Saturday, March 12, 2011

Tips to Aide Recovery

   The best thing I did besides following the Dr.'s orders to rest and elevate my leg was to rent an orthotic scooter for the month.  This eliminated the need for extensive use of crutches and really enhanced my mobility and independence.  I used it the first week primarily to go from the bed to the bathroom, then later to the living room where we stacked 3 pillows on a large foot stool to keep my foot elevated.  The pillows kept slipping so I sent my husband to the basement in search of some mesh that keeps loose carpets in place.  He couldn't find it but came back with a long forgotten roll of rubbery shelf liner that helps keep them in place.  We have wood floors with low pile area rugs in the living and dining areas.  The bedroom is carpeted and we took up all rugs in the kitchen and bedroom.  By week two, with my foot up at 90 degrees on the scooter, I was able to help with meal preparation.  I even went to one store in the mall with the scooter and out to eat several times.  When I go out to eat, I ask for a booth where I can prop my leg or an extra chair.  Unlike with crutches my leg is rarely vertical as it would be with crutches, and this has resulted in less pain and after the first week, very little swelling.  I did spend at least part of each day the second week in bed with my foot elevated on 3 pillows.  Now in my 4th week, I am down to two pillows in the living room, we are going out to dinner with friends tonight and tomorrow and I am spending very little time in bed.  I attribute much of that recovery to the convenience of the scooter.  I am walking more with a wedge shoe and two drug store heel lifts (0ne on top of the other) in my regular shoe to make walking less gimpy.  Still the difference in height between the two feet makes walking any distance awkward and so I use the scooter.  There is so much more freedom and independence than with crutches.  Unfortunately, the scooter is considered non-essential and so most insurance companies will not cover it even with a prescription.  Yes, they will cover crutches and wheelchairs, but that doesn't help mobility in the same way.
   I was instructed not to get the bandage wet, but every two days I feel a great need for a shower.  Fortunately we have a built in tiled seat in our shower and I put a plastic step in there that I can elevate my foot.  I use a tall kitchen can bag with draw strings and then duct tape the top to my leg so I can keep it completely dry while showering.  If you leave a row of duct tape around the top starting at the ties  you can reuse the bag over and over just applying new duct tape over the edge of the old tape and your skin for a completely dry seal just below your knee.  I can use the bag over and over again just pulling and or cutting off the new tape.
  Before I had surgery I went through my socks and since we live near the Great Lakes where it is cold in the winter, I selected an older pair of large warm socks and cut the toes off of them.  I then zigzagged around the cut portion of the sock on my sewing machine to keep it from unraveling in the wash.  I cover the toe with a knit baby premie hat volunteers used to knit for the maternity ward until they decided against using any homemade items.  My husband got one of the last ones when he had foot surgery and we kept it.  The Dr's office usually gives you stockingette and you can ask for another piece which works just fine in the warmer weather.  Pins come out this Wednesday.

Tuesday, March 8, 2011

My first Blog

   I am writing this blog because I have read things on the internet about hammer toe surgery that are scary.  Of course any surgery is something to be avoided; but I have been having a much easier recovery than I expected, so I decided to share information.  First and foremost, if you think you are a candidate for surgery, you need to find a top notch physician particularly one who specializes in feet.  Lets face it, if you were getting married and wanted a really good wedding cake, you'd ask your friend and do some checking around wouldn't you?  Then unless you had someone who offered to bake one for you, you'd probably go to some place that specialized in wedding cakes.  Well then, why go to any surgeon who says they can do bunions or hammer toes?   I have heard too many stories about botched bunion surgeries.  Why not go to someone with a good reputation who specializes in foot surgery.
   In my case, I went to a Dr. who specializes in foot surgery who did my bunion surgery over 10 years ago with superb results!   Of course I went back when I thought I needed hammer toe surgery.  He kindly put me off as he did with my left bunion since the bunion and hammer toes were not causing me severe pain and distress and said to come back when they became a real problem.  That was two years ago.  At that time, he suggested a small orthotic in each shoe positioned  by a pedorthic specialist that would push up just below the base of the tarsometatarsal joint and which would help straighten out the toes.  The orthotic is glued to the bottom of the insert in the shoe provided shoes have a removable insert.
   He asked what I had been doing to my toes as they were still quite flexible.  I had talked to an Occupational Therapist at a party some time back and she had suggested passive stretch.  The first 10 years of my professional life were as an OT so I understood the concept.  I did regular passive stretch (an over simplification) but basically without stretching so hard that they hurt, the procedure is to hold each toe or two toes at the same time in as straight a position as possible without hyperextending them.  The stretch is to be maintained for 5 minutes.  I set the timer on my I-phone and stretch while I am watching TV.  Warning!  Stretching too long can cause the tendons to contract even more.  Its a good idea to have one session with a Physical Therapist to go over the passive stretch technique so you do it correctly.  A lot depends on how tight your tendons are.  I started stretching when my tendons were beginning to show signs of tightening.  It took some time with once a day stretching to get them so I could straighten them out.  Surprisingly, no Dr. ever suggested I do this.
   My Dr. said to keep doing passive stretch but that it was not a cure and that eventually I would need surgery.    I also explained that I was using Gel Toe Protectors that I buy at Walgreens.  I cut the tip off and then cut the tube in two so as to position over the toe joint where it bumps on the shoe.  I also use moleskin I cut in short pieces to cushion the bottom of toes as needed.  He approved of everything I was doing, told me to get the orthotics put in my shoes (cost $30/pr) and to call him when the pain was such that surgery was justified.
  I am now in week three of recovery and doing very well.   On a personal note.  I am a baby boomer and have adult onset diabetes and am on an insulin pump.  I have been diabetic for 26 years and really work at maintaining good blood sugars.  I have no diabetic complications, good circulation and good sensation.  I also heal well.  I had four hammer toes repaired on my right foot.  This is the same foot with the previous bunion surgery.  Tomorrow a few helpful things I did before surgery and the two most important things that aided my recovery.