First Brisk Walk: Day 39 after Cheilectomy

Thought it was time to try a real walk down the road... I walk around school often throughout the day, but never very far or fast. So, this evening after some PT exercises and manual stretches of the sole of my foot, I put on my athletic walking shoes and set out, hoping to get a little exercise. It was not what I'd call a workout---at least not a cardiovascular workout. Three miles per hour, tops, was the best I could manage while trying to maintain normal weight transfer all the way through that final painful push off the big toe. It is so difficult to choose pain! How much easier it would have been to just limp, but that won't get me anywhere. If pain leads to gain, I guess I choose pain. 

No Pain, No Gain in PT: 38 Days after Cheilectomy

No pain, no gain--- absolutely true with regard to this recovery process.  Melissa, my PT, gripped my foot, wiggling and wrenching it until every muscle, ligament, and tendon screamed for mercy.  I kept my mouth shut lest I be told again to put my big girl panties on. Truly, I saw red, visualizing a zealous chef snapping chicken bones with her bare hands. I spent long agonizing minutes with my great toe bent back while Melissa massaged and manipulated the stiff, shortened structures in the sole of my foot.  Massage sounds so tender, but tender it was not.  Like last time, I was shocked to survive the torture, stand, and walk better than before. I even tried standing on my toes for the first time. Pretty amazing! Here's a photo of my foot executing an impressive bend.  Not without pain, but wow!  Just Wow!  

2nd Post-Op: Day 33 after Cheilectomy

No Pain, No Gain

Pain is usually a warning signal--- our bodies telling us to slow down or stop an activity. My surgeon, Dr. Kessinger, confirmed today, though, that for my great progress to continue I must endure the pain of forcing my toe to the outer limits of its current range of motion. She said that if I'm not challenging the joint and nearly in tears, I'm not doing enough. I'm not fond of pain, but I guess I've been doing okay. It's been 4 1/2 weeks since the surgery, and she said that my toe function and range of motion is similar, on average, to patients after nine weeks. Celebration!

I also picked up some interesting and useful information from the nurse. I learned that the smaller joints in the body such as in the hands and feet take the longest time to heal. When I asked about the value of massaging vitamin E into the scar, she explained that vitamin E or Vaseline would be equally fine, because it's actually massaging the scar that helps to heal the suture line and minimize scaring. Finally, she informed me that sun is the enemy of scar healing; she urged me to wear sunscreen on my scar, treating my scar like a newborn with tender skin that must be protected from harmful rays.

Ah, if only my physical therapy exercises were as easy as putting on sunscreen!

Physical Therapy, Day 28 after Cheilectomy

Productive Pain?

Physical therapy is not for the faint of heart. It hurts! I learned this years ago while recovering from rotator cuff surgery. On Thursday, one day shy of four weeks since my foot surgery, my physical therapist friend, Melissa, grasped my foot with a vice-like grip and kneaded my muscles and bones and fascia and scar tissue for 45 minutes with force that left me grimacing and struggling not to moan. In a mistaken plea for advice, or perhaps sympathy, I asked if perhaps I should take a couple of Ibuprofen before the next visit, to which she promptly told me, with a distinctly unsympathetic twinkle, to "put your big girl panties on." Direct quote. Hmphhf! Clearly, pain is part of the process, but sympathy is not. I was shocked at the force with which she kneaded my incision line, as if working some really hard, old plasticine clay in an attempt to get it to loosen up. If I didn't trust her so much after years of successfully rehabilitating other body parts, I might have run screaming from the room. Evidently, sustained force is required to break up scar tissue. After 45 minutes of pinching, crushing, squeezing, wiggling, kneading, stretching... I stood up. Walked. And the shocking thing was, my gait was more normal than before. She didn't cause permanent damage, but actually made it better!

Big Toe Boogie & First Pedicure: Day 29 after Cheilectomy

Big Toe Wanna Dance!!

As I mentioned before, I'm hoping to return to my ballroom dance team as soon as possible. I've gained a lot of range of motion since my April 1st surgery, but my right toe is far behind my normal left toe. I need a lot more range of motion, and I also need to be able to load that joint. My new PT exercises seem to focus on this: applying weight appropriately as I roll forward from the ball of the foot to the big toe and actively push into the floor. Oh, how we take these simple movements for granted when everything just works.

Here I am in the passenger seat where I caught my big toe doing a boogie on the dashboard, flexing and extending like a champ. Of course, I still can't bend it up very far. I'm only four weeks into the recovery period, so I guess it's early still.

So here's my first ever dancing toe video: 15 seconds of cuteness. Yeah, I know, my toe has grown very narcissistic! Still, I thought folks out there considering this surgery--- or recovering from it--- would like to actually see another kindred toe in movement. Best wishes to you and your dancing toes!


First Pedicure  

Hot water, massage. a little pampering... What's not to love? Actually, not much. None of the foot scrubbing, massage, and manipulation was painful except at an area removed from the actual incision line. The painful area had been visibly bruised in the weeks following surgery, but the bruises are long gone. However, a tender area remains. It's evident that this foot underwent some serious trauma, and it's going to take a while to bounce back.

By the way, shown here is now my favorite sandal to wear. Comfy Birkenstocks protect the joint but also allow more motion than my other pair. Movement may not feel fantastic, but it's what the joint needs for recovery. Actually, at this point in time, my stride feels pretty good, as long as I don't race around. A slow to normal walk feels pretty dang normal. Nice! Now, the PT exercises are another story... Not nice.  Not.  Not nice... but necessary.

Working Full Time: Days 25 - 26

Working Full Time

On the one hand, it's been easy to return to work after only three weeks: driving a half hour each way, standing, sitting, walking through the school. There are several shoe options that feel fine. On the other hand, the strain creeps up on me. Welcome relief comes when I elevate my foot on a stool under my desk and ice it several times a day. Yesterday I had a couple of minutes of intense pain when I somehow snagged my right big toe on the low horizontal crossbar of a classroom stool, bending my toe sharply and unexpectedly upward. Yeeowww! I collapsed in a chair and sent a student of another staff member to our staff room freezer to fetch a fresh ice pack. Later in the day my foot was noticeably more uncomfortable and light shade of reddish-purple. I iced and elevated more through the evening at home and my foot seemed to bounce back to normal; well, my current normal. I have high expectations for my new and improved "normal" a few months down the road.

Back to Work: Day 24 after Cheilectomy

It had to happen eventually... back to the salt mine. I really can't complain: two weeks of medical leave followed by one week of vacation, half of which I spent in Hawaii. I'm a teacher. In my own classroom with my fabulous 5th graders, most of the time I'm able to stand, sit, walk, wiggle, fidget, shift, sashay, and elevate my leg as necessary. I did have to forgo my customary speed walking, and I tried to reduce the number of trips to the workroom. 

The only real stress on my foot occurred during those relatively quick conversations while standing with other staff in the hallway or workroom, before or after school and during recess. Two or three minutes of standing is all it takes. My attention would be drawn to the blood pooling in my foot and the whisper of a throb developing, at which time I would "jog" in place or hoist my right leg up on the nearest desk or table. Ahhhh... Flexibility is a plus. I wore the Birkenstock sandals, shown in a previous post, that provide such wonderful support for my entire foot and also protect my toe joint from excessive motion and sudden pain. 

I managed to do some toe PT twice during the day: once during lunch, and once during afternoon recess. This basically consists of rocking the big toe joint gently from front to back and from side to side. Next, I apply pressure outward on my toe, pull it down and hold, followed by pressure outward, pull up and hold. Ouch. Finally, I try to manipulate the sesamoid bones that continue to be uncooperative. After each torture session I strapped on one of my favorite ice packs for a little while. 

Everyone is surprised at how good my foot looks, me included. Visually, the healing is remarkable. As for regaining normal range of motion, time will tell...