I've reached my one month (post-op) today, and now only 5 more months to go! I believe these next 5 months should go by quicker since I'll be back to work in a couple more weeks. Time goes by faster when one is keeping busy. :-)
My feet are still feeling much the same as last week. There is still a little soreness when doing my toe exercises and it is getting much easier to walk. Sometimes too easy and your body forgets to take each step slow. As not much has else has changed with my feet, I will talk about the little things that have made a big difference in this recovery.
As I am able to use a wheelchair when I am traveling outside, inside the house, I've been able to switch between my crutches and my "indoor wheelchair", which is just an office chair I use to roll around the place. This office chair has saved me time to get from one side of the house to the other (using my heels to move/steer), but it also importantly saves me from walking too many steps. Very helpful, especially during the first few months. Luckily I also have an office chair I can use when I return back to the US.
I don't think I've shown a close up picture of the boots that Dr. Wu provides, so here is a picture of them. They are very comfortable, easy to use, and protects the feet enough when you walk. The material is porous so it allows air to circulate well. During the warm weather days here in HK, the boots can make my feet warm, but it is not too bad. When I head back to the US, the weather is much colder, so I'm sure I'll be needing to wear socks with these boots. Luckily, the boots stretch well enough to allow for a "bulkier" foot (ex. with a cast and socks). These boots are not rain proof though, so I'll have to be careful when I'm going out in the rain.
Here is also a picture of the "shower shoes" that were provided by the hospital. They have a rubber part on top, where you insert your foot and the rubber part is supposed to keep the water out. When you first use these shower shoes, these shoes are VERY good and no water comes in when you're showering. Now, after about a month, the rubber has stretched a little more so I'm just starting to see a little bit of water come into the shoe. But so far they are only drops of water, so the shoe still works well. Hopefully, after a few weeks, Dr. Wu will give me the green light to wet my feet, since by now, all the stitches on my feet would have healed my now. I will keep you all posted.
That is all I have for now and I leave you with more pictures of some yummy food I've had here. I have my last appointment with Dr. Wu coming up in about a week and a half and I hope the prognosis will still be good.
Today I'm at 3-weeks post-op but it definitely feels like I'm more than a month into my surgery. Time is passing by more quickly and I've gotten adjusted to walking in these casts. My feet seem to look the same as last week so no major change. The casts are still on pretty tight so I confirmed with Rachel that I shouldn't take off my casts (or change my bandages) unless the casts slip off on their own.
There is now less pain when I do the toe exercises, which is a good thing. I've now been able to go out a little more so it has been fun, enjoying time with family and friends, eating more yummy food, and sightseeing. The only issue when I go out is that I don't have the opportunity to do my toe exercises in between since I don't want to do this in public, especially at a restaurant (gross!). I can see Dr. Wu's disapproving face (:-P) so I need to find ways to still do my toe exercises even while I'm out. Maybe put my jacket or towel over my feet while I'm doing the exercises?
This past weekend, my family took me to Sai Kung and Ocean Terminal to people watch and see the sights. One might worry about lots of people being around, but it is interesting that I actually walked less when I was out, than when I just stayed at home. This is my normal way of transport when I'm out. We're fortunate enough to have access to a wheelchair and my family take turns wheeling me about.
Being transported in a wheelchair gives me a different perspective on life. I always took simple things for granted - like being able to walk to/from the parking lots, being able to walk the stairs or take the escalator, going to the restroom, or catching a taxi on the streets. All of this has now been more difficult because of the recovery process. Wherever we go in HK, we have to make sure that the car we take can fit the chair in the trunk and there is handicap access available wherever we go (ex. Handicap elevator, handicap drop off point, etc).
Not all of HK has this capability so going out needs some logistical planning. Back in the US, there is a requirement for handicap access to be available so I probably will not have to worry as much back home. Even being wheeled to a table inside a restaurant has it challenges and luckily most people have been accommodating. You might ask why not just walk to the table? Well its because it takes an eternity to walk even a short distance because of how slow you're supposed to walk. On the other note, some people are very oblivious to you being in a wheelchair and walk right into you or use the handicap bathroom/elevator. For the person in the wheelchair, it is annoying when people accidentally bump into your feet or use the handicap facilities. Because some people don't pay attention, you have to watch out for your feet and make sure they're protected. When I'm fully healed, I'll be sure to be more aware of my surroundings and not use handicap facilities. It makes such a difference to the person in the wheelchair and I'm fortunate my situation is only temporary.
Of course being in a wheelchair too long is not always a good thing either because I'm not keeping my feet elevated, so there may be some minimal swelling and discomfort in my feet. The solution to that would be to find opportunities to keep your feet elevated when you can. At restaurants, coffee shops, etc, find ways to keep your feet propped up. Even better if you can keep your feet hidden underneath the table, but here were some ways I accomplished my goal.
For my recovery, I had also purchased a basic FitBit pedometer to use to track my steps. The funny thing is that I walk so slowly and gently that the pedometer does not even register my steps. Lol! It's pretty much useless now, but I could try to use my iphone as well, which also tracks steps using GPS. Unfortunately, I don't always carry my iphone so I'm also not accurately tracking my steps using my phone. I have an idea of how much I walk when I'm at home because I counted my steps. Dr. Wu never gave me an exact number of how many steps I should/should not walk, but I'll try to keep it at a minimum for probably the first month or so.
I'll finish this blog with more pictures from my trip to Sai Kung and the wonderful food we ate. Sai Kung has piers where you can buy fresh seafood from people in their boats. You call down to them and let you know what you want. Then the transactions all take place using a basket or net that is brought up/down. Pretty cool! We also got to try one of the famous pineapple buns at the bakery in Sai Kung. It came out fresh from the oven and was delicious. On the other days we were able to enjoy Thai food at Ocean Terminal and then Indian food in Kowloon City. I'm halfway through my stay here in Hong Kong so let's see what other adventures I can have before heading back home.
Sai Kung:
Thai Food and Indian food:
It's Tuesday and I can't believe I'm already 2-weeks post-op! I'm happy that time is going by faster than I'd expected. After my visit with Dr. Wu, I felt a little more comfortable getting outside the house. I went to lunch on Saturday at this delicious restaurant close by. They served Lamb curry and Lamb wraps that were so yummy. And of course, this place had my favorite - HK style milk tea which really does taste better in HK. Oh boy will I be gaining weight during this recovery period! :-)
We chose to go to this restaurant early so there was less people for me to walk around. We also sat in a booth so I could keep my feet up while eating. A great atmosphere and ideally, a great place to allow a slow (very slow) walker like me, to get around.
Okay, now back to my recovery. Not much has changed since I last posted. I am getting better at my toe exercises, but still not yet at the 90 degree bend I'm supposed to be at. You can see here, I'm almost there. I just have to keep reminding myself to do these exercises frequently. Feet are still being elevated as much as possible, even when I'm sleeping. Elevating my feet higher than my sitting position (ex. lay them on top of a pillow) allows the blood to flow away from my feet, which helps with the swelling and comfort.
In regards to pain, a majority of the time there is no pain when I'm resting my feet. Periodically, I do get some spasms of pain but so far it is mainly affecting my right foot. I am assuming this is part of the healing process and I have noticed that my right foot seems to bother me more than my left. This makes sense in that the pain I had before my surgery was primarily in my right foot, so I am thinking my right foot will take more time to heal?? Hopefully, the pain will eventually completely go away, but even now when the pain comes, it is very tolerable and I've had no need for medication. I have noticed that the brief moments of pain come after I've been walking on them a little more than usual, so this tells me to still take it easy and stay at home as much as possible during this first month. Walking with these casts can also lead to me shifting my weight oddly, which also adds to any discomfort I feel. The casts are a good reminder to not walk too much!
The only other minor complication I currently have is a little numbness on top of my right big toe. It is not very numb and it may be due to some swelling that may still be present. Otherwise, I don't notice it unless I run my fingers over my toe. Functionality of the toe is not affected so far.
I realized that I haven't yet described the recommended recovery process for this SP surgery so I will list it now. This is what's recommended by Dr. Wu and his team, but as every patient heals differently, I am considering this to be the minimum guidelines.
1-3 weeks - Use healing shoes and home rest as much as possible to keep feet elevated
1 month after surgery - stationary cycling is allowed, driving is possible
up to 3 months - Use healing shoes with cast-brace, limited outdoor walking
4-6 months - Can wear regular, comfortable walking shoes with special in-soles provided
6 months onwards - No more shoe and activity limitation
Before I take any major leaps, I will always check with Dr. Wu first to make sure it's okay. Since I've invested so much of my time and money into this surgery, I want to be sure it's successful. Dr. Wu has done his part with the surgery, now it is my turn to do mine.
One last note before I sign off - I have been finding different ways to exercise as I believe this is important also for the healing process. Exercise allows the blood (with the vital cellular components) to circulate more throughout one's body and can help prevent atrophy in the muscles. I have found exercises that don't involve using your feet, through the web, specifically You Tube. Just search "exercises without using your feet" or something similar. These exercises are good for the legs, back, and core!
Until next time then...
Note: I am not a fitness professional so always do these exercises carefully after consulting with your doctor.
The days following my surgery were relatively uneventful. I adhered to Dr. Wu's advice and did not leave my uncle's house for over a week. One important item to keep in mind is to do core and back exercises during this time as well. This will help prevent your back from becoming strained due to sitting all the time. I also found that standing every now and then was also important for the leg (and back) muscles.
Otherwise, I hobbled around the house okay, and spent most of my time keeping my feet elevated and continuing with my toe exercises. Keeping my feet elevated for the first week was important because it was uncomfortable when my feet were down and the blood was concentrating down to the bottom. With assistance, I was able to shower each day and we developed a good and efficient routine. Again, those foot covers are life savers! My pain level, at rest, was pretty much at zero after the 3rd day. I never had to take any pain medication after the 2nd day, which was great! The only time I experienced some pain was when I performed my toe exercises and was stretching the muscles/ligaments. This was to be expected and my right foot was a little more painful, whereas my left foot had no pain. The swelling also was not as significant as I thought it would be. The picture below is so far the worse I've seen, with some bruising around the big toe areas. I checked in with Rachel and Dr. Wu and they said it was to be expected. Rachel had provided me with some bruise ointment to use 2-3X a day, as needed. I used the ointment just a few times throughout the whole week. Also used ice packs when needed.
At Day 10 (October 29th), I was finally able to leave the house - hooray!! I had a follow-up appointment with Dr. Wu. Getting out of the house was not too difficult. Again, I needed to walk slowly and luckily my uncle's place has an elevator. I felt bad taking so long to just even walk to the elevator, but I kept telling myself not to rush and that people can wait a little longer for me to get in.
When I got to Dr. Wu's office, I had to wait for a bit because we were early for our appointment. The secretary, Grace, was very courteous and led me to the sofa where she then placed a platform in front of me to help me elevate my feet. Once Rachel was ready for me, she called me into the room to take new X-rays. At the same time, she also gave me the X-rays that were taken intra-op (during surgery). I didn't have an electronic copy available of the intra-op X-rays, so I had to make do with taking a picture of them (sorry for the poor quality). The X-rays look great though! I've also put a picture of my feet "before surgery" to act as a little comparison.
After the X-rays, Rachel checked both my feet to see how far back I could bend them. My feet were registered to be 80 degrees on my right and 75 degrees on my left. They were a little tight in the morning, but I know I needed to keep exercising so I could get to 90 degrees for both. Rachel then went ahead to take off my bandages. Luckily, I didn't quite know what to expect so there was no anxiety. But this part was somewhat painful. Even though the cuts had mostly healed, they still stung when the bandages were quickly removed and alcohol wipes were used to clean them. I was sucking in my stomach a bit to help me cope with the pain. It wasn't a sharp pain, but a very sensitive feeling that was uncomfortable. Rachel then went ahead to cut and remove some of the stitches. Again, it was not a pleasant feeling, but luckily she is so good at doing this, she removed everything quite quickly to minimize the pain. After she finished cleaning, she placed some clean surgical tape on my cuts, asked me to place my feet back into my surgical boots and then walk to a different room.
Dr. Wu joined us not too long afterwards. He asked how I was doing and how the pain was. I told him I had no pain and had not used any pain medication since the 2nd day. He then proceeded with adding additional surgical tape to secure my feet. Then he started to create the synthetic forefoot cast around the mid-to-top section of my feet. It was fascinating how he created this cast and it was definitely different than the casts I was used to seeing. The picture below shows the finished product. The casts do eventually become a little tight over time, which can contribute to some additional swelling of the toes. But overall, the swelling is still not that bad.
Walking in these casts has proven to be more interesting as it is a hard cast and now my feet are somewhat elevated. It kind of feels like I'm walking in cycling clip-on shoes as a comparison. This cast helps keep my feet secure and helps to ensure that the straight alignment of the feet are maintained. Again, doctor's orders are to stay at home with feet elevated as much as possible. Dr. Wu said I could go out to eat, but it is important that I don't walk too much and use my crutches. Eventually, after 1-2 months, Dr. Wu will suggest for me to stand a little more to start re-building the strength in my feet muscles.
Before I completed my appointment, I went ahead to schedule my last appointment with Dr. Wu before I head back to the US on November 30th. At the next appointment, he will be providing me with additional instructions and exercises to use when I am back home.
My uncle treated us to a nice lunch afterwards in Repulse Bay. He said that since I've been couped up in the house these past 10 days, we should eat a nice, stress free lunch. The staff at this restaurant were wonderful and very accommodating. It was the perfect setting as there were few people eating and I could take my time hobbling around the restaurant. The food was great too. Below are pictures of the restaurant and outside, plus me trying to tackle the front stairs. Slow, but I made it down to the bottom successfully!
My second evening at the hospital passed without incident. Again, I was fighting jetlag, but everything else was okay. I was being discharged from the hospital that morning, around 11am. I had eaten some of my leftovers in the morning so when my mom arrived, we went ahead to have me shower once more before I left the hospital.
Dr. Wu paid me one last visit in the morning. He checked again on my pain level and my progress with my toes exercises. I was able to get to about 70-80% bend after all my exercises the day prior. He seemed pleased with the progress and told me to continue with my exercises, but this time do them every hour instead of every 30 min. I had very little pain during rest (probably a level 2) and had stopped taking pain medication the night prior.
The rest of the morning was spent wrapping up my hospital accounts, getting some last minute pain medication from the pharmacy (which I didn't need but took with me anyways), and making sure everything I brought was packed up. The discharge process was very smooth and they provided me with a nice summary of the surgery that was performed on my feet. I was also given some discharge instructions to follow.
Here I am being wheeled out of the hospital to my uncle's car. I was then taken back to my uncle's place to rest and recuperate. Dr. Wu's orders were to not go out of the house for at least this first week. It is better to keep my feet elevated and not walk too much. Also below is one last view from the peak, provided by my friend. :-)
It was Day 2 after surgery and as time passed, the pain was less and less. After about mid-day on day 2, I opted to not take anymore of the pain medication they provided. One, I didn't feel like I needed it and two, the codeine in the medication gave me nausea. I had brought some Advil with me so I felt that if I needed pain medication, I'd prefer to use Advil instead. Again, I was surprised that there was not very much pain. At rest, the pain had dropped to about a 4-5 level already by Day 2.
The nurses came in, early in the morning, to change the dressings on my feet. I was briefly allowed to see my feet post-op, but was only able to snap a couple of quick pictures. Changing of the dressing was not bad and was not very painful.
Dr. Wu then visited me soon after the bandages were changed. He took notes on my pain levels, how I was feeling, and re-wrapped some of the bandages around my feet. He also said that it was important to start my physical therapy exercises today. I was to do three exercises, three times in a row, every 30 min. You can say that I definitely kept myself busy on Day 2! The three exercises he taught involved bending the toes backward and the goal was to get them to 90 degrees over time. This was where it tended to be more painful - when I started doing these exercises. Dr. Wu acknowledged that I needed to work through the pain because as I did the exercises more often, the pain would eventually decrease. He was right of course and by evening time, the pain had lessened and I was more flexible than I was in the morning. He also advised that I wiggle my toes as much as possible to help with the swelling and tightness.
The other good news about Day 2 is that I could get off the bed and walk for the first time, post-surgery. Hooray! I could use a regular bathroom :-) My friend who did the surgery a year ago, paid me a visit in the hospital. She showed me some good ways to use my crutches to help me get up and down. Walking for the first time was not difficult and I mainly needed to be careful to take things very slowly. My feet were a little tight when I walked, but overall the surgical boot helped mask a lot of the "impact" from walking. I was able to walk to the bathroom and back to my bed without much problem. I ended up doing that, on my own, during the rest of the night too. We were allowed to take a shower on Day 2, which was a nice treat. The hospital provided me with these two plastic covers to wrap over my feet and ensure that no water gets in. These were professional grade foot covers and they were very good. I'm so happy I have these and know I will be using these for sometime throughout my recovery.
I was fortunate to have more visitors throughout the day and evening. Family and friends brought me lots of food to eat, including dessert. I definitely was not going to go hungry :-) I had to spend one more evening in the hospital and then I was okay to go home the following day.
Once in my room, they placed ice packs on my feet immediately. There was
no real pain at all. My voice was a little croaky from being intubated,
but not bad. I was not allowed to eat for about 3 hours and I had a
little nausea from the anesthesia medication. My feet look enormous in
the picture, but it really was not bad at all. The ice packs made them
look very swollen, but the swelling was very minimal.
During the first day, we were advised to not get off the bed at all. This was okay except that it made going to the bathroom an interesting experience. Using a bedpan is never a pleasant thing, but I guess it is better than other options. Luckily, it was only for one night. My pain level was tolerable. I think overall, the pain may have gotten to a 7-8 at one point, but never enough to ask for an extra shot of pain medication. I just continued to take the pain pills they provided every few hours, which was panadeine. This and the anti-inflammatory medication they provided was more than enough. Several hours later, I was finally wanting to eat something. I could have eaten earlier, but I was not very hungry - probably from all the medication I was given. Here I am trying to eat some fried rice from the hospital. It was not very good, but did serve its purpose to put something in my stomach.
My mom was such a trooper as she stayed with me throughout the entire day and into the evening. I don't know what I would have done without her and am truly grateful for her love and support. My relatives were also so nice to visit me that first evening and it was great to see them. Once everyone left for dinner, I was left to the care of the nursing and medical staff. They were very attentive, responsive, and helpful. My first evening in the hospital was very pleasant, except for the jetlag I was still fighting. :-)
It was October 20th, 2015 and the day of my bunion surgery! I was surprised to say that I was not very nervous about the surgery. More anxious to get it over with, but I believe I prepared well enough that I knew exactly what I was getting myself into. My surgery was not scheduled until 9:30am, but we went to the hospital early to avoid traffic. Dr. Wu currently operates out of Matilda International Hospital up on the Peak. This was a beautiful hospital and had an intimate atmosphere. The front entrance alone had a spectacular view.
Once inside, the lobby and registration desk mirrored that of a fancy hotel. Marble walls and floors, it really gave us patients a pleasant feel of the hospital. Again, it is a very intimate hospital so each time an employee spoke to you, they were not rushed and were very courteous. After checking into the registration desk, I was escorted to the 2nd floor, which was where my hospital room was. All the nursing and clinical staff were very professional and efficient. After confirming my identity multiple times (a big plus for me since this is SO important), I was given a wristband and brought back to my room. They completed the check-in process, which included taking my baseline blood pressure and temperature readings. They explained to me the schedule of the day and how I could store my belongings. I had my own locker to store my items and also a small bedside compartment to also store other items. Dr. Wu and the anesthesiologist, Dr, Chan, both came by to talk with me beforehand. They had to ask some additional questions, including my current pain level (1-10), and whether or not I had any allergies to medications. I was told to change into the hospital gown and about an hour before surgery, to perform the betadine wash on my feet. Dr. Wu's patients were provided with a betadine wash solution and sponge to soak one's feet into and to clean the feet prior to surgery. They would sterilize my feet again while I'm in surgery, but it was important for me to do this initial cleaning. They provided me with directions as they felt that patients would clean their own feet more thoroughly. Once I completed my betadine wash, I used the clean slippers they provided me and waited.
Once they were ready for me, the nurse escorted me down to the first floor where the operating room (OR) suites were. Again, I was thankful that I was not very nervous as I've been inside ORs before, for my work. I knew generally what to expect. The surgery was supposed to last about 2.5 hrs (1hr 15min per foot), and I would then be rolled into the recovery room to wait until I woke up from the anesthesia. So overall, probably about 3 hrs before I'm back in my room.
They walked me to the OR waiting area where another nurse perform some final pre-op checks (very impressed again). She re-confirmed my identity and asked about my allergies, whether I had any jewelry, loose teeth, etc. Dr. Wu was also sitting there and we briefly chatted about work before I walked into the OR room. Once I was inside the OR room, they asked me to lay on the bed and they immediately covered me with a nice warm blanket which had a hose pumping warm air inside. They definitely did not want me to be cold. :-) On my right arm, they were taking blood pressure readings and on my left, Dr. Chan was explaining that he was going to insert a small needle into my left hand. He said it would sting a little bit, but not too bad. Only at this point, did my nerves get to me a little and I was having jitters. But everyone was very nice and did their best to calm the situation. I chatted with Dr. Chan as well to help me calm my nerves. Once he successfully got the needle in, he then explained that I would feel a slight stinging sensation in my left hand. That was from the medication he was administering to me. I acknowledged that I felt the stinging sensation, and then I don't recall anything after that. That was probably when I blacked out/fell asleep. Haha! Next thing I know, Dr, Chan is waking me up and saying, "Nathalie, we're done now." When I heard that the first thought I had was, "Already? Really? That was fast." I literally only remember falling asleep and then waking up. The whole surgery felt like it lasted only 2 min to me! Below is a picture of them wheeling me out of surgery and everyone was surprised to see how alert I was. I guess it didn't take me too long to wake up, which was great! I think I got back to my room around 12:30pm, so 3 hours was a good estimate.
