Post-Op Follow-up

I met with the surgeon’s assistant at 16 days post-op to have the stitches removed and to do a general check-up.

Since I had never had stitches before, I was worried about any pain. I left the steri-strips on my legs until this appointment, and I would recommend doing the same to minimize exposure to bacteria. Removal of the stitches (4 long ones total) was not painless, but I just laid down on the table and tried not to think about it. The assistant replaced the steri-strips and advised me to leave them on for 5 more days and not to swim until the incisions were completely closed.

Here are a few things that I found out at this follow-up appointment for which I was not entirely prepared:

1. My incisions and the area surrounding them are still numb to the touch, and this is normal for several months. In fact, my father had his gallbladder removed 9 months ago, and he is still numb around the incision.  The surgeon stated that this was due to the disturbance of nerves that are severed when the incision is made.

2. The level of physical therapy that you will require may vary, but my surgeon assigned me to go for 12 weeks, twice per week. I was unprepared for this time commitment, but I will keep everyone posted on how it progresses.

3. I was told that I would return to the gym around 6 weeks after my surgery. However, at this appointment I was told that I would be restricted to the stationary bike at 6 weeks. I would not be allowed to do any running, jumping, or heavy lifting for 3 months. The PA also said that I would probably still not feel like running at 3 months.

4. I am walking normally, with no crutches. I have a temporary disability permit for my campus that allows me to park very close to my building, but things are more or less back to normal in terms of mobility. The PA told me that as long as I am pain-free, I may move around as tolerated. However, I tire more quickly and am unable to climb more than one flight of stairs without getting tired.

5. My new nickname is Cankles McGhee. I have no ankles! My aunt, who is a PT, said that this is normal and that they will return as I bulk up my ankles again, but I was unprepared for looking somewhat like my grandma!

Thanks to everyone for the comments, and I hope that your treatment and recovery is going well. As always, please post any questions that you have about the process in the Comments section. Even though I am not a doctor, I can answer based on my own experience or you may receive an answer from a fellow reader!

Surgery and the next 10 days…

After braving the knife, I am here to talk about my experience with a bilateral fasciotomy / compartment release and the looonnnggg recovery that followed.  If you have any specific questions, I would be happy to answer them – just leave them in the Comments section!

The surgery was routine – a few hours in the pre-operating room, getting hooked up to machines, drawing on legs (“Not THIS leg… Not THIS leg, either!”), getting an IV started (“Someone forgot to bring their veins today!”), meeting with the anesthesiologist, etc.  The waiting game might get to some, but I was pretty tired and enjoyed the time to relax.  I did tell the anesthesiologist that I was nervous about getting sick from the anesthesia and he made sure to put some medicine in the mix to quell the nausea.

Then, it was time to get the show on the road…

The anesthesiologist gave me a narcotic right before I was wheeled into the OR (which I felt was unnecessary as I was already calm and tired).  I moved onto the table, and the next thing that I remember is someone putting a mask over my face and saying “Here is some oxygen – just breathe deeply”… By the way, I don’t believe that it was *just* oxygen

When I woke up, they took out the breathing tube (I proceeded to fall back asleep quickly).  To be honest, the recovery room was the worst part of the whole experience; I am verrrryyyy slow to get over anesthesia and it took about 2 1/2 hours for me to sit up, go to the bathroom, and head home.  If you feel dizzy when getting up, remember to breathe in deeply through your nose and out your mouth!

Getting home was pretty simple, and I was able to get up the stairs using the handrail and one crutch.  I got into bed with little trouble and took a nap.

The next 10 days are kind of fuzzy.  Remember that time when I said that I am very slow to get over anesthesia?  Well, I spent 95% of my day in bed until Sunday (5 days post-op).  I would not recommend this – the quicker you get up, the more quickly the anesthesia will work itself out of your system.  And since I spent so much supine time, I developed benign paroxysmal positional vertigo, i.e., too dizzy to care about life.

When I did get up to the bathroom, I used a walker and went about my business very slowly.

What about my legs?  My legs were wrapped up in tight ace bandages with large dressings underneath.  I was not allowed to remove them (or take a shower – phewww!) for 3 days.  I iced my legs for 30 minutes, 3 times a day for 5 days.  My legs and feet were very swollen, and it took about 8 days for the swelling to go away.  Here is a picture of the bandages 2 days after the surgery:

So 10 days later, I am able to walk, drive, climb stairs, and read.  However, over the past 10 days, there have been periods where reading, walking, riding in a car, watching TV, etc., have all made me want to die.  The best part of the whole experience?  The lack of leg pain!

I must admit that my legs have not been the pain-in-the-you-know-what that I anticipated.  In fact, I did not take any pain pills.  That’s right: not one pain pill!  Some things have changed, however:  I have to get into bed with my butt first, whereas before the surgery I would put weight on my knees and turn around.  I walk a lot slower than before.  I cannot bend down enough to pick up anything on the floor.  You will quickly find your own limitations and crafty ways to get around them (turning off the radio that sits on the floor with my toes instead of my fingers!).  Here is a picture of the battle wounds – 10 days post-war:

The stitches will come out next Thursday, June 24!  I will post some more pictures at that point!

The biggest thing to take away from this experience is that everyone is unique.  One friend had surgery two days after me and was *mowing the lawn* (:-O) four days later, while today was the first day that I trusted myself to drive myself to a store and walk around for a spell.  Just remember to take things slowly, but also remember that you can’t sit around until you feel 100% better.  In fact, I am still not 100% – but, at this point, I’ll accept 93% and counting!

Have you ever had a very slow recovery after (what the surgeon calls minor) surgery?

Nerves before surgery

My fasciotomy is scheduled for tomorrow and the hospital will call me today with the time I should “report” for the operation.

I am a planner and a worrier, and when I don’t have all the information, I get a little nervous. Today, here are the things running through my head:

1. How will I react to the anesthesia? Will I feel sleepy or sick when I wake up?

2. How will my life be different after the surgery and until I am fully recovered? Will my dad, my friends, or my dog get sick of me feeling under the weather?

3. How soon will I be able to get up and move? How will this affect a.) the cleanliness of my house, b.) my ever-expanding waistline, c.) my work ethic (PhD exams, anyone?), and d.) my overall happiness.

I believe that this are all normal emotions to be experiencing before surgery, but I must admit that I was not fully prepared to deal with these emotions.

Do you get nervous before surgery? What is the most calming thing that you can do for yourself?

Compartment Release Fasciotomy: Meeting with the Surgeon

I am scheduled for a bilateral compartment release fasciotomy in less than one week.  My first appointment with the surgeon? Check!

Many of my questions about the operation were answered during the appointment, and I will attempt to tell you all about them right here, right now!

Q: How long will the surgery last?

A: About 1 hour.

Q: Do I need to have general anesthesia, or is it possible to have a local?

A: You will meet with the anesthesiologist the morning of your surgery, and you will decide together what is the best method for you.

Q: I have read a lot on the internet about people still experiencing pain, numbness, etc., after healing from the surgery.  What are the chances that I will also still be in pain?

A: The closer that you fit the textbook signs and symptoms of Compartment Syndrome, the better the chances are that you will experience a successful surgery.  I believe that you will be pain free after recovery.

Q: What is the recovery period like?

A: You will crutch walk for 1-2 weeks.  Some people are off crutches in a week and some take up to two weeks, and it all depends on your individual experience.  You should be back to power-walking and going to the gym in 4-6 weeks.

Q: Will I need any additional appointments?

A: You will need to come back 2 weeks after your surgery to have your stitches removed.  Sometimes, they can become itchy and uncomfortable if your skin is healing well, so you can always call our office to come in sooner to have the stitches removed.

Q: I will be starting school again about 11 days after the surgery.  Will I feel 100%?

A: 10 days after the surgery, you will still be in a bit of pain.  You will probably feel like you got kicked in the calves, but you can still use crutches if you are in a lot of pain.

Q: Where do I get crutches?

A: You will be given crutches after the surgery. (Note: If you know anyone with a pair of crutches, ask them to let you take them for a spin before the surgery.  Although someone can help you learn to use them after your operation, it will be much more difficult if you are feeling poorly.)

Q: Are there any other instructions to follow to help me prepare for surgery?

A: You should not eat or drink anything after midnight (this may vary based on your health).  You should not shave for 48 hours prior to the surgery because your pores need to be closed to reduce the risk of infection.

Q: What is CHG soap and why do I need to use it?

A: This is a special, antibacterial soap sold at pharmacies.  Since your skin will be opened during the surgery, and bacteria and germs live on your skin all the time, this soap will help to reduce the amount of bacteria that could cause infection.  You should get enough to use 1/4 cup each time you need to wash with it.  To use the soap, shower and wash your hair as normal.  Then, wet a washcloth and turn the water off.  Put the soap on the washcloth and scrub yourself from the neck down.  You may need to replenish the soap to cover your whole body.  Do not forget to wash your private parts and your belly button.  Then, turn on the water and rinse your body.  Dry off with a clean towel and put on clean clothes.  (Note: Ask your doctor for specific guidelines)

So there you have it – the answers to all of my nagging questions for my first visit with the surgeon.  I would encourage you to write down your own list of questions so that you can be sure not to forget anything; the next time you see your surgeon, you may already be groggy from anesthesia!

How to choose shoes with Compartment Syndrome

The worst part of living with Compartment Syndrome has to be the shoes.  As a student on a large university campus, it is so hard to see women walking around with their perfect pumps, their heavenly heels, their skinny Sketchers.  Meanwhile, I have to wear linen slacks and shoes that my grandma would pick out (no offense, Grams!).  In short, the footwear faux pas are never-ending when it comes to living with CECS.

Having said that, I firmly believe that the first step in managing CECS is properly footwear.  Yes, this means going to a shoe store with a staff that fits a shoe based on your needs instead of going to an outlet and picking out what you like the best.  In order to get the most out of your shoe fitting, you should:

1. Work with someone who is familiar with, or has at least heard of, Compartment Syndrome.
2. Explain to him or her what it feels like when you walk and let him or her watch you walk around.  The salesman should also examine the bottom of your shoes to see where you wear out your shoes the fastest.
3. Do not even look at the beautiful wall of shoes before you begin to try on your shoes.  Chances are, you will have to sacrifice looks for comfort. (And if you have to walk a lot each day, you will be sore and sorely mistaken if you think that beauty is worth the price!)
4. If your feet start to feel tingly or numb, stop trying on shoes for 15 minutes and then begin again.  Some days, you may need to leave the store and come back later.
5. Keep in mind that shoe fittings result in higher priced shoes.  If you have health insurance, see if they will cover your new pumps as part of your medical condition.

However, if you work at a job where you cannot avoid wearing proper footwear (i.e., no sneaky sneakers), then you must have a game-plan.  Wear tennis shoes to work and change once you get there.  Limit your walking long distances with your work shoes; if you go out for lunch, don your sneakers.  Avoid shoes that pinch, cause your feet to swell, or aggravate your CECS.  Most importantly, remember that one day (with proper treatment!), your legs will be cured and you will be able to wear the cute shoes that you have been eyeing in the window.  Patience is the key (to great footwear)!

Oh, the shoe envy!

Pain after Compartment Pressure Testing

Yesterday was the Compartment Pressure Test, and as I said in another blog post, I did not experience that much pain.

My scary legs after the Compartment Pressure Test

Here is a picture of my legs about 8 hours after the compartment test.  These needle holes were covered with a bandaid, yet they were still sizable after I removed the bandaids.  They are still sore 24 hours later.

Today, my legs are quite a bit more sore than I expected, although they are slowly getting better.  My calves were very tight last night and this morning, and as someone who normally sits in chairs with one leg tucked underneath the other, I have been a little limited in my movement.

If you have the test, you probably will not have any problem driving home as your legs will still be numb.  I also took my dog for a short walk last night without much pain, but climbing stairs and walking long distances are a bit more difficult than normal.

Even though I am not in enough pain to restrict my daily activities, I am sore, and you might be as well.  However, I am much happier knowing that my surgery is coming up soon and that my legs will be as good as new in a few months… perhaps even better than new!

Surgery is scheduled

From SavageChickens.com

After a few phone calls and throwing around the enviable status of bottomfeeder “doctoral student”, my surgery is scheduled for June 9.  I kind of stumbled onto this bit of luck, and I’m hear to let you know how it was done.

As I mentioned, I am being treated at a large university where I am also a graduate student.  Either due to the sheer amount of people that are treated here, or due to the fact that I am probably the lowest of the low (second only to undergraduate students and plants), it usually takes quite a bit of time to schedule referral appointments.  In fact, my first appointment with the surgeon isn’t until May 27.  When the scheduler left me a voicemail giving me the appointment date, she said that if I couldn’t keep that appointment, I would be scheduled at the end of July or August – just for the consultation!

Well, since I am taking Portuguese this summer (not for fun, I assure you) and the classes meet everyday, I have a very small window of opportunity for recovery time, so I went outside standard protocol and put in a call to the office.  I was transferred to the surgeon’s administrative assistant, and the phone conversation went something like this:

Me: “Hi, I have an appointment on May 27 to schedule a bilateral compartment release with Dr. _____.  I was wondering how long after this appointment I would be schedule for surgery because I’m a doctoral student and I’m teaching and taking classes this summer.”

Her: “What’s your name?”

Let’s skip the formalities.

Her: “I can go ahead and reserve you a tentative time and then we will confirm it at the appointment on May 27″

Me: “Thank you so much!”

Me (inside): “I wonder if I’m going to get totally screwed over when I get the appointment on May 27″.

So there you have it, folks!  The lesson to be learned is that sometimes, by asking the right person, you may get a little bit of much-needed help.  Now we all just have to wait and see whether or not my surgery is still “tentatively scheduled” for June 9!  Huzzah!