Saturday, April 26, 2008

Busy Week: My two week check

I have been so busy, that I have not had a chance to get on here and blog about my 2 week follow up appointment with my surgeon.

I went to see Dr. L on Thursday. As usual, it took about an hour before I got back to see him. He was very pleased at how well I was doing in terms of walking and activity level. I have no muscle soreness and I am walking with a normal gait. I can ambulate stairs without any problems. In fact, I have been getting yelled at by the wife for not taking it more easy. He was however displeased with the look of the incision on the left leg where I had the infection. It is still red and slightly swollen. I removed my steri stips on Wed. I could not take the itching and pulling on my skin any longer. I had some oozing from the infected site, although it was clear and had no odor. So, I finished my antibiotics this weekend and I am going to keep an eye on my leg to make sure that the symptoms do not get worse. I am a RN so Dr. L trusts me to care for myself and to come back sooner than my 6 week appointment if there are any other issues.

Signs of Infection:

  • fever of 100.5°F (38°C) or higher
  • severe pain in the area of the incision
  • intense redness in the area of the incision
    bruising.
  • bleeding or increased drainage of tissue fluid

Normal Signs after surgery include:

As an incision heals, it is normal to experience some redness, swelling, itching, minor skin irritation or oozing of tissue fluid, or small lumps in the skin near the incision. At first, the skin over the incision will feel thick and hard. After a period of two to six months, the swelling and irritation will go down and the scar tissue will soften and begin to blend into the surrounding tissue.

The good news is that I can go back to work next Friday and I can also began some light cycling at that time. No tension on stationary bike and no hills on my road or mountain bike. Got to ease back in slowly. He will not release me for any running until after he sees me on my 6 week appointment.

Sunday, April 20, 2008

Not a fun weekend!!!!

My leg did not feel too good this weekend. Every time I try and stand, I feel this tightening, pulling on my incision. It is not unbearable, but it is a new type of pain that I have not had yet. My incision on my left lower leg still looks the same. Pink, but no oozing or separation of the incision. I think that the Keflex (antibiotic) is keeping my leg from getting infected. Nzlife on the runners world forum had surgery on the same day as me and is feeling the same symptoms. Its probably fine but I have been taking it easy all weekend. I don't see my Physician until Thursday.

Thursday, April 17, 2008

Pushed it a little too hard today!!!

Tomorrow is one week since I had my surgery. I have been going nuts just sitting around. I am used to getting up at 5am and hitting the road by 0630 and going crazy until I get home at 6pm. Now I am expected to sit around, elevate my legs and watch the view. NOT TODAY!!! Today I went up and down my stairs several times. I took a walk in the marsh behind my house. I barbque'd chicken for the family and I drove my car to the store. I finally got home at 8pm and big surprise, my leg is aching.... not quite throbbing, but close... So I am watching a movie, legs propped up on three pillows and I'm waiting for the pain meds to kick in... My wife says I'm "one tough dude!" (interpretation: stupid)

Tuesday, April 15, 2008

Scar Tissue......

Staphylococcus aureus
As a clinical specialist for a pacemaker company, I know that anytime surgery is performed in an area where there is scar tissue from a previous surgery, the risk for infection is higher. My leg is no different. I noticed some swelling and tenderness in the suture line on my left lower leg this morning. It was a little pink around the edges of the incision. No drainage and I had no fever, however I knew that something was brewing. When my wife came home tonite, she looked at it and noticed that the pink area had become red and spread and was still puffy. I called Dr. L's office and let them know what was going on. Dr. L was in surgery, but he wanted me to come down to the hospital where he could look at my leg in between surgeries. Needless to say, he agreed with me that it looked like an early infection and he put me on some antibiotics. Word to the wise.... better to be too cautious than to wait too long and end up with a bad infection. There are some pretty nasty "bugs" that can cause tissue to become necrotic. We are talking hospitalization and debridment... Not fun.......

Monday, April 14, 2008

What motivates us to succeed?

Running... Its like a drug is for an addict. The first time I tried it, it was because I was talked into trying it. Did not really want to. I did not want to feel that sensation of breathing so hard my lungs hurt. I did not want to feel my legs ache, my shins become sore and my side cramping. Each time I began to run again, I found that my breathing became less labored. The cramping went away. Then one day it happened on a long run. I hit the zone. Like a junkies perfect high, I had become part of the trail. Part of the environment around me. My feet felt light and my breathing effortless.... As I begin my journey this summer to get back into the shape that I was, I look foward to hitting that pinnicle again. The feeling that nothing and no one can slow me down.

Check out this inspirational video: Whenever I feel down or bummed out about my injuries or my slow recovery back to running, I watch this story about a Man and his love for his Son. If this guy can do this for his kid, it makes my comback seem miniscule.

http://www.youtube.com/watch?v=8gm7XwtIJdM&feature=related

Third day post-op

I woke up this morning at 0830. The wife was running around the house going crazy trying to get the boys out the door so they don't miss the bus. She has been great. Even while I was asleep at 0700 she refilled my ice bags and placed them on my legs. The lack of swelling continues to amaze me. I expected so much more. I am going to keep elevating and Icing just as the Doctor ordered. I am walking with out assistance with a walker or crutches. I am taking it slow, but it feels great.

For four years or more I have felt this constant tingling in my lateral lower leg at the site of my old fasciotomy scar. Whenever I would tap the scar with my finger, I would feel a sharp numbness that radiated down into my big toe. This is called a positive "tinel". Now that the surgery is completed and the doctor has released the nerve from all of the scar tissue, I have no more numbness in the foot. The Tinel sign is gone. Amazing. Hopefully it will stay that way and no more scar tissue will form on the nerve.

I study birds, so I plan on spending my day sitting in the yard with my legs up and using my binoculars to "see what I can see". I can not stand sitting around. I cant wait until I can get off my duff and began rehabbing.... It will be here soon enough. I am thankful to God that my surgery has turned out great and that there have been no problems so far...

Sunday, April 13, 2008

Ace Wraps off after 48 hrs... "warning: a little bit of blood and drainage for the weak at stomach"


Finally took my Ace Bandages off today at noon. I was supposed to wait until this evening but they are irriatating me and everyone knows that the worst patient in the world is a RN, because we think we know everything. I am very pleased at the swelling. My Physician makes longer incisions than most, but that is because he likes to make sure that he does a complete release. On my left leg he had cut a lot of scar tissue off of the nerve so the incision is longer. Not bad at all. I have really kept my legs elevated and have been putting ice on them since friday. I can take a shower tomorrow, which I will be very glad to do. Pictures below...





Saturday, April 12, 2008

My night in the hospital

I am glad that I was admitted into the hospital for the night. My boys needed someone to be home when they got off of the bus and the last thing I want was my wife needing to babysit me postop. I have to say that the staff at the Michigan Orthopedic Specialty Hospital were great. From preop all the way to my discharge. They were very attentive to all of my needs and I never had to hit my call light once.



My room was a private room with a nice flat panel TV. I was placed on a Morphine PCA pump. This is patient controlled analgesia pump that allowed me to push the button and give myself morphine when I needed it. In addition to the pump I also had pain pills ordered. The first night I did not even attempt to get out of bed. I took a picture of my legs with my cell phone camera. They wrapped them in Ace Bandages and with only a couple of layers, my calves look huge.

If I can give one word of advice for those considering this surgery, do not feel that you need to be brave with the pain meds. The first 24 hours can be very painful, and there is no reason that anyone should have to suffer. The staff at the hospital that I was at had a goal of keeping patients pain level at a 3 or below on a 1-10 scale. I was a 2. Very comfortable, only hurt when I tried to move. Another word to the wise, Morphine can cause urinary retention. I found it difficult to urinate. I literally had to push hard in order to pee. The nurses told me that this is very common with Morphine pumps.

When I woke up this morning, I had breakfast and then the Physical Therapist came in to get me out of bed and see if I could walk on my two "carved up legs". I swung my legs around off of the bed and grabbing the walker stood for the first time. I surprised the PT who thought she was going to need to help me up, but actually the pain was not that severe. It is surprising how good you legs can feel after a night of Percocet and Morphine. I walked with the aid of the walker down the hall about a hundred feet and climbed some stairs. When Dr. L came in that morning he was surprised at how well I was doing. He was very hesitant on doing two legs at once because if I had no pain tolerance, how would I walk.

Dr. L talked to me about the surgery. He told me that the Superficial Peroneal Nerve in my left leg was totally entrapped in scar tissue. He told me that he cleared all of the scar tissue off of the nerve and hopefully the numbness I have been feeling in my left foot for several years should go away. The rest of the surgery was smooth with no issues.

I was discharged at Noon today. I went home with a bunch of prescriptions. Vicoden(pain), Ambien(sleep aid), phenergan(nausea), colace(stool softener) and Motrin. I am currently sitting here watching TV with Ice Bags on my Ace wrapped legs. I get to take the bandages off tomorrow. I have been constantly elevating and using ICE so hopefully the swelling wont be too bad.

April 11th. Surgery....

I arrived at the surgery center at 0930. After I was registered they took me into the preop area where they took all of my cloths, had me put on a beautiful hospital gown and my OR bonnet, and then the RN started an IV. The Anesthesiologist came over and did a quick assessment on me and informed me that I was going to have general anesthesia. I would be intubated and put on a ventilator during surgery. Sometimes the Anesthesiologist will perform a spinal for these types of surgeries, but since my Physician was doing a nerve repair, he wanted to be able to assess my neuro status afterwards.

Next came the PA (Physicians Assistant) who works with Dr. L. She asked me some general questions regarding my health history and medications. She also prepped my legs and marked them for the surgery. Shortly afterward Dr. L came by and asked me if I was ready. He reminded me that he was going perform two incisions on each leg. He would perform a fasciotomy on my anterior and lateral compartments on both of my legs. On my left leg he would attempt to release my superficial peroneal nerve from the scar tissue that had built up since my surgery in 2002.

My wife was allowed to come and sit with me in preop before I went in for my surgery. When the time finally came for them to wheel me in to the OR suite it went very quickly. I slid over onto the operating room table. As the nurses started to put equipment on me (blood pressure cuffs, grounding pads for electrocautery, etc...), the CRNA put an oxygen mask on my face and after about 30 seconds told me that he was going to put me to sleep now. That is all I remembered. This was at 1130am. Next thing I remembered is that I woke up in the recovery area at 330pm. Now for those of you who have never had surgery, it is a very weird feeling to wake up from anesthesia. It can be a little confusing at first. The postop Nursing staff will be asking you many questions regarding your pain statis. They will be taking your vital signs every 5 minutes. I had a plastic warming blanket on me to counter act the effects of the anesthesia which can often times make you very chilled and shaky. The warming blanket feels great. I did not have my glasses and I could not see. I had all these people asking me a million questions and all I cared about was seeing my wife. My legs hurt, and I could not see them since they were under the covers. The pain was not excruciating, and I think that they gave me some Morphine while I was in recovery. After a short while, when my pain level fell below a 5 on a 1-10 scale, I was taken to my room.

Thursday, April 10, 2008

Surgery Tomorrow

My surgery is tomorrow. 0930 in the am. I am glad for the early time. I do not want to wait around all day for it. I picked up a couple of large reusable ice bags... I will post again after I get back home from the hospital...

Monday, April 7, 2008

Preop Appointment

Today I went and saw my Surgeon. This is the appointment where he explains what he is going to do and what my recovery time will be. The waiting room was packed at his office and I ended up waiting 2 1/2 hours to see him. Dr. L has been at spring training with the Detroit Tigers, so he had alot of catching up to do since he has been back. While I am there, a Detroit Red Wings player shows up to see him and my apt is further delayed while he See's him.

My surgery is this Friday, April 11Th. After talking to Dr. L it is decided that I will stay over night. He does not usually do two legs at once and is concerned about my ability to ambulate when he is done. I agree to staying over night and find out that I will be under "general anesthesia". This is a very broad term and I will get more details on the day of my surgery.

I ask Dr. L how much time does he think I will need before I can go back to work. He says it will be a minimum of 4 weeks. I am hoping for 3 weeks. I am stressed because I know that my team needs me. However, my health is more important. I will also need some physical therapy.

For some reason I am nervous about this procedure. I have had quite a few surgeries in the past, but this one has me nervous. I do not know why. I will put it all in Gods hands. I just look forward to being able to run again....