My Right Foot (Surgery)
by
Nancy Deming-May
June 2018
I recently had two bones in my right foot surgically fused together and I am in the long process of recovery and have often wanted to know if what I’m going through is normal, but I can’t find much about it, so I shall share my experience…
The surgery I had is called a Talonavicular Fusion. They are joining the talus bone and the navicular bone in the foot. This is usually required due to arthritis (bone on bone pain) and fallen arches, or in my case, life-long flat feet. They go in on the inside of the foot, just above the arch, and smooth off any bone spurs and issues you have with the two bones, and then join them together with titanium screws and staples (that do not set off metal detectors at the airport). There is absolutely no weight bearing for six weeks (to allow these bones to fuse together), and then it is a 4-6-month recovery process. My surgeon said it’s never sooner, but it is almost always successful. The only incidences of non-success that he alluded to had to do with patients who smoked, so they didn’t get adequate oxygen to their foot for healing. Fortunately, he didn’t seem worried about my prospects of recovery.
My surgery was on February 1st, 2018, a Thursday. I had to be at the hospital about 7 am with no food or liquid in me since midnight – missing coffee is the worst! My husband took me, and we were on our way home before noon. All went well, and my foot was wrapped in gauze and ace bandages and I was told to absolutely NOT put any weight on it and handed a script for Oxycontin pain meds. I made it through the weekend – took pain meds for a few days but got off of them as quick as I could; they made me overly emotional. I found myself getting quite upset about a large tax donation we had made that went to a group I didn’t really support (long story) – suddenly I was in tears and completely distraught. Glad to get off THAT stuff! I was able to get around by using the knee cart the insurance had delivered. Joe would carry the cart up the stairs for me and I would use crutches when I absolutely had to, but they were much tougher! The knee cart seemed safer, though I did get better, stronger, and more comfortable on the crutches over time.
I went back for my post-op appointment on Tuesday and they put me in a cast (I selected dark purple) and told me to come back in two weeks. I continued to figure out the logistics of no weight bearing: I ordered my groceries online at Harris Teeter and picked them up at their drive-through service the next day, though getting them from the car to the house was a challenge. I got comfortable with crawling on my hands and knees up the stairs and sliding with my bum back down. I ordered a second knee cart for upstairs as you can’t do much while on crutches other than walk. At least with a knee cart I could chop up vegetables and roll around the kitchen island balancing things on the handle bars of my knee cart – though it was a total core workout to stretch back and grab something I needed/forgot on the other counter (backing up was a pain). I ordered a back-pack style purse (shoulder purses and crutches don’t mix) and several pairs of palazzo pants with the wide legs so I could get them on over my cast. I used a plastic garbage bag and a rubber band to cover the purple plaster and gauze appendage during showers and sat on a wash cloth and a step stool while using the hand-held shower head (thankfully we had that!) I figured out how to drive those electric grocery carts at the store and heard lots of stories about other people’s foot surgeries. Of course, I had several challenges – forgetting to drape my towel over the shower wall (it’s not good to be one-legged and wet on tile), the grocery cart dying in the dairy section, people staring and then quickly looking away, re-learning to drive with my left foot; but nothing was insurmountable.
After two and a half weeks the doctor took me out of the cast and let me just use the boot – as long as I promised not to do any weight-bearing. This was SUCH a welcome early gift. The cast would snag on my bedspread and it marked up the dashboard of the car from me trying to keep my foot elevated. I could shower without worrying about it getting wet and I don’t recall feeling anything so sweet as the feel of a soft sheet slipping across my bare foot that first night I went to bed cast-less. The doc also said I could sleep without the boot which truly helped my soundness of sleep. I also think that the early release from the cast helped with my quicker recovery as I could get mobility back sooner – even though I wasn’t doing any weight-bearing. I found that I used the boot less as time went on – not around the house – just when I went out and wanted to make sure I didn’t bump into anything with my healing foot.
So, I have been basically walking on this foot since about six weeks post-op. (I’m at the four-month point now.) It still gets swollen and achey and sometimes I have to take acetaminophen or naproxen, or when it’s really bad, diclofenac (a 24-hour arthritis med), to deal with the pain. But I have been teaching TRX and yoga (both with gradually lessening modifications) since I started walking on it. I get discouraged by the continual yet evolving pain. Some days I feel pretty good and then I probably overdo it, and it hurts like hell that night and for the next day or so. What’s also strange is that the pain moves around in my foot. Sometimes it seems to be about where the bones were fused together, and other times it’s on the outside edge of my foot, or the top of my foot where its starts out from the leg. Perhaps this is due to the brain’s ability to only focus on one pain point at a time – so it just picks out the most acute one. I learned about that strange aspect of our brains on a House episode, where Dr. House is so sick and fed-up with his chronic leg pain that he stabs himself with a fork in the other leg – just to get a break from the pain in the one leg. Wow. My doctor says this is all normal and that I have a pretty much re-constructed foot, so it will just take time.
This gimpiness has had other effects on me besides researching pain theories. I have gained a great appreciation for the Americans with Disabilities Act (ADA). This is the federal law that has led to all these ramps around the country. As I would approach a new building, I would find myself quickly searching for the access that would accommodate my knee cart and shouting, “Thank goodness for the ADA!” with great enthusiasm. (Actually, it’s thanks to some committed, hard-working people and lawyers that pushed these requirements through our court system.) I would also find myself comparing my disability to others, like when I’m NOT parking in a handicap spot, and I see someone who can move around a lot better than me getting out of that closer wheelchair space while I hobbled in on my crutches looking for the electric cart the stores are generous enough to provide. I didn’t dwell on it though. I would remind myself that I’m getting better. Some of these people aren’t and never will. And when I really might be feeling sorry for myself, I would think of the folks who are completely missing legs and or feet, and think, “Get a grip!”
I recently had a unique experience of doing a walking meditation one afternoon during my yoga training. This is the practice of walking very slowly and concentrating on/being mindful of every aspect you can find about your walk. What is happening with all of your senses – how the weight rolls from the heel to the front of your toes, the coolness of the grass, the smoothness of the floor, the sounds of the birds, the soft touch of the breeze, the different sensations throughout your body with each movement, etc. (You try to ignore the little thoughts that creep in about what strangers might be thinking of these people walking in extremely slow motion and looking down very seriously at the ground in front of them.) I found myself truly marveling at the complicated process of walking – how we tall, awkward things are able to stay upright; the AMAZING qualities of our incredible feet; how important the WHOLE foot is when it comes to walking and balance. I even found myself getting emotional about the entire experience of walking and what an incredible gift it is to be able to do it.
So, the next time you bound up the stairs, or even just take them slowly, or you remember something you forgot on the other countertop and you step backward, reach around and grab it without a second thought, or you get up in the dark to head for the bathroom, think about the gift of walking; of feet that balance without extra concentration; of simplicity of effort; and please feel grateful for the beautiful gift of stepping out on our own two pain-free feet.
And when you get a chance, hold the door open for or smile at someone in a wheelchair.
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