Just over three weeks since my ankle replacement surgery, and the big event of the last week has been my first follow-up visit to RNOH since the surgery.
In preparation, made my first journey down the stairs at home since coming home from surgery - despite the presence of my brother, decided to be ultra-cautious and do it using the inelegant but effective "bum-shuffle" method!
Taxi arrived bang on time, with a driver I know well, and we passed most of the journey talking about cars. Once again (this luck surely can't continue), both the M11 and the M25 we're flowing remarkably smoothly, so as a result (having allowed a "cushion" for traffic), we actually arrived at Stanmore almost three-quarters of an hour before my scheduled OPD appointment.
They really seem to be well organised and patient-focused there; first, a porter appeared within less than a minute and wheeled me to the admissions desk, where I was quickly processed and asked to take a seat. I imagined I would have to wait at least until my scheduled appointment time before I started to get "processed", but to my delight, within five minutes, another porter appeared to take me straight off to my first stop, the plaster theatre.
There, I was wheeled straight in, and helped up onto a table. The plaster nurse then cut away my existing cast (easy, just needing scissors, as I only had a back slab), and then for the first moment of truth as the surgery wound was uncovered.
Whilst the actual incision was somewhat longer than I had anticipated, the really good news was that the wound was healing really well - the nurse did not need to do anything at all to it, and even my untrained eye could see that it looked "healthy", confirmed by the nurse.
A quick wash of the foot, which was probably a bit rank after more than two weeks encased in plaster, and then the staples securing the wound were taken out - mildly uncomfortable only.
They were then ready to do the new plaster, and you could have knocked me over when the nurse produced a colour palette and asked me to select my preferred shade! Just like being in John Lewis' upholstery department! I went for the rather fetching bright red.
This time they put on a full below-knee cast, which I shall be wearing at least until my next follow-up, four weeks away. The finishing flourish was a soft, velcro-fastened "over-shoe" to give a flat walking platform on the bottom of the cast.
As if by clockwork, the (same) porter arrived the moment the new plaster was finished, and took me back to the foot and ankle clinic where, after just a couple of minutes, I was wheeled in to see Mr. Goldberg's SHO, Dr. Amanda Ifie. Deirdre Brooking also joined us, and made some notes on my TARVA trial file. We reviewed my progress since the surgery. I was pleased to get the news that the cysts they had dealt with during the surgery had revealed nothing untoward on a biopsy, and more pleased still to be told that I could move immediately to full-weight-bearing on my operated ankle.
After a routine blood test next door, I gingerly made my way back under my own steam to the waiting room, and was able to tell my driver that I was ready to go home at least two hours earlier than expected - great news!
Well, what a contrast the last few days since have been, now I can put weight on my ankle. Able to move around the house fine by myself so life has become infinitely easier (for my wife also!). I did find one problem - because there is a significant "heel" on the cast, and with the over-shoe, I was quite lop-sided, which caused a few balance problems, but fortunately I dug up a pair of walking boots with a deep, cushioned heel; one of those on the right foot succeeded in evening things out.
The only slight negative since getting back home is that I have been feeling weaker than I had hoped for, but that's my fault for not setting my own expectations appropriately - improving day-by-day, but I do need to rest quite frequently at the moment if I am standing/moving around doing things.
Will be working on building up my strength/stamina over the next few weeks, and looking forward to my next OPD appointment in mid-August, when there is a chance I believe, and depending on X-rays and - obviously - the view of my consultant, that I may finally be able to cast off the cast!
I need to say once again what a great bunch of people they have at RNOH - I couldn't believe how quickly and efficiently I got processed through all my steps there last week, and always with politeness, professionalism and good humour - thank you all.
So, feeling pretty good about things at the moment - hope that continues as I start to actually use my bionic ankle in the future.
See you here again soon.
David
ReplyDeleteHi David. Sorry for the delayed reply, however, like you, I was so busy putting all the plans in place before hospital admission, the time just ran away. So pleased to hear you are doing well despite the practical challenges you have faced. I can relate to many of your frustrations and, independently, also purchased a leg rest and cast shower protector which have been invaluable. And yes, the Lactulose is proving to be a daily requirement!
I had my ankle replacement surgery on 23rd July so am now 12 days post op - my first visit to the plaster room was 24 hours post op to have dressings changed and cast adapted with Velcro straps. However the wound was still a bit wet so they just changed the dressings. I went back again 3 days later and then had a new cast fitted, confined to my hospital bed in the meantime. I go back to the Plaster Room again 18 days post op for stitches out and another cast (I have also had my Achilles' tendon lengthened as I haven't been able to stand flat footed for 40 years so they are gradually repositioning my foot - my surgeon gave me the wonderful news that he got more than 90 degrees in theatre). I was therefore in hospital for 6 nights. The Nuffield Orthopaedic Centre at Oxford was fantastic, without fault, except the food!
I find the swelling/pain comes and goes but is mostly confined to the top of my foot, just below my toes. The foot certainly does NOT like being below heart level for long. Did you experience any pain or did you keep taking codeine 24/7? I have taken mild pain killers during the day and 60mg codeine at night and this seems sufficient.
We are very lucky to live in a spacious bungalow which is already equipped for my mobility needs eg swing out shower seat, high loo etc. I am therefore able to get around from room to room in a wheelchair (now fitted with an extended leg rest to keep my foot elevated at the dining table) as my other joints prevent me from taking full weight through crutches. I have been allowed to partially weight bear since day 5 "as much as you find comfortable". Well, in reality, it isn't! So I am currently only putting a little weight through the foot when transferring from wheelchair to bed/sofa/loo.
I had the STAR design. Do you know what you have?
I shall look forward to reading your next post ..... whilst appreciating that every TAR patient comes to the surgery from a different starting point and, therefore, their recovery is going to differ also. Having read other patient experiences on the Internet a while back, and based on my own experience of other joint replacement surgery, I had long ago decided to keep recovery time expectations realistic .... I'm giving it 18 months! I remember reading an American bloggers summary of her TAR recovery ..... at 6 months it felt good, at 12 great, at 18 fantastic. I'd settle for that! Best wishes, Sandra