Post Op: Days 4 & 5. Hooray for Tuesday!

Tuesday, was to all intents and purposes, blissful. I managed my pain well, hobbled around on the boot and crutches and decided my new best friend was Tylenol 3. I ate my first real food in four days and coped with the weird, tingling sensations in my foot as the bandage loosened.

The swelling was going down somewhat, although I was seeing nice, funky bruising move up my leg. My big toe didn’t look so much like a huge sausage anymore and didn’t feel like a huge rubber ball when I prodded it. The sensation that my foot was being split in two was slowly diminishing.

I also indulged in my first real “wash” – a sponge bath. How delicious. I actually didn’t smell like a dying, rancid animal anymore. I wanted to look (and smell) my best for Wednesday’s appointment with Dr. Nutig, where he planned on changing the dressing.

I was still eating very little. I think my stomach shrunk over the last several days and I was terrified of throwing up again. I was eating enough soup, juice, plain crackers etc. to line my stomach so as not to get sick from the pain meds. Also, my blessed synagogue community had been showing up with enough food to feed an army (it’s what Jews do – feed you!) even though I couldn’t eat. Still, I nibbled on some great home made veggie chili (I’m vegetarian), some pasta (yes, with pesto!), and  some banana.

I was so excited Wednesday morning to get out of the house and go to the doctor. I felt like I had been trapped in prison. A trip to the ER on Sunday didn’t count! I wanted fresh air and to see streets – rather than the four walls of my bedroom!

Randall drove me to the doctor and I had planned on taking photos of my foot when the bandages were removed but Randall stepped out to make a phone call and took my handbag with my iPhone with it, so he wasn’t around for the great reveal, and neither was my camera. Rats. Oh well, next time.

First the nurse cut off the ten tonnes of bandages, which revealed gauze with lots of dried blood from the surgery. Then she removed that to show a fat, pudgy foot with three superb scars and lots of fun bruising. My foot felt so light that I thought it would float away!

The truth is that reveal was incredibly emotional. I started to cry. Not because the foot was ugly – I was surprised at how unintimidating the scars were, and certainly not because I missed my bunion (good riddance to bad rubbish I say), but looking down at my STRAIGHT foot, I didn’t recognise it. It didn’t look like me! I’ve had these bunions since I was a kid and there was a huge disconnect. I felt like I was looking at someone else’s body. A strange sensation indeed and it made my cry.

I got over it though and admired Dr.Nutig’s handiwork. Then it was off to x-ray the foot. The nurse was wonderful at guiding my naked, purple foot as I sat in the wheelchair through the corridors, terrified she’d hit a doorjamb – but it never happened. She’s a pro.

Back in the room, Dr. Nutig came in, looked at my foot and asked how my “Frankenstein” foot felt! He was right, the stitches were a bit gruesome, but I was fine with it. He showed me the x-rays and my beautiful new foot along with the screw inside it that is permanent. He said it’s buried deep in the bone so apparently I won’t beep when I go through x-rays at the airport. Hope he’s right!

He was very pleased with his handiwork and said it should be beautiful when done. He also assured me when we do the right foot (I can’t even THINK about that right now), he’ll make sure to adjust meds accordingly so I don’t have such a horrible reaction and spend three days throwing up.

He then rebandaged my foot with a much smaller dressing after asking the nurse for some “four by fours.” Apparently, these are bandages, not planks of wood. Phew. He told me to start walking with the boot using the crutches after assuring me that my stitches would not rip and my foot would not split (my fears that I articulated out loud to him).

I’m on this smaller dressing for another 10 days, then it’s back to Dr. Nutig to remove the stitches. In the meantime I’m still not allowed to get my foot or the bandages wet so it’s off to get a shower chair so I can still take a shower and keep my foot safe.  Apparently my insurance will cover this chair and I’m also going to get a handicap parking permit for the six weeks I’ll be off this foot so people can drive me places in my car.

I headed home with a much lighter foot and a resolve to walk on the shoe with the crutches, even though the shoe feels weird (it’s designed to make you walk on your heel only), and it still hurts to put pressure on it. Still, one day at a time. I’ll keep you posted.

The best news is that it was so much easier to sleep last night with all that weight off. Hooray!

Here’s my newly-bandaged foot with less dressing. I promise to take pics next Friday when the stitches come out.

My foot feels so much lighter - but nowhere near ready to do pirouettes.

 

Post Op: Days 1 through 3 “REAL” pain.

By the time I got to Cedars Sinai my pain was an "11"

NB: THROUGHOUT ALL THESE TRIALS AND TRIBULATIONS I WAS ALSO KEEPING MY FOOT ELEVATED AT ALL TIMES – ABOVE MY HEART – AND ICING THE POOR THING  NON-STOP.

Not to put too fine a point on it, but I threw up well into Friday night. Not fun. The pain in my foot was excruciating (probably not helped by the fact that I wasn’t keeping my pain meds down). However, sometime around 8 p.m. my stomach said “Enough!” and settled down. What a relief!

Luckily (or not) I was not hungry at all. I still tried to eat crackers, jelly (jell-o as you Americans are wont to call it), and drink ginger ale. Hmmm….

Still, I woke every four hours (actually more often than that), convinced I was a junkie. Definitely needed the pain meds on a regular basis. It’s almost as if the pain began wearing off around 3 hours and 45 minutes and I’d find ways to count down the last 15 minutes before I could take another pain pill. What was the pain like? Hmm… It felt like my foot was being pulled apart. I could swear my stitches were splitting (they weren’t but I have a vivid imagination) and most of all the “phantom pain” of intense sharp stabs and continuous throbbing in the place where my bunion once was. Oh joy.

Still, I kept the pain at bay throughout Friday night and well into Saturday morning. Saturday, I only threw up once. Hooray for me! I remember very little, mostly waiting for the next “drug fix,” and trying to eat but feeling nauseated most of the time.  By Saturday night I was VERY queasy, despite doing my best to keep food down.

During my “okay” period on Saturday, Dr. Nutig called to tell me in a jolly voice how WELL the surgery had gone and that he was very impressed, had achieved everything he set out to do and I would be delighted with my beautiful, new foot. Yeah? Not today, mate.

He also gave me an ominous warning: The first 48-72 hours I would be in some pretty extensive pain. I know, it seems obvious if your foot has been chopped, hacked, resectioned etc. that you’d be in intense pain, but somehow that part of your brain switches off when you’re contemplating surgery….

Early Sunday morning things took a turn for the worse. I threw up three times in the space of an hour. Now, I was no longer keeping my pain meds down, and I couldn’t even swallow a sip of water without throwing that up too. The combination of the vomiting and the excruciating pain did me in. I cried like a baby (in between throwing up into a conveniently placed bucket alongside my bed).

Despite my dear friend and neighbor Randall’s coaxing throughout the weekend that I was feeling nauseated because I wasn’t eating, I wanted to smack him upside the head and tell him, no, the reason I wasn’t EATING was because I was NAUSEATED… oh and throwing up!

Clearly by Sunday morning, things were dire. When I could NOT stop retching even though there was nothing left inside me and the pain in my foot threatened to have me commit a homicide that a jury would surely acquit me of knowing the extensive pain I was in, Randall made an executive decision to take me to Cedars Sinai emergency room. I was clearly dehydrated and unable to think coherently due to the pain. And so, off we went – me with  a plastic bag in hand in case I decided to puke in the car (luckily I didn’t).

Waiting to be triaged in the ER was the worst wait I can remember. I was CRYING I was in so much pain and still retching. After finally being taken into a bed, the nurse was very quick to come in as was the doctor and hook me up to 2 litres of saline to rehydrate me and pump me full of morphine and anti-nausea medication. They infused the morphine slowly – FOUR separate bags over a period of about 4-5 hours. What did this mean? A) I didn’t puke but B) a LONG time before the horrific pain in my foot began to subside even a little.

The doctor changed my take home pain meds to Tylenol – 3. This is apparently Tylenol with codeine and not the third installment in some blockbuster movie, which is good. I didn’t even know there was a Tylenol 1 let alone a sequel. Usually a third installment of any film sucks, but I was happy to go home with meds that weren’t going to make me puke my guts out.

However, I was warned that the nausea might last some time and was given two separate nausea medications, one orally and the other — yes, not to put too fine a point on it – as suppositories. I figured once I got home pumped full of pain meds and saline I’d feel better. I was wrong.

I managed to eat a banana and some red jelly and felt vaguely okay until about two hours later when I threw it all up. I couldn’t believe it! Hadn’t I been cured by the ER gods? I guess not. I also had the beginnings of a major headache that threatened to split my head in two. I lay – well into the night – with cold compresses on my head and woke the next morning with yet another (or the same) splitting headache. I finally fell asleep though on Sun night by using the suppositories – the waves of nausea abated v quickly.

Mon morning another non-oral nausea tab helped, and I was FINALLY on the road to recovery. Nausea abated, puking stopped and I knew I was on the mend because I suddenly felt the pain under my armpits from using the crutches, the incredibly sore stomach muscles… who needs an ab machine or sit ups when you can just puke your way for three days straight to a six-pack?  I also felt the pain of a HUGE bruise forming just above my left wrist where I had fallen over on my way to the bathroom at some point on Sunday evening. Yeah, it had definitely been a rough weekend.

Monday morning I also received a chirpy call from the nurses at the surgery center asking how I was doing? I let forth, not holding back on how “well” I had been recuperating. She sympathised and said it’s not common but there are a few people who do not respond well to anesthesia. Hey! Guess who falls into that category? Why do I have to be part of that “special” group? Sigh.  She did suggest I drink Pedialite – to get the electrolytes back in my system from all the throwing up.

Let me pause here to say to all parents, do you have any idea how bad this stuff tastes? Do you really give this sickly sweet syrupy drink to your kids? Ugh. Still, I bore it with good grace, especially as my foot had now started cramping and my big toe – coddled though it was in cotton bandaging – was seizing with alarming regularity. NOT fun. Randall concluded it was because I was electrolyte low and stocked up on Pedia-shite – I mean lite… Phooey.

On pain meds but a whole lot happier. Whee!!! Floaty drugs...

The GOOD – no, GREAT news was that Dr. Nutig was right. Fri, Sat, Sun were so incredibly painful. My foot was in agony (and remember, multiplied x 17 because I wasn’t keeping pain meds down at one point), but by Monday it was as if the sun had come out. I was on the Tylenol (sequel) 3 and the pain was actually tolerable. It seems getting past those first 72 hours was key and then things would be a whole lot less painful.

I know this blog is hard to read. I don’t want to sugar coat what I went through those first few days. However, I AM the exception to the rule. Most people do NOT have such extreme anesthesia reactions and they don’t land up dehydrated and screaming in agony in the ER. If you take your pain meds regularly and have no adverse reaction to them then you’ll make it through those first few days just fine.

Surgery day!!!

My swaddled foot - post op. Note those yellow streaks are not a bad home tan - it's iodine to help stop infection post op.

Friday, July 15, I was scheduled to rock up to the La Peer Surgery Center in Beverly Hills at 5:30 a.m. Really? Isn’t that a somewhat hellacious hour? Then again, when IS a good hour to have your bones sawed off? Probably never. Anyway, I figured that if I were Dr. Nutig’s first patient of the day that was a GOOD thing. Surgery was scheduled for 6:30 a.m. The 5:30 a.m. start was to fill in all those forms where you say “If I die while on the operating table it’s not your fault and my dog can’t sue you for emotional distress…”

FYI – My dog has her own blog here.

Bronte - my "emotionally distressed" puppy.

Bronte beside herself with despair.

I’d made sure to have my “last meal” the night before at a fancy Italian restaurant. I could die happy having eaten pasta with pesto sauce….

They were all VERY nice at the center, even when asking for my $491 co-pay.

I was called into the surgery center, and told to put on those funny gowns, hats, and booties and pee into a plastic cup “for a pregnancy test..”

I waddled off to the “bed” waiting for me, while the nurse prepped me with my IV and we waited for the doctor and the anesthesiologist to show up. Dr. Nutig showed up bright and perky. “Are you good?” he said. “Are YOU good?” I replied. “Yes,” he said. “Then so am I,” I replied, noting that HE was the one doing the heavy lifting here. He said “Did you have a hearty breakfast?” I said “No” (as per doctors orders) and he said “excellent!”

Next up, the anesthesiologist whom I explained to very clearly that in my last surgery almost 20 years ago, I’d had an epileptic seizure while on the operating table (I had childhood epilepsy), so he probably didn’t want to screw up the drugs unless they all wanted a HUGE shock, mid surgery.

Then it was off to be wheeled into the operating theatre, where I was told they would put a tube in my throat to breathe once I was asleep. “As long as it’s after I’m asleep, knock yourself out,” I said. I guess they then knocked me out. I remember them saying “We’re going to put some medication in your IV to make you sleepy.” That’s all I remember.

I woke up two hours later in quite a bit of pain and a VERY itchy nose… they were removing the plastic breathing mask from my face, which apparently can be quite itchy. Who knew? I guess I do now. They kept me hopped up on demerol and anti nausea meds – I was feeling VERY nauseated – NOT fun, before finally releasing me about two hours later.

My foot was swaddled in a HUGE bandage and looked liked Bigfoot. Pain was something akin to feeling my foot being ripped in two but the meds kept it on the duller side. More pressing for me were the waves of nausea. I did throw up as a parting gift on my way out the door, wrapped in my boot and with a pair of crutches to aid me along.

I’d love to say when I got home the nausea and pain subsided. They didn’t. First order of business was to get new pain meds. Doctor had prescribed Vicodin but I’m allergic to that (joy) so he switched it out for Percocet and my friend had to run down and pick up the prescription. I probably got home around noon on Friday and continued to pretty much throw up the rest of the afternoon and early evening. Sorry, but it’s true. The pain was also reaching excruciating levels because I couldn’t keep the pain meds down. NOT fun.

Somehow, though, in my warped mind I was more than willing to take on the pain as long as the nausea and vomiting stopped. They didn’t – well not till about 7 p.m. and that was a RELIEF.

So how did the next day go? Stick around….

Can I get a triple word score with that?

First things first. I do NOT have a penchant for scary high-heeled shoes. I’m not a Blahnik or a Choo aficionado and do not have a Carrie Bradshaw/Sarah Jessica Parker obsession with blowing my salary on ill fitting footwear. Ergo, my bunions are not the result of wearing “the wrong shoes.” Rather, they’re the product of the wrong parents. Genes (jeans?) not shoes have contributed to my downfall – or rather, footfall. In my case, I was cursed with flat feet. Despite custom made shoes as a kid, with arch supports, they did not stop the progression of my bunions. An early ballet career (like all good little girls with tutu obsessions) probably didn’t help my cause, either.

Anyway, by the time I was 14, I was covering up my bunions in the same way most teenagers were covering up zits. Except I was trying to cover both. Curse number two… my older sister has perfect feet. So perfect, that people used to say she should be a foot model. She’s not, but that still was cold comfort to me and my ugly toes. Oh, plus I appeared to have had my feet bound as a child – although I’m told that wasn’t the case. Still, my left foot is a whopping size 4.5 and my right is a 5. I buy a lot of shoes in the children’s department or Chinatown. Oh, and I’m 5’5″ tall. Cursed, I know.

Truthfully, I learned to get used to my bunions. I never contemplated surgery because they didn’t hurt me and  I had heard horror stories about the pain involved. So I lived with them and they lived with me. Until…

A year ago they became ridiculously painful – the left far more so than the right. They hurt when I walked in shoes or not in shoes. They hurt when I wasn’t walking. They hurt when I was sitting. They woke me up in the night sometimes the pain was so bad. They hurt while I was SLEEPING!!!!

Of course I procrastinated, but as the year wore on and I could no longer exercise or walk more than a block without being in abject agony, I knew it was time to seek a surgeon to wield his knife. Ugh. I’d tried shoes, supports, drugs, cursing, praying. Surgery was clearly the option.

I’m grateful I found Dr. Melvin Nutig in Beverly Hills. Actually I found his partner who said “I don’t do feet, but my partner does…” I chose an orthopedic surgeon. I know there’s a lot of debate about surgeon vs. podiatrist. I don’t know, I wanted an orthopedic surgeon. I think it’s just a personal choice. Go with what works for you – get several opinions. I was happy and felt comfortable with Nutig so he was “my man”

Here is why procrastination is a BAD THING – at least when it comes to bunions. I’d left mine so late that a simple bunionectomy would not do for me. Oh no. I required a series of procedures that would win a Scrabble tournament in one fell swoop. Dr. Nutig told me I required:

• A bunionectomy
• A Proximal Metatarsal Osteotomy and
• A Crescentic Osteotomy

Yep, all THREE!!!! Hooray for me. What did this mean? a) removing the bunion, b) straightening the big toe (with a pin and a screw – that remains there permanently), realigning the tendons to keep my big toe straight, and chopping off those pretty bumps – the hallux valgus bunions – never a better term for those unsightly, ugly bumps.

In case you missed it, that’s three chops, three cuts, three sets of stitches and breaks in three places in my foot. And both feet needed doing!

We decided to start with the left foot as that was the most painful and we scheduled the surgery two weeks hence. Got all my pre-ops done and headed off to surgery. General anesthesia was needed for this surgery as it was a two hour procedure. I was grateful in a way as I really didn’t want to be awake – even if sedated – to witness or hear the slicing of bones and tendons. NO thank you…

Next up – DA SURGERY and its aftermath….

Here’s a pic of my feet pre-op….and the surgical boot I was given ahead of the surgery, to wear after the operation, obviously, not before it.

Feet - pre-surgery

Das Boot!