Mission Accomplished

     Indeed my mission has been accomplished!  Both eyes have new implants, cataracts gone.  Both feet have been rebuilt successfully.  Today I had my 30+ stitches removed 11 days post op on the left foot and all is well!

There are two screws that will stay permanently fusing the joint just below the big toe - this procedure is called arthrodesis of the big toe.  The 4 pins (or pearls as I call them) will be removed in about 2 weeks.  This procedure is called ostectomy.  I got a gander of the xray of the pins and how far in they go and it was pretty amazing. I have no pain and no sensation of them being there which is awesome.

   

     This time around all the things under my control went much more smoothly thanks to the Tip Sheet I compiled last time.  It was filled with tips about everything from the type of ice bag to use to what to eat before and after pain meds.  I cannot say enough about the value of this.  Not only for the practical reasons of having a written record but also the psychological benefit of having so much written down that it   gave me a great sense of relief and stress reduction.

     So once the stitches were out they re wrapped it with gauze and put on steri strips and an ace bandage and now it is safely protected till I return in two weeks for the pin removal. 

     One big difference this time was the boot I am using which is drastically different than the last one....

     This is the last one...total overkill for a forefront foot procedure and this thing was so cumbersome it was very uncomfortable to say the least.  I ended up with a swollen and bruised ankle after just one day so I switched on my own to a boot shoe I had worn for a stress fracture I had on the top of my foot several years ago. I cannot tell you how much better it worked!

Last time, I took it with me for my next follow up appt. with the surgeon and he said it was fine to use, especially since I use the knee walker versus crutches which is much safer in terms of the likelihood of accidentally putting any weight on the foot.

     You can see in the photo above how heavy and cumbersome the old boot was, hanging off the scooter and creating more problems than it would solve.  It felt like a ski boot!

     The day of surgery started out a bit negatively as my surgery was delayed by 4 hours due to an emergency.  That made for a very long day but it went fine.  In addition, this time, instead of the nerve block from the knee down (with two injections sites) they chose to do it in the ankle (7 injection sites).  It hurt a WHOLE LOT MORE but worse the block only lasted 12 hours this time versus 2 days the last time!  Not sure I would even suggest it to anyone since I had a general anyway.

     My biggest issue, and this was true the last time as well, is my reaction (aversion) to pain medication.  This is nothing new.  I have said here on blog many times that I do not use prescription pain medication to manage my RA.  I use Tylenol, the various DMARDS, ice, heat, braces, hot tubs, etc. I simply cannot tolerate the way I feel on pain meds.  Once again, and I was on the smallest dose of 5mg., I felt like a person who was in the midst of a "bad drunk", nauseous, dizzy, disoriented, emmotional and worst of all it did nothing for the pain!  That said, I took a total of 5 and then said, NO MORE and switched to super strength (650mg) Tylenol which worked fine and soon I was back to normal.  

                                                               

          The real key for me was rest, ice and elevation of the foot.  That really controls the pain and swelling and makes the entire recovery go much more smoothly.  I cannot say enough about how critical it is to have your RA Support Team around throughout the process both to help on a personal note but also to act as your advocate and support person when dealing with the entire surgical team and hospital staff.  That really can make the difference in ensuring a successful and stress free procedure.  Friends dropped off food and that was so wonderfully appreciated by both me and my husband!

I am forever grateful to my husband who was my rock of Gibraltor throughout these surgeries!  He was literally at my beck and call, taking such good care of all of my needs and taking me out almost every day so I did not get cabin fever! I am blessed beyond words to have such a wonderful husband and best friend!  

Nan

Twice is nice!

     So it is finally here!  Monday (in three days) is my second foot reconstruction surgery.  Yes, I am doing it again!  I knew from the moment I committed to have the first one done that I would have the other done within a year.  No question, no discussion. 

     I felt that I was only half finished when I had my right foot done last June.  I said to someone the other day it would be like carrying twins and giving birth to one, knowing that the other one was due to be born.  I have to be honest,  I am not thrilled with going through the surgery, post op, recovery and rehab but I know full well that in order to have this process completed it has to happen.  I have to simply DO IT!

   No putting it off, no excuses.  The time has come and I am ready...I guess....No matter how well prepared I am I am still finding myself getting anxious.  Mostly I am not looking forward to the confinement of the 8 week recovery, 4 of which involve no weight bearing on my foot at all.  

     As is true for many of us with RA, crutches are not an option so that means I had to come up with another alternative or sit for 4-8 weeks...not an option if you know me...so instead I got a wonderful device...a knee walker.  I credit this "scooter" with keeping me sane!

     I intend to make good use of this once again and will be calling upon family and friends to take me on some excursions.  The biggest difference this time around is that my last surgery was in the summer and this one will be the middle of winter in Vermont.  Right now we have about 18 inches of snow on the ground and today it was 12 degrees.  Last time we had sunshine, 80 degrees and I had a screened in back porch to enjoy while recuperating.  So I suspect that my ability to go out and about will not be as easy as the last time....

      That said, I also will not be looking longingly outside wishing I could go for a walk. I will be perfectly happy to sit by the fire while the snow flies and the temperature falls.  It will be interesting to compare the two experiences afterward.  As similar as they seem to be I am certain there will be circumstances unique to each surgery.

     I partially base this on the fact that last spring, in consecutive months, I had eye lens implants done to correct cataracts that had formed prematurely thanks to prednisone.  Each experience was different from the moment I arrived at the hospital.  The recovery was very similar but actual surgery was different so I expect that to happen again this time.  I guess we will see....I do feel much better prepared this time around thanks to a couple of things I did which I would highly suggest other folks consider if they are having surgical procedures done.

     I made sure to write a "tip sheet" filled with items to help me get through this a second time.  I updated it, added to it, adjusted it, etc. until it was all set to be used for this procedure.  I have everything on it from what to eat before taking pain meds. to the use of kinesio tape to help reduce swelling.  I actually feel better each time I review it.  It is like having a How To manual and it really does give me a true sense of comfort.

     In some respects having to manage RA for 15+ years has given me the confidence to tackle this with the same deliberate approach that I have used for so many years to deal with the ups and downs and uncertainties of RA.  Not unlike the "RA Toolbelt" I so often reference in my blog, having surgery requires its own unique set of "tools" to get through this experience.

     I believe I am as ready as I can be.  There was much to do to get prepared...from work related tasks to something as simple as making sure we had enough water and paper products to last a month!  I tend to be a bit of an "over organizer" so I may have covered a few extra bases but since that gives me some degree of calm I am OK with it.  
     My goal through all of these surgeries was to have them done before my 60th birthday which is still over a year away so I am pleased to be achieving that!  In addition, my son is getting married next August and I want to be able to dance all night at his wedding and now I will be able to, God willing....

Nan