The Cut that Won't Go Away

The one area that continues to cause me some grief as I continue my recovery is the place where they cut the skin. It is just a tough area of the body to get healed I guess. Applying Neosporin whenever I have the chance seems to help as does keeping it unwrapped and exposed to air whenever I don't have to wear a shoe. During the day, I've been wrapping it in 4 inch gauze and tape, however last night I got some of those oversized band-aids which seems to cover the wound pretty good and is a little less of a pain to apply. It still doesn't look all that pretty, but there are no signs of infection and it is improving, so I guess I'll take that for now.

The flexibility of the joint is improving as well. I can now confidently say that I have better range of motion post-surgery than I did prior to the surgery. Prior to surgery, if I used all my physical and mental strength, I could lift my big toe high enough to slide a piece of paper under it. Maybe two pieces on a good day. Today, I could probably slide a 300 page book under there. Soft cover. While that may sound impressive (or it may not, I have no idea), there is still work to be done with my toe exercises. The doctor said that you basically have 6 weeks post-op to get as much range of motion back as you can. After that, you're not going to improve much. So I'm trying to stay diligent with them, which isn't always easy.

As far as running goes, I didn't run at all since Thanksgiving until today when I did 5 miles on the treadmill. The toe joint felt the best that it has in a long time...probably even before the surgery. There was absolutely no pain in there for the entire run. However, when I finished, I did have a strange pain behind my knee, which could have possibly been caused by some over-compensation that I didn't realize I was doing. It subsided after a little stretching, but it is something I need to keep an eye on.

So for now, things continue to progress. If you'd have told me that I'd be running pain free only 3 1/2 weeks after the surgery, I would have been thrilled. The goal is still to be able to handle a marathon build up by the 1st of the year, so everything I do between now and then is in preparation for that. I need to keep reminding myself of that though so I don't overdo things. I have a tendency to do that.

Happy Thanksgiving - Day 20 Post-Op

I'm extremely thankful for the 3 miles I was able to slog through this morning. It was my first run outside (on concrete) since the surgery, and while I still have a ways to go to be able to handle a true marathon build, I'm gaining confidence that in another month I'll be there.

I'm continuing to work on my toe exercises, which are just range of motion of bending of the toe. It isn't too painful and I actually have better ROM now that I did prior to the surgery, which is encouraging. If there is one nagging thing it is the incision, which continues to be a pain in my, err, foot. While it has improved, it continues to annoy me when pretty much anything rubs up against it. That's OK during the day, but at night, I've been waking up far too often as I bang or rub it against the bed throughout the night. I never even considered that the incision would be a consideration in the recovery process, but it is definitely proving to be the biggest area of concern.

Happy Thanksgiving to everyone!

Pictures, Neosporin, and Turkey Trots - Day 17 Post Op

I had somewhat of a set-back on Friday night. I unwrapped my foot when I got home from work and was kind of alarmed at the condition of the incision. It was oozing some liquid and it was discolored and generally disgusting looking. Well, I mentioned earlier that I might post some pictures, so this seems as good a time as any.



Yeah, not pretty. So after getting some expert opinion on how to care for the foot, I pretty much ignored it all and just went to bed. The next morning, after seeing no improvement, I started putting some Neosporin on the cut prior to wrapping. I was told this wasn’t the best idea as it can cause allergic reactions in deep cuts, but I’m too big of a wimp to even think about alcohol swabs. The Neosporin did seem to help, so I’ve continued to apply Neosporin and change the wrap about twice a day since then. It has greatly improved and seems to be healing much nicer now. However, because of the bad condition of the foot, I decided not to press my luck and did no running or any real form of exercise all weekend long.

Then today, I decided I needed to sweat, so I went to my gym at lunch and remembered that they were having a “turkey trot” today. Basically, what it consisted of was running 3.1 miles on the treadmill and one of the trainers recorded your time. Fastest time of the day wins a prize. No mention of what the prize is, but I’d imagine it’s something I can’t live without, like a cheap cotton t-shirt and some energy drink mix.

Anyway, I really wasn’t planning on doing it, but once I got into the gym area, there was a big sign up that said “BEST TIME OF THE DAY: 18:19.” Then the ego took over. I went over and asked about it, got the run down on the finer details from the instructor and climbed on a treadmill. The instructor punched in the workout and said, start whenever you’re ready. Well, I was at least expecting a warm-up, but figured, I’m not here to kill myself, so mile 1 will be my warm-up. I started at 10MPH and slowly crept up throughout the first mile and finished in 5:50. I was feeling fine cardiovascularly and the foot was holding up great, so I pushed a little on the next mile and did mile 2 in 5:20. The foot was still fine, but I’ll admit that my breathing was getting a bit labored. I have run exactly 3 miles in the past 20 days so I guess it should have been expected. However, I decided no guts, no glory and continued to push the pace finishing with a 5:12 mile and a 17:01 overall run.

Most importantly, the foot held up fine. It was a little sore after I showered and but it has since calmed down and feels good now. The cut area also held up fine with no additional bleeding from the hard running. Overall it was a success. Now I just have to sweat out the next 10 hours to see if a 17:01 will hold up, allowing me to claim the lucrative prizes. I’ll keep you posted.

My First Run in 2 Weeks

I actually got up my nerve today and climbed on the treadmill for 3 miles of running around a 7 minute pace. The results were pretty encouraging. The toe joint itself held up just fine. My biggest concern and biggest source of discomfort is the place where they made the incision on the side of my foot. That area is still very tender and I'm a little nervous about splitting it back open. However, it held up fine today, which is encouraging. Hopefully as the air continues to get at it, it will toughen up and speed up the healing process.

I'm still having problems walking without a limp, again due to the discomfort around the incision. However, for whatever reason, things feel a bit more natural when running. I do have to keep a watch out for weird sore spots though, as the fear of over-compensation is always there. I'd hate to hurt a hip by pushing things too quickly.

If you would have told me that I'd be able to run for 20 minutes only 2 weeks removed from surgery, I probably would have done this a long time ago. I know I'm not all the way back yet, but so far things continue to progress about as well as I could expect them to.

Day 13 - Phase 2 Begins

I handle pain pretty well. What I don't handle all the great is the anticipation of pain. I get nervous when I need to get a shot. I get nervous before I have to do a hard workout. Heck, I get nervous before I jump into cold water. So, I'll admit that I was looking forward to, and dreading, today's visit the doctor, where I was scheduled to get the stitches removed.

Of course, the actual removal turned out to be no big deal. It didn't hurt at all, except for a few little tugs and it was over in about 2 minutes. I still managed to work up a pretty good sweat as I was sure that as each new stitch got cut, the student assigned to the task would surely lop off half my toe.

After that was done, the doctors came in to give me some instructions for the next few weeks. They said I can start wearing a normal shoe immediately, and as far as everyday activities, let pain be my guide. They said I do need to be careful, as there is some healing that still needs to be done to the underlying tissue, but didn't give me any hard restrictions.

They also said now is the time to really start working the toe. They didn't give me a script for physical therapy yet, but said if they don't see progress when they see me next (in 3 weeks), they will have send me at that point. For now, I'm on my own though, which I like. With 4 kids at home, making time for PT would be difficult. Again, they said let pain be my guide with the toe exercises as well, but in this case, I want it to hurt. The doctor actually said "no pain, no gain" so hopefully I can make it hurt. We'll see.

As soon as I got back to my desk at work, I quickly took the boot off and put my shoe on. I'll admit it felt weird. After having no pressure on the top of my foot for almost 2 week, it was a new sensation to now actually feel something up there. However, despite being pretty tentative, there is no real pain when walking in a regular shoe, which is encouraging. I think I mainly need to gain some confidence for a day or two and then things will be close to normal. At the very least, there are no more bag foot showers, which is definitely a gigantic step in the right direction.

10 days Post Op

Another encouraging couple of days as the comeback is definitely on at this point. I spent most of Saturday on my feet (and on a ladder) painting the front entrance to my house and the foot held up fine. My 6 year old daughter called me nuts a few times, but other than that things went off without a hitch. I have now completely weaned myself off of the painkillers. During my check-up last Thursday, the doctor mentioned that I had a lot of bruising around my heel and she said it was most likely due to me taking Ibuprofen and elevating my foot. So in an effort to get rid of that (and since there is no noticeable swelling in the foot anymore), I’ve decided to just try and stay away from Ibuprofen for the time being. Probably not coincidentally, the bruising has also gone away.

If it wasn’t for the stitches in my foot, I’d probably be tempted to go out for a run at this point. That’s easy for me to say, as I know it isn’t an option since I cannot get out of the walking boot until the stitches are removed, but at the very least it doesn’t seem like crazy talk. That’s a start. As an alternative, I went to the gym today and did 5 minutes on the bike and couldn’t take it anymore so I moved over to the elliptical for a half hour. While it’s definitely not the same as running, at least I was standing and moving my legs. I really felt it in my quads more than I ever have running so I know it’s working different muscles, but it’s probably a little more specific than biking was. I’ve also realized that between my fashionable walking boot on the elliptical and then plastic bags that I have to wrap my foot in for the shower afterwards, I’ve pretty much lost all self-esteem. Oh well. Easy come, easy go.

I noticed today at my gym that they are having an indoor “Turkey Trot” next Monday. It’s basically consists of running a 5k on the treadmill and then reporting your time to a trainer when you’re done. Top runner gets some sort of prize. While I realize it’s probably pushing things and not very smart, I’m tempted to target it. Luckily, I don’t have to decide anything right now. I have a few more milestones before next Monday. Like the stitches coming out on Thursday and possibly wearing two matching shoes for the first time in a couple weeks. Thank God for life’s little joys.

One week later

Things continue to move in the right direction. Wednesday was my first day back in office, and I was a bit nervous about the long walk from the train to my building. It took a long time, (25 minute walk instead of the usual 15 minutes), but I made it. My foot was sore when I finally got into the office, but it wasn't so much from the surgery but more from the overcompensation. My ankle and knee actually hurt worse than the toe. The walk back to the train was a bit of a pain as well, but I made it.

Thursday was more of the same, but the walk was much better and if I didn't have a gigantic boot on my foot, you probably wouldn't even know that I had surgery 6 days ago. The limp was almost completely gone and other some occasional shoots of pain, things felt good.

I then had a check-up around noon to get the dressing changed and I had my first look at the scar on my foot. It wasn't pretty. It's about 3 inches long and all discolored and scary looking. I should have brought a camera to take a picture of it. A medical student was the first one to look at it and he said it looks healed and I think we'll take the stitches out today. Now if this thing was healed, I hate to see what it looks like when it's not healed. Luckily the doctor could come in before he could get his scissors out and put a stop to this crazy talk. The stitches will come out in one more week.

They took xrays and compared them to last time and things look good. It's a little weird seeing a staple in the middle of my toe, but it's small and hopefully I'll never know it's there. They rewrapped everything and sent me on my way, and for some reason, my foot hurt like crazy the rest of the day. Maybe it was just the exposure to air or something.

Today things continue to improve and when I realized I was late for the train this moring, I actually ran, with my boot on and all) the half mile to the train. The people on the street probably thought I was a bit nuts, but it didn't really hurt. Then at lunch, I hit the gym for a 30 minute ride on the stationary bike. It was the first physical activity I've done since the surgery and it felt great to finally sweat. Again the foot held up fine. I'm hopeful that in one more week, once the stitches come out, I'll be ready to do some easy running on this thing. So far, things are going great.

Day 4 - Post Op

Not a whole lot of new stuff to report today. The foot continues to improve although there are still times where there is a shooting pain in the joint. I can tell that the foot is quite bruised up as I can see a lot of discoloration right at the edges of the bandages that is covering the foot. I have my first follow-up appointment with the doctor on Thursday so that will be my first chance to see how the foot looks in all it's glory. Right now, the really ugly stuff is mostly covered. They'll also take some fresh x-rays at that point so we'll be able to get an idea of how the healing is coming along.

I'm trying to stay patient and to not push things too much, but as my walking continues to improve, I just can't help but spend more time on my feet. I'm an antsy person by nature. Tomorrow will be my first day in the office (I've been working from home the past 2 days), so that will be another test. I have close to a mile walk from the train station to my office. I'm a little nervous about it, but if things continue to progress, I'm hoping it should go OK.

Today was the first day we're I actually feel like I have realistic shot at running again this year. Up until now, the thought of running on my foot kind of made me sick to my stomach, but today for whatever reason, I have a bit more confidence. Hopefully that confidence will continue to improve as well.

Day 3 Post-Op

Phew! Yesterday was a real test of the foot. As I mentioned, it was my son's 3 year old birthday party yesterday, and while my wife tried to make it as painless on me as possible, there was still a lot of activity going on. I can only watch for so long before I have to jump into the mix. So I spent a good portion of the day on my feet, cooking, socializing, and chasing kids around.

Finally, when everyone left around 8PM or so, I sat down on the couch and realized that my foot had swelled up quite a bit. It didn't really hurt that much, but it was big. So I followed the basic RICE recipe of icing, elevation, and some ibuprofen and called it a night around 10PM.

I've been sleeping with my foot elevated on a couple of pillows all night, and I slept great again last night without any pain until about 5AM, when I woke up to a shooting pain right in the big toe joint. I went down stairs and took some of the prescribed vicoden, which at least helped me sleep until the kids woke up around 6:30.

This morning, most of the swelling from yesterday has gone away and the shooting pain that I had in the toe earlier this morning is only there when my foot is elevated. I think that is a little strange. From what I've read, people usually get relief from the pain by elevating their foot. For me, the pain is at it worst when I elevate the foot. If I'm walking around or even sitting it's much more manageable.

I took today off of work, and tomorrow I'm working from home. I'm still targeting Wednesday as my first day in the office which will be a challenge. I have about a quarter mile walk to the train station from my house, then a 45 minute train ride and then a mile walk from the train station downtown to my office. If I had to do it today, I probably could, so hopefully with two more days of healing it will be even more manageable. If not, I'll have to buck my cheapo ways and pay for a cab for a few days. Ugh. For a cheapskate like me, that's really painful.

48 Hours Later

You'll have to excuse the frequent postings. As I mentioned in the first entry, the main purpose of this blog, at least for the short-term, is to document my recovery from my Hallux Rigidus surgery. I know it's probably not the most interesting thing to read about for those of you who have no experience with it, but my hope is that this can be used as a resource for other runners as they contemplate moving forward with a similiar procedure. I know I had a hard time finding a lot of information, from a runner's perspective, on recovery from this surgery.

So as of right now, I am 48 hours removed from surgery. Yesterday, around 2PM, I decided to try and move around without the crutches. At first I was extremely tentative and didn't think it was going to work. I didn't have a lot of confidence in the foot holding up to my full weight. However, once I figured out how to do it (lead with the heal and keep the weight off the toes), it became much easier, and within about an hour, I was pretty much done with the crutches. Thank God, because my underarms were getting quite annoyed with those things.

Pain has been manageable and I've pretty much stopped taking the pain medication on any sort of regular schedule. Going forward, I'll just take it on an as needed basis. It feels like I have a foot bruise right now, with an occasional shooting pain through the toe. I have iced it a few times over the past day and that does seem to help if the bruise feeling starts to become annoying. Last night I slept the best I have in a long time, although after 10 hours of no pain medication, the foot was a bit sore when I woke up.

Overall, I think things are going about as good as could be expected. The past 24 hours have been extremely encouraging, and hopefully things will continue to improve. Today's main objective is to survive my son's 3 year old birthday party. I was able to make the chili last night and chicken wings are going on the grill shortly. Hey, I'm not running for the foreseeable future. I can eat chicken wings and chili if I want to.

24 hours later

Last night around 7PM, the nerve block officially ended and I was greeted with some pretty intense pain in the foot. I was pretty much expecting it to happen, but man oh man it hurt. The pain was really two-fold. There was a lot of pressure in the entire foot, which I'd imagine was from a tight wrap around the foot coupled with the swelling in the foot. Then there was a burning pain right in the toe, where the operation actually took place. I couldn't say which one was worse though as they both were pretty bad, and when combined it was close to unbearable. OK. I'm a wimp.

I was taking the maximum dosage of the painkillers (Hydrocodone & Acetamenaphine combo), but it really didn't seem to help at all. So I sat and tried to get all "embrace the pain" with it. That worked for about 2 minutes, but the rest of night was pretty ugly. Finally, at 1AM I was so wiped out that I was able to fall asleep and slept pretty decently all things considered.

This morning, I woke up to the same burning pain in the toe, but the throbbing pain from the swelling seems to have eased up a little. I have absolutely no appetite, which is causing some nausea, but things are definitely better. It is now 5 hours since my last painkiller and things are tolerable. The nurse told me I wouldn't have to use the crutches today, but that just seems completely insane to me. If I tried to put any weight on the foot, I think I'd fall on my face. So another day of crutches and another day of laying around on the couch. For now, I think I'm just in survival mode for a few days until things start to stabilize.

My wife, Kelly, continues to save my butt by pretty much taking care of everything for me, which isn't easy with the 4 kids and a crippled dad. I'm a lucky guy.

Surgery Done

Well I am now 5 hours post-op. Both the Cheilectomy and Akin osteomoty were required, which means I now am the proud owner of a staple in my right toe. Hopefully it's small enough where I won't be setting of metal detectors for the rest of my life.

No problems thus far, although I still have no feeling below my knee yet, so I guess that should be expected. I assume the real test will be in a few more hours when the nerve block wears off.

Keeping my fingers crossed (not my toes though as that just ain't happenin' today).

Three Days To Go. I'm Getting Nervous.

Ok. Somebody needs to turn off my internet. As the surgery day approaches, I’ll admit that I have officially gone into full-blown panic mode. There are times that I wonder if I should just cancel the whole surgery and just deal with the pain that I have. As they say, better the devil you know than the devil you don't.

So in an attempt to calm my nerves, I usually wind up turning to Google to try and find some examples of people who recovered quickly from this type of surgery. What I usually find are cases filled with people who experience longer than expected recovery times and complaints of intense pain for the first few days following the surgery. However, even in these “worse case” scenarios things seems to eventually calm down though, and when there is an update a year post-op, it usually is the person happy with the final outcome and willing to do the surgery again.

But a year later? I don’t have a year. I’ll be lucky if I don’t go crazy after 3 or 4 weeks of no running. But I do need to smart about this. Setting artificial milestones (like be able to fully train for a marathon by Jan 1, 2010) is probably not a great attitude to have. That will be exactly 8 weeks post surgery, and while I hope that I will be able to handle some running at that point, it’s probably more realistic to figure out a 3 to 4 day a week cross-training program to supplement my running.

If there’s one thing I learned from marathon running, whether it be rehab or racing, it’s not how you start, it’s how you finish.