My lisfranc vacation is over!

It has been 5 days since I started physical therapy and my life has happily started to change.  Outside of the safety of physical therapy room, I was given permission to either walk with one crutch and my sneaker on my recovering foot or walk without crutches and with my boot protecting my foot.  ( I was taught how to do both things.) My foot's vacation is over!!

My foot longs to walk in a sneaker

So this morning I decided to brave going to church without crutches or my beloved scooter, wearing just my bedazzled boot. It is quite a walk from the parking lot to the sanctuary and I knew I was taking a bold move.  My husband was willing to let me use his arm for my "crutch" and after a few steps we both realized I didn't really need his support physically, but I needed the reassurance psychologically.  

It was a heady experience walking into church for the first time in 7 weeks!  The friends I saw rushed over to say "hi" to the new me, walking once again!  The exhilaration of walking far outweighed the amount of pain I had to endure.

Here's what is happening to me psychologically.  I am now having a hard time not walking!  I find myself more and more passing up my scooter and my crutches and just walking to my desired destination despite the pain. Walking makes me feel normal and I love it! 

This afternoon, I paid the price for my new found confidence.  All the walking I did this morning followed by my physical therapy exercises, and my water walking therapy, caused my foot to swell up like a bloated wood tick!

My foot was so swollen it barely fit in my sneaker

So once again I am back to icing and elevating!  It feels like I am taking 2 steps forward and 1 step back.  But at least I am making progress!

Icing and elevating again!






This evening will be filled with rest for my foot, ice, elevation and extra strength tylenol. However, no amount of pain can take away the satisfaction I feel from walking again! 

7 weeks post lisfranc surgery

                 I have finally made it through 7 weeks of healing! 

7 weeks post lisfranc surgery

My recovering foot looks almost normal

7 weeks post lisfranc surgery


My ankle is more swollen today because of intense physical
therapy yesterday.

Moving around more causes more pain and swelling, but it is worth it!  

On the road again 7 weeks post lisfranc surgery

Today is exactly 7 weeks after my surgery for my lisfranc fracture,  and I am now officially driving!!!!!  Since my recovering foot is my right foot, I have been unable to drive for 7 long weeks!  

My surgeon cleared me to drive as soon as I could move my foot well enough to apply pressure to the gas pedal and, more importantly, the break.  The exercises my physical therapist gave me this week included re-learning several of the motions needed to drive, and various stretches for the muscles in my toes, ankle and calf.

This morning my husband and I took a practice drive around the neighborhood, just to see if I was going to be able to physically manage the movements and deal safely with any pain while driving.  The driving aspect actually was very natural for me and the transition was painless.

However, I discovered having the physical ability to drive is just half of the equation. I also needed to be mentally prepared to drive. The fear of re-injury, and thoughts of having to experience the painful recovery again has made me hesitant for each new step in my journey.  I am constantly surprised at how much psychological healing I have to do during each stage of recovery. 

Today, during physical therapy, my therapist had me walking over barriers which were no more than a foot high.  Sounds easy, right?  Not for me! 

She told me to lead with my recovering right foot and remember to put my heel down first and then my toe and then let my left foot follow.   I was hesitant to take the first step, trying to remember everything she said, wondering how much it was going to hurt and fearing I would completely lose my balance.  I stood there for a while thinking things through and finally she held out her hand which I immediately grasped.  Suddenly, I could slowly walk the  hurdles.  

The next attempt she held out her hand, and asked me not to hold on.  But, mentally I knew it was there if I needed it, and once again I could manage the hurdles with ease. It became clear to both of us that I had the physical capability, but I needed to gain confidence mentally in order to proceed.  


When we got to the part in therapy where it was time to practice walking, I was concentrating so hard on all the proper movements, and even held my arms away from my body for balance when my therapist started to laugh.  I looked up at her smiling and asked her what was so funny?  She said that her 1 year old walked better than I do!  So, of course I got the giggles as I pictured her one year old tottleing around with more natural balance than me!   It felt so good to laugh at myself! She then said that I was over thinking my steps and to try and let it come naturally for me.  This was wonderful advice.  After letting go of trying to do it perfectly, my steps did come out right.  Slow, but great for now!!!

My physical therapist and I spent some time discussing the psychological aspect of recovery and she assured me that with a lisfranc surgery, psychological healing is always a part of rehab.  It often times can be harder to conquer than the actual physical rehab!  I am learning to not be so afraid and more importantly to remember to find humor during this part of the journey.

Pool Therapy for lisfranc surgery recovery

Today I started pool therapy for my lisfranc surgery recovery.  My physical therapist endorsed my surgeon's suggestion that I walk for 20 minutes each day in our pool in chest high water. 

 I found walking in the water is a lot less painful than trying to practice walking in a sneaker. It proved to be a wonderful way to practice learning to walk again while I repeated my mantra "heal, toe, follow through."  If you have access to a pool, I highly recommend water therapy.  (with your doctors and therapists permission of course.)

I did 2 20 minute sessions followed by the exercises my physical therapist gave me.  I am so tired physically and mentally!  And  my foot is really upset with me, so I have to call it quits for today.  I am once again sitting in my chair with my ice air cast on and my foot elevated.  But, despite the pain, I also have a sense of satisfaction that I haven't felt in a long time.

Lisfranc physical therapy

Yesterday was my first physical therapy appointment.  I woke up at 5:00am anticipating the beginning of the 3rd and final part of my lisfranc recovery journey.

My therapist is well informed about lisfranc surgeries and we spent the first several minutes talking about how I acquired my injury, all the misdiagnosis' and finally how I felt the surgery went.

She then asked me to take off my boot and she inspected my foot comparing it to my normal foot.  We talked in depth about pain levels and which movements cause which kinds of pain.  I was immediately impressed that she already knew so much about all the different kinds of pain I have been experiencing.

When we started talking about my continual big toe aching and ongoing numbness I found out that during lisfranc open reduction/fixation surgery my big toe was held down in an awkward position throughout the entire surgery.  Now I know why it still hurts so much and I am no longer worried that something is wrong.

When she asked me to stand in my stocking feet and put all of my weight on my recovering foot I broke out into a cold sweat and started to shake all over.  I told her that as motivated as I was to get my life back, I didn't think my foot was ready yet. I honestly thought the pain would be too great.

My therapist said a lot of the recovery from lisfranc surgery is psychological.  We talked several minutes about the fear if re-injury and how tough the last 6 weeks have been.  I shared with her that even the thought of having to go through this experience again terrifies me.  She reassured me that my bones have done all the healing they can and that there was no way I was going to re-injure myself with the exercises she was going to ask me to do.  

She then took my hands and I slowly lifted up my good foot and eased into putting my entire weight on my recovering foot.  Did it hurt?  Absolutely!  Was it worth it?  Without a doubt!  After holding the position for 20 seconds, I was so happy I couldn't stop smiling.  I looked up at her and she was beaming too.

She showed me 4 other exercises she wanted me to do which were all painful at first.  But as my muscles started to wake up again, it got easier and less painful with each movement.

Next she brought me over to a recumbent stationery  bike and told me I was going to pedal for 7 minutes.  I couldn't believe it!!!  I looked at her in shock and said, "really?"  She had me grab the handle bars which showed my pulse at 130.  That was how scared I was to try peddling a bike!  At first she let me use my left leg to do all the work while my right leg went along for the ride.  But after a few revolutions, my right leg was able to join in.  As the pain lessened, my pulse dropped down to 72 and I was able to go faster and faster.  I was so pleased with myself that I went 10 minutes and 1 3/4 miles before she came and pulled me off the bike.  I was out of breath and ecstatic!  I actually used my foot to pedal a bike.

Now I was ready for the final part of my first physical therapy session.  She was going to teach me how to walk again! Very slowly I took my fist step: Heel down, rotate weight to toes, follow through with bending the arch.  I had to take it slower than a 2 year old, but I managed several steps in a row and all without the boot!!!!!

We finished the session with the most wonderful ice machine which wrapped my foot in ice and massaged it at the same time.

I was sent home with 6 exercises to do twice a day and was also instructed to practice walking a few steps several times a day while repeating my new mantra, heel, toe, follow through!!

Frustrated with lisfranc recovery and pain

Oaky, I'm done with this whole lisfranc surgery/pain/healing process.  I just want it to be over!!!!  I am at 6 weeks 3 days post lisfranc surgery and am really tired of my foot aching and not being able to walk and not having my normal life back yet.  That is my rant for today.

I tried to rush the healing process yesterday and paid the price. Unfortunately the friend of mine who lent me her knee scooter fell off her bike and broke her leg.  Needless to say, she needed her knee scooter back.  I thought I was far enough along in my partial weight bearing to be able to transition away from both the shower chair and the knee scooter.  I was dead wrong!  

My head is not in tune with the current ability of my body.  We went to church and ran a couple of errands which meant I took way too many steps with the help of my crutches. By 2:00 I was back in my bed, curled up in pain with my ice air cast on.

We met some friends for dinner but had to forgo going to their house afterward because I was in so much pain.  Once again I came home and curled up with ice and pillows.

This morning my foot was almost too sore to bear any weight.  I had to admit to myself that this is not going to be over for some time yet and I needed to dig deeper for more patience.  So I found a place to rent a knee scooter and have stayed off my foot for most of the day.  Sigh

John Deere Taxi for lisfranc injury

John Deere taxi as an alternative to doing steps.

My recovering lisfranc foot composes dissonant music

Last night my foot decided to start crooning in pain like a string quartet.  What does that mean you wonder?  Well it was like this.

Since I had several pain free moments during the day yesterday, I decided I could move around enough to make dinner for my husband.  It was a heady idea that filled my soul with delight to think I have come far enough in my recovery to start to do things I enjoy like cooking.  I e-mailed my husband the grocery list and when my husband returned home I was already waiting to get started. He sat at our counter and we talked about our days while I sliced tomatoes, onions and chopped up mushrooms.  It was so nice to return, in part, to our normal domestic routine.

After dinner I was sitting on the couch when my 2 little toes decided to start  a sad melody. It was like hearing violin number 1 and 2 tuning up for a string quartet concert.  I tried to ignore the plucks of pain by concentrating on the TV show we were watching.  

Soon my incision decided to join it's mournful voice to the forlorn music much like the alto sound of the Viola.  Once again I told myself, the escalating pain is nothing to worry about and would subside soon enough.

 Like the cello’s rich solid tone, my ankle decided to howl it’s aching cry.  At this point, my big toe joined in the sorrowful music and bellowed like a double base.   

My string quartet was complete with 5 parts of my foot all hurting together creating a dissonance symphony of pain.  My husband got me down to my bed, and I elevated, iced and listened to the moronic music of my foot.

6 weeks post lisfranc surgery

I have finally made it to week 6 of my lisfranc recovery journey.  Physically and psychologically this is a gigantic mile stone in my recovery.  

Here are some pictures of  6 weeks post lisfranc surgery:

My incision if finally starting to heal. But my foot remains discolored with faint blue and red tones especially when not elevated.

  Both sides of my ankle remain swollen, but the bruising is entirely gone. The black, yellow and green tones have disappeared.

I celebrated my 6 week milestone today by having lunch with a girlfriend at one of my favorite restaurants.  It was fabulous being able to navigate the stairs in our home, use crutches to get to her car and not be afraid of either the pain or re-injury.  It is a beautiful day and we were able to sit outside at a table by the lake. I was able to prop my foot up on the chair next to me and quite astonishing, there were times I completely forgot about my foot!!! I felt almost "normal."   Pain free times have been few and far between and to experience pain free moments while celebrating this day was a true blessing!!

Psychological transition from non weight bearing to partial weight bearing.

The toughest transition during my lisfranc recovery has been psychological.  I desperately want to walk again and resume my life.  But the fear of re-injury causes multiple feelings of unease, trepidation and worry. I am constantly concerned that my foot won't be able to support my weight.  Just thinking about having to go through lisfranc surgery again and the seemingly endless recovery has the power paralyze and even drown me.  And most certainly these thoughts make me hesitant about taking the next steps in my journey.   I am trying to learn how to prepare, mentally, for each step that I take, whether it is standing, walking, or climbing stairs. I had not counted on not only having to rehab my foot but having to also recover my confidence in something I used to take for granted.....walking.

What you will experience after lisfranc surgery

Through my lisfranc surgery and recovery I have learned what to expect.  Everyone's journey is different but I thought I would share a few things that are considered "normal" during recovery.

                                

2 weeks post lisfranc surgery

You may experience:
Big toe pain 
Big toe numbness 
Feeling needle like pain in the bottom of your foot
uncontrolled muscle spasms of your leg
bruising on all areas of your foot
burning, itching, aching of your incision
swelling of your entire foot
ankle pain, swelling and bruising
4th and 5th metatarsal pain and tenderness
discoloration of foot when taking a shower or when it isn't elevated
diminished sensation on the top of incision
not being able to move toes as freely as before
painful moving toes
different kinds of pain on different days

Transitioning from non weight bearing to partial weight bearing

                     Standing with equal weight on both feet

This has been an exciting, exhilarating  and painful week!  I have spent 5 weeks dreaming of the day when I would be able to start putting weight on my foot.  I knew it would be a painful transition, but I never thought about how much it would hurt!  My foot definitely has enjoyed it's "vacation" and does NOT want to be called into service again!

After several endeavors of trying to stand and several clumsy attempts at trying to walk I discovered several things:

1.  It is too painful to walk in sneakers yet.   My surgeon has given me permission to try and walk in my sneakers, but at this point in my journey it is just too painful.  

2.  Slowly easing into equal weight bearing causes less pain.  I have been experimenting with partial weight bearing in my boot.  I found that if I stand up putting all my weight on my left foot and slowly ease into partial weight on my right foot, (with the boot on) the pain level diminishes.   This morning I was able to stand with weight equally on both feet for a few minutes with a minimal amount of pain.  (level 2.)  This is HUGE for me.

3.  Walking slowly in my boot is possible.  I have been trying to "walk" with my boot on and found that taking it slow....really slow....I mean like tortoise slow, makes my foot have a chance to adjust to the weight and is less painful.  "Walking" in my boot causes pain at a level 4 so I am only trying this a few times a day.

4.  I never considered how many steps it takes to get from point A to point B.  Honestly, I look at my living area differently now.  Everything is judged by how many steps it will take to arrive at my desired destination.  It takes much longer to navigate around my living space than it did with my scooter, so I am still using my scooter for most of the day.

5.  My foot swells and aches when I try to do too much.  I have to listen to my foot when it says it's had enough.  Ice and elevation are still a part of my daily life.

Married to the boot!

If you are married to the boot, make it something fun to wear!

I am having anyone who has been involved in lisfranc journey sign my boot!

5 weeks post lisfranc surgery

I am now at week 5 following my lisfranc fixation/fusion.

                            My foot and incision at 5 weeks

Swelling has started to go down and the bruising is almost gone

The right side is still swollen, but not as painful as last week.

My surgeon cleared me to start partial weight bearing which is a week ahead of schedule.  He said I could put on a sneaker and try walking around my living area with a walker!  It was tough getting the sneaker on my right foot as it is still a little swollen, but I did it with the laces tied loosely.

              My first time standing with the help of a walker

The first few moments felt like I was standing on sharp shards of glass!  That still didn't take away the moment of exhilaration of being able to stand on 2 feet once again!!  I was able to walk a few clumsy steps but found it was still two painful. (level 7)

 I called my physicians office to see if I was supposed to push through the pain or listen to the pain.  I was told following lisfranc surgery to always listen to my foot and the phrase "no pain, no gain" does not apply.

So now I am experimenting with taking careful steps wearing my cast/boot with the aid of either my walker or my crutches.  I still have to use my scooter for longer distances.

Partial weight bearing also means I can now navigate the stairs in our house with the help of our railings!!  I have a backpack that I can fill up so I can even manage doing some of my own laundry.

It feels like my life is slowly starting back up again, after being shut down for weeks......Re-hab starts in 7 days!!!!!

New technology for Lisfranc injuries and fusions

I had my 5 week post lisfranc surgery appointment last Friday and my surgeon said my healing couldn't be more perfect! Together we looked at the 3 x-rays he had taken of my foot, and then he showed me the before surgery and after surgery x-rays plus a side view.  I commented that I had done some internet research on the titanium  plate he drilled into my foot and discovered it is new "state of the art" technology.  He smiled and said yes it is!  I mentioned to him that I was writing a blog, so he took pictures of my x-rays so that I could post them in my lisfranc blog:
   

                                      This is before surgery

Note the space between my first 2 metatarsals and how the metatarsal joints are out of alignment.

         This is 5 weeks following lisfranc open reduction surgery

Note the placement of the new titanium plate which corrected not only the space between my first two metatarsals, but aligned my joints once again.

This is a side view which shows how the plate is screwed into my metatarsals and cuneiform joints

This new titanium plate came on the market in 2012.  It cuts down on joint damage and  I won't have to have additional surgery to have it removed.  It has now become a permanent part of me.  And the good news is that it is only 1.4mm thick and won't set off metal detectors at the airport!  

I am posting the description of the new Lisfranc plates which I copied from Arthrex's website.   If you would like more detailed information about the surgical procedure, check out this link:

  https://www.arthrex.com/foot-ankle/lisfranc-plates  

under surgical technique guides click on "Lisfranc Reduction for Injuries and Fusions using Lisfranc Plates"

"Lisfranc Plates offer multiple solutions and are easily contoured to patient’s needs

The new Lisfranc Plates were designed to provide fixation for acute Lisfranc injuries and fusions of the tarsal-metatarsal joints. The unique design allows for compression along the Lisfranc ligament and allows the surgeon to visualize the healing process during recovery. These plates come in three different sizes with both left and right plates to fit any patient and are contoured to fit the Lisfranc anatomy at only 1.4 mm thick.

• •  Allows visualization of the Lisfranc joint during healing process
  
• •  Compresses along the Lisfranc ligament—along the line of injury
  
• •  Eliminates the joint damage that may occur with the use of screws and guide wires
  
• •  Bridge-plating preserves the joint surfaces and results in larger surface area for bony fusion
  
• •  1.4 mm maximum thickness, provides minimal prominence and low profile contouring
  
• •  Contoured to fit the1st/2nd metatarsal—cuneiform joints
  
• •  Allows room for normal interfrag screw placement"
  
  (Taken from Arthrex's website) https://www.arthrex.com/foot-ankle/lisfranc-plates
  
  
  I was also given permission from my surgeon to start partial weight bearing after only 5 weeks, which is a lot earlier than what other lisfranc surgeons are recommending to their patients.  I am sure it is because of these new plates! 
  

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Lisfranc surgery recovery can be a blessing

I am finding the non weight bearing period of my recovery has actually been a blessing in many different ways.  It has forced me to slow down and become completely sedentary, mostly helpless and dependent upon others for almost all my needs.

The biggest reward of my temporary sedentary life has been the generous people who have stopped by to visit me, run errands for me, call me or send me emails and texts.   It isn't the delicious breakfasts, lunches and dinners, DVD's, books, flowers, candy, cards, snail mail, e-cards and voicemails (I could go on and on) that mean so much, but it is the time people have taken out of their  own lives to encourage me, in whatever way they could, during my difficult journey.  

I have been so fortunate to be able to spend quality time, without distractions, with the people who have stopped by in person.  These times spent with my family and friends has greatly deepened my relationships with each and every person. So lisfranc surgery recovery really can be a blessing if you look at it as an opportunity to re-connect with not only yourself, but your loved ones as well.

The Truth About Lisfranc Surgery Pain

I have had countless people ask me "are you in pain", or "how is your foot is doing?"  Most of the time I assume it is kind of like saying to someone you haven't talked to in a while "how are you?" and their response is usually "I am doing well." Yeah, it's kind of like having that conversation.

Last night we had a few friends stop by to have pizza with my husband and me.  When they arrived, my girlfriend went upstairs to help my husband in the kitchen.  As her husband leaned down to give me a hug, he said "how are you really, and I don't want the "I'm doing great" answer."  So I told him the truth.  Today I was with another person whom I knew wanted the truth and not the "I'm doing great" stock answer.  So I also told him the truth.  In both situations, neither man tried to "fix" my pain, or tell me they know how it feels, or try to tell me about a time they were in pain.   Instead they both just sat with my information and listened to me.  Both times, it was a very rewarding experience.  I felt understood and somewhat relieved to be able to share my pain with someone else.

Until yesterday,  I have not wanted to bore people with my details of my painful journey and certainly have never want to be labeled a complainer, so I have kept the bulk of my pain to myself.  But now, after 2 positive experiences of sharing my pain I have decided to be honest  with anyone who really wants to know.  *But I have to sense they are really interested.  So if you don't want to know, you should skip the next couple of paragraphs.

Any surgeon will tell you that lisfranc surgery is one of the most painful surgeries there is.  There are a multitude of bones, ligaments and nerves that all congregate in the mid foot area. Slicing that area open, drilling in a plate and screws will surely result in pain.  I was mentally prepared for this.  What I wasn't prepared for is how long I would be in some sort of pain.

Because my lisfranc diagnosis took so long, I had already endured a lot of pain while walking. I had a couple of months with a steady level 4 pain (and ate Advil like candy.)  After waking up from surgery, the nurse asked me if I was in any pain and I said I was.  This surprised her since I had a nerve block that was supposed to take care of my pain for up to 24 hours. (not a good sign.) My heel felt like it was on fire and she said that was from the cast.  I then told her the top of my foot hurt at a level 5-6.  She immediately got me some crackers and gave me 2 different kind of pain meds.  It took a while, but my pain level did go down enough so that I could get into our car and go home.

The nurse told me in order to stay ahead of the pain, I needed to take the pain meds on time, so when I got home, I set my iPhone alarm and took the meds right on time.  This worked through the first night.  The second night home, some friends were over bringing food and flowers and while I was trying to visit (although it is all very hazy) my pain level suddenly started ramping up like a train going down the tracks.  I knew beyond a shadow of a doubt that the nerve block had worn off (my foot felt like a dozen needles were being stuck in it) and that I was going to be in trouble pain-wise soon.  My girlfriend is an RN and immediately noticed something was wrong.  She got me up and literally put me to bed with pain meds, elevated my foot and put fresh ice on it as well.  It hurt so bad at that point I couldn't speak and felt like I was going to throw up.  (level 9) I am lucky that was the only time my pain reached that high of a level.  Within 5 days of surgery I was completely off narcotics and OTC (Extra Strength Tylenol.)

Each week as been a new kind of pain.  One week it was the top of my foot that throbbed.  Another week it was my ankle and 2 of my toes.  Last week it was my big toe which still aches like a toothache.   At all times the incision hurts and burns and I hate having anything (including my boot) touching it as this makes the pain worse.  I get shooting pains in all areas of my foot and at different times during the day and night.  I believe this is caused by my nerves trying to heal.   So now you know the truth.  Lisfranc surgery is painful and will cause various parts of your foot to hurt off and on and at different levels all throughout recovery.  I am looking forward to the day when I can honestly say my pain level is zero today! 

Exhaustion during lisfranc surgery recovery

I am now in my 5th week post lisfranc surgery and each week I have felt stronger and less tired.  I knew I was getting better when I started to notice all the little things that were not being done in my living area, such as the carpet hadn't been vacuumed, the weeds were growing next to the house, cob webs on the ceiling, etc.  In previous weeks all I could concentrate on was getting myself showered and dressed in the morning, icing my foot and elevating.  I didn't even look at my environment. I think this is a very good sign!  I am starting to care about more than just my foot and the healing process!

And then yesterday happened.  I did my usual routine of showering, dressing, icing and elevating and instead of feeling wide awake, I did all I could to stay awake.  I finally lost that battle around noon and laid down to take a nap, something I haven't done in over a week!  I slept 3 1/2 hours and woke up refreshed and ready for our evening visitors.

Today I realized why I was so tired.  Yesterday was the day my body needed to recover from all the new exercise and I simply needed to rest.  On Sunday, my husband and I went to church, but because it was raining, we couldn't take his John Deere up the hill to the car.  So we had to figure out a new way for me to get upstairs.  I ended up going up the stairs backwards, using my arms and than crawling to the next half level of stairs and repeating the process.  I was horrified at how winded I became!  It was quite the workout.  And then I had to hop down the two stairs in our garage to get myself in the car.

After church, we went out to lunch with my father and a friend, which posed another mobility challenge....navigating into a booth.  By the time we got home, it was still raining so I had to figure out how to descend the stairs back to "my" level.  By the time I was back in "my chair" I was sweating, breathing hard and exhausted.

I am not an exercise nut, but I am certainly no couch potato.  Before my injury I had been walking 3-5 miles a day and in the summer I swim laps in our pool.  So this new feeling of exhaustion over simple things like navigating stairs is quite disturbing to me.  I didn't realize how much energy my body has been using to heal from lisfranc surgery.

What is a lisfranc fracture anyway??

Lisfranc fractures are extremely rare.  Only 1 in the 55,00 fractures per year are lisfranc.  

The word lisfranc refers to any injury involving the mid foot area.  A lisfranc injury is when any of the bones in the mid-foot are broken or any of the supporting ligaments are ruptured or a combination of both.  My diagnosis was a lisfranc fracture of the first and second metatarsals with ligature rupture and joint displacement.  Yes, my fracture was pretty severe which is why I required surgery.

The lisfranc fracture is named after Jacques Lisfranc de St. Martin,  who was a surgeon in Napoleon’s army. A soldier who fell of his horse during battle while his foot was stuck in the stirrup would likely sustain multiple injuries  to his mid foot.  Dr. Jacques Lisfranc De St. Martin perfected the art of amputating the injured soldier’s foot at the mid-foot to prevent gangrene from setting in.  

I am very glad that I am living more than 200 years after Dr. Jacques Lisfranc De St. Martin perfected the first surgical techniques to the mid foot area!

Muscular Atrophy

I am now in my 5th week of recovery from Lisfranc surgery and have noticed a large amount of muscular atrophy in my right calf and thigh.  It is hard to believe that not using my right leg for 4 weeks has already made me lose over 1 1/2 inches in muscle.

On the positive side, my leg jerks (where my leg jumps automatically like it has been electrocuted) has died down.  All I am left with now is big toe throbbing and mid foot pain.  I am still not taking any OTC’s (extra strength tylenol) and find the pain to be more annoying than anything else

I am looking forward to my 5 week post op appointment on Thursday and am hoping for good news.  

4 weeks following lisfranc surgery

Week 4 following lisfranc surgery

Here is what my foot looks like 4 weeks after my lisfranc surgery.  The swelling is down and the incision is almost healed.

There is still a little bruising and ankle swelling on the right side:

 My foot still turns bright red and gets warm and swells when it is not elevated for any length of time.  And my big toe is still numb to the touch and throbs with pain, especially at night.

Learning to say YES!

Learning to say “Yes.”

Learning to say “YES” has been the toughest part of my lisfranc recovery journey.  The surgery was scary and the recovery has been long and painful.  But being so dependent on others has been the biggest lesson I have had to learn.  Like most women, I am much better at taking care of other people than I am at letting people take care of me.  My first innate response when someone asks if they can bring dinner, or pick up some groceries, or come over to keep me company is “no.”  I feel unworthy, and really hate asking people to go out of their way for me or having people do something just for me.

Today marks 4 weeks into the non weight bearing portion of my lisfranc recovery and I have had to force myself to learn to say, “yes, that would be nice.”  Or, “here is what I really need.”  Because guess what?  It is true that I have needs that I cannot take care of on my own.  And I really have needed tons of help.

I think it comes down to this:  When you say “no” to someone offering to help, you take away their opportunity to feel pleasure at being able to fill a need.  I think back to a time recently when I found the perfect gift for a friend of mine.  I knew it would mean a lot to him and couldn’t wait for him to open my present.  And when he did, the smile on his face and heartfelt “thank you” gave me more joy than I can express.  I often think back to that moment of giving and what a blessing it was that he received my gift with such pure delight.

During my lisfranc  recovery, I have learned to accept offers of help.  These offers are not just countless  blessings that have enriched my journey, but have also provided the opportunity for the giver to feel  joy that they were were there for me during my time of greatest need.

Lisfranc surgery recovery survival guide

When I was told I had a lisfranc fracture and would need surgery involving 6 weeks on non weight bearing inactivity, I admit I went numb.  I couldn't comprehend what it would be like to sit around for 6 whole weeks!  After the initial shock, I decided I had to have a plan in place that would make me as independent as possible, for the next couple of months.  I thought I should share my lisfranc recovery survival ideas:

1.  Pick a place in your home where you have a bedroom and easy access to a bathroom with a shower.  If possible have a small refrigerator near by for water and ice packs/ice.  A TV with a blu ray player can ease boredom.

We have a multi level home and I decided to move down to our lower level where we usually entertain.  This space has a small kitchen, bathroom, shower, guest room,  and TV.  It was set up perfectly for my temporary mini apartment.  We decided to have a TV/Satellite and Blu Ray DVD player installed in the bedroom since the first 2 weeks I would most likely be in bed.

2.  Assemble ways to mobilate on one foot.

I have used 4 different kinds of "transportation."  A walker, (without wheels) a wheelchair, crutches and a knee scooter.

After trying out all 4 devices, the knee scooter has quickly became my favorite.  I like it because It doesn't hurt my arms like the crutches and the walker, and it  is completely independent (unlike a wheel chair that my husband has to push) and I can move around my space easily.  It also feels "safe" and my foot feels very protected.  A basket on the front is a real plus and has quickly become my "purse" and a way to haul things from room to room.

3.  Set up the bathroom you will be using to accommodate standing on one leg. 

I started with the toilet.  I knew I couldn't stand up from a seated position using only one leg so I found this toilet seat riser in a medical device store:

Having the arms on the device is helpful, especially at first when fatigue from surgery is the greatest.

Next came the problem of how to shower and still keep my cas/splint dry.  So I bought "the giant condom."  The rubber piece fits snug against your thigh and your cast stays completely dry.

A friend of mine gave me a stool to sit on while showering.  It doubles as the "chair" I use to put on make-up and dry my hair while siting in front of the bathroom mirror.

I found a lot of the shower stools sold are pretty low and the height of this one is much easier when trying to stand back up on one leg.

My father came over and replaced the shower head with a hand held shower.  This was essential since it allowed me to move the water where I needed it and not have to move my body.

4. Have plenty of ice, ice packs and instant cold available.  

A friend of mine brought this over to me during my 3rd week of recovery.  I wish I had known about the air cast Cryo/cuff earlier!  I have been using it everyday since!  All you do is fill it with water and ice in the morning and it keeps cool all day!

5. Learn to say "yes" to friends who offer to help.

More on this tomorrow.....

New lisfranc surgical plates

I am now 3 weeks post surgery and have been curious about the plate my surgeon put into my foot since most of the lisfranc surgery pictures on the web didn’t look at all like mine. Most of the pictures  I could find were of various horizontal plates and elongated screws placed at different angles.  I didn’t find any pictures with a square plate like mine. I also noted that  several lisfranc surgery pictures showed more than one incision on top of the foot.

Yesterday I found a manufacturer of the square plates and discovered this is a newer concept in lisfranc surgery.  Here is the the website in case you want to check it out:

https://www.arthrex.com/foot-ankle/lisfranc-plates

I have only one incision on top of my foot and the plate my surgeon inserted will never have to be removed, so there will be no need for a second operation. am very fortunate to not only have found my surgeon, but that he is on the cutting edge of lisfranc surgery.