PATIENT:Female, Age 60

SURGERY:Right Scarf/Akin Osteotomy

SURGEON:Mr Mark Blackney

HOSPITAL:Mercy Private Hospital

DATE of SURGERY:8th November 2009

Sunday, 8 November 2009

Plan for six weeks off work. Last day at work Friday 6th November, tidied up loose ends. Locum to commence tomorrow until 18th December. Emailed some project work to home and will work on over sick leave period.

Pre-cooked and froze several meals and shopped for extra pantry supplies.

Arranged cleaner and ironing person.

Daughter and son in law to stay with me until I am on my feet.

Borrowed a shower stool.

Supply of books and DVD’s.

Past several weeks have begun majority of christmas presents and wrapping.

Compiled family Christmas annual newsletter and will write and send cards later.

Have made Christmas puddings and ordered ham etc.

Monday, 9 November 2009

7.30am – arrived at Mercy Private Hospital pre-admission. 1st on list for theatre (so pleased to be 1st on list). Ward nurse helped me to prepare.

8.00am – Anaesthetist Dr Christopher Hoy explained clearly about general anaesthetic and also about the nerve block. Talked about potential anaesthetic risks and also about pain management post procedure.

Met Mr Blackney in theatre – revised procedure with me.

9.45am – returned to ward feeling sleepy but fine. No pain. Right foot completely numb. Post op obs 15 minutely for 2/24. IV fluids. Didn’t like having to use bed pan – but no problem.

10.00am – 2 x Digesic. Sandwiches and cup of tea very welcome.

2.20pm – 1 x Endone. Wound redressed, slight ooze.

Slept most of the afternoon. Several phone calls.

Pharmacist explained take home meds and advice re regular use and action of each. Explained clearly. Had analgesia 2/24 regularly. IV fluids ceased. Given Clexane injection (because of history of DVT’s in the past).

Nice wash in bed and bed linen tidied. Foot remains numb – no sensation or pain. Drowsy and slept all night until nurse woke me at 3am for obs and digesic.

Tuesday, 10 November 2009

3.00am – 2 x Digesic. Obs taken. Slight sensation right foot. No pain.

6.00am – Obs, blood pressure a bit low. Normal foot sensation. No pain or discomfort.

8.15am – 1 x Endone, dressing change – some ooze. Mr Blackney visited – all OK to go home.

Dressing – no discomfort after shower.

Physio – demonstrated use of crutches. Felt a bit woozy when first got up.

Showered without a problem.

10.30am – change of dressing. Orderly arrived with wheelchair to take me to car. Discharge instructions from nurse and physio and advice re regular analgesia.

No problems with using crutches at home but ordered wheelchair delivery also to speed up getting about the house and perhaps getting outside next few days.

Kept foot elevated when sitting. Alternated Voltaren and Digesic as instructed. Up for toilet purposes only. No pain.

7.00pm – Dinner.

8.00pm – Digesic before bed, tired – slept well. (Thank goodness for air-conditioning – 34˚).

Wednesday, 11 November 2009

Slept throughout the night. Kept foot elevated on pillows in bed.

8.00am – tea and toast in bed. Voltaren post breakfast.

9.00am – shower – took longer than usual. Glad to have shower stool and use of portable towel rail as frame.

10.00am – friends popped in for coffee.

11.00am – had frittata and salad for lunch with friends. Voltaren after lunch. Leg exercises as advised when resting.

1.00pm – made phone calls – read a little with feet up.

2.30pm – Digesic – no pain but following instructions.

3.00pm – Wheelchair delivered – ideal for whizzing up and down my very long hallway.

Aimed to keep foot elevated as much as possible. Managing crutches well. Drinking water to avoid constipation relating to regular analgesia and decreased activity.

7.00pm – Dinner at home.

Notes – Took Voltaren after meals and Digesic 3 times between – no pain – minor swelling when foot not elevated.

Thursday, 12 November 2009

Slept all night – no pain.

7.00am – tea and toast in bed. Voltaren.

8.00am – some blood visible through dressing.

9.00am – showered etc, kept foot dry.

10.00am – friends for coffee and muffins.

12.00pm – friends left, felt tired – went to bed for a sleep – took 2 Digesic.

1.30pm – some minor tidying up of house.

3.00pm – a friend came around with dressing pack and dressing, sterile saline etc. Sue is a registered nurse. Blood at site – needed soaking with saline to remove. Wound looks clean and dressed when dry. I felt very faint and dizzy during dressing change – no actual pain.

7.00pm – dinner. Voltaren. Watched some TV.

8.00pm – bed early. Took 2 Digesic before sleep. Foot elevated on pillows and light rug only as doona too heavy on foot.

Friday, 13 November 2009

Slept all night.

7.30am – tea and toast in bed. Voltaren.

8.00am – up at 8am. Made phone calls, paid bills, emails.

10.00am – shower etc, foot throbbing slightly and felt heavy. 2 Digesic.

12.00pm – friends for lunch – kept foot elevated. Voltaren after lunch.

3.00pm – friends left, tidied up a little. Used crutches and wheelchair to get about inside.

6.00pm – heated pre cooked pasta for dinner. Voltaren after dinner.

7.00pm – friends for coffee.

Notes – no actual pain today. Some tingling, throbbing when foot down only.

Saturday, 14 November 2009

Slight tingling in foot when I woke up – not exactly painful. Took last Digesic.

8.30am – breakfast in bed, read the newspaper. Voltaren a bit later.

10.00am – tidied up around the house and put some washing on, emptied dishwasher etc.

11.30am – longer shower today.

1.00pm – friends for lunch.

2.00pm – watched some pre recorded TV shows but hobbled about the house in between.

Have not been outside the house since Tuesday. It has been too hot, grateful for air-conditioned home.

5.00pm – no ooze through dressing – looks and feels good.

Notes – only took 1 Voltaren today and Panadol twice. No significant pain in foot -just more aware of throbbing when not elevated. Will take regular analgesia as advised until the appointment.

Sunday, 15 November 2009

Slept all night.

7.00am – breakfast and read the paper. Voltaren after breakfast.

9.00am – Shower etc. Emails and phone calls.

10.30am – moving about better. No pain – but foot throbs if not elevated. So rested with foot elevated periodically.

12.30pm – lunch at home. Voltaren post lunch.

2.00pm – had afternoon nap – slept for 2 hours.

Notes – Voltaren x 3 today and took 2 Panadol x 3. No pain in foot.

Monday, 16 November 2009

Slept well all night.

Not feeling 100% today – no pain but discomfort due to constipation! Thankfully relieved by mid morning prune juice. Consequently lack of motivation to do much.

Did some light chores around the house, arranged for cleaner to come on Wednesday and fortnightly until Christmas.

Couple of friends came during the day. Sat outside for a while – beautiful day – 22˚.

Took Voltaren after meals and Panadol twice today.

Walking short distances without crutches. Mild throbbing right foot – relieved by resting with foot elevated.

Increased uptake fo fluids today and moving about more freely. Foot elevated when not ambulant.

Tuesday, 17 November 2009

Slept well all night.

Feeling generally much better today. Eating and drinking well. Getting more efficient with showering and keeping dressing dry.

Took 2 Panadol with breakfast, lunch and dinner.

12.00pm – Friend for lunch.

1.00pm – did some washing and hung it out on clothesline. Minor tidying up.

2.30pm – emails with foot elevated on cushions

No pain.

4.00pm – aware of discomfort when foot is not elevated. Slight throbbing and tingling.

6.00pm – dinner.

Wednesday, 18 November 2009

Slept well all night.

8.00am – showered without use of shower stool – managed well. Dressing dry.

11.30am – cleaner came for 1.5 hours. Sat outside for a couple of hours with neighbour – kept foot elevated.

2.00pm – did some washing – hung it outside. Folded and sorted when ready.

3.30pm – made a start on some stats for work.

5.00pm – made some muffins for morning tea tomorrow.

Notes – Panadol with breakfast, lunch and dinner. Also had Panadol before sleep as foot was throbbing a little.

Thursday, 19 November 2009

Slept all night.

Up early this morning, showered and dressed by 8.30am. Some discomfort when I first got up but subsided after breakfast and Panadol.

10.00am – coffee morning – Thursday group @ my home. Muffins pretty good.

1.00pm – friend for lunch – did some shopping for me. Made arrangements for dinner and birthday cake for friend tomorrow night at my house. Will have take away Vietnamese.

6.00pm – dinner at home.

Notes – Panadol with breakfast, lunch and dinner. Also before bed as foot was more uncomfortable. Have been walking about more.

Friday, 20 November 2009

Slept very well. No pain or discomfort on waking.

Some minimal throbbing in foot after shower. As usual, foot more comfortable when elevated.

12.00pm – lunch – prepared baguettes with ham and salad.

2.00pm – made some appointments for next week at home. Arranged to stay with friends on the peninsula from next sunday for a week.

5.30pm – ordered foot, set table, etc.

6.00pm – birthday dinner at my house for six. Late night but most enjoyable. Bed after midnight.

Notes – No pain or change to foot. Getting around ok and resting with foot up between times. Panadol post breakfast, lunch and before bed.

Saturday, 21 November 2009

Slept all night.

Shopping list prepared and helped put shopping away. Tidied up a little around the house, foot elevated periodically.

Panadol with breakfast, lunch and dinner. No change – discomfort, throbbing and slight stabbing sensation when foot is not elevated. Dressing is dry and intact.

6.00pm – friends picked me up and took me to their house for dinner.

Raining heavily tonight, took longer than usual to get to sleep.

Sunday, 22 November 2009

Slept well – woke a few times because of heavy rain.

Neighbour drove me to grocery store and picked up a few odds and ends – didn’t walk far. Prepared some meals for freezer. Rested with foot up whilst cooking.

Daughter and son in law moved back to their house today. I am managing very well.

Panadol with breakfast, lunch and dinner.

Had a 2 hour nap this afternoon.

No pain in foot. Occasional stabbing sensation and tightness only if foot down for lengthy periods.

Monday, 23 November 2009

Have followed all instructions for post op care with excellent outcome.

Took analgesics as advised regularly with the exception of Day 5 when I forgot – woke aware of discomfort that day. Up to today had 2 Panadol at meal times.

Constipation an issue on Day 7 post op – increased fluid intake and had some prune juice – with effect. No further problem.

Did foot exercises as instructed when at rest post 7 days.

Found sleeping with foot elevated comfortable. Used a warm but very light rug to cover in bed as doona was too heavy.

1.30pm – Appointment with Mr Blackney for suture removal.

Only deviation from instructions was that I had a wound specialist nurse friend change dressing which was blood stained on day 3 post op. Dressed the same as that done in hospital – strict aseptic technique. No further problems.

I am amazed and pleasantly surprised that I have not experienced any pain either in the immediate post op period or in the last two weeks. Have heard some horror stories about other people’s experience.

My advice – follow instructions and advice from surgeon and team. Prepare as much as possible for this period of limited mobility.

PATIENT:Female, Age 59

SURGERY:Bilateral Scarf/Akin Osteotomy

SURGEON:Mr Mark Blackney

HOSPITAL:Mercy Private Hospital

DATE of SURGERY28th July 2009

Tuesday, 28 July 2009

6.30am - light breakfast, no food or water after

(don’t want to suffer any pain, hopefully it’s not too bad)

12.30pm - Driven to hospital by 25 year old daughter

Questions:

  • How long will I need to be off my feet each day?
  • When can I return to gym?
  • Can I walk up stairs?
  • When can I drive car?
  • Toilet after operation?

Wednesday, 29 July 2009

7.30am - feet still totally numb

8.30am - read, eat, TV. Try using chair for toilet/shower

10.00am - much better

11.30am - Mr Blackney checks feet. Have no questions as I am still out of it.

2.00pm - pins and needles in feet (like at dentist after anaesthetic begins to wear off)

4.30pm - redress feet, looks quite good

7.00pm - need pain relief, morphine injection to help sleep

Thursday, 30 July 2009

Ok now, slept all night.

7.00am - breakfast, shower. Dressings changed, no problems.

8.00am - get dressed. Practise walking with OT. OK to go home now.

9.30am - picked up by neighbours.

11.00am - Feeling woosie, have low blood pressure and drugs making me feel light headed.

12.30pm - Arrived home, hobbled to bed.

1.30pm -  not hungry.

4.00pm - Up and down 8 feet to toilet and back, all I can manage – can’t wait to re-evaluate feet to relieve pain (throbbing).

6.00pm - Take one Endone, eat light dinner (salmon & salad, cup of tea).

Notes - Maintain 2 x 6 hourly Panadol.

Friday, 31 July 2009

Wake early, take 2 Panadol.

8.00am - Shoes on, waddle with crutches to toilet.  Glad to return feet to elevated position.

10.00am - Lay around, watch TV, read books, Sodoku, Crosswords etc.

11.00am - Shower, tidy self up. Not too difficult.

11.30am - Friends drop in.

5.00pm - Kate arrives for dinner (Sally organises it). She takes dogs to beach house to give them exercise.

6.00pm - Visit from Heather for 30 minutes. Feet elevated.

7.30pm - OT exercises.

Notes - No Endone today. Panadol 2 x 6 hourly, do notice when I need it.

Saturday, 1 August 2009

8.00am - hobble to kitchen this morning, less pain.

9.30am - bag feet, have shower, wash hair – great feeling. Chair in shower and hand held shower head very handy.

12.00pm - tidy up bedroom, unpack bag.

1.00pm - no lunch today, not hungry as not using much energy.

3.00pm - rest in bed. Watch TV documentaries and read. Feet elevated.

5.00pm - Sally organises my dinner then goes to 21st. Ok alone.

5.30pm - Neighbours visit, share red wine. Back to normality, sit up chatting until 10.30pm. Feet elevated.

Notes - OT exercises when I remember, feeling greatly improved today. Panadol 2 x 6 hourly, but not needing it so much. No Endone.

Sunday, 2 August 2009

7.30am - wake, toilet, waddle to kitchen, managing to walk more confidentlyjust using crutches for extra support every now and then.

10.00am - make tea and toast and eat at kitchen bench.

10.30am - sit in family room, read, crosswords etc. Feet elevated until 11am when daughter arrives.

11.00am - shower, change pj’s. All ok so far today, less pain with each trek.

1.00pm - visitors all arvo, lots of tea and chats. Feet elevated.

5.00pm - prepare vegies for dinner standing.

Notes - OT exercises, every time I think about it. Panadol 2 x 6 hourly. No Endone today.

Monday, 3 August 2009

Notes - no crutches in house. No Panadol today. Removed chair from shower, had shower standing. Exercises whenever I remember, sit ups too.

Tuesday, 4 August 2009

Breakfast – tea and cereal. I managed to get it myself.

Bag feet for shower.

Elevate feet whenever possible.

Have pins and needles, itchy ? healing.

Short trip in car for coffee with feet up. Hobble about the supermarket for 15 minutes. Arrive home with feet up for about 1 hour.

Dinner – go out for Indian, put feet up in back seat of car for 15 minute drive.

Notes - no crutches in house. No Panadol today.

Wednesday, 5 August 2009

8.00am - breakfast, boots on.

Neighbours visit – tea sandwiches. Feet up.

Rest with feet up in bed – pay bills online, sort mail, prepare taxation papers.

Exercises and tummy sit ups too.

Sort through photos for Sally’s 21st. Feet elevated.

Bag feet for shower.

Prepare soup for dinner, sit on kitchen bench and elevate feet.

Rest with feet up, read and watch news.

Notes - No Panadol today. Getting easier each day.

Thursday, 6 August 2009

Using heels and outside of feet to walk. Shower bags OK. Manage to walk around with no crutches most of the time inside on even ground.

Potter around, make lunch and soup for dinner.

Pretty easy now, except getting very bored, missing exercise now.

Can’t drive, very dependent on others.

Rest of day ok.

Notes - No drugs today. Walking easier each day.

Friday, 7 August 2009

8.00am - get up, have shower and dress.

9.00am - potter around, sit by fire, read TV, play games, Sodoku etc.

10.30am - visit from Heather.

12.00pm - Lunch – sandwich.

1.00pm - walking much easier now (Am I doing too much?)

3.00pm - drop into work – visit students and catch up with relieving teacher.

4.30pm - feet a little painful when home, elevate to relieve. No drugs necessary.

6.00pm - didn’t feel like “Christmas In August” function at school.

8.00pm - watched DVD’s, relaxed by fire. No pain but fuzzy feeling in feet sometimes.

Notes - no drugs.

Saturday, 8 August 2009

8.00am - get up, have shower, get dressed. No problems.

9.30am - sit around, bored, read etc.

1.00pm - washing, hang clothes on inside airer.

2.30pm - clean toilet, shower, bathroom. Tidy house – very slowly.

4.00pm - Kate and friend take me to Monsalvat for coffee and cake. Escape – wonderful to sit in sun (use crutches on uneven ground).

6.30pm - out for dinner with friends. Great, get picked up and driven. A little wine, great food and great company. Feet elevated when necessary. Get home about 10.30pm.

Notes - no drugs.

Sunday, 9 August 2009

9.00am - cut out dress for Kate, when we sew we will complete this.

11.00am - tidy house slowly, fold washing and do ironing.

1.00pm - Kate hires me wheelchair so that I can go to shops for birthday presents, food etc.

4.45pm - arrive home. No problems but elevate feet for a while.

6.00pm - neighbours invite us for dinner. Great no cooking, pampered.

Notes - no pain, feet elevated.

Monday, 10 August 2009

Pick up X-rays left at Mercy Private Hospital.

2.30pm - visit Mr Blackney’s rooms.

Questions:

  • have stitches removed? (All ok, no problems. No pain but looks yucky).
  • questions to ask – when is driving possible? stairs?, sewing?, physio?,  when in shoes?, gym?, walking distances.
  • bruising and swelling. Whose feet are these?
  • medical certificate until 18th September.

Wednesday, 12 August 2009

Walking much better, less strain on wound now that stitches are out.

Trying to weight bare on whole foot.

Screw up toes – very stiff not much movement.

Shower – foot free. Take it easy, prepare for slippery surface – towel on base.

Out to dinner. Take stick for uneven ground and stairs. Feet elevated during dinner. Restaurant very obliging.

Thursday, 13 August 2009

All happening each day easier. Remove pillow from base of bed. Bed clothes not causing an issue now.

Shower without shoes/bags again. YAY!

Great improvement.

Friday, 14 August 2009

Find Graeme’s “Crocs”. Large but perfect for feet – no pain and very light.

Tidy house – sweep, vac, dust, washing, make bed, prepare dinner.  Rested inbetween when feet “throb” and elevated.

Saturday, 15 August 2009

Shopping – in between coffee breaks.

Watch video, read etc when feet ache or have pins and needles.

Still not much movement in big toe but keep trying.

Leg muscles, calves feeling odd – missing adequate exercise– stomach crunches, leg raises, point / flex feet.

Sunday, 16 August 2009

Wash feet, gently rub away scabs. Feet begin to peel.

Wheelchair to get to/from zoo for Alex’s birthday.

Raining – very hard in wheelchair.

Elevate feet whenever possible.

Monday, 17 August 2009

More skin peels away from scar today. Soap, massage and wipe.

Much better wearing “crocs”. Must get smaller ones to fit when swelling subsides.

Feet look neat, scarring less red and bruises almost gone now.

Walking much better today.

Thursday, 20 August 2009

Soak feet – lavender oil. Pamper beautiful new feet.

Wow!! thinking about new shoes. Shoe shopping spree.

Painted toenails for the first time in my life, and sandals where feet can be seen. Hooray!!

And of course, no pain too. This will be great! Not long to go now.

- How long do I need to wear the spacer on big toe and 2nd toe?

Tuesday, 25 August 2009

Soak feet again. only the odd twinge in feet, especially at night.

Tightness in instep / arch.

Sweeping garden.

Wednesday, 26 August 2009

Lots of sitting. Feet tired at end of day.

Thursday, 27 August 2009

Sitting as much as possible. Have shopping delivered.

Friday, 28 August 2009

Sally’s 21st birthday party at home with 50 guests. Get friends to present and serve food.

Saturday, 29 August 2009

Clean up aftermath of party. Feet up most of the remainder of day. Aching and tired feet. Must rest a lot next couple of days.

Wednesday, 2 September 2009

Rest at beach house at Phillip Island. Slow walk along beach with dogs – not too far.

Thursday, 3 September 2009

Walk on beach.

Friday, 4 September 2009

Walk on beach.

Saturday, 5 September 2009

Home, clean up garden – sweep, rake. Vac house, clean toilets, etc. (Yuk, back to housework). No one sorry enough for me to do it from today.

Monday, 7 September 2009

Fill/patch guest bedroom walls. Stand on box for high bits (can’t stand on toes yet).

Thursday, 10 september 2009

Only odd twinge in feet now. Tight arches still. Can’t wear shoes – still in crocs.

Tuesday, 15 September 2009

Back to gym – low impact/weights only.

Shoes – gym shoes on today. Unlace and push foot in slowly. Great once on.

Can get feet into soft stretchers now. Wow! Almost there.

Wednesday, 16 September 2009

Gym – low impact only.

Feet tired –  rest feet up.

Wearing shoes for longer periods. Broad/soft sketchers.

Friday, 18 September 2009

Gym

Monday, 21 September 2009

Gym

Tuesday, 22 September 2009

Gym

Friday, 25 September 2009

Gym.

Longer walk on beach and around block with dogs in gym shoes.

Rest feet at night.

Sunday, 27 September 2009

Soaked feet peeled off last of old callus. Neat feet.

Still concerned about angle of big toe on left foot without wedges.

Tuesday, 29 September 2009

X-ray of feet.

2nd toe on left foot much longer than big toe.

  • have big toes been shortened?

Wednesday, 30 September 2009

Breakfast out.

Shopped 1-2 hours.

Feet aching and need to bat in cool water. Pad beneath toes burning. Big toes ached.

Feet elevated for rest of day.

Thursday, 1 October 2009

12.30pm - appointment with Mr Blackney. (need X-rays before appt).

Questions:

  • ask about certificate from 27th July until 18th September inclusive.
  • orthotics? where, when, who?
  • big toe – anything I can do to straighten it?
  • how long do I wear wedges between toes?

Monday, 5 October 2009

Back to work – hope feet hold up.

  • yard duty, sport supervision. correction.

Be prepared to be on my feet all day.