Showing posts with label lisfranc surgeon. Show all posts
Showing posts with label lisfranc surgeon. Show all posts

Saturday, October 12, 2013

22 weeks post lisfranc surgery

Before I ever heard of a lisfranc fracture I took my feet and my ability to walk for granted.
Normal feet before a lisfranc injury


I was diagnosed with a lisfranc fracture of my first two metatarsals  with ligature rupture and joint displacement and on May 10th, 2013, I had this titanium plate inserted into my foot.




Lisfranc fracture repair X-Ray



Lisfranc fracture repair X-Ray 

2 weeks after surgery, I had my cast removed.


2 weeks after lisfranc fracture surgery


Today, 22 weeks after my lisfranc surgery, my foot is almost healed!  I am approximately 75% - 80% of the way to the finish line!

During my 27th physical therapy appointment, my therapist was astounded at my progress just in this past week.  I was able to get through my exercises with little to no pain, even when he decided to make them harder and more challenging.  






22 weeks post lisfranc surgery


In the midst of my weekly foot massage and manipulation, I was mortified that my therapist noticed I was beginning to get callous' on my recovering foot. ( I had made sure I received a pedicure before my appointment, so that my feet would look acceptable. ) He laughed when he saw how horrified I was and quickly explained that callous' were a good thing and showed him I was healing. Callous' mean that I am walking more and that my skin is starting to toughen up just as it is supposed to.

I shared a story with my therapist about how I woke up during the night, thinking I had a spider crawling on my big toe, which is still partially numb.  After snapping on the light and assuring myself I was not in bed with a spider, I realized what I felt was the sheet on my big toe!  Finally, after 22 weeks, I can feel a sheet sliding on the top of my foot!!!!!!  



lisfranc surgery image 22 weeks post op, right hand side

During my appointment my therapist worked with me on activities I can start to do at the health club ON MY OWN!!!  

At home, I can now be on my treadmill for 10 minutes a day.  (Forward, backward and sideway walking.)  I have permission to increase the amount of time slightly each week, because I promised to listen to any type of foot discomfort.






lisfranc surgery image week 22 left side view
It helps that my therapist is encouraging, patient, kind and is also my biggest cheerleader.  I am absolutely thrilled with my ability to walk forwards, backwards, sideways and with my strength to balance on my toes.  



But there is sadness to this process too.  I will soon be saying "good-bye" to the man who gave me back my ability to walk again.  Countless times he calmed my fears and patiently explained to me, in detail, what was going on during my recovery. Picking the right lisfranc surgeon is crucial, but having the right physical therapist is indispensable! 


22 weeks post lisfranc surgery image















Sunday, September 8, 2013

17 weeks post lisfranc surgery


Looking back on my 17 weeks of lisfranc surgery recovery has been like watching an infant grow.  You don't really take note of all the day to day minuscule changes, but after 4 months, you realize HUGE changes have occurred!

This is what happened to me this week when I arrived at 17 post lisfranc surgery.  My physical therapist gave me permission to walk on the treadmill!!!!!!!






treadmill at 17 weeks post lisfranc surgery
Okay, so I don't get to walk more than 1.5 miles per hour with no incline and have been instructed to walk no more than 5 minutes a couple of times a week, but still.....I am back on my treadmill!!!  

By the way walking 5 minutes at 1.5 miles an hour means I can now walk .13 of a mile without stopping and limited discomfort....not completely pain free, but no more than a 1-2 pain level!!!!!!!!!!


Dusting off my treadmill at 17 weeks post lisfranc surgery
I have been instructed to still "listen to my foot" and quit if it becomes painful and I start to limp.  5 minutes is just the right amount of time to practice correct "heel, toe, follow through" at a slow pace.  Now that I have learned to walk again, the treadmill is letting me practice all of the correct walking motions that I have been taught!



17 weeks post lisfranc surgery image

17 weeks post lisfranc surgery scar


Left side view 17 weeks post lisfranc surgery image

By the way, my foot envy broadened today with the official start of the NFL season.  I spent most of game time today watching the Vikings player's feet with complete fascination and awe!!!!!!
Right side view 17 weeks post lisfranc surgery

Wednesday, August 7, 2013

12 weeks post lisfranc surgery X-rays

12 weeks post lisfranc surgery repair X-ray


Yesterday I met with  my surgeon for my three month post lisfranc surgery appointment.  It was depressing to learn that I have 3 more months of recovery until I can walk comfortably again.

The good news is that the current X-rays show that I don't have any stress fractures.





12 weeks post lisfranc surgery X-ray outside left side view

The X-rays also show that my joints are starting to fuse the way they are supposed to at this point in recovery.  My surgeon showed me my current X-rays and compared them to the ones taken 6 weeks ago:





12 Weeks post lisfranc repair X-Ray.  You can clearly see the joints around the prosthetic starting to fuse.

6 weeks post lisfranc surgery repair X-ray.  Joints have not started to fuse.



Meeting with my surgeon 12 weeks post lisfranc surgery

I was really looking forward to seeing my surgeon yesterday for my 12 week post lisfranc surgery follow up.  Armed with my list of questions and notes from my HydroWorx therapist, I was well prepared for my appointment.  I even went as far as to have a fresh pedicure with hot pink toe nail polish to match my sneakers.  

I was fully expecting my surgeon to be extremely pleased with my progress and tell me I was way ahead of schedule.  After all, I have been attending either HydroWorx therapy or physical land therapy 6 days a week, plus performing my at home exercises given to me by my physical therapist.  I knew I had worked hard these last 6 weeks and was well on my way to pain free walking again. I expected my surgeons  full endorsement and recognition of my progress.

After I arrived, I was escorted into my patient room where I removed my boot and headed to the X-ray room in my stocking feet.  I was in more pain than other days, so I did have to use my cane, but I kept up with the X-ray technicians gait which made me smile proudly to myself.

I was able to step up easily on the X-ray pad without difficulty and even mentioned to the technician how much easier it was for me this time as compared to 6 weeks ago.

Shortly after returning to my room, my surgeon walked in.  He sat in his chair and said, "you are still limping quite a bit."  I was surprised he knew.  After all, I fully intended to demonstrate walking without a limp so that my surgeon could see my gait during the times I am not experiencing pain.  BUSTED!!!
 Apparently, he had observed me walking to his X-ray room.  (I guess that is the best time to asses a patient is when he or she does not know he/she is being watched. )

I then admitted I was experiencing pain when walking and asked him realistically when I could expect to be able to walk down our driveway, which is a steep hill, and pick up my mail pain free.  Not running or jumping or anything fancy, just pain free walking doing everyday activities.

My surgeon said realistically it will be 3 more months until I can walk comfortably.  I was stunned and I started to feel my world shatter once again. I had to try hard not to burst into tears, which most certainly would have embarrassed us both. 

I sat quietly with this information for a few moments, not wanting to meet his gaze.  When I collected myself I looked up at him and repeated quietly   "three more months???"  He nodded slowly maintaing eye contact.  (My surgeon is quiet, gentle and a man of few words.)

Desperate for my surgeon to revise the remaining three months of recovery to something shorter, I asked him if he had a chance to read my physical therapist report and the report from the HydroWorx therapist.  I thought certainly he must not have had time to read the glowing endorsements from both modes of therapy.  

(Hint to my surgeon,  this the part where you are  supposed to "pat me on the head" and tell me what a good girl I've been!!! )  My surgeon didn't get the hint.  Instead he nodded quickly and asked me why I was in such a hurry?   I said, I was determined to walk like a normal person again and that I was tired of the lisfranc recovery.  

We briefly discussed stress fractures and I found out it would not be uncommon for that to happen during this period, especially if I am pushing myself too hard.  My surgeon said I needed to cut down on the amount of therapy and just relax and give my body a chance to heal.  "Healing takes time and cannot be rushed," he said.   He looked at me long enough to make sure I understood and then he smiled and said, "look at it this way, you are half way there."

I slowly nodded still trying to comprehend that I am not almost at the finish line but am only halfway through this journey. 

Tuesday, July 9, 2013

At last pain free sleep after lisfranc surgery

Last night was my first full night's sleep completely pain free since my lisfranc surgery on May 10th.  I didn't even need extra strength tylenol!  I woke up this morning and realized that I had not only slept through the night without waking up, I was completely pain free!  What a wonderful milestone to have achieved! 

I have spent several minutes this morning going over yesterday's activities to determine what I did right to earn pain free sleep.  Yesterday my sports trainer increased my activities during my hydroWorx therapy but did start and end my session with deep tissue massage on my injured foot.  

click here for more information on HydroWorx therapy

In the afternoon I had 5 kids over to swim in our pool, but I let their grandma and mother be the life guards while I iced my foot.

I did my land physical therapy exercises and iced afterward.  So I am thinking ice and elevation after using my foot is the key to less pain.


Ice air cast

Wednesday, July 3, 2013

lisfranc surgery double down meltdown!!

Yesterday I doubled down by having physical therapy followed by hydroWorx therapy which landed me in bed with a pain filled meltdown. 

My physical therapy session started out on the recumbent bike for 8 minutes which was more painful than it has been in the past.  My therapist did deep tissue massage on my foot before putting me through my paces of stretches, bridges, 6 inch hurdles, and trampoline balancing.  We ended the session with the fabulous ice massage machine.

I drove straight to my next appointment with the therapist at the hydroWorx pool.  Standing on my recovering foot was very painful while I was lowered into the water.  But when the water was up to my shoulders, the pain disappeared. 

We started out the session with stretches and balance work followed by walking on the underwater treadmill.   My therapist was in the water with me and together we watched the camera to determine if my muscles were making the correct motions.  She can actually see if I am limping and will slow the treadmill down, or deepen the water level to take away as much pain as possible while my foot re-learns to walk .

We finished the session with some deep tissue massage which felt absolutely wonderful.  She carefully massages my recovering foot with a hose that in connected to one of the hydroWorx jets. These deep tissue massages have been some of the only pain free moments I have experienced during recovery.  

Click this link if you want more information about where I am taking hydroWorx therapy.

http://www.silvercrestproperties.com/node/459

She suggested that since I did 2 therapy sessions that morning that I might want to go directly home and ice my foot as it may be a little sore.

Well, by the time I arrived at home, my foot stiffened up to a painful level 4.  I immediately put on my ice air cast, elevated my foot above my heart and laid in bed.  After about 1/2 hour, my pain level was increasing, instead of decreasing so I took some extra strength tylenol and tried not to feel sorry for myself. 

As I  felt the pain engulf me,  I was overcome with serious foot envy. Day after day, I have watched people walk down our street clueless as to how lucky they are to be able to do something so normal like pain free walking.  

What is hard for me is I have now experienced being able to walk "normally" while under water and walk a few steps, albeit painfully, with a sneaker outside of the water.  But I am not anywhere near being able to walk down the driveway, or in a mall or the grocery store etc. It's like I can see the end in sight, but I just can't quite reach it, and it is so frustrating!!  The harder I try to grasp it, the further away it seems.  

These thoughts, coupled with experiencing a level 5 pain led me to a tearful meltdown.  I just want to be done with this whole lisfranc pain, recovery, re-hab thing already!!!!  I just want to walk around the block again!!!

After shouting all of those words out loud (my husband wasn't at home) I decided to resume my affair with Keiffer Sutherland, aka Jack Bauer and watch more episodes of 24.  Jack Bauer got me through my non weight bearing period, and it looks like he will also be getting me through my painful re-hab period.  I am almost through season 6, so I hope my rehab doesn't last longer then the final 2 seasons!!



Monday, July 1, 2013

HydroWorx aquatic treadmill for faster lisfranc surgery recovery


Click here for more information on HydroWorx therapy

If you have been reading my blog, you know how highly motivated I am to recover as quickly as possible.  I got permission from both my surgeon and my physical therapist to start additional re-hab in a HydroWorks pool. Professional athletes use Hydro Therapy to speed up recovery, so I am hoping it will work for a "normal" person as well.
The HydroWorx pool is kept at 94 degrees, which is a few degrees below body temperature.  This is the best temperature to help with swelling while still moving.
Today I entered the HydroWorx aquatic treadmill for the first time.  I stepped carefully on the treadmill grasping the safety bar.  My therapist  lowered the treadmill until the water was chest high.  After several minutes of underwater foot stretches she set the treadmill speed at a low level and activated the underwater cameras. It was fascinating to watch my injured foot re-learn the correct motions for walking.  

After 15 minutes of walking and re-building muscle memory she had me once again do foot exercises under water. After raising the treadmill to floor level, I was amazed to note that my foot was less swollen than before we started!
Today in the Minneapolis Star Tribune there was an article about Senior housing which includes wellness centers. Towards the end of the article, the reporter, Janet Moore, talks about the exact HydroWorx aquatic treadmill that I am using for therapy.
"One of the stand-out features of Summit Place is the HydroWorx aquatic treadmill. For years, athletes from the Vikings, Wild, Twins and Timberwolves sports teams used the pool-treadmill at the senior complex because there was nothing like it elsewhere in the Twin Cities. “When I told my partners I wanted to buy [the $300,000 piece of equipment], they thought I was out of my mind,” Gould said." quoted from Janet Moore's article in the StarTribune titled "Senior housing booms as cities age" July 1st 2013
Here is a link if you want to check out the entire article:

I am hoping that daily HydroWorx therapy will teach me to walk again as fast as possible!

Saturday, June 29, 2013

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!  





Friday, June 28, 2013

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.



Wednesday, June 26, 2013

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!!

Saturday, June 22, 2013

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.

Friday, June 21, 2013

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!!

Monday, June 17, 2013

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:


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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Tuesday, June 4, 2013

New Lisfranc surgical plates




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:
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.

My lisfranc surgery day





My lisfranc surgery day


My husband and I arrived early as we had heard my surgeon is typically way ahead of schedule.  The dear friend who helped us get an appointment with my surgeon had left a gift bag for me with my nurse.  So I already felt spoiled and loved.
I was taken back to a room and changed into a heated gown and was told to lie on the bed which had heated blankets. I felt like I was at a spa!  My nurse was fabulous.  She came in and told me she would be my best friend.  I told her I was concerned about how painful the surgery was going to be and she told me not to worry since she came packing.  She asked me what my favorite cocktail was and I told her a Belvedere martini straight up, a twist a couple of olives and extra dirty.  And she said ‘coming right up!”  And not only could I have 1 martinis she would give me 2.  I said I can only drink one and she said in this room, I could have 2.
The anesthesiologist  came in the room to discuss what he was going to do.  He had me write on the foot that was going to be operated on and I drew a smiley face.  I told him my surgeon said I could watch the surgery and he laughed and said, it wasn’t like having a baby where they have mirrors on the ceilings and that if I were to watch all I would be able to see was my surgeons head. He then told me I couldn’t watch anyway since I was going to be put under general anesthesia. Suddenly my wonderful nurse who was putting  a needle in my hand for my IV ran round to the right side of the bed and asked me to hold her hand and squeeze.  As I did and I felt the worst pain (level 9) since this whole thing started.

 My anesthesiologist was finding the nerves in my foot so that he could do a nerve block.  I didn’t cry out, but I did tell him he was mean (must of been the 2 martinis talking) and he said that I would be very happy with him after the surgery was over.  Nerve blocks can last up to 24 hours and really help with immediate pain following this type of surgery.  (I am so glad I had one!!!)
After Dr. Jekel was done with me, my surgeon came in the room and drew on my foot and assured me that all was well. Since my surgeon had already done 2 operations before me (and it was only 7:00am!) I offered to buy him a cup of coffee to make sure he was alert.  (again the martinis were talking) and he laughed.  I hate to think what else I might have said that I don’t remember!!!
Next I was wheeled down to the frigid operating room.  I reluctantly left my heated bed as I was asked to transfer myself to the skinny cold operating table.  I remember looking up at the white light fixture that looked like a giant spider with 8 legs.  As my arms were being strapped down I said to no one in general, that I was claustrophobic.  I told my nurse that I felt like I had been abducted by aliens and that they were going to do experiments on me.
When I woke up from surgery I was shown this picture of the operation:

lisfranc surgery

Monday, June 3, 2013

lisfranc diagnosis


I often wish my lisfranc story was more exciting.  Wouldn’t it be more fun to tell people I sustained my lisfranc injury while skydiving in Brazil or snowboarding in Aspen?  But my story is much less dramatic. I was celebrating the grand opening of a new restaurant with friends and we were on our way out when we saw some of my son’s friends sitting in the bar.  I went over to collect my hugs and turned to leave, and missed the step down, falling off my 3 inch heels.  I was mortified and tried to stand up right away, but my right foot was so unstable that I fell again. (I was hoping none of my sons friends were taking a video and that I would end up on youtube the next day. )I took off my shoes, thinking the heels were the stability problem and my husband helped me hobble painfully to the car.  I remember thinking how weird my right foot felt when I tried to walk on it.  My foot felt wobbly and I didn’t trust it to hold my weight.

I was in a lot of pain that night and in the morning my husband took me to urgent care.  The doctor took an x-ray (non weight bearing) and said I had not broken  anything and that it was a bad sprain.  I asked how to take care of it and he said Advil and elevation and rest.  I asked for some crutches since I couldn’t walk on that foot and it was too painful to put any weight on it at all.  I wish I had taken pictures, but I had the classic bruising of a lisfranc injury where even the bottom of my foot was severely bruised.

The Urgent care discharge instructions said that if I wasn’t better in 10 days, to seek help.  I waited the 10 days, and not only did my foot not get better, the pain and bruising got even worse.  So I sought out my Podiatrist who had helped me in the past with Plantar fasciitis.   I brought a copy of my x-ray from urgent care and he agreed that it was not broken.  He put me in a walking cast, the kind that goes up to your knee and said to use that and crutches and informed me that bad sprains take time to heal.

I waited another 10 days and still, my foot was not better.  The bruising was still there and my pain was hovering at about a level 4.  I decided to seek a 3rd opinion from one of the top orthopedic clinics in Mpls.  The doctor who had time to see me was a surgical podiatrist.  He looked at my x-ray and said he wanted to take one of his own as he suspected a lisfranc injury.  This was the first time I heard the word lisfranc.  I was brought into his x-ray room, where the technician had me stand on my injured foot for the x-ray.  My new doctor than gave me the tragic news.  We viewed the new x-ray together which showed a large separation between my first two metatarsals.  He asked how the x-ray was taken at urgent care and I told him laying down.  Lisfranc injuries are often missed because a weight bearing x-ray is the only way to see a lisfranc injury. 

 My new doctor then told me I was a few days outside of the optimum surgery window for a favorable outcome and that he would still be willing to do the surgery but it had to be done immediately on an emergency basis.  If I didn’t have the surgery, I may never walk again and would have pain the rest of my life.  I felt tears leaking from my eyes as he delivered this news.  He went on to say that he would come in on Good Friday (2 days away) and do the surgery for me.  That is how strongly he felt I needed immediate attention. He went on to tell me he would be putting plates and screws in my foot and would make up to 3 incisions and as he was talking, his voice started to fade in my mind.  I was having a hard time accepting what he was saying. Next he explained that I would have to be non weight bearing and in a cast for 3 months, I felt my life completely collapse.  I told him my husband and I were going to Israel with our church group and he said I had to cancel the trip.  The trip we had looked forward to, planned for was gone!  

The next few hours were a blur.  I was seen by another physician in his group for my pre-op physical, I was given instructions for surgery prep.  I was scheduled for my surgery plus 3 more post surgery follow up doctor appointments.  I was given a packet on what to expect after surgery.  A knee scooter was put on order for me and then an appointment was set up for me for a CT scan. 


I walked to the parking lot and sat in my car and cried.  I couldn’t believe this was happening to me!  I wondered how I would ever tell my husband, not only about the surgery and the after care that it would involve, but that we had to cancel our trip to Israel.  After I calmed myself down, I decided to drive to my husband’s office and tell him in person.  He met me in the parking lot and I broke the news to him while sitting in my car.  He was astonished, disappointed but was glad I had something that was fixable.  It really bothered him, though, that this all was on such short notice.  We both knew that for a major surgery we really should be seeking a 2nd opinion, but I was told I didn’t have time.  Not if I wanted to walk again.

My husband decided he was going to find a 2nd opinion and find it fast.  We both knew that would be a long shot since all the top surgeons are booked weeks in advanced.  Well, he called his primary care physician and asked who the top foot specialist in the Twin Cities was and was told the name of a doctor who works out of Twin Cities Orthopedics and that this surgeon was a “doctor’s doctor.”  AND he took care of the Minnesota Vikings players feet.  Well my husband left 3 messages with the surgeon’s assistant that he wanted the surgeon just to take a look at my x-ray and tell us if it really was a lisfranc midfoot fracture and if emergency surgery was indicated.  We didn’t hear back from her, so my husband decided to hand deliver the x-ray to this surgeon.  Meanwhile, a dear friend of ours, who co-owns the building Twin Cities Orthopedics offices in, called in a huge favor and had one of the owners of Twin Cities Orthopedics call the surgeon and asked him to take a look at my x-ray.

The next thing I knew, the surgeon called me on my cell.  He said that after looking at the x-ray, he didn’t think lisfranc surgery was indicated.  I was stunned!  I told him what the first doctor had said and that I was scheduled for surgery in the morning and he said that it was not true that this was an emergency and that I would not walk properly again if I didn’t have surgery right away.  I asked him if he would like to see my CT scan and he said yes and could I bring it to him right away.  

When I arrived at Twin Cities Orthopedics, I felt like a celebrity.  There were sticky notes with my name on them saying not to let me leave before seeing the surgeon.  I was ushered into a room and waited.  Shortly afterward the surgeon walked in smiling and commented that I had friends in high places.  I liked him immediately and felt calm settle over me.  His aura was one of quiet confidence.  He pulled up my CT scan and showed me various pictures of my foot.  He said with this new information he would have to reverse his opinion and that I did indeed have a lisfranc mid foot fracture with ligature rupture and joint displacement.  Surgery, however, was not an emergency, but rather a choice.  

I explained to him about our trip to Israel and how disappointed I was to have to cancel but that walking properly again was more important to me. I asked him if he was taking new patients.  He said “apparently I am.” and smiled. He asked me to cancel my surgery with the other surgeon and told me to go ahead and go to Israel.  I was stunned!  He said his surgery schedule was 6 weeks out anyway, so he would put me in a walking boot and if I wanted to go, I could. I had to promise him that I would “listen to my foot” and not push myself if it hurt.   He promised me that he would be able to fix my foot and that I would be able to walk again. I felt tears of happiness slipping down my cheeks as he delivered this news. He also said that after surgery I would be in a splint/cast for 2 weeks and then a walking boot for 4 more. (for protection.)  I would be non weight bearing for 6 weeks followed by re-hab.  I was thrilled that he had a much more aggressive healing plan! 

So my husband loaded up with Advil, instant ice and my walking boot and and I headed to Israel for a life changing marriage changing experience.

When I returned I had an appointment with my new surgeon who took another x-ray and confirmed that I still needed to have the surgery.  This time, I knew I had the right surgeon operating on me.