Week 5

Week 5. Monday. 27 March 2017

Just in from cycling to St Kilda, where I enjoyed coffee in a cafe beside the beach.

The toe is a little more painful to walk on than it was before the surgery, but I can feel incremental improvement. I no longer limp.

In the evenings I sit and work it with my fingers to improve flexibility - the joint doesn't have full range of motion, but is getting better.

I am going to the gym regularly, but, as I mentioned in a previous post, I do not run and normally avoid exercises that cause excessive jolting of joints anyway.

The wound is healing well. I kept a plaster over it until a few days ago, mainly to stop it abrading against the sock as I walked, but have done away with that now. No swelling. I often forget I had the operation.

Week 4

Week 4. Monday. 20 March 2017.

Exactly 4 weeks have passed since the surgery.

I returned to the gym yesterday, also went today. I mainly work out on the stationary bikes - which is easy on the toe as it isn't required to flex.

As an aside, I have never been into running - I believe the jolting puts too much stress on joints and that excessive running is not a natural form of exercise. Our hunter gather ancestors probably only ran when they had to (to escape predators or chase down prey) and would be aghast to know people these days run miles for entertainment. I can't believe it when cheilectomy patients write that they can't wait to start running again. As for me - I'm going to get maximum mileage out of this surgery by not abusing my foot. I prefer walking up hills to get a bit of puff going.

Enough rant - back to the post. Last Thursday I cycled about 20 kilometres to St Kilda for coffee. No problem. As I said before, the foot is fairly flat on the pedal which minimizes flex and pain.

I've also been doing quite a lot of walking - several kilometres each day. The toe is painful, around 3 on a scale of 10, but I can tell it is improving. I still have a very slight limp and this is enough to continue to cause me some pain in the thigh and hip from walking slightly unevenly.

The wound is healing well (see photo - taken yesterday). It is a little soft in a couple of places, so I have decided to keep it covered with a plaster for a few more days rather than have it abrade directly against a sock.

The toe doesn't have full flexion by any means, but I wriggle it around in the evenings. I am confident it will gradually improve.

Week 3

Week 3. Monday 13 March 17

End of the third week - 21 days since surgery.

I have been walking at least half an hour a day, plus wandering around the apartment.

At rest the foot is fine - only slight tenderness on the site of the surgery.

Walking there is low level pain in the toe joint, enough to make me limp a little, but nothing more than I would have expected after surgery. I also have some pain in the leg and hip joint, which I expect is a result of the unnatural stresses caused by limping.

Day 19. Coffee at the market

Day 19. Friday. 10 March 2017

Here's a picture of my foot taken this morning. The nurse put the dressing on when the bandage was removed and sprayed it with waterproofing.

This morning I walked something less than a kilometre to Chapel Street, then caught a tram a similar distance to the Prahran market. I am limping and still wary about the foot, but gradually becoming more confident. The joint is stiff, but I am confident it will slowly loosen up with use. It is a little sore when walking, maybe 2, sometimes 3, on a scale of 10.

I regularly have coffee at the market and a had a bit of a chat to the cafe owners, George and Lea. Then limped around doing some shopping before catching a couple of trams home. That will do for today.

Prahran market

 

Day 18 - resuming a near normal life

Day 18. Thursday. 9 March 2017

Having a coffee at a cafe is something I do regularly. Sitting for half an hour with a book or watching people wander by is one of life's pleasures. I know those $4.50 a day coffees add up, but I think its a cheap delight. I'm not, at any rate, much into restaurant eating - and one restaurant meal can gobble up as much cash as a fortnight of cafe crawling.

So I was chuffed to be able to have a decent coffee in a cafe after 17 days of medical imprisonment at home (with the exception of the weekend jaunts with my wife). A sign that life is returning to normal.

I am wary of the foot, and tend to limp a bit. I expect that will pass before long as I become more confident and the healing progresses. There is no pain, though I am aware of sensitivity in the area of the wound. I haven't been game to really try bending the toe yet, but that will come.

Yesterday the surgeon said he has moved away from recommending people see physiotherapists. He said he just wants me to start walking. Half an hour to start, then gradually increasing as I feel comfortable. In his mind, the natural process of walking around will do as much good as physiotherapy. He's a nice guy - Paul Rice - I'd recommend him. Must be pretty qualified as he's ceased being called Dr and has returned to being called Mr (that happens to some highly qualifed Docs).

I am a doctor, by the way, but I'm not a physician. I have a Ph.D. in geology. I also usually get called Mr, but in my case its because that's what people call you by default and I can't be bothered correcting them - you sound like a bit of a wanker if you do. Even my mother still writes Mr on my birthday cards after 30 years of me being a Dr - but she just forgets. 

Day 17 - Bandage off

Day 17. Wednesday. 8 March 2017

I feel like I have had this thick bandage on my foot for 2 months, not 2 weeks.

Late afternoon Wendy drove me to the hospital and the bandages were cut off. Much less ghastly than I had expected. There is an incision about 6 centimetres long along the toe. All looking very clean. Just slight swelling. The only bruising is a small patch just below the toenail, separate from the incision, where some blood has migrated.

The stitches were removed - uncomfortable but not painful. Some plaster was placed over the wound.

Then the surgeon (Paul Rice) saw me. He was pleased with progress. Large chunks of bone had been removed from both sides of the joint to improve movement.

My instructions are to walk 20-30 minutes a day to start to start working the joint, plus puttering around the apartment. Gradually increasing the time and distance. Cycling is fine, as is swimming.  
I was able to wear my outdoor shoes out of the hospital. Hooray!

We then went shopping. I was tentative on the foot, but the only pain I felt, after about 10 minutes, was in my calf. The muscle must have atrophied a little from all the sitting and laying around. 

The crutches are now in the car boot and will be put out for the hard rubbish cleanup in our street next week. And good riddance to them.

Note: I mentioned the sensation I have been experiencing along a nerve on the right hand side of the foot to the surgeon. He said it is not unusual and will fade.

 

Day 16

Day 16. Tuesday. 7 March 2017

Tomorrow the bandage comes off. Hooray.

Here is an extract from Day 16 of the blog I referred to earlier, written in 2012 by a person called Parsifel:

'I did go to the gym today. I managed to put on my squash shoes. and I was perfectly OK. Obviously no running, but I spent 30 mins on the training bike (no problems whatsoever), stretched, and did weights. In the afternoon I went with my daughter to the beach and had a nice swim in the waves'

Hah! I, on the other hand, spent day 16 stuck in my apartment, obeying the surgeon's instructions to keep my leg elevated as much as possible, with my foot encased in bandages. As for going to the gym - well, I did lay on my back and run through my stretching regime (which has been helping with the sore back I was experiencing). Any other exercise I got consisted of hobbling around on my heel.

When I was considering a cheilectomy I had found Parsifel's blog and thought to myself 'this doesn't look too bad'. I suggest that if you read that same blog, you take it with a grain of salt. I expect it is more likely for patients to be up on blocks on day 16 - not peddling a training bike and going for a swim. 

Day 14

Day 14. Sunday. 5 March 2017

Another day not doing much.

What I did focus in on today was sensitivity on the top right side of the foot. My affected foot is the left one, so this across from the surgery and not, therefore, likely to be a direct result of the surgical incision.

Going back a step, I had noticed a row of 4 small bruises or blood blisters around the upper part of my ankle, about 2 centimetres above the top of the bandage, some time ago. They are spaced about 2 centimetres apart. I have assumed they were something to do with the anesthetic and didn't take much more notice of them until yesterday, when I had a closer look out of curiosity.

In addition, I had also noticed that if I stretched my foot, there was a slight pain, as if there was a small plaster on my foot that was being tugged, along the left hand side (under the bandage). I assumed this was something to do with the bandage and would go way when it is removed on Wednesday.

Now I'm wondering.

During the course yesterday's inspection of the tiny bruises, I gave the one on the furthest left (near the ankle bump - furthest from the incision) a little rub and it sent a bolt of nerve pain shooting along my foot. Along the same route as the slight pain I mentioned previously. Not a dissimilar feeling to having one's funny bone tapped. Just the slightest bump and -zowy- there's a pulse of nerve pain.

Naturally I am concerned about this. My first thought is that I have suffered nerve damage from the administration of the anesthetic.

I will discuss with the surgeon on Wednesday afternoon. 

Day 13

Day 13. Saturday. 4 March 2017.

We live on the boundary of two Melbourne suburbs: Toorak and South Yarra. They are quite different. Toorak is one of the most affluent suburbs in Australia. The many cafes of Toorak village are frequented by well-heeled older folk. South Yarra, on the other hand, with its trendy Chapel Street, is one of the most vibrant and fashionable suburbs in Melbourne. Most of its residents seem to be under 30.

I can walk to cafes in either direction in about 10 minutes. Normally. Today Wendy drove me to sedate Toorak for coffee. We then had a picnic lunch in the landscaped gardens of historic Como House. I can normally walk there in 3 minutes, but had to be driven.

The point being that I am getting thoroughly cranked off at my immobility. I usually walk everywhere - the car hardly comes out. But now I am being driven to a place 3 minutes walk away.

Patience. On Wednesday the bandage comes off and then I should be able to start moving around without a hobble and a crutch.

Apart from my frustration things seem to be progressing well, though I actually have no idea what things are like under the bandage.

Day 12

Day 12. Friday. 3 March 2017

Wendy took today off work to help relieve the boredom. She drove me out to Olinda, in the Dandenongs, where we sat in a cafe for a while. Then to a nearby picnic ground for lunch. After being cooped up in a sunless apartment for 4 days, it was pleasant to just lay in the sun for a while soaking up some rays and getting some vitamin D.

While I no longer use both crutches, as I quickly develop pain in my hands if I shift all my weight on to them, while out I did use one crutch as a prop to help take some of the weight off the left foot.

At home I hobble around on my heel. Mostly, though, I continue to sit on the lounge, lay on the bed or floor with my foot propped up. Prior to this surgery I would go to the gym most days and, living in the inner city, would walk everywhere rather than drive. So this inactivity is driving me up the wall.
The toe itself gives me no trouble.

I pulled the bandage back a little from my big toe nail, just a few millimetres, to peek at what might be going on in that direction. Beyond the toenail the toe looks pretty bruised and dark. It will be interesting to see the wound site when the bandage comes off next Wednesday. 

Day 11

Day 11. Thursday March 2. 2017.

I am not the first person to write a blog about their cheilectomy experience - copy and paste this address for an account by someone who had the surgery several years ago. There is a link opposite.

It is interesting reading that blog to find how far the writer had progressed this long after his procedure. He had his stitches out on day 10 and by day 11 was in shoes and walking around!

I, on the other hand, have my foot wrapped in a mummification of bandages and am under instruction to rest and keep the foot elevated as much as possible until my appointment with the orthopaedic surgeon next Wednesday. I'll do as I'm told, but it's quite frustrating.

Nothing to write about yesterday - kept a low profile at home. Ditto today.

I have dispensed with the crutches - the weight they transferred to my hands was making them quite painful. I watch movies, read, listen to music and keep myself amused until Wendy comes home in the evenings.