National Arthritis Week: My Foot Surgery

This is the second part of a post about my arthritis diagnosis and surgery. The first bit can be found here.

The Operation
I’m overweight, I’ve got asthma and I have scoliosis, all of which mean that a general anaesthetic carries a higher risk than normal, but I met with the anaesthetist and she approved me for surgery. Interestingly, the thing about which she had the most concern was my TMJ Disorder, as people with that can have problems opening their mouths wide enough for tubes and stuff to be inserted. She made me do a massive wide-mouthed frog demonstration and peak flow tests to reassure her that her team would be able to anaesthetise me, which was fine, since I don’t have restricted mobility in my jaw. (I swear I look normal, really: the stuff that’s wrong with me isn’t normally visible, unless I’m limping: that’s always attractive.)

I then got a surgery date of early March: was nil by mouth from 6 a.m., arrived at 7.30, had the op at 8.30 and was sitting in a Little Chef eating an Olympic Breakfast by 3 o’clock that afternoon with my mum, who’d had to drive me there and back. I had to stay with my parents overnight, and couldn’t drive until I was able to perform an emergency stop without pain. I was signed off work for 6 weeks, although I was actually able to work again two weeks later, given that I work from home and could be propped up on the sofa. Had I needed to go into an office or had school-age children I would have taken at least double that – you’d need to in order to do the post-op care and get enough rest.

[Side note: I wear glasses for short sight and one of the nicest things that anyone did for me in hospital was to take care of them. They understood I wanted to wear them as long as possible because once they were removed I wouldn’t be able to see anything in detail, which affects hearing when you lose the ability to lip-read. So they took them off me just before I had the anaesthetic and then when I came round, I opened my eyes in the recovery bay to find that I could see. A lovely team of nurses keep watch as people come round and as soon as they saw signs that I was waking up, they put my glasses on my face. If you’ve ever tried to put glasses on someone else you’ll know it’s not that easy to avoid poking them in the ear and sitting them straight, but the one assigned to me had done it while I remained unaware. It was incredibly kind and was a very different experience to my last one of coming round from surgery, when nothing was in focus and it added to my momentary confusion as to where I was. There was none of that this time. I didn’t ask them to do anything or mention my concern: this was standard practice and I thought it was great.]

Recovery

No. Bad plan, SAM.

No. Bad plan, SAM.

I returned home to my place the following day, overruling parental objections, and proceeded to do precisely what the detailed post-op care leaflet had advised me to do. If you have this surgery, you need to elevate the foot above your heart frequently (they’ll tell you when and how long for etc.) and ice it regularly. If you actually do that, you will recover far faster than if you push it and try and test yourself too much. You don’t generally need to be and shouldn’t be bed-bound, but nor should you walk to Tesco in the snow to buy Diet Coke, like I did, 3 weeks later. I pulled my stitches and it bloody hurt and was stupid and I was much more careful after that. The biggest thing really was fighting boredom at having to stay still with my leg up.

They gave me a boot thing with a rigid sole, to protect my foot, and a pair of crutches. I’d had a couple of stints on them as a kid, so was quite happy that I knew what to do but actually had to wait and have an actual demonstration and pass a test in using them (seriously hot male physio made that more bearable, although I wasn’t on top pulling form) before they’d discharge me! The pain was manageable. I took a trip to the pharmacy and got a massive bag of Tramadol and paracetamol they’d prescribed for me, but I only needed the strong stuff for maybe the first 24 hours. It made me very nauseous so I took it rarely after that, only if I felt paracetamol wasn’t cutting it, usually later in the day. Crystallised ginger and gingernut biscuits helped with the nausea – a trick I’d remembered from morning sickness days. I would nibble a bit of crystallised ginger periodically for hours so I didn’t end up eating loads of sugar.

The crutches were only needed very occasionally after the first week: only really as a sign if I was somewhere busy that I needed people not to step on me if possible. I had a disastrous shopping trip with my mother, when maternal protectiveness went into overdrive and she practically snarled at people in Waitrose who came within the perimeter she clearly imagined around me and looked like she was about to punch one pensioner who knocked my crutches. I did my own shopping after that: online and then making short trips once I was able to drive, which was about two and a half weeks after the surgery. (Having surgery on my left foot made this faster – you’d don’t depress the clutch pedal with the same degree of pressure as the brake in an emergency stop.)

I got sick of faux sheepskin boots. They're horribly unflattering.

I got sick of faux sheepskin boots. They’re horribly unflattering.

Fast-forward through a six-week check (doing way better than they’d expect) and physio and actually remembering to do that and, now, eighteen months on, that foot gives me very little in the way of problems. The side-effect of the surgery that took the longest to go was the swelling – I temporarily went up a shoe size and couldn’t wear anything other than knitted slippers or Uggs for weeks. Mine reduced far faster than expected: which the medical types all said was down to elevation and icing in the early days, then just frequent elevation for a few weeks after that, so it’s really well worth making the effort to do it, even though it’s a total pain to position yourself comfortably with a leg up that high for 20 minutes at a time. You can pretty much only do it if you lie down, which leads to iPods falling on faces and similar minor inconveniences.

Mobility
I can help things by keeping mobile – if I’ve sat in front of a screen and done nothing else for a few days and then go for a walk, I’ll notice the stretch and need to take it easy at first. Better to maintain a decent level of flexibility: use it or lose it, and all that.

I can and have done both yoga and Pilates classes since my surgery. I have to adapt that sort of thing because of my spine sometimes anyway. Pre-surgery I would struggle to hold Plank pose¬†(stop laughing) with my toes and so would maintain the upper body¬†position but with knees bent, shins and below flat on the floor and toes pointed out behind me. Post-surgery, I maintained that but can now (temporary blip aside) hold the pose correctly, although I prefer not to do it for more than a few seconds at a time. (I do go on about looking like a Weeble but, that said, having a spine like a noodle can have its advantages. I can hold both the Bound-Angle pose and the Downward-Facing Dog for hours. I didn’t know that being able to do the former was weird until people pointed and stared in class and then kept making me do it because they couldn’t, even though they were ‘proper’ yoga types who looked good in vest tops and shorts. Oh, being able to hold this one‘s apparently weird too. It’s nice to have a talent, I suppose…)

In terms of the outdoor stuff, I do have to be more aware of the surfaces on which I’m walking and will err on the side of caution and take a slightly longer but lower-risk route if I need to. Uneven ground is high risk and catching on stones, clods of earth and roots is going to hurt a lot, so I prefer not to do that unless it’s unavoidable, or I can choose my footing carefully. I can climb, although I try not to have to do anything that involves all my weight being on my toes, using the side of my foot, turned so my instep lies along the earth/rocks. I need slightly wider toe-holds but it’s safer and I get to do what I want to do, rather than having to stop, and leading a less-fulfilling life as a result.

To read what I do to make life easier for myself, click here.

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About SAM2.0

You'll want me on your team for the Zombie Apocalypse.
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