Had a good night's sleep last night for the first time really, must be the Scotch and Green Ginger that I gave a chance with last night whilst watching re-runs of the X Factor! My partner and Mum cooked a lovely meal of Pork Belly with red wine sauce and potato wedges and peas. All washed down with a glass of Shiraz....bliss. I feel like I am getting back to normal, well apart from the crutches of course.
Feeling much better all round, however some pain creeping back in where the foot is concerned, so I took a couple of pain pills at 0700 and just about to down another couple just now (1300).
I've been researching this morning to see if I am eligible for any sickness benefit due to the operation, but it seems that I will get nothing because it's all means tested, and my partner has a good job.
The lad who works for me is taking Toby the dog out every morning and evening and then doing a full day's work in between, so the business is still ticking over anyway, despite me being unable to work in it.
It's my partner's birthday on Saturday so I've ordered a present and card for him online. I suppose all of my shopping is going to be online for the foreseeable future.
I phoned the hospital too, in order to find out about my first follow-up appointment and they're talking three weeks. From what I've read on the internet, it seems everybody has had an appointment at two weeks post op. Anyone any idea why it would be as long as three?
Thursday 16 October 2014
Wednesday 15 October, 4 Days after surgery
Big improvement in my overall feeling of well-being, almost stopped the pain meds, no more anti-inflammatories or blood thinning injections, only taking extra power pain reliever one at a time when needed, however very little pain.
My mum went out and got Bisodol for the trapped wind, and this seems to be working, however still the odd gripe.
If everything was ok apart from the foot I would be happy right now!
Amazed how little you can do on crutches. It is very debilitating because you obviously have no hands available as well as only one useable foot! I think I underestimated the fact that you really can't do much at all around the house, and I am totally reliant on my mum as a full time carer. God knows what I would do without her here!
My mum went out and got Bisodol for the trapped wind, and this seems to be working, however still the odd gripe.
If everything was ok apart from the foot I would be happy right now!
Amazed how little you can do on crutches. It is very debilitating because you obviously have no hands available as well as only one useable foot! I think I underestimated the fact that you really can't do much at all around the house, and I am totally reliant on my mum as a full time carer. God knows what I would do without her here!
Tuesday 14th October, 3 Days after surgery
Slowed up on the frequency of pain meds, no appreciable pain in the foot, still suffering the effects on my guts though, with little sign of improvement.
Monday 13th October, 2 Days after surgery
I have kept my leg elevated with the shoe on the whole time, doing the circulation exercises, though not every 30 minutes as per the instructions I have to admit.
Hardly any swelling or pain from the foot, horrendous griping pains still from the guts. Laxatives do not seem to help with trapped wind.
Pain meds still taking regularly as prescribed, but feeling like they could be reduced so I feel better and start getting my digestion back to normal.
Hardly any swelling or pain from the foot, horrendous griping pains still from the guts. Laxatives do not seem to help with trapped wind.
Pain meds still taking regularly as prescribed, but feeling like they could be reduced so I feel better and start getting my digestion back to normal.
Sunday 12th October, 1 Day after surgery
Kept on the pain medication as prescribed, leg elevated, shoe on.
Very little pain from the foot, however the effects of all the medications where starting to affect my digestive system (again).
I will make a very important observation at this point, it is absolutely essential that you do not ignore the advice regarding laxatives after general anaesthetic and when you're taking pain medication on a regular basis.
I started filling up with gas and my stomach was distended, same as last time I had a general anaesthetic. I realised that it was too late, I should have had some laxatives yesterday and not waited until the day after. The pain was excruciating and there is no reprise from it, you go to the toilet and sit there as if your entire digestive system has just "shut down", indeed this is exactly what has happened.
In a bit of a panic I sent out for some oral laxatives and a product called "lactulose" was brought back. Here's another thing, when you're taking strong pain killers you can't think straight, your mind is affected and also your judgement. I read the minute printed instructions on the bottle and couldn't make sense of any of it. In one place it said "dose: 30-45ml three times a day" and another place it said "one dose with breakfast". In shear frustration and in abject agony with constipation, I swigged down 30ml and waited for something to happen. I looked up lactulose on the internet in the meantime, and to my dismay it quite clearly stated that it could take up to 48 hours for it to work!
"I haven't got 48 hours, I f***ing need relief NOW", I shouted in frustration.
So trying to convalesce from an operation, this is really not what you need.
In frustration I took another 30ml - this was about 2000 at night.........very bad idea in hindsight.
Went to bed around 2115 in total agony with trapped wind, stomach gurgling like you can't imagine, fell into a restless sleep.
0315 in the morning I am woken up with huge stomach cramps and rush to the toilet on crutches where I sit there for over an hour feeling sick, going green, feeling like I was going to pass out, until finally relief came.......I shan't go into more detail here but you can imagine the outcome.
I remembered reading that taking an overdose of lactulose, however small could be extremely dangerous because of the alteration in electrolyte levels. I thought I had probably overdosed by 30ml which was quite a lot. Maybe that's why I felt so ill.
0415 Back to bed only to wake up a few hours later, desperate for the toilet again, and again, and again etc you can imagine.
Moral of the story: Take your laxatives as soon as you get home after surgery and keep to a maintenance dose whilst you are on pain meds regularly.
Throughout this entire episode, I have had more pain and discomfort from constipation and trapped wind, caused by the medications and aesthetic than anything relating to the surgery itself!
Very little pain from the foot, however the effects of all the medications where starting to affect my digestive system (again).
I will make a very important observation at this point, it is absolutely essential that you do not ignore the advice regarding laxatives after general anaesthetic and when you're taking pain medication on a regular basis.
I started filling up with gas and my stomach was distended, same as last time I had a general anaesthetic. I realised that it was too late, I should have had some laxatives yesterday and not waited until the day after. The pain was excruciating and there is no reprise from it, you go to the toilet and sit there as if your entire digestive system has just "shut down", indeed this is exactly what has happened.
In a bit of a panic I sent out for some oral laxatives and a product called "lactulose" was brought back. Here's another thing, when you're taking strong pain killers you can't think straight, your mind is affected and also your judgement. I read the minute printed instructions on the bottle and couldn't make sense of any of it. In one place it said "dose: 30-45ml three times a day" and another place it said "one dose with breakfast". In shear frustration and in abject agony with constipation, I swigged down 30ml and waited for something to happen. I looked up lactulose on the internet in the meantime, and to my dismay it quite clearly stated that it could take up to 48 hours for it to work!
"I haven't got 48 hours, I f***ing need relief NOW", I shouted in frustration.
So trying to convalesce from an operation, this is really not what you need.
In frustration I took another 30ml - this was about 2000 at night.........very bad idea in hindsight.
Went to bed around 2115 in total agony with trapped wind, stomach gurgling like you can't imagine, fell into a restless sleep.
0315 in the morning I am woken up with huge stomach cramps and rush to the toilet on crutches where I sit there for over an hour feeling sick, going green, feeling like I was going to pass out, until finally relief came.......I shan't go into more detail here but you can imagine the outcome.
I remembered reading that taking an overdose of lactulose, however small could be extremely dangerous because of the alteration in electrolyte levels. I thought I had probably overdosed by 30ml which was quite a lot. Maybe that's why I felt so ill.
0415 Back to bed only to wake up a few hours later, desperate for the toilet again, and again, and again etc you can imagine.
Moral of the story: Take your laxatives as soon as you get home after surgery and keep to a maintenance dose whilst you are on pain meds regularly.
Throughout this entire episode, I have had more pain and discomfort from constipation and trapped wind, caused by the medications and aesthetic than anything relating to the surgery itself!
Wednesday 15 October 2014
The day of the Operation
Saturday 11th October 2014
0530 Get up and have a thorough shower. Feeling very hungry and could kill for a mug of coffee, but nil-by-mouth. Order my taxi for 0630. Filled in registration forms, got together my dressing gown, slippers, overnight bag just in case...
I should say at this point my intention was to try and stay in overnight if this was offered as an alternative to going home. The last time I had an operation was in 2004, a hernia repair at Wharfedale hospital on a day case and the only other time I have had a general anaesthetic in my life. On that occasion I travelled to my parents home in Middlesbrough after the surgery, only to suffer an Ileus (mechanical blockage of the intestines) and be rushed into South Tees hospital in an ambulance with flashing lights, only to spend the entire evening there on IV fluids and an ECG.
I maintain unto this day, that even this type of "minor" surgery carries too many risks of complications, post-operatively and to operate under general anaesthesia and send you home is utterly wrong, and that everyone should be kept in for at least 24 hours in order to monitor the patient afterwards and manage their pain in those crucial few hours.
0640 Arrived at Spire hospital (too early as usual with me!) no receptionist, just the security guard who took my name and had me sit in the waiting area. There was only one other patient there with her mother, I think. Around 0655 a steady stream of patients and the receptionist arrived and the waiting room filled up. The receptionist checked in quite a few patients and then came to get me in order to register. After another ten or twenty minutes I was collected and taken up to ward 2 and my own personal room.
All very clean and tidy with a machine that goes "Bing" and a cardboard tray for being sick into. They might have kept that hidden until it may become necessary I thought.
So that was to be my own private space for the day. I made myself comfortable and prepared for a wait of unknown duration.
Several people came, all very bubbly and excited, which seemed to me entirely appropriate, much rather that than sombre.
The surgeon came in and got me to sign the consent form, reminding me that there were the chance of complications which included infection, bleeding etc but 99% of these cases went without a hitch.
It wasn't until I got home and read the form a little closer to see that one of the complications was DVI which I gather stands for "Deep Vein Incompetence", PE which I think is "Pulmonary Embolism", alongside the words, "Non-Union", "Nerve Injury", and the most horrific, "Amputation". I'm glad I didn't read that beforehand. I'm pleased to tell you that I still have ten toes, at this moment in time anyhow.
The surgeon whipped out a felt pen and marked my operation site....
The Anaesthetist came in all humorous and charismatic, as most anaesthetists seem to be in my experience, perhaps someone who holds life in a constant state of balance needs a certain type of personality. Anyway he was very supportive and upbeat. I did raise my concern of being a total wimp and being most anxious about post-surgical pain and also my experience of the last time I had a general. He explained that Ileus is mostly concerned with abdominal procedures and there should be no such complications with a big toe. He also said they would put in a pain block which should last up to 48 hours rendering the leg completely numb from the knee down. This put my mind at rest considerably. He finished up by saying that the only problem was, that I was last on the list, right up to lunchtime, around 1300. I remember thinking, "my god I hope they are not too tired or hungry to do it by then!".
Several other nurses came and did lots of tests, a physiotherapist came and brought me a boot that I would wear post-surgery, went through the circulation exercises that I would need to do, and then it went very quiet. For what seemed like a very long time.
I read half of my book, "Dear Friend and Gardener, Letters on Life and Gardening" by Beth Chatto and Christopher Lloyd" which I am finding fascinating.
I kept looking at my watch and seeing other patients walking past the door in hospital gowns on the way to surgery, and then the same person being pushed back to their room with a drip attached and an oxygen mask on...quite surreal, but when would I be next?
At 1230 a nurse came in and said, "haven't you got changed yet, your going down at 1300?"
I got changed.
1300 passed. Then 1400. At 1415 I saw the young nurse who I had spoken to earlier and asked what was happening, At that second a man turned up in theatre green. I was on.
1425 In the holding room, and the anaesthetist starts telling me about a surreal story of skiing in the alps or something, sounded like he was performing a play...he put a needle in my hand and pumped in what looked like about half a gallon of clear liquid,,,,,felt like he had given me a whole bottle of scotch in one go.......next thing I remember I was waking up in the recovery room.
1600 or there abouts I am in a different room with tubes coming out of everywhere and a mask on. The nurse says, "how are you feeling?". I remember feeling as drunk as a skunk but with a burning, searing, unbearable pain in my foot...."My foot hurts", I said, "My foot really hurts"...
"I can give you some morhpine, but we don't want you to choke to death, we've done very well so far today and don't want to spoil anything!".
I have to tell you here that this is what I think she said, I was completely paralytic and might have dreamed it.
I said something like, "Yes, morphine, please, if I choke then you have my permission".
After a long time, which was probably only a few seconds, the pain in my foot started to ease. The anaesthetist came over and said, "You look like you're grimacing, you were worried about the pain were'nt you?" Again I might have dreamt this.
Anyway this scene from Alice in Wonderland through a haze of morphine carried on for some time.
1615 I was back in my private room. Peace and quiet and allowed to rest for a while.
Soon I was brought a jug of water which I sipped away at from a tiny glass with a straw. It tasted like mountain spring water after weeks of being stranded on a desert island. My foot was still hurting so the nurse gave me more morphine, this time liquid form, and a pot of pills to take.
20 minutes or so I was feeling as right as rain, ready for my sandwich, smoked salmon on brown bread with a nice salad, lemon and a pot of fresh coffee.......it was bliss to me.
1715 The door opened and there was my dear partner and as a lovely surprise, my beloved Mum too! I was suddenly really looking forward to going home.
The physio came in with crutches and taught me how to use them with the shoe, I was given pain medication to take home (co-codamol, diclofenac, and some injections to thin the blood and prevent Thrombosis), and that was it, discharged!
That night got into bed with pillows under my leg to raise it, laid awake all night, no pain though as the block was obviously working with the pain meds.
0530 Get up and have a thorough shower. Feeling very hungry and could kill for a mug of coffee, but nil-by-mouth. Order my taxi for 0630. Filled in registration forms, got together my dressing gown, slippers, overnight bag just in case...
I should say at this point my intention was to try and stay in overnight if this was offered as an alternative to going home. The last time I had an operation was in 2004, a hernia repair at Wharfedale hospital on a day case and the only other time I have had a general anaesthetic in my life. On that occasion I travelled to my parents home in Middlesbrough after the surgery, only to suffer an Ileus (mechanical blockage of the intestines) and be rushed into South Tees hospital in an ambulance with flashing lights, only to spend the entire evening there on IV fluids and an ECG.
I maintain unto this day, that even this type of "minor" surgery carries too many risks of complications, post-operatively and to operate under general anaesthesia and send you home is utterly wrong, and that everyone should be kept in for at least 24 hours in order to monitor the patient afterwards and manage their pain in those crucial few hours.
0640 Arrived at Spire hospital (too early as usual with me!) no receptionist, just the security guard who took my name and had me sit in the waiting area. There was only one other patient there with her mother, I think. Around 0655 a steady stream of patients and the receptionist arrived and the waiting room filled up. The receptionist checked in quite a few patients and then came to get me in order to register. After another ten or twenty minutes I was collected and taken up to ward 2 and my own personal room.
All very clean and tidy with a machine that goes "Bing" and a cardboard tray for being sick into. They might have kept that hidden until it may become necessary I thought.
So that was to be my own private space for the day. I made myself comfortable and prepared for a wait of unknown duration.
Several people came, all very bubbly and excited, which seemed to me entirely appropriate, much rather that than sombre.
The surgeon came in and got me to sign the consent form, reminding me that there were the chance of complications which included infection, bleeding etc but 99% of these cases went without a hitch.
It wasn't until I got home and read the form a little closer to see that one of the complications was DVI which I gather stands for "Deep Vein Incompetence", PE which I think is "Pulmonary Embolism", alongside the words, "Non-Union", "Nerve Injury", and the most horrific, "Amputation". I'm glad I didn't read that beforehand. I'm pleased to tell you that I still have ten toes, at this moment in time anyhow.
The surgeon whipped out a felt pen and marked my operation site....
The Anaesthetist came in all humorous and charismatic, as most anaesthetists seem to be in my experience, perhaps someone who holds life in a constant state of balance needs a certain type of personality. Anyway he was very supportive and upbeat. I did raise my concern of being a total wimp and being most anxious about post-surgical pain and also my experience of the last time I had a general. He explained that Ileus is mostly concerned with abdominal procedures and there should be no such complications with a big toe. He also said they would put in a pain block which should last up to 48 hours rendering the leg completely numb from the knee down. This put my mind at rest considerably. He finished up by saying that the only problem was, that I was last on the list, right up to lunchtime, around 1300. I remember thinking, "my god I hope they are not too tired or hungry to do it by then!".
Several other nurses came and did lots of tests, a physiotherapist came and brought me a boot that I would wear post-surgery, went through the circulation exercises that I would need to do, and then it went very quiet. For what seemed like a very long time.
I read half of my book, "Dear Friend and Gardener, Letters on Life and Gardening" by Beth Chatto and Christopher Lloyd" which I am finding fascinating.
I kept looking at my watch and seeing other patients walking past the door in hospital gowns on the way to surgery, and then the same person being pushed back to their room with a drip attached and an oxygen mask on...quite surreal, but when would I be next?
At 1230 a nurse came in and said, "haven't you got changed yet, your going down at 1300?"
I got changed.
1300 passed. Then 1400. At 1415 I saw the young nurse who I had spoken to earlier and asked what was happening, At that second a man turned up in theatre green. I was on.
1425 In the holding room, and the anaesthetist starts telling me about a surreal story of skiing in the alps or something, sounded like he was performing a play...he put a needle in my hand and pumped in what looked like about half a gallon of clear liquid,,,,,felt like he had given me a whole bottle of scotch in one go.......next thing I remember I was waking up in the recovery room.
1600 or there abouts I am in a different room with tubes coming out of everywhere and a mask on. The nurse says, "how are you feeling?". I remember feeling as drunk as a skunk but with a burning, searing, unbearable pain in my foot...."My foot hurts", I said, "My foot really hurts"...
"I can give you some morhpine, but we don't want you to choke to death, we've done very well so far today and don't want to spoil anything!".
I have to tell you here that this is what I think she said, I was completely paralytic and might have dreamed it.
I said something like, "Yes, morphine, please, if I choke then you have my permission".
After a long time, which was probably only a few seconds, the pain in my foot started to ease. The anaesthetist came over and said, "You look like you're grimacing, you were worried about the pain were'nt you?" Again I might have dreamt this.
Anyway this scene from Alice in Wonderland through a haze of morphine carried on for some time.
1615 I was back in my private room. Peace and quiet and allowed to rest for a while.
Soon I was brought a jug of water which I sipped away at from a tiny glass with a straw. It tasted like mountain spring water after weeks of being stranded on a desert island. My foot was still hurting so the nurse gave me more morphine, this time liquid form, and a pot of pills to take.
20 minutes or so I was feeling as right as rain, ready for my sandwich, smoked salmon on brown bread with a nice salad, lemon and a pot of fresh coffee.......it was bliss to me.
1715 The door opened and there was my dear partner and as a lovely surprise, my beloved Mum too! I was suddenly really looking forward to going home.
The physio came in with crutches and taught me how to use them with the shoe, I was given pain medication to take home (co-codamol, diclofenac, and some injections to thin the blood and prevent Thrombosis), and that was it, discharged!
That night got into bed with pillows under my leg to raise it, laid awake all night, no pain though as the block was obviously working with the pain meds.
Waiting to hear about the operation, and then a big shock!
Having heard nothing for several weeks, I decided to call the hospital to see if they could give me any idea of when the operation might be, explaining that I really needed to plan for my business and I really needed a date.
Very surprisingly I was given the surgeon's personal mobile phone number. I dialled the number, expecting to be diverted to his medical secretary, however, to my surprise, he answered it himself; sounded somewhat flummoxed, and said he would need to consult the hospital and get back to me. I thanked him and hung up the phone.
I was quite concerned that they might spring this on me unexpectedly and send me a letter saying it was the next day.
Monday 6th October
Sitting in my study doing some invoices and suddenly Toby, my dog went bonkers - the postie.
My heart was racing as I opened the envelope and unfolded the small bundle of papers.
"A consultation has been arranged in the outpatients department treatment room on Tuesday 7th October 08:40".
Just as I had worried, it's tomorrow!
Then the next letter:
"Your admission will be on Saturday 11th October at 07:00"
Pre-op checks on Tuesday, operation on Saturday, and we're not even at the end of October.
I called the hospital to see if there had been a mistake, the receptionist said, "No, he's definitely got you down on the list for Saturday". I said this was rather too soon, and what would happen if I asked to postpone it, she said they would not be able to guarantee when it would be put back to. Needing to make a decision, I said ok lets get it done.
Talk about a flat spin....now what would happen with everything? The business, insuring my assistant for the works van, how would I cope on crutches with my pets, walking the dog, shopping, feeding ourselves etc. it was all rather overwhelming to say the least.
The next few days I can say I was in a very strange place in life. So many things to think about, so many plans and provisions to make.
I phoned my mum who lives in Middlesbrough, she said she could come through to look after me but not until Tuesday as she had several previous engagements. This was worrying as my partner had just started a new secondment and would be at work on Monday. From what I had read previously the worst days for recovery are the first and second day after surgery i.e. Sunday and Monday.
The lad who works for me is just 19, so I needed to insure him for my works van which is a 2 litre Ford Transit....I was worried how much this might cost so that would need doing before Monday morning. All that and shopping for food, pet supplies, and everything else, including trying to get as much work done as possible to give my assistant a head start before going it alone for the first time, next Monday morning.
Tuesday 7th October 2014
Spire Hospital Leeds Outpatient treatment room.
I reported for pre-operation checks not knowing what to expect.
I was taken into a room and sat down expecting all kinds of prodding, poking, blood pressure tests etc. To my pleasant surprise the nurse said all they were doing was checking to see if I was a carrier of MRSA. A quick swab up the nose and one in the groin and I was sent on my way. The nurse reassured me that I needn't worry because even if I was a carrier it would not affect my operation.
I rushed around like a loony making as many arrangements as possible.
Friday 10th October 2014
The night before no alcohol and nil-by-mouth after 03:00 are the instructions. So stressed out that this is the night that I would love a few snifters!
Drank lots of water, had dinner around 21:30 (a big pizza called hot or not from the supermarket - very nice if a bit doughy).
Important note here: you will read (hopefully if you're still with me) that, despite going to hospital at 7am I don't go into surgery until 1430, absolutely starving and hypoglycaemic!
With hindsight, I would have had a substantial meal, much later in the night or early morning, probably midnight or after, so as to be not too washed out the next day. Also have some slow release carbohydrate, instead of pappy white bread on a pizza...
Went to bed at 12pm though not to dream.........no sleep was had whatsoever.
Very surprisingly I was given the surgeon's personal mobile phone number. I dialled the number, expecting to be diverted to his medical secretary, however, to my surprise, he answered it himself; sounded somewhat flummoxed, and said he would need to consult the hospital and get back to me. I thanked him and hung up the phone.
I was quite concerned that they might spring this on me unexpectedly and send me a letter saying it was the next day.
Monday 6th October
Sitting in my study doing some invoices and suddenly Toby, my dog went bonkers - the postie.
My heart was racing as I opened the envelope and unfolded the small bundle of papers.
"A consultation has been arranged in the outpatients department treatment room on Tuesday 7th October 08:40".
Just as I had worried, it's tomorrow!
Then the next letter:
"Your admission will be on Saturday 11th October at 07:00"
Pre-op checks on Tuesday, operation on Saturday, and we're not even at the end of October.
I called the hospital to see if there had been a mistake, the receptionist said, "No, he's definitely got you down on the list for Saturday". I said this was rather too soon, and what would happen if I asked to postpone it, she said they would not be able to guarantee when it would be put back to. Needing to make a decision, I said ok lets get it done.
Talk about a flat spin....now what would happen with everything? The business, insuring my assistant for the works van, how would I cope on crutches with my pets, walking the dog, shopping, feeding ourselves etc. it was all rather overwhelming to say the least.
The next few days I can say I was in a very strange place in life. So many things to think about, so many plans and provisions to make.
I phoned my mum who lives in Middlesbrough, she said she could come through to look after me but not until Tuesday as she had several previous engagements. This was worrying as my partner had just started a new secondment and would be at work on Monday. From what I had read previously the worst days for recovery are the first and second day after surgery i.e. Sunday and Monday.
The lad who works for me is just 19, so I needed to insure him for my works van which is a 2 litre Ford Transit....I was worried how much this might cost so that would need doing before Monday morning. All that and shopping for food, pet supplies, and everything else, including trying to get as much work done as possible to give my assistant a head start before going it alone for the first time, next Monday morning.
Tuesday 7th October 2014
Spire Hospital Leeds Outpatient treatment room.
I reported for pre-operation checks not knowing what to expect.
I was taken into a room and sat down expecting all kinds of prodding, poking, blood pressure tests etc. To my pleasant surprise the nurse said all they were doing was checking to see if I was a carrier of MRSA. A quick swab up the nose and one in the groin and I was sent on my way. The nurse reassured me that I needn't worry because even if I was a carrier it would not affect my operation.
I rushed around like a loony making as many arrangements as possible.
Friday 10th October 2014
The night before no alcohol and nil-by-mouth after 03:00 are the instructions. So stressed out that this is the night that I would love a few snifters!
Drank lots of water, had dinner around 21:30 (a big pizza called hot or not from the supermarket - very nice if a bit doughy).
Important note here: you will read (hopefully if you're still with me) that, despite going to hospital at 7am I don't go into surgery until 1430, absolutely starving and hypoglycaemic!
With hindsight, I would have had a substantial meal, much later in the night or early morning, probably midnight or after, so as to be not too washed out the next day. Also have some slow release carbohydrate, instead of pappy white bread on a pizza...
Went to bed at 12pm though not to dream.........no sleep was had whatsoever.
Background
My name is Steven and I am a 47 year old male, very active, living in Leeds, West Yorkshire with my partner, dog, cat and two chickens.
Having searched online for similar blogs regarding this condition, I have found relatively few, and none that are still active. I am running this in order to share my experience, so that it might help others come to terms with the condition and maybe help where I have gone wrong (or right!).
For about ten years now I have noticed gradual deterioration of movement in the big toe joint of both feet, especially the left one.
My background is made up of jobs that typically involved standing up all day (and all night too in some cases!), my initial career choice being catering, followed by promotional work and, more recently gardening.
22 January 2014
I was cleaning the car park for a commercial customer of mine, and very unusually made the decision not to wear steel toe cap boots (I was jet washing so Wellies seemed a much more practical proposition for keeping my feet dry).
During the course of jet washing the car park, the drain became blocked and needed freeing up so that I could continue. There was a very heavy cast iron grate cover which I could hardly lift, suffice to say I did get it out, but slipped and dropped it on my left foot, just where the swollen big toe joint was, and onto a soft wellie, instead of a steel toe boot.
Agony. sheer agony and I thought I must have crushed it pretty badly, however I was on my own, so decided to crack on and get the job done.
I hobbled around until it was time to go home.
Next day I could hardly walk and decided I should really get an x-ray in order to assess the damage.
I went down to A&E at St James Hospital in Leeds, and after several hours I had some x-rays which revealed a sprain to the first MTP joint of the left big toe. What was more interesting was that the nurse showed me the bigger picture and explained that there was major deterioration of the joint in terms of wear and tear, no cartilage left in the joint and new bone-like deposits had grown around the joint (I later found out these are called osteophites). The nurse suggested I have the joint looked at by an orthopaedic surgeon, with a view to possible surgery.
I went home with a course of pain killers and anti-inflammatories and waited for the pain to subside.
Throughout the 2014 season, the pain and lack of movement in that joint became worse and worse, the start of the week having rested was ok, but by the end of the first couple of days working, my joint was red raw and screaming with pain, getting to the end of the week was a major challenge.
By late summer, I decided to go to my GP and try to do something about the situation.
I was referred to go to Chapel Alerton Hospital or Spire Hospital Leeds in Roundhay, and decided to opt for Spire (ok I was maybe being slightly elitist thinking that a private hospital might have more cutting edge equipment and better surgeons than the NHS one, although I would be treated under the NHS funding).
11th August 2014
At the first consultation with the surgeon, he examined my feet and tried to move the joint, which was more or less completely stiff, and oversized from the osteophites surrounding it. He knew immediately that this was osteoarthritis caused by a gradual wearing out of the joint. He explained that this is a degenerative condition and that surgery was the only way forward. X-rays were taken and an appointment made for a month later.
8th September 2014
At the second consultation I was shown x-rays of both feet, and I could see that on the x-ray it looked like a snow storm around the first big toe joint on both feet, however the left one was far worse than the right. Also the surgeon showed the difference between the gaps between the joints on the healthy toes in comparison to the big toe joint, indicating the fact that there was no cartillage in that joint and it was "bone on bone". He explained that my body was trying to fuse these two bones together and that fusion was getting broken every time I rested for a period of time and then went back to flexing the joint. The surgery he suggested was to fuse the two bones together using a plate and screws (called athrodesis), the result being no more pain, but also no movement of that joint ever again.
I had done quite a bit of research myself on the subject and was anxious to explore alternatives to fusion, indeed what I really wanted was increased mobility and not a decrease. I looked into other options such as a mechanical joint implant, and another (which seemed more feasible) which involved implanting a piece of pva the size of a wine gum that would effectively replace the lost cartilage.
With my internet knowledge (!) I quizzed the surgeon about alternatives, but unfortunately he told me that I was in the latest stage of the condition with severe joint deterioration, and other methods may work for a short time, but the long term prognosis was athrodesis or fusion of the joints.
He explained that recovery was not fast, 6-8 weeks minimum, with most of that time non-weight bearing which means crutches.
Now even for someone who is employed, this might be a problem. That fact that I am self-employed as a gardener was an even more scary proposition, no work equals no income for me.
Decision time then. It's the right time of year, he said he could do the operation in November which is when our garden maintenance basically slows down substantially until February or March. Do I bite the bullet and do it now and hope for a pain free 2015 gardening season?
I should say that I also started a course in Garden Design at the beginning of the year, which I have only got halfway through because the season has been so busy...I could finish that whilst out of action, rest up during the bad weather and have the lad that works for me tick over the business until I recover.
Next year I might need to have the other foot done too!
After a whole lot of soul searching I decided to take the plunge and asked the surgeon to put me on the list for November, that way we could do all of the leaf clearance and autumn clear ups and my assistant would have minimal work to do on his own, until I had recovered, hopefully early January.
Having searched online for similar blogs regarding this condition, I have found relatively few, and none that are still active. I am running this in order to share my experience, so that it might help others come to terms with the condition and maybe help where I have gone wrong (or right!).
For about ten years now I have noticed gradual deterioration of movement in the big toe joint of both feet, especially the left one.
My background is made up of jobs that typically involved standing up all day (and all night too in some cases!), my initial career choice being catering, followed by promotional work and, more recently gardening.
22 January 2014
I was cleaning the car park for a commercial customer of mine, and very unusually made the decision not to wear steel toe cap boots (I was jet washing so Wellies seemed a much more practical proposition for keeping my feet dry).
During the course of jet washing the car park, the drain became blocked and needed freeing up so that I could continue. There was a very heavy cast iron grate cover which I could hardly lift, suffice to say I did get it out, but slipped and dropped it on my left foot, just where the swollen big toe joint was, and onto a soft wellie, instead of a steel toe boot.
Agony. sheer agony and I thought I must have crushed it pretty badly, however I was on my own, so decided to crack on and get the job done.
I hobbled around until it was time to go home.
Next day I could hardly walk and decided I should really get an x-ray in order to assess the damage.
I went down to A&E at St James Hospital in Leeds, and after several hours I had some x-rays which revealed a sprain to the first MTP joint of the left big toe. What was more interesting was that the nurse showed me the bigger picture and explained that there was major deterioration of the joint in terms of wear and tear, no cartilage left in the joint and new bone-like deposits had grown around the joint (I later found out these are called osteophites). The nurse suggested I have the joint looked at by an orthopaedic surgeon, with a view to possible surgery.
I went home with a course of pain killers and anti-inflammatories and waited for the pain to subside.
Throughout the 2014 season, the pain and lack of movement in that joint became worse and worse, the start of the week having rested was ok, but by the end of the first couple of days working, my joint was red raw and screaming with pain, getting to the end of the week was a major challenge.
By late summer, I decided to go to my GP and try to do something about the situation.
I was referred to go to Chapel Alerton Hospital or Spire Hospital Leeds in Roundhay, and decided to opt for Spire (ok I was maybe being slightly elitist thinking that a private hospital might have more cutting edge equipment and better surgeons than the NHS one, although I would be treated under the NHS funding).
11th August 2014
At the first consultation with the surgeon, he examined my feet and tried to move the joint, which was more or less completely stiff, and oversized from the osteophites surrounding it. He knew immediately that this was osteoarthritis caused by a gradual wearing out of the joint. He explained that this is a degenerative condition and that surgery was the only way forward. X-rays were taken and an appointment made for a month later.
8th September 2014
At the second consultation I was shown x-rays of both feet, and I could see that on the x-ray it looked like a snow storm around the first big toe joint on both feet, however the left one was far worse than the right. Also the surgeon showed the difference between the gaps between the joints on the healthy toes in comparison to the big toe joint, indicating the fact that there was no cartillage in that joint and it was "bone on bone". He explained that my body was trying to fuse these two bones together and that fusion was getting broken every time I rested for a period of time and then went back to flexing the joint. The surgery he suggested was to fuse the two bones together using a plate and screws (called athrodesis), the result being no more pain, but also no movement of that joint ever again.
I had done quite a bit of research myself on the subject and was anxious to explore alternatives to fusion, indeed what I really wanted was increased mobility and not a decrease. I looked into other options such as a mechanical joint implant, and another (which seemed more feasible) which involved implanting a piece of pva the size of a wine gum that would effectively replace the lost cartilage.
With my internet knowledge (!) I quizzed the surgeon about alternatives, but unfortunately he told me that I was in the latest stage of the condition with severe joint deterioration, and other methods may work for a short time, but the long term prognosis was athrodesis or fusion of the joints.
He explained that recovery was not fast, 6-8 weeks minimum, with most of that time non-weight bearing which means crutches.
Now even for someone who is employed, this might be a problem. That fact that I am self-employed as a gardener was an even more scary proposition, no work equals no income for me.
Decision time then. It's the right time of year, he said he could do the operation in November which is when our garden maintenance basically slows down substantially until February or March. Do I bite the bullet and do it now and hope for a pain free 2015 gardening season?
I should say that I also started a course in Garden Design at the beginning of the year, which I have only got halfway through because the season has been so busy...I could finish that whilst out of action, rest up during the bad weather and have the lad that works for me tick over the business until I recover.
Next year I might need to have the other foot done too!
After a whole lot of soul searching I decided to take the plunge and asked the surgeon to put me on the list for November, that way we could do all of the leaf clearance and autumn clear ups and my assistant would have minimal work to do on his own, until I had recovered, hopefully early January.
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