was time. (Incidentally, if you are also a music teacher, it was the day after I taught the "Sasha" dance to my 2nd and 3rd graders - so a bit more movement than usual.) 

My family doctor is part of a much larger practice of physicians and programs, so I was able to directly make an appointment with a foot & ankle doctor within my practice without needing a referral. My first visit involved X-rays and, after the doctor pushed around my foot and ankle a bit, he diagnosed me with a torn posterior tibial tendon in my right foot. I was prescribed a walking boot for four weeks. 

One of my coworkers, upon spotting me with the boot, advised me to make an appointment with a chiropractor. She said when she had worn a boot for a foot injury in the past, it threw off her gait and gave her hip and back pain. After just a weekend of wear, I could see she was right. I quickly found a chiropractor in town and he was helpful in adjusting my back and hip throughout the last few months. (Honestly, I wish I would have thought to go to a chiropractor when I was breast-feeding my babies. That was so hard on my neck and shoulders, and having adjustments would have been miraculous... but I digress.)

After two weeks of wearing the boot, I was feeling significantly better and my foot doctor was impressed with my progress, so he downgraded me to a brace, which I was to wear with sneakers at all times. After two weeks of the brace, he started transferring me to shoe orthotics (I was familiar with these, having worn them as a kid). Then, over Memorial Day weekend, something happened within my foot to send me straight back to where I'd started with pain. I honestly have no idea what caused it - I didn't do any out-of-the-ordinary activity, but when I woke up that Monday morning I put my boot back on because my foot hurt so much.

I had a follow-up appointment scheduled for that week anyway, so I told my doctor that I was back to the same pain as before. He scheduled me for an MRI and a follow up appointment to go over the results. At this point he was warning me that surgery was becoming a more distinct possibility. When I returned to his office post-MRI, he asked if I looked at the results. I told him I'd looked at them, but they hadn't meant much to me between the medical jargon and images. He said, "Well, we'll talk about your tendon first, and then move on to the other things." My brain immediately went on alert - other things?! Basically, my tendon was definitely torn and the only way to repair it was going to be to build an arch in my foot. 33 years of my lack-of-arch pulling down on my PT tendon had stressed it to its breaking point. If they would just try to repair the tendon but not the arch, it would be pulled down again in no time- a worthless surgery. Official Surgery Conversation then began.