Another reconstructive foot surgery ...

Echodelta

Echodelta

Member
Hi CGA,

I've been out of touch for awhile. Last year I posted a prayer request because I was having reconstructive foot surgery to my right foot, which occurred in July 2013. What was supposed to be 1 operation turned out to be 3. Overall, it was the 22nd operation to my right foot that dates back to 1990, when I was in a work accident where both feet were crushed by a 5000 lb generator. I've had chronic pain when walking or standing ever since.

I was non-weight bearing for 2 months. In October, I began 6 months of physical therapy. That ended in March. But my foot still has pain and swelling. Due to the type of surgery including orthopedic and plastic, the foot now has 3 plates and 18 screws plus about 75% of my right foot is covered with a skin graft.

Tomorrow, I'm having a more complex reconstructive surgery to my left foot. While it's similar to my right foot (bone fusions & reducing the high arch), it also involves moving the 4th and 5th toe so they're not on top of each other, cutting tendons, and shifting the heel slightly to the left. After all that's accomplished, my plastic surgeon takes over to install the new skin graft. This involves taking the outer most muscle on my inner thigh (gracilis muscle) and transferring it to the open wounds on the foot then new skin is placed over the muscle.

This is a 10 hour minimum operation with a 10 to 20-day stay in the hospital. I'll be non weight bearing for 2 to 3 months and the recovery time is 1 to 2 years.

So I ask for your prayers. One, to guide these surgeons hands as well as to minimize problems. Last summer's surgeries were originally supposed to be 1 long operation but turned into 3 over 7 days. Two, to help deal with the pain immediately after the surgery. Thankfully, I may get a nerve block which numbs below the knee but only lasts a few days. Three, for my recovery. As I said, I'm not fully healed from the surgeries to my right foot. At issue is the fact that my right foot still isn't healed and I'll need to rely on it in the coming months while recovering from tomorrow's surgery. I'm also a type 1 diabetic (insulin dependent). As a result, there is risk involved. BTW, I became a diabetic as the result of the accident so I've been dealing with all this for almost 24 years.

For those interested, follow this link for a collage of my right foot; how it looked prior to last summer's surgeries and how it looks today. I threw in an xray as well.

My left foot looks a little more mangled but will likely look like my right foot after tomorrow's surgery.

Please pray that everything goes smoothly.

God Bless,
Ed

PS, Aside from a few games on my Ipad and playing a little Xbox, I haven't done much gaming because I've spent the last 9 months doing everything I can to strengthen my right leg and foot. It became bone thin. It's still a little thinner than my left but I can live with that :)
 
Thank you.

So here's an update: my surgery was canceled the day of the operation.

I got to the hospital in time and right before I was to be admitted, I was told that my plastic surgeon wasn't scheduled to operate. So it was a scheduling error on the hospital's part. I went home and was so tired that it lasted 2 days. I did make an official complaint especially that this occurred last year as well for my right foot. But last time, I was informed 1 month before the surgery. This time, it was just a couple minutes before I was being admitted, lol.

I'm fine. This gives me more time to heal my right foot as well as do some gardening in the back yard. I believe God intervened because I was too hardheaded to say, "My right foot isn't healed yet." So I'm not bitter or upset.

I will provide the new surgery date when I hear from the hospital again.

Thanks for the prayers,
Ed
 
Hello again,

The reconstructive surgery is scheduled for tomorrow morning. I ask for your prayers that it goes smoothly. Please refer to my first post in the thread for a description. Thanks, -Ed
 
How'd the surgery go?

Praying for a quick recovery!
 
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Hello,

Thanks for the prayers. Surgery went well and was about 10 hours long. Afterwards, I was immediately placed in the "tropicana" room, where the heat is turned up to ensure the muscle and skin graft get the best blood flow circulation. But it was like living in a sauna and being unable to move. I hated it, lol.

Yesterday the heat was shut off and I began PT. These are "dangling" sessions where I simply hang the foot off the side of the bed. I only completed 2 sessions, 10 minutes each due to pain.

So speaking of pain, I did well for the first few days. But once the bandages were removed yesterday, its been steady pain in the "6" level. I had to take multiple doses of pain medication at one point yesterday. I can already tell that this recovery will be harder than the right foot. Discharge depends on being able to handle these dangling sessions and right now, its way too painful to dangle longer than 10 minutes.

Again, thanks for the prayers. I'll let everyone know when I'm discharged.
 
Hello,

Hello,

Here's another update. I was discharged from the hospital on the 4th of July. Now it's Monday and I've stopped taking the pain meds. Reason for this is it caused massive itching as well as a rash on my back and on my right bicep. A nurse suggested to take more Benadryl. It gives a small 2-hour window of itching relief but causes more drowsiness. This morning, I switched back to Oxycodone, which I took last year for the surgery to my right foot but it only caused a "buzz" and did nothing for the pain. I have a followup appt on Thursday. I could get Vicodin. But from now until Thursday, I've chosen to go without pain meds. The itching and rash isn't worth it. So I'm definitely dealing with a lot more pain for now :(
 
It's been about almost 2 months. Here's an update:

I began weight bearing at about 25% weight on my left foot about a week ago. It's been painful. No pain meds work or I'm allergic to them: oxycodone, dilaudid, vicodin, morphine, tramadol, & percocet. Docs are referring me out to see a pain management specialist. This has definitely been surprising compared to last year's right foot surgery. But holding steadfast on God's grace. I've had tears not due to feeling sorry for myself but due to intense pain. Only relief I get is sleep. Then the cycle begins again in the morning when I place weight on the foot. But overall, I'm standing/walking using a walker & crutches for only 15-20 minutes per day. I've had continued problems in my right foot which was reconstructed last year, my doctor is considering removing some screws. I'm uneasy about that, I'd rather he add a few more than remove them. Currently waiting for PT to begin on September 15. Staying positive. No regrets :)

I'm waiting on official x-rays. I'll post them when it arrives. Unsure about posting an actual pic of my foot since it's still swollen.

Thanks for the prayers.
 
Ouch to say the least. Still praying for you. So they might have to do more surgery for the screws on the right foot but are you going to need more for the left too?
 
You could always post a text link to a photo and let people decide if they want to click it or not.

As someone who's struggled with back, leg, knee, and shoulder pain for years, I can sympathize to a point, but I won't even begin to claim to have experienced anything like what you're describing. Nevertheless, I find hope in knowing that physical pain is temporary and often a prerequisite for us to stay in this world long enough to share the Gospel with others. Some day, we'll shed this mortal frame and go to be with Jesus. We certainly never want to rush the process as it's a grievous sin to try to control that timing, but it's reassuring knowing this pain isn't forever--and that it means we have one more day of opportunity to do the Lord's work.

To quote C.S. Lewis, "God whispers to us in our pleasures, speaks in our conscience, but shouts in our pains: it is His megaphone to rouse a deaf world."
 
The Mighty Gerbil said:
Ouch to say the least. Still praying for you. So they might have to do more surgery for the screws on the right foot but are you going to need more for the left too?
Click to expand...

Thank you. It's too early to tell whether the left will need another operation as I haven't begun PT yet. It has less hardware in it than the right but more surgical incisions were performed. Plus docs couldn't repair everything; the 4th toe, which had already been fused, needed work and they were unable to fix it.

Tek7 said:
You could always post a text link to a photo and let people decide if they want to click it or not.

As someone who's struggled with back, leg, knee, and shoulder pain for years, I can sympathize to a point, but I won't even begin to claim to have experienced anything like what you're describing. Nevertheless, I find hope in knowing that physical pain is temporary and often a prerequisite for us to stay in this world long enough to share the Gospel with others. Some day, we'll shed this mortal frame and go to be with Jesus. We certainly never want to rush the process as it's a grievous sin to try to control that timing, but it's reassuring knowing this pain isn't forever--and that it means we have one more day of opportunity to do the Lord's work.

To quote C.S. Lewis, "God whispers to us in our pleasures, speaks in our conscience, but shouts in our pains: it is His megaphone to rouse a deaf world."
Click to expand...

Yes I'll provide links. Don't want to shock anyone :)

I haven't placed any weight on the left foot since Thursday. I never mentioned how with the type skin graft/free flap coverage on the foot, it's very slow healing. It took my right foot 6 weeks to completely heal over. However with my left, I'm over 2 months now and it still hasn't healed, meaning I have open wounds remaining. When I place weight on the foot, it bleeds more due to the pressure. So I'm staying off the foot for a few days. A prayer for these wounds to close up would be appreciated as well.

Everyone says I'm really calm through all this and I am. Even all the medical notes state this. I've dealt with a lot since that crush injury 24 years ago and now since 2012 when I got a 2nd opinion leading to these new set of surgeries. I keep this as my prayer as well as God's promise:

1 Corinthians 10:13

"No test or temptation that comes your way is beyond the course of what others have had to face. All you need to remember is that God will never let you down; he’ll never let you be pushed past your limit; he’ll always be there to help you come through it."

And I've also thought about heaven and how I won't have to deal with any foot pains anymore. The Scripture above and the thought of heaven certainly help me cope. I remain cool, calm, and collected.

Again, thank you for all the prayers.
 
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I will pray that God will continue to heal you and encourage you! It sounds like you're handling this affliction far better than I would.

And adding to the thoughts about Heaven: "He will wipe every tear from their eyes. There will be no more mourning, or death, or crying, or pain, for the old order of things has passed away." - Rev. 21:4. One of the most beautiful verses in the entire Bible, in my opinion.
 
Tek7 said:
You could always post a text link to a photo and let people decide if they want to click it or not"
Click to expand...

Ok here you go. In the spoiler are descriptions and links to x-rays and pics. I didn't include any gruesome pics but the scars alone have shocked others. So fair warning:

First to remind everyone, my feet already had numerous surgeries to fix the problems due to the work accident that crushed my feet. They had bone fusions and skin grafts. After a 2nd opinion in 2012, numerous tests revealed the original bone fusions had failed thus requiring new fusions. The skin grafts were needed due to "compartment syndrome." The new scars are from a "free flap" procedure. This involves taking the gracilis muscle from the upper thigh and installing it over the open wounds left from the removal of the old skin graft. Then a new skin graft is taken again from the upper thigh and installing it over the gracilis muscle. Everything is connected via microsurgery. The free flap procedure takes 8-10 hours to complete.

Right foot first since this was operated on in July of last year.

Before and after of what my foot looked like prior to the surgery and then a pic taken a couple days ago.

3 before and after x-rays of the right foot from different angles:

Comparison 1
Comparison 2
Comparison 3

Now onto the left foot which was operated on in June 25 of this year. Note, more work was performed on the left than the right but most were similar. Here's a list of each procedure for the left:

  • 1st metatarsal (TMT) osteotomy (movement of bone)
  • Lateralizing calcaneal osteotomy (heel slide)
  • 4th digit extensor release and osteotomy (doctors unable to perform this one)
  • Peroneus longus to brevis transfer (tendon transfer)
  • Gastroc recession (release of larger tendon that's part of the Achilles)
  • Free flap (muscle transfer & new skin upper left leg to cover old skin graft on foot)
Before and after of the left foot

3 before and after x-rays of the left foot from different angles:

Comparison 1
Comparison 2
Comparison 3

Finally, here's a 2-pic collage of my upper left leg that shows the donor sites of where the gracilis muscle and skin graft were taken. My right leg has the same scars in the same locations.

Here's an update. I returned to my plastic surgeon last Thursday. This was due to the continued open wounds not closing. It only added to the stress. I had not placed any weight on the foot for about 8 days because each time I did, the foot would bleed plus the ongoing pain. In these wound locations, he pulled out several internal stitches that were being forced out due to my body recognizing these as foreign. This occurred with my right foot as well but in that case, it didn't prevent healing. To this day, internal stitching is still being pulled from the right foot but they are now minor occurrences.

Now it's Tuesday, 5 days later and the wounds are finally getting smaller. Yay! My plastic surgeon said I need to continue placing weight on the foot. I'm still not taking any meds and I must say, the intense pain remains when I stand or walk. It still causes tears and prevents me from getting to sleep right away. I was scheduled to begin PT yesterday but now its rescheduled for this Friday. Although I'm yearning for PT, there's concern due to no pain relief. Last year, for the right foot, I had pain meds that worked. This time around, nothing works. Still putting all this in God's hands. Staying positive.

Thanks for the prayers,
Ed
 
That is some painful looking feet. I thought the weight that crushed them landed flat on the them and mushed them out but after seeing the pics it looks like your foot was crushed sideways? I mean it looks narrower not wider so it gives that impression.

We are manly men we can take it! Right! Uh tears? No that's just, um, from the onions I was eating >.> <.< XD .

Seriously though still praying for you.
 
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The Mighty Gerbil said:
That is some painful looking feet. I thought the weight that crushed them landed flat on the them and mushed them out but after seeing the pics it looks like your foot was crushed sideways? I mean it looks narrower not wider so it gives that impression.

We are manly men we can take it! Right! Uh tears? No that's just, um, from the onions I was eating >.> <.< XD .

Seriously though still praying for you.
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The left was flat and the right was sideways/diagonally. The reason they're narrow is due to a lot of muscle, tendons, and tissue were removed due to damage. I've had more problems with the right foot over the years. It never felt right and still has pain. Too early to tell concerning outcome with the left. Staying strong overall.

Thanks for the prayers :)
 
Hi again,

It's been over 3 months. A lot has happened and most of it hasn't been good. I'll summarize though. It's now almost 6 months since the surgery to my left foot. There's been complications with healing. So much that my 4th toe needs to be amputated. Yes, not due to diabetes or anything like that but due to ongoing pain and it interfering with this new free flap/skin graft. That surgery is set for February 10 of next year. Since I've begun walking on it, I've developed the same navicular bone pain in the left as in the right.

As for my right foot, I've had 2 cortisone shots in the foot in an attempt to diagnose the pain. They didn't work. I had a CT scan yesterday which revealed nothing wrong with the navicular bone itself but a problem in the joint. My doctor isn't sure if this is the source for the pain but suggested to fuse the bone. I concur. This bone pain did not exist prior to the reconstructive surgery but is very apparent now. My doctor will have difficulty fusing the bone though since the area in question already has 3 plates and 19 screws. The navicular bone is rather large as well. I'm unsure what he'll fuse the bone to. It remains to be seen. No surgery date has been set yet. I've had this bone pain since October of last year when I began placing weight on the foot after the reconstructive surgery. This pain is only getting worse.

If the surgery is successful, then my left foot's navicular bone is next.

Right now, I have terrible pain in both feet each time I take a step. I walk very slowly and with a slight limp. I cannot walk far. I gave up on pain meds long ago, they never helped. I remain an active person but it has been very difficult recovering from these recent set of foot surgeries dating back to last year. And it looks like 2015 and 2016 will be 2 to 3 more operations with 2 being long and complicated ones again.

My faith has never wavered though. I've been though too much to question God. I am however, praying for a miracle. I ask this of CGA members here.

Merry Christmas and God Bless,
Ed
 
Sorry to hear the bad news still praying for you though Echo. Thanks for the update too.

I feel gruesome asking but if they have to amputate more are your wounds in such a position to allow a vestigial foot below the ankle or would removing the afflicted parts require complete loss of your feet? I'm not suggesting it but the thought occurs to me because at some point I'd wonder if the years of my life spent fighting it were worth the parts I might get back. I'd feel completely different if it was my hands though. They don't have cool bionic parts that work for those XD.
 
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The Mighty Gerbil said:
Sorry to hear the bad news still praying for you though Echo. Thanks for the update too.

I feel gruesome asking but if they have to amputate more are your wounds in such a position to allow a vestigial foot below the ankle or would removing the afflicted parts require complete loss of your feet? I'm not suggesting it but the thought occurs to me because at some point I'd wonder if the years of my life spent fighting it were worth the parts I might get back. I'd feel completely different if it was my hands though. They don't have cool bionic parts that work for those XD.
Click to expand...

Ask any questions you'd like. When the accident originally occurred, I almost lost both feet to amputation. My doctors tried to convince me that it was the best thing to do but I said no (Back then, I was so weak and depressed about it. If I lost both feet, I would have committed suicide). It all came down to the 7th operation where I had to sign a consent form that I may lose them if they were unable to do a certain procedure. I'll always remember what one of those doctors said though, "If we don't amputate, you'll never have a normal life. Your life will be full of pain." Well that doctor was right.

To return to your question, I think at this point losing only a toe is preventing something more drastic that may occur in the future. If more problems occurred, such as another bone infection, I'd likely lose the entire foot due to the damage that remains.

To be honest, I have wondered how different my life would have been if I had chosen to have both feet amputated. Would I have less pain or more? I'd likely walk better with prosthetics. I don't regret the decision but it has been a life a severe chronic pain. And no, I don't feel sorry for myself. I overcame that when I accept Jesus as my Lord and Savior.

I tried not to let it get in the way of what I wanted to do. Believe it or not, I do enjoy the outdoors. I love to hike and camp. I'm just unable to hike far. My longest hike is 11 miles and that really really hurt :) In fact one of my goals is to do this hike again. But being that I'm unable to walk even 5 minutes now without the pain overwhelming me, that goal may not ever occur. I do everything I can to work towards it though. The type of physical therapy I do is intense and that's 6 days a week. My upper legs have put on about 15 pounds of muscle alone. The strength is there but the pain remains and is actually more intense than prior to these recent set of surgeries.

Thanks to everyone for the support and prayers this year. 2015 and 2016, I'll need more though :)

Happy New Year,
Ed
 
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