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!!!

8 weeks post lisfranc surgery

                  8 weeks post lisfranc surgery

Lisfranc surgery left side view

I have finally made it to the 8 weeks post lisfranc surgery milestone!  

Lisfranc surgery right side view

 I have had 4 physical therapy sessions and 5 hydroWorx sessions and can now pick up marbles with my toes!

 I love this land exercise because it challenges me to try and regain the ability to bend my big toe again. Plus if I leave my therapy marbles laying around when friends stop by it challenges them to whip off their stockings and try to pick up the marbles with their own toes.  It is a great party starter!  HA HA HA

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.

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!!

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

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!!!!!

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! 

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!

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.