1 Month update

Well instead if outlining my daily trials and tribulations I figured I was at the point where I can start to update the blog on a weekly basis. Things are hopefully taking a turn toward normalcy, but I still think that it may still be a little while until I'm feeling completely myself.

This week was the first week that I was physically back in the office. My work has been great about being flexible. I know that lunches were still gonna be a crapshoot with my stomach issues, so they allowed me to work remote in the afternoons. It was actually good to be back in the office. It kept my mind active and distracted from things. Also, I had wonderful support from long time friends in the office. I have one co worker who I've known since I pretty much started work many years ago who has offered up great advice relating to her own experiences with surgery. If anything it was therapeutic. But everything she said made perfect sense. Basically that no matter what kind of surgery it is, it's still a major surgery. It's something that your body has to recover from. We tend to live in a "want it now" society, and I guess that's the mindset I had coming into the surgery. But the fact of the matter is that I have to give my body some time to heal. She also mentioned how much random stuff happens to the body when it's trying to adjust. So maybe Im not going completely crazy.

As for the ankle, it has gotten progressively better each day. It's still pretty sore, but feels stronger. Couple if things I'm noticing. So at the 4 week mark, it's still pretty numb in places. Primarily on top of the foot closer to the ankle. Also tapping the right side incision still causes the nerve to shoot weird electrical stimulation through the foot. It's not painful until I accidentally hit it hard, but just a weird sensation. The redness below the incisions has gone waaaay down, and the scabs have finally come off. The one thing is that I'm still not sure if it has fixed my original problem. It's still early, but I feel soreness in that same area. I'm guessing its mostly due to the surgery, so I'll give it a chance to heal.

2 Weeks

3 Weeks

4 Weeks

It has gotten a lot stronger. I've begun to increase my workouts...while at first I was a little hesitant on the elliptical, I've now expanded it to 30 minute sessions, instead if 3 minutes. Because if the nerve, the foot tends to get pins and needles after my sessions. It's not debilitating or anything, just annoying. The other thing I've done the last couple of days is started to mix in some runs on the treadmill. The ankle is still not ready for prime time, but since the treadmill surface is still light, I've been giving it a go. I've only maxed out at 1 mile, but considering I'm only 4 weeks out if surgery, I'll take it.

As for my other issues, I'm still having patchy sleep. Per surgery I was going to bed a 1 am and waking up at 8, these days I'm trying to get ahead of the sleep and have been going to bed at 10 pm and waking up at 5 or 6. Unfortunately I'm not asleep for that duration. Usually I woulda fall asleep by about 11pm and then I ALWAYS wake up st 2:30am. I just can't get that blasted hour out if my system. Then depending in what my body wants to do it'll either wake up every hour on the hour, or just random give me times to sleep. I think Im averaging around 5 to 6 hours a night of patchy sleep. But I guess it's better than the 3 that I was getting before.

My stomach is still a bit on the tweaky side. I've been starting to increase my food intake, bit by bit. At this point I'm not sure if it's acid or trapped gas, but I do know that I can't eat anywhere as much as I did before without my stomach feeling like I just hit a local chinese buffet. It's a little difficult considering I want to increase m workouts, but am only able to take in about 1000 calories a day. Yesterday I was able to up it a bit, but still not anywhere near normal. At least I've been able to get off the soup and crackers diet. Just have to eat slower, smaller bites and many more times throughout the day. I'm hoping that I'm getting better versus the fact that I'm just on Prilosec. I've got only 5 or so more doses, so hopefully when i stop it I'll continue to improve. Who knows? Maybe my stomach shrank after the surgery?

The one thing that still kind if bugs me is that I am still getting some of those anxiety feelings. They arent as plentiful as before, but still feels weird when it happens. They tend to show up as either shortness if breath or a weird twitch in my chest. I'm scheduled to have a stress test done in two weeks just for peace of mind. Lately it's only been happening while I'm exercising, so it'll be a good test to have done nonetheless. It may still be stomach as well.

Well that's pretty much my update for the week. Next week I'll be going into the office full time, so hopefully it'll be a good distraction for me...and hopefully my stomach will hold out through lunch time! Gotta just keep in mind that everyday is jut a little better and just to have a little patience.

3 week update

So I've been blogging about this for 3 weeks now. It's been a roller coaster ride. I figured I'd give an overall update of where everything is at. The ankle itself is actually doing pretty well. I'm not ready for any races yet, but at the 3 weeks mark, I've been able to get on the elliptical almost every day since the cast came off. I was also able to get on the treadmill for a teeny bit. I was also able to do a slow jog on the treadmill this week..I think it was 5 days post cast. I'd say e ankle isn't ready for prime time yet. It's still sore when Im on the treadmill and even more sore if I try to push off. I guess I just have to be a little patient.

As for the rest of me, I think my body is still trying to heal from the surgery. I still don't know whether my issue is due to the ultra conservative recovery plan that the surgeon gave me...or someone that has to do with the stress of just having surgery. I might have actually been ok had I not been put in he cast for 2 weeks. That led to the pain, which led to the stress and insomnia (and painkillers) which I think eventually just messed things up for me. So now 3 weeks post op I'm still trying to figure out what is going on.

I know for a fact that part of my problem had to do with anxiety. Some of the issues that my pal had described about his anxiety were exactly the things that I had experienced. Luckily for the most part, those issues have seemed to dissipate. The thing at I still can't quite get away from is if something else is still going on. I'm just not sure if that's still the remnants of the anxiety speaking. I'm hoping that it's just a very slow healing process and will eventually just get better until I'm back to my normal self. I've had moments of being myself and in the last few days it seems those moments have been longer and longer. But then the low and scary moments are still there and are just enough to keep me from being totally happy still. I guess we'll see what the future holds.

So sorry if this blog turned into something completely off the mission agenda of the ankle arthroscopy experience. Perhaps it could used for some psych 101 class.

Anyways. As things progress I'll post updates. As for the day to day,

2 Weeks + 7 Days

After yesterday's pretty rough evening, I decided to take it easy, both on the ankle and the eating.  While it seemed like I had a decent total number of sleep hours, it seemed pretty restless.  I'd guess partially the stomach with the added stress on top.  I know that I woke up a couple of times in the night feeling uncomfortable...but I did get to bed semi-early and didn't get up for about 7 hours.  Just choppy.

Anyways, I got up and instantly called the to get one of my tests scheduled for the day.  This was the ultrasound to check my gallbladder.  I was able to get an appointment for 1pm.  Part of the requirement for this was to fast for 8 hours...luckily, I hadn't eaten since 3pm the day before.  Unluckily, since the appointment wasn't until 1pm, I would have to fast for another 5 more hours before eating, which would put me at about 23 hours of no food.  I was actually ok with that, since I was still tight-chested and had zero appetite.

I worked from home for the first half of the day, and then had Becky drop me off at the hospital to get the test.  I was taken in right away, and it was a fairly simple test.  It was basically the same ultrasound that a woman gets when they're pregnant...except, of course, it was around the upper-right abdomen.  I got to see the inside of my gallbladder, but sadly they didn't tell me it's gender.

The test took about 30 minutes, when my mom picked me up from the hospital.  She had brought soup and cracker for me to eat.  At this point I had started to get hungry, and decided to munch on the cracker...I slowly ate the first one, waiting for the tightness to start.  Nothing happened, so I started eating the 2nd....and then 3rd...and then as soon as I knew it, I was down 20 crackers.  There was a little tightness that had started, but I got home and tried to counteract it with some TUMS. 

I then ate some chicken rice soup...and then continued my work day.  It started getting a little tighter throughout the day...it wasn't as bad as the night before, but still felt uncomfortable.

A couple of things happened today...I got a call from one of my friends, asking how I was doing.  I told him my story about the anxiety and all the problems that I had been having.  He actually had relayed almost the exact same experiences that have happened to him...everything from the anxiety to an ulcer that he got a few years ago.  It was crazy to hear him describe something that I thought I was crazy having the last 2 weeks.  Talking to him was amazingly therapeutic.  He told me it gets better, and then gave me some tips for dealing with the stomach issues. 

Now I'm not sure if I definitely have an ulcer or an irritated stomach...but the symptoms sounded very similar.  He described it as feeling like you have a bubble in your stomach, and you instantly feel a tightness in your chest, right below your sternum.  Antacids help, but not completely.  One of the biggest reasons for this to happen is the use of NSAIDs, like aspirin or advil.  I haven't taken that much but perhaps because my body isn't used to it, it could have at least caused irritation in my stomach.  The other thing is that for a while there I was drinking a ton of orange juice, which didn't help...and of course the stress.  This kind of put my mind a little more at ease...while even though I don't know exactly what's wrong with me, it would be nice to have something as common as an ulcer.  I guess time will tell if my body responds to the prilosec.

The other thing that happened today was that I decided to drive for the first time since my surgery.  I just wanted to get out of the house, and considering I was able to "run" on the treadmill, I figured I could handle a simple dorsiflexion to drive.  I only just drove up to the local CVS and bought some anti-gas medication.  I wasn't sure if that would help, but it gave me a purpose.

So I got home, ate some chicken-rice soup, crackers, and then 3 chicken nuggets, with a pre and post meal of TUMS...The stomach kind of settled down and I went to bed around 10.

The stomach actually settled down enough for me to get some decent sleep.  I slept for a total of 7.5 hours which is the most I've had since the surgery.  I did wake up, but only woke up around 12:30 and then 2:30.  So, even though it was slightly patchy, it was good enough for me to wake up semi-refreshed.

2 Weeks + Day 6

Ankle Update
Well, Day 6 was kind of a mixed day.  I got up early and did the elliptical for .25 miles.  Ankle felt really good.  I still have numbness right around where the top of the foot meets my ankle.  It's not too noticeable unless something is touching it.  Then I can feel the pressure, but not really feel the touch itself, if that makes any sense whatsoever.  Again, just refer back to getting a novocaine shot at the dentist, and that's exactly the feel of it.  It's definitely not as annoying as having your mouth numb, though!

One other interesting thing that I was able to pull off this morning, is that I was actually able to run on the treadmill!  The ankle felt a little sore, but the treadmill seems to lessen the shock on it.  I think most of the soreness of running comes with an overstretching of the muscles in the ankle.  The calf actually feels decent, but I feel like I lost a lot of range of motion with the ankle.  So, the treadmill work seems like it'll help (along with all my PT exercises).  I only ran a quarter mile, and set it to 4.3, which is pretty much a 14:00/mile pace.  Not quite where I was...but I'll take it.  I think the cardio is gonna be harder to build than the actual muscle.

Other Issues Update
My stomach/chest was a little tight in the morning.  I'm not sure if working out would make it worse or better, but I figured I'd give it a shot, nonetheless.  It basically didn't do much.  I started work around 7am again, which is crazy early.  I had my doctor's appointment at 9:45 to get whatever this thing is checked out.  Because, Becky was working, my parents yet again picked me up and drove me there.

I explained to the doc all the events that have transpired since the "incident" 10 days post op.   I told her that lately, I'm just feeling tightness in my chest primarily after I eat.  She asked about my history, my parents history and even grandparent's history.  Of course, my parents and grandparents all have some form of heart issues or high blood pressure.  She did the procedural checkup, where I would breathe in and out with her listening through the stethoscope.  Then they did another ECG on me and compared it to the results from when I went into the ER. She found that my mom had to have her gallbladder removed, so she ordered an ultrasound as well as a stress test for me.

The other thing she mentioned that it could be some inflammation in the stomach lining, or acid reflux.  She gave me a course of Prilosec, which is used to inhibit the production of acid in the stomach.  I hadn't eaten anything since the night before, so we went out to eat afterwards.  I just had a plain hamburger from McDonald's and a Hi-C.

This actually turned out to be a mistake.  I got home and instantly felt the tightness in my chest.  I waited 2 hours and then tried to eat some chicken-rice soup that my parents brought me.  My chest just kept getting tighter...I should have stopped, but I was eating such small portions, I didn't think it mattered.  My last attempt at eating was just a single slice of bread with some jam.  I think that was at 3pm.  Then the discomfort really started to kick in.  I couldn't even think about eating anymore the rest of the day.  It was almost unbearable.  I forced myself to take the Tums, as the Prilosec is a slow-releasing preventative medicine.

I went to bed pretty miserable, but managed to make it through the night.

2 Weeks + 5 Days - Back to work

Well, I got up around 7am after lying in bed for a little while.  The top of my foot was still a little numb and tingly.  I can still feel some pressure when I scratch, but when I sort of rub my fingers on the top of the foot, it gets that same weird sensation that you get when your mouth is numb from novocaine.  The area doesn't seem to be as large as it was before, but it's much more noticeable closer to the base of the ankle.

As for the stomach, I woke up feeling that same kind of "bloated" feeling...but a lot better than the night before.  Before logging into work, I decided to do a bit of elliptical work.  This time I went for quarter mile, instead of just by time.  It took only about a minute longer.  So far, so good.  I maybe felt a slight pang of breathlessness, but it went away quickly. 

Afterwards, I logged into work, and I'll have to say that it was a pretty good feeling of normalcy.  It was a good distraction, and it helped by the fact that I was feeling a little bit better.  I ate some watermelons for breakfast.  Then for lunch I ate some rice and some leftover broccoli.  I'd say it was about a medium portion.  I felt a little tight right after eating, but it wasn't too bad or distracting from work.  I also cut a bit of a papaya fruit and tried to eat some of that as well. This tightness is interesting...there definitely seems to

The good news about getting up and starting work early, I got to get off the clock early as well.  This time, I tried to take a nap, but of course, my body would have none of that.  Instead, I just got up and watched some tv.  I ate dinner around 6pm...The chest/stomach was getting a little more tight, so I decided to eat light.  I just had some Ramen noodles, going college old-school.  The tightness just increased more.   I felt it when I tried to settle and sit down.  It took a few hours, but eventually got to the point where I was a little more comfortable sitting.

I went to bed early again, around 10pm.  This time I fell asleep around 11 and stayed asleep 'til 2:30am.  This was actually the longest amount that I've slept straight through in a while.  I went back to sleep 'til 3:30 and then again 'til 6am.  So patchy 7 hours of sleep...but it was decently restful.

2 weeks + 4 Days

Well, last night was just restless.  This morning I got up at 6:50am to a stomach ache.  After using the facilities, I couldn't really get back to sleep.  I just laid in bed for a few hours until maybe around 10am.  I don't think I actually got any real sleep in.  I was feeling some pretty crazy, tightness from the night before.  Definitely think I need an appointment with my primary care physician.

The ankle felt pretty fine.  I can definitely tell that the stiffness is starting to subside.  The one thing I do notice is that the incision areas are still on the swollen side.  The swelling has gone down a bit, but not anywhere close to where my good ankle is at.  On another positive note, the redness around the incisions has gone down to a slight pinkness.  It's definitely not as dark as it was before and the reds are now just barely noticeable.  One thing that I'm noticing is that the skin that was underneath the cast is starting to flake a little bit more.  I think it might be something that requires some lotion.

My parents, again, picked me up today.  This time we went downtown for some food.  Unfortunately, the tightness was still there, I was dragging and I didn't have very much appetite.  While we were downtown, we saw my aunt and uncle come into the same restaurant, so decided to just sit together.  This was good, 'cuz my Aunt is a doctor and I could grill her on all my questions.  She said that it's probably just the anesthesia or indigestion.  I only had a bowl of soup in front of me, and I was barely even picking at that.  I was noticeable miserable and untalkative.  She said to try some antacid pills when I eat.  My uncle actually had some on hand.  I figured, what the heck, it couldn't hurt.  So I popped two tums...the weird thing is that I started to actually feel some relief.  My appetite kind of came back and I started feeling a bit better.  I think it probably just resolved part of my problems, but it was good to feel a little human again.

We then hit a few grocery stores to prepare for my impending workday tomorrow.  I just got some quick, light meals that I could put together during the workday.  If it is my stomach that's causing some of my issues, I figure that I would start lightening up my meals a bit to see if that makes a difference.  We basically just got some yogurt, juices, bread and things of that nature.

Afterwards, my parents dropped me off back and my place.  I was thinking about a nap, but then had the opportunity to have some of my closest friends come and visit.  I wasn't gonna pass that up, and I knew that I probably woudn't fall asleep anyways.   It was seriously therapeutic.   They got me out of the house again, and helped me walk Kodo around the block...then we just sat outside for a couple of hours and chatted.  I could feel the "pangs" while we were talking...but they actually had eventually faded.  It was a nice distraction, and really just to have the company.  They had left, right before Becky got home, so I had a pretty constant stream of socialization.

I decided to eat lightly this time.  I ate a little before my friends stopped by, and then I expanded the meal when becky got home.  I took 2 tums before I ate, and decided to keep myself standing up.  The badness always happened while I was sitting and eating.  Surprisingly enough, even after about an hour, it didn't really hit...maybe a little tightness, but no the full blown "attack".

Before it had the chance to actually hit me, I decided not to tempt fate and decided to head to bed.  It was only 10 pm, but I was already wiped from all of today's activities.  I stayed up just long enough to watch the last bit of the Miami/Boston game and then went right to sleep.  I think the last i saw the clock was around 11:30pm.  I woke up around 2:30, which was decent, considering it was about 3 hours straight of sleep.  Then fell asleep and woke up again around 4am.  I turned my head and tried to fall asleep.  After a little while, I turned to look at the clock and it was 6...I just couldn't tell if I had actually slept or if I had just laid there for 2 hours.  ohwell, I guess no major attacks overnight was a good thing.  We'll see what tomorrow brings.

2 Weeks + 3 Days - Best parents ever

So after that miserable night, I woke up feeling a little more refreshed.  I tried to stay in bed as long as I could.  I eventually got up around 10am and called my parents.  They were planning on picking me up and taking me out to lunch today.  At this point, if it's anxiety, then any out time is a blessing.

Ankle actually felt good getting out of bed this morning.  No stings that I can remember.  I was able to start walking right out of bed.  Not too shabby for 3 days out of the cast.

I got up, did some elliptical work again for a little over 2 minutes.  I took a shower and then called my parents. My parents drove the distance to pick me up, and then we went out to Red Robin for some food.  Afterwards, we just went from store to store around the mall area and browsed around for the next 3 hours.  I wore my walking boot most of the time and walked myself.  When my ankle finally started to get tired (i.e. I started feeling some stings) I switched to wearing my shoe and sock, and then just crutched around.  We capped the day at DQ for some ice cream and headed back home.

We got home around 5pm... the ankle felt decent again, so mom and I decided to take Kodo for a walk.  Well, mom held Kodo while I crutched/hobbled around.  It wasn't actually too back.  I walked some of it, but then decided to crutch whenever I felt any twinges.  Kodo, got tired first as he usually does and it started to rain, so we just called the walk short.

It was a wonderful day out, and I didn't feel any issues throughout.  I thanked my parents profusely as they looked pretty tired too.  They went back home.

I tried to take a nap, but could only toss and turn...so instead, I did a bit of laundry and opened all the windows just to aerate the house.  I sat on the patio outside with the pup and just played a couple of games on the iPad.  Then I ended up eating around 8:30pm.  I had a sneaking suspicion that somehow that my eating is somehow related to my shortness of breath.  Sure enough, just around 9pm, I felt my first "pang" of the day.  What a bummer, since it was such a great day.

The tightness got worse and worse, and I think as it gets tight, my anxiety rises more and more.  By 10:00pm I was pretty wiped from the day, and decided to try to get some sleep.  I lied in bed for about an hour and probably was pretty restless until finally falling asleep around 11.  It was restless sleep.  I remember waking up a bunch of times, but then being for a bit longer and then waking up around 2:30am.  I just turned and fell asleep again, and I think I saw 4:00, and then 6:50am. 

2 Weeks + 2 Days

Well, the good news is that the ankle pains seem to be settling down a bit.  I took two advil last night and the burning sensation wasn't nearly as bad.  It was still choppy sleep, but I was able to get back to sleep every time I woke up.  There still a little bit of a stinging sensation in the ankle when I get up and start walking.  It wasn't as bad this time though.  I felt like I could have gotten up on my own, but decided to use the crutches instead.

After the initial stings wore off, I actually felt semi-comfortable walking without my crutches or boot.  I started slowly, and there were some aches and stiffness, but overall it wasn't too bad.  The top of my foot is still pretty numb and the right-side incision is definitely sensitive next to that nerve.  If I even tap around it, I can feel the tingles through the top of the foot.  So best to avoid any significant contact around it.

The skin around the incisions still seems pretty red.  No streaking pattern, so not gonna worry too much about that.

I spent most of the day cleaning and doing more chores.  I figured, now that I feeling semi-decent, I should take advantage while it lasts.  Also, anything to keep my mind off of things.

I at half of last night's leftovers for lunch and then continued my activities.  I also started to work in some physical therapy activities that were given to me back when I first hurt my ankle.  Just the ankle alphabet, calf stretches...that and even tried the elliptical again.  It wasn't too bad.  I could tell when my ankle wasn't quite ready to go on, because the stinging started occurring a little more consistently.  But overall, it was nice to be able to be even more mobile again.

It was pretty decent anxiety-wise most of the day...however the tightness came up again just after dinner around 8:00pm.  I guess it was nice to happen later on in the day?  It kind of stuck for a while...so I decided to try going to bed early at like 11pm.  I woke up only 30 minutes later feeling like I was breathing in, but just not getting enough oxygen or something.  Around the same time, our dog, Kodo, came to the bedroom being all antsy.  This was not good timing, since I was trying to get to sleep and Becky had to get up early the next morning.  Since it looked like sleep wasn't gonna happen for me anyways, I decided to just head downstairs and hang with Kodo for a while.  We were quite the pair....the both of us panting away.

After about an hour, I came back to the bedroom and decided to give sleep a shot again.  Kodo followed suit, though, he was still panting up a storm.  I woke up around 2:30am, and decided to check on him, and he was back to sleeping calm as a cucumber (how calm are cucumbers, really?)

I went back to bed, and slept for another hour and a half...then back to sleep for another 2 (maybe).  It's hard to tell how long I'm actually sleeping...just that it's patchy.  Not a great night.

2 weeks + 1 Day - Walking again

Well, the 7-hour patchy sleep seemed to be enough to keep my energy high today.  I was ecstatic that I was finally out of that evil cast.  I got up pretty early.  Unfortunately, one of things that did remain even post-cast is that when I get up, I feel that sharp nerve pinch for a second...and even for the first first steps out of bed, I can't seem to put any weight on it without feeling some sharpness.  The good news is that it only takes a few seconds to settle down, and then I was back to moving around like I was.

I got out of bed feeling energetic, and after the sharp stings subsided, I decided to take my new ankle for a test "walk".  I was without crutches, and although  my calf felt tight, and my ankle was a bit on the achy side, I was mobile pretty much first thing in the morning.  I used my crutches as I went down the stairs and then was able walk slowly on my own toward the kitchen.  The more I walked, the more relief I felt.

The ankle is more stiff than my calf...but I did some interesting comparisons today.


1. Size of my calf - Lost about 1-inch.  It measured a little above 14" while my good calf measured about 15".
2. Weight - Lost about 5 pounds.  Before I was around 165, today I was easily 160.

The weight loss is most likely a combination of muscle and diet.  I haven't really been eating too much lately throughout this whole process.  I'm trying to be better about it though.

With my new found ability to walk, I actually got myself to do some much needed cleaning around the house.  Anything that gets me back to a semblance of normalcy.  I deflated the air mattress that was sitting in our living room.  I also did some cleaning in my bedroom and bathroom.  I figure since I'm going to be taking an actual shower today, I should make sure that everything is pristine.  I also did a much needed load of laundry as well.

As for my routine, I tried to do some calf stretches from this site:
http://www.summitmedicalgroup.com/library/sports_health/fracture_exercises/

I also gave the elliptical a try, and to my surprise, I was actually able to do a bit without any pain!  I only tried for a few steps.  I didn't want to over push it.

I hadn't had any weird anxieties throughout most of the day...I kept the windows open since it was cool outside, and just sat on out patio with the pup to calm myself down.

Anxiety report
Unfortunately, the panics weren't completely gone.  I think I lasted all the way until about 5:30 pm when the first one hit.  It was a bit of a shortness of breath again.  Like things are getting a little tight in my chest.  I'm still hoping all this is just anxiety and nothing more serious.  I was hoping that after getting my cast off and not getting an attack for most of the day that I might have been past all these shenanigans....but unfortunately, it would not be the case.

Dinner with my parents
I invited mom and dad to head out to dinner on me.  It would get me out of the house, and I owed them big time.  I decided to use the walking boot while we were out.  It's quite a bit lumbery so being in the boot for long periods of time was a little uncomfortable, but I ended up walking fine with the thing on.  On the way back, we stopped by a CVS, so I could pick up some hydrogen peroxide, so I can clean the area of the wound...now that it's healing nicely.  My mom's a Med Tech and my aunt is a doctor, so I asked both if this would be ok.  I had some concerns (surprise) about redness around the incisions as well.  In my copious amounts of research, one of the signs of infection is growing redness.  They both said that it looks ok if the wound is dry and there's no pain.  If the redness starts growing in a "streaking" pattern, than that would be cause for concern.  But as of now, everything looks good.

I went to bed, still feeling some tightness in my chest and a little antsy.  Similar to last night, I had maybe 5-6 hours of patchy sleep...waking up almost every hour.  Still not sure what to do about that, as I have work in 2 days.

Day 14 - Cast - Post Op appointment FINALLY

Well, after many, long nights of sweating about this cast, I finally had my 2-week post op appointment.  After spending the last restless night reading about all the worst things that could possibly be happening in the cast, I sat up from 4am until around 6:30 am when I finally got up.  The appointment was at 8:45am, so we left an hour earlier.

Even up to this point, I felt some random stinging pains on the right side of my ankle.  This mostly occurred when I was crutching around, since the weight of the cast was heavier on that part of the ankle.  Also, if I stood up for long periods of time, I would feel some burning and stinging on the top of my ankle.  My toes would turn red, and I'd feel the tingles.  So, how on earth  would I be able be upright in a walking boot?

What's under the cast? 
We finally arrived to the doctor's office.  It wasn't more than 10 minutes when I was called in.  The surgeon's assistant, who I talked to on the phone brought me into the room.  She mentioned my call to the doctor's office, and I reiterated that I feel like there is drainage that I'm feeling.  She, again said that was normal, and she would be taking off the cast now.

So, she pulled out a pair of scissors and started cutting the outer-layer of the cast first...basically the Ace bandage.  As soon as the entire bandage was off, I instantly felt some relief from my ankle.  The burning sensation lessened.  Now was the time to starting cutting down the layers. There were like 20 layers of cotton and padding.  She started cutting them down one at a time. I reiterated that I didn't see any drainage come through, so not sure how much there was.   After getting through like 10 layers, the cotton layer was still pristine. 

I was slightly embarrassed by this, but she would see that it would be soaked as we got down.  So, she started cutting the last 10, layer by layer.  Each layer cleaner than the last.  Then the last layer I knew had got to be the worst and then would reveal some type of boils or something.    She cut down to the last layer....and nothing!  Solid white layer of cotton...nothing!  Then she removed the last layer, and voila, and completely dry ankle! 

Cast finally comes off!

The assistant only said that everything looks really good.  In fact, other than the markings on my ankle and some slight redness, I could barely tell that I had surgery.   Very weird.  So, I'm definitely going crazy.

The next step was that she cut the sutures.  There were only two...one on each side.  Basically 2 snips and then a slight tugging sensation, and they were out.  No pain or anything.  She reiterated that everything looks good and left the room to get the surgeon.

I sat there in relief when I took the above picture. 

Talking with the Surgeon
The surgeon came and said things look pretty good.  He said I have some slight bruising and then started feeling the top of the foot, between the ankle and the toes.  It was a little numb as he was touching it.  He said that was pretty much nerve irritation, possibly inflammation from the incision.  He also said that there could be some after effects from the nerve block still present.

The next thing he did was start tapping around the right-side incision.  He asked if I felt anything...I didn't feel any pains.  He said because this incision is so close to the nerve (which, of course I had googled a million times), it can cause some sharp sensations.  I think these are the stinging pains that I feel first thing in the morning.  Other than that, he said the wounds look good and everything looks like it's healing well.

He said that I would get into a walking boot to help me walk again.  I asked him a few questions:

1. Were there two bone spurs?  Did surgery take them both out?
   Yes, one on the side of the talus, and the other on the bottom-middle of the fibula.  Both were taken out.  Also, there was some synovitis swelling which he took out as well.
2. Was there anything to watch out for?
   He said there could be some discoloration...your toes could even turn bluish, which is normal.
3. Should I do physical therapy?
   He said that he could order physical therapy if I think I needed it.  It might be better for me since I'm active and would need to get up and running quicker.  
4. How long should I be in the boot?
   Until it feels comfortable to walk...probably within 1-2 weeks, and when the shoe fits my foot again. It's based on how I feel.
5. Should I continue to elevate?
   This is also based on feel.  If I start feeling pain or swelling, then elevate it.  It'll be based on how much I do on my ankle...so play it by ear.
6. How much can I do?
   As much as I feel comfortable doing.  He said I couldn't really hurt it anymore.
7. How long before driving?
   When I'm able to stand fully weight-bearing, on both legs without pain.  No driving on the boot!

Then we talked a bit about the things that have been going on.  I told him that I've been experiencing insomnia, and even had to go to the ER with shortness of breath.  He only relayed a story about when he was younger that we used to experience heart palpitations during some stressful times...and that it could be a product of the anxiety.  He said that pulmonary embolisms are a really low percentage, as well as infections from this particular surgery. 

His recommendation, though, was to see my primary care physician to check out what could be going on.  A bit of a relief, but I think it'll be a while before I'm comfortable with these "attacks". 

And now the walking boot
So the surgeon's assistant came back in with the walking boot.  She show me how to use it. It's basically a large padded cast that fits around your leg from knee down.  When wrapped around it, it feels really snug, but not painfully tight like the cast.  It also felt really heavy.  

My new robot boot

It was awkward at first trying to walk with this thing on.  I had to use both crutches to get around.  Since the thing was a lot heavier than the cast, I wasn't as mobile...and that was it.

My next follow-up is in 1-month.


Walking with the boot was pretty rough at first.  I actually try to walk without the cast for one step, and my calf muscle instantly cramped up.  It was as if you were lifting weights and you were on the very last rep, where you could only half-lift.  That's how weak the muscle felt. 

The thing felt awkward, but somewhat comfortable.  As I went through the day, I was able to walk on it with one crutch...and then eventually got to the point where I could walk without a crutch completely.  Very short distances, but still.

Toward the night, I was actually able to walk even without the boot, but didn't want to do too much yet, since I didn't know how it would react overnight.  Unfortunately, as expected, the ankle still burned quite a bit...I fell asleep around 12:30am, and woke up at 2:30am, feeling the burn.  The good news, though, is that the burning sensation was lessened quite a bit as soon as the foot came out from under the covers.  It was still uncomfortable, but nowhere near having the cast's padding right on top of the sensitive nerves. 

I actually got a patchy 7 hours of sleep...but at this point, I will definitely take any sleep I can get!

Day Thirteen - One more day 'til cast off!

Finally, only one more day until this bloody cast (hopefully not literally).  The cast is the bane of my recovery.  When I was originally told two weeks, I wasn't sure how I was gonna make it.  But still one more day to go!

The morning at my parents was nice.  My parents get up early, so I pretty much followed suit after waking up around 8am.  I was tired, but I couldn't sleep...so I just decided to get up instead.  7 hours of patchy sleep is still better than 3 hours of non-patchy.  (don't quote me, I'm just assuming it is)

The ankle, as usual, it felt pretty decent in the morning.  I was still getting a stinging pain when I first get up from the bed.  Again, it feels like the blood is rushing all at once, and then certain parts of the ankle, I'm guessing where the incisions are, just burned for a bit.  After a few seconds, the burning settles down and I'm am ready to actually get vertically up and crutch around.

I was totally being babied by my parents, and I was totally ok with it.  Dad cooked nummy blueberry pancakes for breakfast.  I was still feeling little pangs throughout the morning...perhaps a little more constantly than usually, but not as intense as usual either.  Either way, though, it was still a little unsettling.  Mom actually went out and bought me a thermometer (to ease my nerves that I'm not coming down with a fever) as well as some fruit.  This was good, 'cuz we don't have much of a variety of natural foods at home.  We ended up ordering pizza for lunch, and watching a movie.

The doctor's office called me back in the morning and I told them that I have a dripping sensation in the cast, and of course, the shortness of breath issues.  She said that the dripping could be be just the moisture building up from the inside of the cast or even a little blood. She also said that they've had people report some claustrophobia with the cast, that could lead to those anxiety-type responses.  I asked what the plan was for tomorrow, and she assured me that we'd be able to take the cast off tomorrow, which made me feel better. 

(More anxiety stuff...nothing about ankle):
The one thing weird that I noticed (and I apologize if this is turning into an anxiety blog as well) is that when watching the movie, I would kind of start dozing off...but just as I was about to fall completely asleep, I would feel a rush and wake up completely.  Not good if you're trying to catch up on sleep.

Anyways, so after the movie, my parents brought me back to my house.  It felt a little foreign, even though I've only been away for a day.  I still kept getting the weird panic sensations (surprise) but I started giving it a little thought and figured that perhaps it was a combination of being cooped up in the house too long, with my body not knowing how to deal with going from constant activity to nothing at all.  In addition, the few days before it hit, I had barely been doing anything to keep my mind active.  I was laying in front of the tv, and watching it without really watching it, if that makes any sense.  (kinda of keeping it on for the noise, but not really invested in the show).  So, I decided to keep my mind active.  I started to play piano again...started to play some word games.  If anything, it'll keep me distracted.

I found it kind of hard to concentrate...whenever I tried, I again, would feel that rush of something (adrenaline) that breaks me out of the concentration.  I notice this when I'm trying to speak...I'd be speaking and then would just feel the flash and then lose track of what I was saying.  It seems to occur when I try to recall things as well.  It's a very odd sensation.  Maybe chalk it up to anxiety again...but I just felt off.

(Back to ankle stuff)
So that night I was up and around.  My appointment for getting my cast off was at 8:45am the next morning...so we had to leave around 7:45.  I was freaked that feeling all this dripping sensation that I might be stuck with the cast on for even longer.  (anxiety anyone?) So, I went to bed around 11pm...  This was another rough night.  My ankle was burning again, which seems to be the trend...hoping this nerve will settle down soon.

I didn't get to sleep until midnight and then just woke up at 1...feeling the burning.  I took a tylenol and then was able to back to sleep, and woke up again at 2.  This time I couldn't get back to sleep.  The burn was intensify, and of course, my mind was racing to what was going on with my ankle.  I was thinking a bunch of things....infections, bleeding, sepsis (combination of the two).  Oh and having the iPad by my side did NOT help.  I would just keep looking up things that my mind raced to.  It's like going to webmd, when you have a cold and then thinking you have the plague.

I did manage to fall asleep again at 4am and then again, woke up an hour later.  This time it would be final.  I just lied in bed until it was time to get up for my appointment.    Only a few hours to go!

Day Twelve - Spending time with my parents

Monday was memorial day.  It was a miserable night.  As usual, the burning occurred worst at night.  I kept feeling like there was some leaking happening in the cast.  I couldn't sleep too much.  I think maybe only 3-4 hours at most.  I tried to go without taking any Tylenol, as this was one of the changes that I made before my shortness of breath incident.  Mental note: burning pain minus painkillers equals burning pain!

I did wake up to my ankle nerves being settled in the morning, though.  It's very weird how much of a difference it makes from night to day.  All the burning sensations went away and the ankle pain settled.  It was such a difference that I thought I might perhaps join Becky for a cookout at her parent's house.  I decided to wash up, which always refreshes my body/mind.

The one thing that happens with the cast, is that the longer I'm up, the more burning sensation I start to feel.  It seems like the wrapping is too tight or that it's just rubbing right on the nerve.  Then I started feeling that leaking sensation and with each of the "leaks" I felt a pang of nervousness....almost as if my heart had fluttered.  Of course, this started making me nervous again.  I was actually nervous about not just being left alone, but also going to Becky's family's place and then having something happen. 

My mom actually offered to have me come over and stay the night.  So, prior to Becky going to her family's house, she took me over to my parent's house.  This was such a good idea.  Mom and Dad did everything they could to calm my nerves.  The current theory is that I'm having anxiety attacks...probably from either the lack of sleep, the stopping of the oxy, or even maybe even just being inactive for so long.

So as I lie on their couch, elevating my foot, Mom just sat and chatted with me.  She brought me water, fruits, snacks.  Just chatting with my mom helped take my mind off of things.  Dad threw in a movie, and cooked a nice steak dinner.  ha, it was like I was a 10-year old kid with a flu.

This was a nice change of pace for me.  It had been a while since spending significant time there.  As wonderful as Becky has been through this whole thing, I needed some change..and this was exactly what the doctor ordered.  It didn't fix whatever my breathing/heart/anxiety problem is, but changing environments was a good thing.

I slept semi-decently overnight.  I took 2 tylenol before going to bed.  I fell asleep around 12, woke up around 2.  Fell asleep at 2 woke up around 4...then finally fell asleep around 5 and woke up maybe around 8...  So added all together was about 7 hours of sleep.  Unfortunately it was pretty patchy, but it was the most total sleep that I've had in quite some time.  So I'll take it!

Day Ten (part two) and Eleven

So the night of day ten changed the course of my healing a bit and may change the course of this blog a bit. I had been resting the ankle quite a bit throughout the day. The night before was pretty uncomfortable, so I had to skip a party in the afternoon. Instead we decided to do something low key and have friends over. It was wonderful...they brought me some healing ice cream cake and provided the much needed distraction from the pains.

Unfortunately the nit took a weird twist, when I suddenly started to feel a sense of nausea and then felt that I couldn't breathe in all the way. I had been doing so much reading that I knew that this could be a sign of a pulmonary embolism. I started to sweat a ton and felt like I was breathing in, but just not getting enough oxygen.I wasn't sure if the feeling had gone away, but the sense of dread was still coursing through my veins. So, I ended up crashing the party with a trip to the emergency room.

The ER took me in right away and they immediately placed an IV on me (after missing a vein). They took four vials of blood samples and the doctor told me that a pulmonary embolism is pretty rare, but still worth checking out. So they wheeled me into a CT scan of my chest. The injected a dye and basically said that I would feel a warm sensation throughout my body and would make me think I peed myself. I felt it exactly like she describe. They put me through the scanner laying on my back and had me hold my breath and then start to breath. Twice for two pictures. That was it...and it went by pretty quickly. As the dye wore off, I fell shivers for a little bit as they wheeled me back to the ER room.


The ER doc came in and said that it was the right thing to do to get it checked out. They looked at the results of the cat scan and saw no evidence of an embolism. They had me do the usual physical tests where they listen to your chest while you breathe in and out as well as cough everything sounded Norma. Then they did an ECG on me, where they taped these white sensors all over your chest to see how your heart is beating. Then another where they tape all these black sensors to your chest and knees and they hook up what looks like jumper cables to each one. I asked, and I guess it's supposed to take an image of your heart. They didn't find anything abnormal there either. So, he just chalked it up to asthma that I had when I was a kid.

He said everything would be ok and had someone from respiratory give me instructions on using an inhaler. So,after all that I seemed to alm down a bit. I didn't feel anything else weird the rest of the night.

Day Eleven

So, the next day I woke up and for the most part felt pretty normal. I didn't have a lot of sleep, cuz the events had freaked me out so much. I was going through my normal routine of pretty much just laying down and elevating my ankle. Then I got up and crutches around and then sat down on one of the couches and bam! It hits me again. A little bit to a lesser extent than the night before...but kinda a pang of overwhelming dread...like something bad is about to happen. I didn't break out into sweats this time, just decided to lay down instead.

I basically laid there, kind of afraid to get up and experience this "doom" sensation again. I thought maybe it was cuz I've been inactive for eleven straight days and my body didn't know how to deal with inactivity. So I decided to crutch around and spend some energy. It seemed to have helped as it didn't really occur when u was crunching around. I had stopped for a moment and then it happened again. Same feeling...it was like my heart pounced really quickly and then that danger feeling occurred. It's really hard to describe of you haven't felt it before. It's like your body's way of telling you that something bad is about to happen...but in my case it just creates a bit of nausea and then eventually dissipates. Almost like the feeling you get when you hold your breath to its limit right before you exhale. Only, at youre breathing in normally, just still not getting enough oxygen.

I felt like I was going crazy. I read some things that point to anxiety or panic attacks, which commonly occurs after quitting oxycodone. I had really been on the ox for a few days at its minimum dosage, but who knows?

I had to skip another event, just due to both the ankle being painful and my nerves being shot.  My girlfriend was wondering and brought home some KFC and we ate it outside on the patio.  I didn't realize it, but this was pretty much the first time I've been out of the house since the surgery.  It's been pretty hot, and I've been in pain and on basically bed rest.  I felts the pangs a couple of more times, even though it was a nice mix in my recent activities.

Anyways, that night, was a bad ankle night...probably from all the crunching around trying to get exercise. The ankle burned up and it felt like it was boiling on the inside of my cast. I didn't want to take an oxy or a tylenol as that is the only thing I changed since the issues started happening. So, it made for a pretty miserable night of very little sleep.

Day Ten - AM

This might be a 2-parter since I'm writing this so early. But I figured I'd relay last night's experience while it's fresh in my memory. So, I was a bit on the miserable side last night. It wasn't necessarily a painful night, but just a very uncomfortable night. First off, whether it was nerves (literally!) or the cast, but my ankle and foot were just burning up. It was like that part of me was in an oven, and the rest of my body followed suit. I was just lying there broiling, trying to get myself to go to sleep.

Now, I hadn't taken an oxy since the morning, so perhaps because it was night, and I was completely off of painkillers, caused the flare up. I'd say about 30 minutes after I took the oxy, things settled down. I woke up at 3:30 am, which was exactly 4 hours since I took the oxy, and I was back to the oven state again. I immediately took another, and it immediately settled down. I woke up again at around 6:30, but this time, I was relatively comfortable still. I think the ankle was still warm, but the rest of me felt normal. I decided to wait instead of dosing up early. 7:30 came around and I was still relatively comfortable. Then, masochistic me decoded to wait. I was still relatively comfortable around 8:30 (1 hour post dose duration) but decided to just take it.

I was kinda hoping that I wouldn't be as dependent on the oxy as I am...but I guess it's early days.
But, hey, it's day 10, ankle.. Figure it out already!

On a positive note, I was off the painkillers for most of the day yesterday. And I guess if I were to compare, at least I didn't wake up to random stinging pains. Just this burning warmth. I'd love to find out if it is just the cast that's exacerbating the warmth or if it's just the nerve irritation.

I think I'll try to switch out to aspirin during the day to see if that makes any difference. But I am planning a date with oxy again tonight.

Day Nine - decent start, uncomfortable end

Well, today started out pretty decently. I woke up to no pain or tingles. I took my normal dosage of oxy in the middle of the night and when I woke up. My ankle felt cool and not heated at all. It was actually to the point that I wasn't really hesitant to get up from bed because the stings weren't even around.

I actually laid in bed for about a hour after I woke up. Of course, getting up, I can feel a bit of the warmth still rush to my feet. I'm guessing that's the blood just rushing down. So, I don't feel very confident crutching around too long. First thing I did was go and wash up. Since I was feeling a little more human this morning, I figure I would go all out.

Today, I actually decided to skip the pain meds and for the most part I don't think anything flared up. I did feel the tingles im the top of my foot every now and then. I only rarely felt the heat wave in the cast. The only time I felt it was if I got up. One thing I notice, is that when I do get up and I feel the rush of heat come down, I see that my toes start getting more and more red. I'm not sure if this is due to some constriction in the cast, but I still do have a sneaking suspicion of it.

So for most of the day, I was relatively comfortable. I also kep radiating the cast, and didn't feel any of the sharp twinges that I had before.

Of course this was too good to be true for the whole day. I should be so lucky...I think by around 7pm, the tingling started getting a little more constant. On top of that, I really felt some significant flashes of heat in the cast in general..that I I feel like I have some sore spots on the skin that the cast is rubbing on. I almost think that when the heat waves come, I feel like my leg is sweating in the cast. Then the sweat makes the skin irritated when it rubs against the inside of the cast. Argh. I really wish I could just take this stupid thing off, but I'm trying to be a good patient. How do people do this for months?

I guess the consistency is that the all the weird tingles and heat seems to always come toward the evening. So before I go to bed tonight, I, gonna take some oxy and then maybe take the, consistently tomorrow. (why do I tempt fate like this?).

Just a few observations:
If I elevate too high for long periods of time I start feeling tingles
If I stand up, my toes start turning red and I start feeling tingles
My compromise is to elevate with maybe two pillows
I notice that I can sit for short periods of time without the tingles starting (maybe 15 minutes)
I hate this cast...splint.

One Week Report

Today marks the one week point since I've had my ankle arthroscopy.  Surgery is a completely new thing for me (I don't count Lasik as surgery), so I'll recap what I've learned, but first, let me go over the last few hours.

So, last night, even though I was on the Oxy, I continued feeling all the sharp twinges and burning in my ankle.  It was decent during the day, but I guess it does get worse as it get toward the evening.  However, I think I did discover one of the sources of the problem (other than the cutting of 2 holes in my ankle).  I mentioned that when I bump the cast, it hits my ankle on the inside and then it flares up.  Well, I think it's actually one step further.  First off, I should probably describe the cast.

It's basically a splint that run along the calf muscle and the bottom of your foot.  It's basically a cup that the back of your leg and foot goes into...think of a cast, but then the top half of the cast is gone.  So my leg goes into the bottom half the cast and then it's stuffed with cotton (at least that's what it feels like) and then wrapped all the way down with a large elastic bandage.


From what it feels like, the hard shell also surrounds the bottom half of my ankle.  I think since the swelling has gone down (I'm guessing this since I can't actually see), the cast has been able to move around a bit.  Well, last night, I was feeling these sharp nerve twinges waaay more than normal.  It seems like the cast had started rotating a bit, and the hard edge of the cast started to dig into the area of my incision.  I start rotating the cast the opposite way, so that the soft bandage part was on top, and it instantly started to feel better.  I still felt tingles and the heat sensation, but the sharp twinges seem to have stopped ( or at least occur less often.)

I think the Oxy still helps with the ongoing tingles and how sensitive the area is, so I'm gonna continue taking it...but it does seem that the cast was part of the problem.  So, hopefully that didn't cause any further damage and add to the healing process.

This morning, I woke up with no major pains...I did notice that upon getting up, I still feel the rush of heat move to my leg, plus the associated tingles.  I'm hoping that's more indicative of the blood all rushing downward after being elevated for so long versus being an actual nerve injury.  As soon as I get up, I basically keep my leg completely still while I wait for the rush of heat to go through the leg, and the eventually dissipate.  Once that passes, I can pretty much crutch around without too much problem.  It's about 1:45pm now and it has been happening every time I get up so far.


One week lessons learned
As promised, here's a recap of lessons learned so far...I'll break it down:

Surgery:

1. Prep your house for your recovery areas before you go in.  I set up my beds and cleared paths for crutching and it helped tremendously!
2. Inserting the IV needle is probably the worst part of the actual surgery. 
3. Scratch #2, failing to insert the IV needle twice before finally getting it in is the worst part. 
4. General anesthesia, while freaky, turned out to be a no biggie.   
5. Don't try to do too much after waking up!  Take your time, and don't let them rush you into anything!
6. Lorna Doone cookies post surgery are amazing (so are cupcakes)

Post Surgery:

1. I've got post-op anxiety big time...
   Google + downtime + new and painful experience = anxiety
   If you're like me, this can't be helped...just try to learn as much as you can of what to expect before the surgery.   Ask lots of questions!
2. Nerve block can last past 24 hours.  I saw a forum post on this, and most people averaged from 24-72.  
3. Nerve block = foot doesn't work right.  I've only found 1 site that specifically said that you will not be able to move your toes while the nerve block is in place.  All other sites, says that it just makes your leg numb (duh)
4. Call your doctor and ask questions...if something doesn't feel right, ask...if anything, maybe it'll settle your nerves so you can sleep and heal better.
5. Take your painkillers that they prescribed.  They are there for a reason...don't tough it out unless you have a bad reaction.  The more they give, the more they expect you to feel it.
6. Ask for help!  I don't know where I'd be without my girlfriend or my parents to help me.  This is not a time to be selfless...I'm getting a bunch of help and still managed to fall over a couple of times on my own.  (Also, managed to spill drinks everywhere)  At least you can minimize these accidents with those who are wiling to help
7. Try not to freak - I have problems with this...but it's something that I need to do, so I'm listing it.

Day Seven

Well, masochistic me decided to see what it'd be like to be off of the oxy again for a little bit last night.  I had another scheduled dose at 9:30, but I decided to skip it and just take one at bed time.  There's definitely a difference, but it wasn't agonizing or anything.   I think the worst part of my pains is probably exacerbated by the morning time when I try to get up too quickly.

After skipping, I started feeling tingles occur a little more often, even while I had the foot elevated.  I also felt the slight burning sensation on top of my foot.  I'd say the burning pain, felt similar to a sunburn...so maybe a pain of 2 on the scale.  The tingles are just annoyances...1 on the scale.  However, I also feel the twinges when I move the wrong way.  These guys, I'd still give a 4.  I don't think it'd be something that I'd be able to run through, if they happened consistently.  Again, they seem to happen when I bump the cast and the cast bumps a part of my ankle...so hopefully, my running shoe isn't gonna bump the nerve or anything. 

I wonder how much this warming sensation is part of the big, honking cast on me.  I know it has to be part of the whole nerve thing, 'cuz the sensation happens instantly and I can actually feel it spread.  I'd be completely comfortable one second, and then I just feel as if I just walked next to a heater blowing hot air (as opposed to cold air as heaters often blow).

Anyways, so experiment without oxy showed some difference, but I didn't go from a 0 to a 10 or anything.  However, I do think the Oxy is reduces the occurrence and consistency of these effects. 

I took an oxy before bed and found a comfortable position to sleep in...I woke up a little past my dosage time...no pains, just tingles.  Took my dosage and then went back to sleep. 

Today, I'm feeling tingly all over the foot. It's still a normal color.  I had maybe one instance where I bumped the cast and felt a more painful twinge.  I'm gonna sticking with the Oxy for my normal schedule today.  

Side Effects of Oxy
I'd say I'm relatively ok when it comes to taking the Oxy.  I do think I get a bit sleepy within the first 15 minutes of taking a dose.  Not sure that's the oxy's fault or just my own laziness...but it's been pretty consistent timing.  If I'm reading something, I'd probably start dozing off.  I'm not out of it the entire 4 hours, though...I can probably take a power nap and then be good the rest of the time.

I mentioned that my heart rate has been pretty low.  Not sure if that's coincidence or not.  Again, my heart rate is normally pretty low.  But being consistently in the low 40's, is low, even for me.  It is supposed to be a side-effect to look out for (along with shallow-breathing, which I don't think I have), so it's something to keep in mind if you start taking.

Visitors!
Ok for those of you who may be laid up, like I am...never underestimate the positive effects of visitors.   My parents came over to end multiple days of boredom.  They brought over some food and we just caught up on how the progress is going.  Mom was kinda enough to help with some of the chores that I can't really take care of right now.  It was really a nice change of pace...my dog, Kodo, who has been really bored with me, was even more ecstatic at the visit...even the kitties were ecstatic. It was a nice change up to my normal routine, and good to get a little different food in my system.

Shower!
This isn't the first time that I've tried to wash up.  I'm kind of on the every other day plan.  I won't get into the nitty-gritty detail, as I'm sure no one wants to hear that...but this is another thing never to underestimate!  While I can't actually get the cast wet at all, it was nice to at least get a refreshed feeling every once in a while.  I basically have a soap towel, a wash towel and 2 dry ones.  I wrapped one of the dry towels around the knee of my bad leg to catch any water that wants to stream down into the cast.  Then I just wash up just like any other normal hobo would do.  I actually haven't shaved since the surgery, so I'm actually looking the part as well.  Still refreshing though!


After my parents left, I just felt the constant pins and needles all over my foot and ankle.  I think I had the leg down for a little longer than I should have...(really only maybe 1 hour)  Time to go back to my boring elevation.  18.5 hours until I officially his the one week mark. 

Day Six - The wonders of oxycodone

I actually posted a message on a forum about the nerve twinges, asking if it was normal...here's one response that I got:
"Nerves are really delicate, and surgery tends to freak them out. Being brushed against or even just exposed to air can cause weird nerve symptoms for weeks to months after the surgery. Permanent and significant nerve damage is rarer.

After my ankle arthroscopy, I had this "electric shock" sensation on my last two toes. That faded within a few weeks as I healed. Half of my big toe was completely numb, that went away 14 months after the surgery. A LOT of us experience weird nerve symptoms, most of them go away or decrease significantly.

Also, some of the tingling may just be from swelling. Keep elevating, be patient, and DO mention it to your surgeon at your scheduled follow-up.  "


I'm not sure if I should feel at ease with this or not...but at least I'm not alone. 

So yesterday evening was a little more on the painful side.  As I mentioned, I tried to swap to Motrin, which I will go ahead an call it a failed experiment.  I guess it doesn't really help too much with nerve pain, but my hope was that the nerve might have been just aggravated by swelling, and the anti-inflammatory meds would have helped with that.  I was getting a bunch of tingling before bed, some twinges and the warm sensation before bed.

This time, I decided to switch back to the Oxycodone.  Unfortunately, since it only lasts about 4 hours, I was expecting the worst as soon as it wore off in the middle of the night.  I took an Oxycodone just before falling asleep, right around 1am.  I woke up around 4am.  To my groggy joy, I didn't feel any pain.  I decided to slowly move my ankle around in the cast before getting up to use the bathroom.  In my weird way, I felt this would warm it up enough so that nothing gets kicked off when I finally get up.  Well, not sure if it was that, or the Oxycodone, but I got up pretty much unscathed.  The only thing that I felt was the warming sensation in my calf muscle.  I felt it was close enough to the next dosage that I would just go ahead and take another Oxy and then head back to sleep.

I woke up at around 9am, again, no major stinging pain.  I'm guessing the Oxycodone has to be the key?  Well, whatever it was, I was just glad not to start off the day in any major pain.  I laid in bed again, letting the ankle warm up a bit, before getting up, when I got a call from the surgeon's office.  Perfect timing!  I described the pain that I was having and asked if it was common.  She said that it was a common pain, and it might take "some time" for it to go away.  Not sure what she means by "some time", whether it's a few days, weeks, months or years.  She also said that tingling was common as well.  That made me feel a little better.

She also said that in my follow-up appointment, I should be getting rid of the cast, and they will allow me to walk for the first time also.  That'll be a relief!

Pretty much a standard post-op day...I'm still going to keep my foot elevated.  I am still feeling an occasional sharp, burning pain and warm sensation...but it's not radiating through my foot.  Unfortunately, that with me on the wonder-drug keeping the pain at bay.  Can't imagine what it'd feel like without  (is this how pain-killer addiction starts?)

Day Five - Return of the pain

Well, this morning didn't fair quite so well.  I woke up around 2:30am, which was well within the dosage for the Motrin that I took (took it at midnight), and I felt that familiar stinging pain.  It basically started in the right side of the ankle (probably where the portal was), but then a warm feeling resonates down to my toes.  It wasn't terrible...I'd rate it at about a 4, but more due to the shocking nature of the pain.  It went away quickly though

I didn't take another motrin, as the bottle was unfortunately out..so I just went back to sleep and woke up again at 6:30am  I felt another sharp sting...same area, but the warm feeling was a bit more of a burning feeling.  It wasn't agonizing or anything, but still very uncomfortable.  Still about a 4...while the sting eventually died down, the burning sensation just died down to a warm sensation, and then eventually just dissipated. 

It seems these pains get kicked off when my cast gets bumped in a certain way that ends up bumping the ankle on the inside.  The other thing is that I'm not feeling these pains when I'm moving my foot around in the cast..so it's got to be either randomly happening or just in a very specific spot.

I'm trying to hold myself from freaking out (as you've noticed I often do).  The only thing that I read on the internet about this (as related to ankle arthroscopy) is that there's a "small" chance for nerve damage.  Nobody says anything about whether at least some nerve pains are a normal part of the healing process for the first few days.  I guess I can't imagine the nerve not doing some weird things considering it's moved around and stretched during the surgery.  So, being that it's only 5 days out of surgery, I'm trying to keep perspective.

I guess that's why I'm writing this thing...in case anything else goes through the same experience and has similar issues or concerns.

Day Four

I got another good night's sleep last night.  I took another Oxycodone around 2am before bed, and then fell right to sleep.  I woke up around 7:30am, no stinging pain this time, just naturally woke up.  I took a second dose of Oxy and then fell back asleep until around 9:30.  While I didn't feel any stinging pains like I did yesterday morning, I did feel some funny twinges in the same area.  I'd say maybe a flash of 3 on the pain scale.  I slowly got out of bed, and decided that since yesterday I had a few sharp stings, that today would be another elevation day. 

I basically laid in bed most of the day, getting up for food.  I just took it easy and made sure that I took my pain meds on time.  During the day, I decided to switch back to Motrin.  The couple of times that I did get up, I didn't feel pains save a few small twinges.  One of the things that I noticed today was that my resting heart rate was crazy low.  I think at one point it was down to 39 bpm.  I am usually in the high 40's low 50's...and the day of surgery, it was in the 60's....so for it to be < 40 is quite a difference. 

One of the other things that I've noticed is that even though I'm getting a good amount of sleep the last couple of days, I've been feeling really tired.  I know I'm spending most of the day lying down with my ankle propped up, I feel like I can doze off at any moment.

The leg is starting to feel generally achy...kind of a "tired" feeling.  I also feel pings and tings thoughout the day, but nothing that has caused me to wince, thankfully.  I'm guessing they are occurring at the site of the portal incisions, but can't tell for sure since I can't see them.  The good news is that it feels like I'm getting more mobility back...The cast is preventing me from going into a full plantar or dorsiflexion, but I feel like I can put more pressure on the cast when I try.  I can also move my foot left to right.   

This cast can't come off quick enough.  It's the waiting game that bugs me...having to wait 2 weeks before knowing if anything has gone wrong or telling if my issue has been fixed.  I keep reading on the internet about how doctor's allow their patients to start walking the day after.  At this point, I can't imagine myself walking on my own yet.  The conservative treatment is frustrating, but probably will be better in the long run.

So, pretty much a small improvement over yesterday, but also took it really easy today.  

Day Three - Starting to feel again

I actually got some decent sleep last night.  I went upstairs at about 1am, and I was already pretty tired at the time.  I don't remember when I actually fell asleep, but I woke up to a stinging sensation in the right side of my ankle.  I'd say it was about a 4 on the pain scale.  Since this is the area where the Saphenous nerve was blocked, I'm guessing the pain means that the block finally wore off.  I reach to my calf that was numb before and I had full feeling.  So, the Saphenous nerve block took about 51 hours before it was restored.  Again, wasn't too worried about this, since the bock was only sensation versus motor skills, but still good to know that I can feel again...even though that it includes the pain.

I had left my painkillers downstairs.  The stings kinda resonated in the cast...I think there were portions of the cast that were riding up next to the incisions, so when I moved my foot, it pushed it again the cast causing it to sting more.  I think I'm gonna take Motrin instead of the Oxycodone today.  It hurts, but not excrutiatingly, so no need to go overkill on the pain meds yet.  I just took two and we'll see how it goes. 

Today, I'm going to try to be up and about a little bit more.

Evening update:
The ankle wasn't too bad for the rest of the day. I tried to sit upright a bit more for things like writing is blog or eating...versus my usual and doing them while in bed. I did experience another sharp sensation of pain, similar to what I had woken up in the morning with. I was beyond the duration of the last dose of pain meds and was sitting upright without elevating my ankle. I was trying to shift positions and was dragging my cast on the ground, when I felt that sharp sting on the top part of my foot. Maybe about a 4-5 on the pain scale. It was followed by a bit of a burning sensation that radiated out toward my third and fourth toes. It only lasted for a few seconds, but was jarring enough for me to instantly pain med myself and elevate for the rest of the night.

This is a bit concerning since it sounds like it's nerve pain of the superficial peroneal nerve, which is what the doc said would have a 7% chance of injuring. It's still early days, so I'll try not to obsess too much. I don't feel it all the time, even when I'm moving my foot around in the cast. Just that once in the morning and then again in the evening, both time were out of the pain killer range.

I made sure to take an oxycodone before bed and keep my leg fully elevated.

Day Two - Overnight and the Next day

I don't know if it was the extra sleep that I had from the surgery, or the stress about the nerve block, but I barely slept a wink last night.  It was probably the former.  I was told to take one of the painkillers before bed, to stay ahead of the pain.  Which I did and was hoping to feel drowsy from it.  Unfortunately, my mind couldn't help but focus on the block.  I kept doing a pinch test on my toes (yes, I'm a freak) to see if I felt anything (i.e. checking to see if the nerve block was starting to wear off).  My middle toe was the only one that I felt any sensation...after a few hours, 4th toe started to get a little feeling, though still numb.  The big toe and the pinky were the ones that had no sensation whatsoever.  Then I would hop on the iPad and tried to look to see if anyone had a similar experience.  Always a bad idea...it just stresses you out more reading the worst case scenarios.

It wasn't until around 4:30 am when I finally dozed off for about an hour.  Lather, rinse, repeat...i even tried to take my mind off of things by watching videos on the iPad or reading articles.  I was able to doze off for about 30 minutes from 8 - 8:30...

I finally got up around 10am, toes still numb.

Getting up  and crutching around actually helped the most trying to keep my mind off of the numbness.  I did have a couple of things that I needed to do post-surgery.

The surgery center also gave me a follow-up call today.  They were extremely nice.  They asked me a number of standard emergency follow-up questions, like if I'm bleeding through my bandages.  Do I have a fever?  Have I been able to eat?  Everything checked out...fit of health for me, cept I was still all numb, so I wouldn't be feeling any pain and I have a honking cast on the leg so I wouldn't be able to see if I'm bleeding through.  I again asked about the numbness and they said that the nerve block could last up to 48 hours...

I also called and schedule my follow-up appointment.  I had originally thought that I'd be off of my foot for just a week and then be able to try to start walking.  But they said that the follow-up appointments are always two weeks out.  Arrgh, another 2 weeks in the cast/splint thingie is gonna make me crazy!  I asked the about the numbness (you can tell where my focus was today) and they actually said 72 hours!  yeesh...

Nerve block finally breaks!
It was about noon and I finally started to feel drowsy again, so I went back upstairs to try to sleep.  I laid there for an hour and dozed off for another 30 minutes.  I woke up and something felt different...I was "slightly" able to move my big toe up.  I wasn't quite sure, but figured I'd mark the time at 27 hours, when the block started to finally settle.  I kept wiggling it, and it started to feel more and more comfortable.  The big toe was starting to break away form the pointer toe.  I still wasn't able to dorsiflex my ankle, but this was such a big relief for me.

Fast forward 3 hours later, I'm still in bed with no naps....Lots of toe wiggling...and I was finally able to feel a bit of dorsiflexion in my ankle.  So, I started focusing on that now.  It was at about 30 hours from the inital surgery for this to wear off as well.  Things are still a bit numb, so I'm not sure how much range of motion I have.  Also, the point of the cast is to restrict movement, which may also be prohibiting the movement.  But I didn't get the helpless feeling of thinking about a movement and not seeing anything happen.

Pain starts
So with the nerve block starting to wear off, the pain twinges started.  They weren't bad.  Mostly just little pings of pain, both on the left side and right side of the ankle.  Nothing major, especially considering the pains that I've been through to get here, so I just went ahead and took another Oxycodone, and the pains went away.  I may try switching to advil or something, but Becky reminds me that some of the drugs don't mix well...and they noted that in some of the documentation they sent to me.

One last thing that i notice before ending this entry for the night.  While the nerve blocks are wearing off, I do notice that the skin on the outside of my calf is still fairly numb.  It hasn't changed in a while.  That sounds like the Saphenous nerve, which I believe was the second nerve block.  It's also the nerve that Dr. Junko said was the 7% change of injury.  It doesn't have any motor function, just sensation...so I'm not too worried about that yet.  famous last words.

Anyways, that's it for day 2...as long as nothing new comes up.  Night all!

Nerve Block and my Freakout

So after I got home, I went straight to bed.  I had planned to pretty much veg the rest of the day in bed.  So I crutched up to my bedroom and elevated by leg with pillows  My leg was completely numb, primarily from the nerve block that they had given me.

What is a nerve block?  Basically it is an injection that is place on specific nerves that prevents signals from getting through.  It pretty much made my leg completely numb.  The sensation is similar to the feeling that you get at the dentist when they inject your gums with Novocaine.  In all the paperwork, and many sights it says that surgical nerve blocks can last up to 24 hours after the surgery.

What I wasn't prepared for was the fact that the muscles in my leg had stopped functioning as well.  My impression was that, similar to Novocaine, that it would be numb, but you still had control of your muscles.  So, when I wasn't able to lift my toes upwards, it freaked me out.  I also wasn't able to move my ankle upward at all (dorisflex).    One of the common risks with any surgery that has to do with nerve damage.  Nerve damage can basically cause numbness and in some cases paralysis.

So as I'm lying down in my bed, and staring at my toes sticking out of my cast/splint...and trying to move my toes but can't...my mind instantly went straight to the worst case scenario.  I wondered if something had gone wrong.  It may be my own phobia, but there's nothing else more frustrating than the helpless feeling trying to get your mind to do something that your body does not want to do.  It's downright scares me.  So, trying to concentrate and will my toes to move, and seeing them paralyzed freaks me out.

Wiggle your big toe...

I asked the nurses about this before I left, and they said it was normal, and just to wait 'til tomorrow.  Again, the paperwork said it should only last 12-24 hours.  Even the medical websites say around 24 hours.  Well, this got me so freaked that I couldn't even get to sleep after the surgery.  I kept doing my internet research.

I asked my brother, who had surgery to fix his achilles tendon.  He said the exact same thing happened to him.  He even said that it lasted about a week.  So, that put my mind at ease a bit.  My mom called a family friend, who happens to be an anesthesiologist, and he said to wait it out. He also said you can check the blood flow to make sure that the wrapping aren't too tight.  Just squeeze the toe for a few seconds, and then check to see if it return to normal color or if it stays white for a few seconds.  My aunt, whose a retired doctor, who also was concerned that the wrapping were too tight, said to make sure that the base of the nail color are purple.  That would cause the  increase numbness as well.

None of these were the case...I just had to wait it out.  I was stressing about it all night.

Surgery day

Full disclosure in this post... 1) I'm writing thing on an iPad, so if something I write complete makes no sense, blame auto-correct or my inability to type on this keyboard. 2) I'm actually writing this post a day late since I spent most of the day recovering yesterday.

Surgery day
I actually slept decently well the night before. I figured he more I slept, the less I would have to keep the family waiting for me post-op. Becky and I left around 6:30 am and it was about an hour trip to the hospital.

When we got there, I just went straight to the registration area and they had me just sign a few things, hand them my insurance card and I'd, and then they immediately took me back to the prep room. Becky was able to sit out in the waiting area until I was ready. They gave her a pager in case she was needed at any point. My parents were also planning on coming up, so I was able to add their names to a list for them to wait for me.

I wast taken into the area, and the nurse asked my name, date of birth and type of surgery I was having. She let me stop off in the bathroom, and then brought me to one of the beds in the prep room. She asked me a number of questions about my history. Things like if I had diabetes or diagnosed with heart problems. She asked about allergies, and them had me repeat my name, date if birth and them who my surgeon was. Then she gave me a consent form to initialize and check. Another round if asking about my name, dob and dr/surgery question...I guess they want to be sure that they're doing the right surgery in the right person. Can't complain too much about that! They then gave me a pill to help calm my nerves. I told her I didn't really need it, but she said that they wanted me to take it anyways. I think I heard it was xannax?

Afterward, she had me change into the gown. Basically just down to my underwear and then the gown. My clothes were placed into a clear plastic bag to go with my after the surgery was over. She had my lie down in the bed and she out a bunch of warm blankets on me. After I got comfy and warm, she started to try putting in the needle for the IV drip. Unfortunately, although she was able to find my vein, she wasn't able to get it all the way in. Needless to say, it was a bit painful. So she took it out and tr to warm my veins again.

Another nurse came in, and went through another line of questioning. She asked the same questions about history, allergies. She also took my vitals...blood pressure was a little high, 144/70 but pulse rate was a nice 51.

The first nurse came back to take another stab at inserting the IV in my vein. She decided on a different vein this time. She had t twist and turn it but she managed t get it in. Apparently not all the way again, because when she started the saline drip, it didn't take again. So she prepped my left arm and called a different nurse. She seemed to have done this many a time, and got it into the new vein. She was a little more forceful, and it stung like a mother (no offense, mom) but rather have one painful hole than three. I never had an IV before...it stung for about 2 minutes and then the pain kind of went away. When she started the saline, I felt a cool sensation go up my arm. It didn't hurt, but was just interesting to feel how the blood travels.

Then the anesthesiologist came He asked me similar questions about my history. He didn't sound too worried when I mentioned about my parents having a history of heart issues or when I mentioned that my heart rate sometimes spikes when I run. He said that at my age the heart rate was nothing. Then he mentioned about a nerve block that he would be applying which would involve two Injections, but would allow me to be pain free after the surgery for about 24 hours. He asked if that was ok, and I told him yes. So he said that I was all set and would see me in a few.

They then called in Becky and my parents t visit me before going in. They only allowed two at a time so mom and dad switched off. We had a brief chat, said our good lucks...and the nurse brought me to the anesthesia area.
they hooked me up to a pulse rate monitor which was nice to see I didn't have irregular heartbeat or anything. She had
She had me turn over on my back and switch my IV to another drip. My surgeon, dr. Junko, came in and talked to me. He in and confirmed the procedure. He gave me the opportunity to ask questions. I asked him about the procedure in more detail. That it was not just shaving the bone spurs but also a comprehensive cleaning of the ankle. Also asked him about post op which he said I would be non weight bearing and would order physical therapy of needed.
I didn't have any questions and then the anesthesiologist came in to start the nerve blocks.

He start with one injection, though I can't remember the placement of the needle. It was pretty standard and didn't hurt than any other injection. The he put a device on and said I'd feel some twitching. I'm guessing this was for the sciatic nerve block (more to come on that later). He said this was gonna be a little rougher. I remember feeling some pains but nothing too sharp to anything.

His assistant said that she was gonna start to give me "the medicine" She switched my IV drip and attached it to another bag. I was staring at the connection and then that was it.

Recovery
I woke up to a new person calling my name. Once my eyes were open, she said "you're all done!". I looked down and saw the splint cast on my leg. I was really groggy. She asked how my stomach was and then asked if im feeling ok..no pains or anything I said I was doing well. She then asked me if I wanted ice chips. Not sure what ice chips are for, but I passed. I immediately felt the scratchiness in my throat and a taste of plastic in my mouth.  My first question to her, "was I intubated?"  Kudos to me for the usage of that word in my uber-groggy state. She said yes. I felt too goggle to get up, so I just laid there hoping that she would just let me go back to sleep. I asked her how long I was out between now and the surgery and she said about an hour. She asked if i could move my toes and I did, but couldn't lift them up, which freaked me out.  I didn't mention anything about it, though...and so after clearing me, she rolled my bed back to the pre-op area where I started. 

The familiar nurses were still there.  They went to get my family. Beck and my mom came in which was a wonderful site.  I started to sober up a little managed to keep up a small conversation with them. The nurse asked me if I wanted cookies and a ginger ale. Um...yes please. Then she asked if Lorna Doones were ok. Um...yes please.

Post Surgery my Lorna Doone's in hand

As much as I love me some Lorna Doones. I had to just nibble them. I was a little woozy after the first few bites. I finally managed to sit up, and talked with beck and my parents (again, mom first and then dad, due to the 2 visitor max policy). After knowing that I was ok, mom and dad decided to take off. The nurse gave me crutches and then called for a physical therapist to come down and show me how to use them.  The PT was this 5' tall gal, maybe weighing in at a buck ten soaking wet. She was showing me how to use the crutches up and down he stairs. She stood in front of me the entire way down the stairs so that she would brace me if I fell. Here I'm thinking if I fell I might snap her in half. I did make it down the stairs...but exerting myself so soon, made me start to feel nauseous.  We raced back to the pre-op room and I laid there a bit longer. After about 5 minutes we were off. One of the nurses wheelchairs me to the door where Becky picked me up. No major problems driving home..though we did have to detour to get a prescription of the painkillers that they gave me.

We got home around 4pm and I went straight up to the bedroom to eat and catch some zzz's.