Removing stitches after lisfranc hardware removal surgery

The morning after we arrived in Cabo, the swelling had gone down in my foot and my husband was ready to try and remove my stitches.

I could not wait!!

3 weeks post op after lisfranc hardware removal surgery

I thought I could do it on my own, but my hands were shaking too hard, so my husband took over.  The top of my foot was very sensitive, so he had to be very gentle.

Removing stitches after lisfranc hardware removal surgery

My husband took his time and made sure each thread of my 8 stitches was accounted for.

Removing stitches after lisfranc hardware removal surgery

After we were sure everything was done correctly, he adhered steri-strips to my incision to help hold it together.

3 weeks post op from lisfranc hardware removal surgery

I was now ready to do the "homework" my surgeon gave me.  He asked me to walk several times a day in the resort pools in order to begin to regain the proper movements for walking once again.

Relaxing by the pool after lisfranc hardware removal surgery

I was surprised to find that I had to once again, re-learn how to walk by repeating the mantra "heel, toe, follow through."

 I was not able to swim at all, and was actually content walking around the pool smiling to myself because I was walking again without pain!!!!!!

My homework assignment after lisfranc hardware removal surgery

As you can see, the pool was large enough to really get in a lot of walking!  Once I was able to walk without concentrating, I pushed my husband on a float around the pool while he read a book. Other guests asked me if they could hire me to do the same thing for them!

Recovering from lisfranc hardware removal surgery

I decided that recovering from lisfranc hardware removal surgery is best done in Cabo at the Esperanza resort!!!

Lisfranc hardware removal 2 weeks post op

2 weeks after my lisfranc hardware removal surgery I couldn't wait to have my stitches removed.  The pain from this surgery mostly stemmed from the incision site and each step I took made me feel like my skin was ripping.  Because my incision looked red and was hot to the touch, I was concerned that it may be infected.

2 weeks post lisfranc hardware removal surgery

When I arrived at my 2 week post op appointment, my surgeon assured me I did not have an infection and that my incision looked "normal" with the amount of weight bearing I had been doing.  

2 1/2 weeks post lisfranc hardware removal surgery

At this appointment my surgeon also decided not to remove my stitches after all.  My husband and I were leaving for a trip to Los Cabos a few days later and because feet often swell on long plane rides, my surgeon was not comfortable removing my stitches.  He didn't want my incision to break open and then have me find someone in Mexico to stitch it up again!!!  (No one was going to touch "his" foot.)  

He asked me to remove the stitches after waiting 24 hours for my foot to recover from plane swelling.  He sent me to Cabo with a suture removal kit and showed me how to remove my own stitches when the time came.

Suture removal kit

 Notice how the scissors has a pointed edge to help pull up the stitch for easier cutting..

On the plane, I brought along an ice substitute and iced my foot each leg of the trip.  We had to switch planes in Arizona and the airlines had a wheelchair waiting to transfer me to my new gate.  I honestly thought I was past all of the handicap stuff, so I was a little embarrassed as my wheel chair pusher wisked me through the Phoenix airport at lightening speed, with my husband trying to keep up!

lisfranc hardware removal surgical boot

Lisfranc surgical boot Esperanza Resort Cabo San Lucas, Mexico

We arrived at our favorite resort in Cabo San Lucas, the Esperanza Resort.  My "cute" surgical boot and I made it at last!!

Lisfranc hardware photos

A few days after Thanksgiving, the hardware my surgeon removed from my foot arrived in the mail!!!

Hardware used to heal my lisfranc fracture

My surgeon knows I have been writing a lisfranc blog and was more than happy to let me keep the hardware he used to help my body heal from a lisfranc fracture.

lisfranc fracture plate

lisfranc fracture screws

What amazed me was to see the screws varied in color,  physical size and thread size.  Check out the teeth at the end of the screws!!!  YIKES!  Maybe it was for the best that my anesthesiologist would not let me watch either surgery!

lisfranc fracture screws



Psychologically it has been very rewarding to think I no longer have plates and screws in my foot.  My surgeon has assured me that in the next 6 weeks, the holes in my bones left by the screws will fill in.

33 weeks after lisfranc surgery

I cannot believe it was 33 weeks ago today that I had my lisfranc surgery!  I apologize for not keeping up with my blog these past few weeks.  

I had my lisfranc hardware removal surgery on Nov 20th (5 1/2 weeks ago) followed by entertaining for both Thanksgiving and Christmas plus my husband and I took a  "lisfranc hardware removal recovery trip to Cabo.  So things have been hectic.

I will try and pick up where I left off from my last blog.  

One week after my lisfranc hardware removal surgery was Thanksgiving and we were having 14 people over for Thanksgiving dinner.  I was told I could not lift a finger and had to stay off my foot as much as possible icing and elevating, so my husband and I had to get creative.  (As you can see, at Thanksgiving, my foot was really swollen, black and blue and extremely painful)

1 week after lisfranc hardware removal surgery

My husband hired a chief to prepare the food so the only thing my husband  had to do was warm up all the food.    Our guests were mostly family members and all understood that I had to play the princess once again.

1 week after lisfranc hardware removal surgery

2 days after lisfranc hardware removal surgery

 2 days after my lisfranc hardware removal surgery I was told to remove the dressing and ace bandage.  I wasn't sure what my foot would look like, and I was surprised it wasn't more swollen.

2 days after lisfranc hardware removal surgery

You can still see where my surgeon placed his initials and where I signed "yes!" indicating my right foot was the correct foot to be operating on.  My surgeon used the exact same incision for removing the hardware as he did for my original lisfranc surgery repair.

lisfranc hardware removal incision

After a shower I had to let my incision air dry and I needed to elevate and ice, something I know how to do!  My nurse told me the ice doesn't have to be over the incision, and that icing the ankle will help just as much.  That knowledge came in handy since the incision area is very tender!

I have been keeping the incision covered with a large band-aid which protects the area from germs.  I remove the bandage daily to make sure the area around my stitches is not turning red with infection.

Lisfranc hardware removal surgical site

I have been meticulous about staying off my foot as much as possible and have been icing and elevating most of the time.  This has been hard, psychologically, for me because it seems like I have gone backwards in my lisfranc journey.  But I know, that in a little more than a week, my surgeon will remove my stitches and I will be able to resume walking again, and this time, I hope it will be pain free !

Lisfranc Hardware removal surgery

lisfranc hardware removal surgery

Last Wednesday I went in for my lisfranc hardware removal surgery.  I requested the same nurse that I had for my lisfranc surgery and was thrilled when she came to get me from the waiting room.   Nurse "Emily" is the perfect combination of humor and empathy with the ability to convey information in a way I can hear.   

In preparation for my surgery, nurse Emily got me into a heated gown, and covered me with heated blankets, which made me feel like I was at a spa.  As she started my IV and explained exactly what was going to take place, I shared that I  wasn't nervous about the surgery itself, but was really anxious about the pain and recovery period.  As we were talking, Emily took my blood pressure and it was 168!!!!

Nurse Emily immediately started re-assuring me that it would be nothing at all like my last surgery and that I would be feeling "normal" in a few weeks.  Then my surgeon walked in, calm as ever, and with a reassuring smile asked me how I was doing. Since it was nearing the end of his surgery day, I immediately asked him if I could buy him a cup of coffee.  He laughed and said he was plenty alert for me.

 He reassured me that this surgery would be nothing at all like the last one and then talked with me in depth about the kind of anesthesia I would be having.  The biggest question I had was whether I would have to go another 6 months with my big toe and the top of my foot being numb.  We decided together that I would not have a nerve block unless I absolutely needed one which would cut down on the likelihood of lingering big toe numbness.

After he signed my right foot and turned to leave, I told him that the anesthesiologist said I couldn't watch the surgery.  He smiled and said, "bummer."  

When he left, I was a lot more at ease with what was about to happen.  Emily shut my curtains and told me to rest until it was my time, which turned out to be 1 1/2 hours!  I have never sat in a room, with nothing to read and nothing to do for that length of time. Unrestrained thoughts can be a dangerous thing!

Finally, my surgical nurse, Sarah, came to get me and she and the nurse anesthetist  wheeled me into the operating room.  The operating room was quite cold and when I mentioned the cool temperature, I was asked to transfer to the operating table with the promise of more warm blankets.  The operating room table was really narrow and did not have space to put my arms by my sides. While I was still trying to decide where to put my arms, someone took my arms and placed on side tables located on either side of the operating room table while someone else secured a thick strap over my stomach.  I asked why the strap and was told it was so I wouldnt fall off the operating room table during surgery.  About  now I was starting to get a little creeped out, and as I was staring up at the ceiling at the many bright white lights that looked a lot like  spider's legs, a mask was placed over my mouth and nose.  I was very happy to succumb to the anesthesia!!!!!

It felt like only a few minutes when I woke up in recovery with my nurse Sarah asking me if I had any pain.  As I slowly came to, I felt a searing red hot pain in the top of my right foot and noticed tears starting to stream down my face.  I told nurse Sarah I was quite uncomfortable and she said I did not have a nerve block and that they needed to control my pain with meds instead.  She immediately gave me a couple of opiates and some crackers.  After about 20 minutes my pain level decreased from a 7 to a 3 for which I was grateful.  After getting my pain under control I was offered ice water and I can honestly say, no ice water has ever tasted so good!!

My surgeon came in smiling widely and told me everything went extremely well and asked me if I wanted to keep the hardware he removed from my foot.  I told him I planned to take pictures of it and post it on my blog and keep it next to my boot.  He laughed and  said they would sanitize it and mail it to me.  Eventually, my pain remained under control and I was told I could return home, where I have been mostly in bed, sleeping and occasionally visiting with family and friends who have been care taking me and my husband.

lisfranc hardware removal surgery ice and elevation and a cute new surgical boot

27 weeks post lisfranc surgery with more surgery tomorrow

After recovering from lisfranc surgery for 27 weeks, my husband and I took a quick trip to Florida before I head back into surgery tomorrow.

I was not able to walk barefoot on the beach, and sandals were still uncomfortable, but that didn't stop me from being able to enjoy the feeling of sand on my toes!

27 weeks after lisfranc surgery

I decided to be really adventuresome and try walking through Sea World.  We took it slow, and I was able to manage walking around the entire park and enjoy several of the shows!  

After visiting Sea World, I even managed to walk through the airport to catch our plane. When we got home last night, all it took to be pain free was a little ice, elevation and tylenol!!

Tomorrow I am having the hardware removed from my foot.  I am not at all nervous about the surgery itself, but am apprehensive about the recovery.  I have been assured by both my surgeon and his nurses that recovery will be much easier this time, but I still wonder how long it will take to recover to the exact point I am now.  I have worked hard to regain almost normal walking and I dread going backward.

I know, though, for a positive long term outcome, hardware removal is necessary.

Amazing leap forward at 26 weeks post lisfranc surgery

Today marks another milestone in my lisfranc recovery journey!  While shopping at the grocery store, perusing isle after isle of items, I suddenly became aware that I hadn't thought about my foot since I walked into the store!  The realization hit me after walking halfway through the entire store without one ounce of pain or stiffness.

26 weeks post lisfranc surgery scar

 I couldn't stop smiling at feeling so "normal" and greeted everyone I saw with a huge grin.  I did resist the urge to tell complete strangers to notice that I was just a normal walking shopper, once again.

  After checking out, another shopper bumped into me and I didn't fall apart in a panic worrying she would step on my recovering foot.  In fact, my first reflex was no longer to pick up my right foot and hide it behind my left for protection.  Instead I managed to smile and say, "hello."  WOW!!!!!

I am now able to walk about 3/4 the speed of other people and I can keep that gait without a limp!

26 weeks post lisfranc surgery wardrobe

I still am much more comfortable in sneakers and decided to buy matching jackets.  I girl needs choices of what to wear in  the cold Minnesota fall weather!!!

25 weeks post lisfranc surgery

Finally, after 25 weeks of healing from lisfranc surgery, I am able to do 2 full hours of regular housework, including being able to vacuum!!  I never thought I would say I enjoyed doing laundry, cleaning the kitchen, picking up, getting out Thanksgiving decorations etc!!!  My foot told me I need to stop, but that's OK. I can honestly say, I am thrilled to be able to take back another part of my life!!! 

I also decided to move up my hardware removal surgery to Nov 20th.  This decision was based on my insurance, who will pay for the entire surgery if I have it done by the end of 2013.

I traded a couple of e-mails with my physical therapist (whose wife has still not had their baby boy yet) and he wants to come and observe my operation! (My surgeon and my PT have a good relationship.) I am absolutely thrilled!!!!!  How cool is it that he wants to follow my case even after I have graduated from PT!!!!

plates and screws after lisfranc surgery
24 weeks post op

So, in a few weeks I will be saying "good-bye" to the plates and screws that were imperative to my healing bones!!

Bones fully healed!!!

Today I had my 24 week surgical follow up and my surgeon's exact words were:

"The bones in your foot are completely healed and fused together, exactly like they should be."

x-ray showing complete healing 24 weeks after lisfranc surgery

All of my fractures are healed, my joints are aligned and my lisfranc joint is fused.  I couldn't be happier with my healing and progress!!!

lisfranc healing 24 weeks after surgery

He went on to review with me my x-rays from before my surgery, at my 2 week check, 6 week check, 12 week check and today's 24 week check. 

Lisfranc injury before surgery

lisfranc joint completely healed 24 weeks after surgery

My surgeon noted that my foot still has some slight swelling and discoloration and I filled him in on my continued pain when walking, especially when I try to walk fast.  I also told him I was unable to run, jog or jump and he said that was normal at this stage, and realistically it would take another 6 months to fully and completely recover. 

He also said that if I was an athlete it was time to have the discussion about hardware removal, and I laughed and told him my goal has always been to walk down our steep driveway and get the mail, and I can do that now!   He smiled, and continued to say that a lot of women want the hardware removed in order to be able to wear cute shoes again.  Of course that got my attention, especially after wearing neon green and pink sneakers for the last couple of months! 

I showed him the top of my foot and traced the area with my finger where I thought the hardware was and he affirmed that it was indeed the plates I was feeling under my skin.  I also asked if hardware removal would help with the itching in that same area and he said it definitely would stop the irritation.  Removing the plates and screws may even help with the cramping I have been getting in the arch of my foot.  (Although the cramping most likely is related to my muscles re-building.)

Removing the plates and screws is a simple procedure, and the incision would be along the same line as my lisfranc incision.  I would be full weight bearing right after the surgery with stitches removed at 2 weeks and full recovery at 3 weeks.  So, I decided to have my plates and screws removed and scheduled surgery for Jan 8th 2014.  (Hardware removal should be done within 1 year of original surgery.)

I am not at all discouraged, though, since I know my bones are healed, my muscles are continuing to develop properly  and my lisfranc recovery journey is on the right path.

Success!!!!

After healing for 24 weeks from lisfranc surgery, I am finally able to walk DOWN the steep hill of our driveway!!!!!!

For weeks my ultimate goal has been to be able to walk both up and DOWN our driveway to get our mail which  not only emcompasses a very steep hill, it is 2/10 of a mile round trip!

Today I accomplished my goal!!!!!!!  My recovering foot ached a little going down, but I have to say it was more tender than painful.  Going up was not too hard at all!

With the help of my husband, I also planted 90 tulips, and did several other outside tasks.  When my foot said it was time to quit, I happily elevated and iced, knowing I am now doing things I haven't been able to do in over 7 months!!!!!

There is a pot of gold at the end of lisfranc recovery and today I took back a few more missing pieces of my life.....

Graduation Day!!!!! (24 weeks post lisfranc surgery)

 Today I officially "graduated" from physical therapy!!!  Plus, my therapist said it was time to retire my cane permanently!!!! I am absolutely ready to start my "real life" and slowly begin my "normal" activities once again.

Good - Bye cane!  (24 weeks post lisfranc surgery)

My PT measured my range of motion and compared it to my non injured foot and announced that I now have my full range of motion once again.  When he measured my foot strength, I almost pushed him off his chair!!  He actually laughed and said my foot is now full strength.  No more atrophy!!!

24 weeks after lisfranc surgery image

My actual recovery test score came in at a disappointing 70% but that is because I cannot run, jog or walk very far yet.  That will take more time. But I can walk slowly, and I am absolutely thrilled with my progress!

24 weeks after lisfranc surgery picture
right side view

My instructions moving forward are pretty simple.  "Listen to my foot."   I can resume going to the club and use the stationery bike, the elliptical machine and also the leg press, (In addition to my treadmill at home.) He also said to go ahead and do the balancing exercises and stretches to keep my range of motion and flexibility.

24 weeks post lisfranc surgery
left side view

When it came time to actually say "good-bye" it was much harder than I ever imagined.  How do you say "good-bye" to the man who taught you to walk again?  There are not the right words to express the depth of my gratitude for what he helped me accomplish.  He gave me my life back! So, after a huge hug and a few tears (on my part), I rushed to my car consoling myself with the fact that today is most likely his last day before he goes out on paternity leave.  His wife is due to have their baby boy any minute, so I wouldn't have had him for another PT session anyway.

24 weeks post lisfranc surgery scar

The next milestone for me will be my 24 week post surgical follow up which is next Tuesday.  Hopefully that will result in good news as well!!!!!

23 weeks post lisfranc surgery

The first snowflakes of the season are falling today in the Twin Cities and not the pretty fluffy kind. This snow is more like ice pellets.

I cannot believe my lisfranc recovery summer is over and winter is edging near.  My lisfranc injury occurred on March 9th 2013 and my lisfranc surgery took place on May 10th, 2013.  At that time, I never dreamed I would still be thinking constantly about my foot and my ability to walk as the Minnesota snow season officially starts once again.

23 weeks post lisfranc surgery image

I now have the ability to stop quickly and even maneuver at a moments notice to get out of someone's way. Even though I cannot do quick actions pain free, this new ability has come in handy in crowded situations.

Not every step I take is painless, but I have worked hard to reach my goal of "normal walking" and celebrate each step that is pain free  as I march towards the finish line.

23 weeks post lisfranc surgery scar image

I still measure how many steps it takes to get from one place to another, but the scope has greatly increased!  For example, instead of judging the actual step count from my chair to the kitchen, I now measure how long I will be on my feet happily walking around Nordstroms or the grocery store.  I know I have a limited amount of pain free steps, so I try to space out my errands so I can accomplish a little pain free walking each day.

23 weeks lisfranc surgery image right side view

I am really looking forward to my 24 week surgical follow up with my surgeon next week. I am hoping my x-rays will show a full recovery.

23 weeks after lisfranc surgery image left side view

 Friday, I will have my 28th and final physical therapy appointment and hope to hear I am 90% recovered!

lisfranc recovery image  23 weeks after surgery ( right foot)

Wearing "real shoes" at last!!!!!!!!!!!!

After 23 weeks of healing after my lisfranc surgery, I am finally able to wear "real shoes."

OK, so their not "cute shoes," but they are not ugly!!!

23 weeks after lisfranc surgery and finally wearing real shoes

For weeks I  have been searching for comfortable flats that wouldn't put pressure along my incision or press on the big toe area that is still numb.  In other words, I was looking for a shoe that fit like a sneaker, but looked like a real shoe.

I was just about to give up when I found out that I would need to attend a funeral of a dear friend.  I just couldn't imagine wearing either pair of my neon sneakers to such a somber and formal affair.  So off to Nordstroms I went.  The salesman I had was fantastic and after explaining my situation, brought out these shoes:

Comfortable shoes after lisfranc surgery

 These shoes have a zipper on both sides for an easy, painless entry.  The leather is soft and flexible, virtually putting little to no pressure on the top of my foot when I take a step.

Double zippers make these shoes comfortable after lisfranc surgery

 The inside of the shoe has a nice arch support with removable soles in case my surgeon decides I will need to have orthotics.

When I wore my new shoes to church today, I was bubbling over with happiness.  I had to resist the urge to tell everyone, including  complete strangers, that I was wearing real shoes for the first time since March 9th, 2013!!! 

Instead I settled with smiling widely as I proudly walked down the isle to my seat. I felt my heart racing and it was hard to contain my elation at this momentous occasion. 

My friends, who asked me how my foot was doing,  were met with me excitedly pointing at my feet and announcing that I was wearing my first pair of real shoes. I received more than my share of hugs today!!!!!

A comfortable shoe brand to wear after lisfranc surgery

In case you want to check out my shoes, the brand name is Munro. They are not cheap, but not nearly as expensive as Manalo Blahik's.

A reason to celebrate

I am celebrating today!  

Ever since I had lisfranc surgery  my mantra has been, 

"I am just a middle class housewife who wants to be able to walk down her driveway and get her mail."

This dream doesn't sound unattainable until you realize our driveway is not a short driveway with a mailbox at the end.  Nope.   Our mailbox is located exactly 1/10 of a mile from our garage door and our house is perched on top of an immensely steep hill, which makes it perfect for sledding in the winter. 

walking a hill after lisfranc surgery

My physical therapist and I discussed the possibility that I may be ready to take on "the driveway challenge" and he ultimately gave me permission to try walking up our driveway and see how that goes, before trying the harder challenge of walking down the driveway.

Walking up a hill during lisfranc recovery

So, after coming home from church today, I had my husband drop me off at our mailbox so that I could make my first attempt at my driveway dream.  I knew that if I ran into trouble, my husband would come down and pick me up.  My taxi ride may be on his John Deere instead of in a car, but at least I knew I had a ride if need be.

Pain free while climbing a hill 22 weeks after lisfranc surgery

I was apprehensive, wondering if my foot was physically able to make the climb, and I was also curious if scaling the hill would cause pain.

22 weeks post lisfranc surgery and walking up a hill

After managing the steepest part of the journey, I knew I was going to make it all the way to the top AND I made it 
PAIN FREE!!!

Next challenge---walking down my driveway!