Thursday, June 27, 2013

The All American Foot Surgery

This is a blog about the summer of my foot surgery, known as the All American. The surgery consists of two bone implants in my foot, three screws, and the replacement of the posterior tibial tendon. Here is a description from the New England Foot and Ankle website where Dr. Pomeroy (my surgeon) is based.

 "The All American procedure is an innovative operative approach to reconstruct the flat foot deformity. Originally developed by Dr. Gregory Pomeroy of New England Foot & Ankle Specialists in conjunction with Dr. Arthur Manoli of Michigan International Foot and Ankle Center, this procedure has now become a standard in operating rooms around the country and indeed around the world"

 I have known about my flat feet since I was about 7, when the doctor was concerned for my health after noticing my severe flat feet during an annual visit. Suggesting I wear orthotics or simply wear supportive shoes, I continued with my life, unaware that a larger underlying problem was waiting for an opportunity to make itself known.

Skip ahead to the end of my sophomore year of college. I always wore shoes with good support, exercised on a regular basis, and was on my way to begin training for my first 5k. I was feeling good and, through the use of barefoot shoes, I had fixed the muscle weakness in my knees and ankles, or so I thought. After a nasty fall, what I thought was a bad sprain started me on my journey to the All American surgery and my eventual recovery, now over a year later. I spent most of the summer between my junior and sophomore years at home and in pain due to a misdiagnosis of a sprained ankle. I went from doctor to doctor, some guessing a greenstick fracture, some guessing a ruptured ligament, all of which were wrong. After months of physical therapy, cortisone injections and walking casts, what I thought was a proper diagnosis brought me to surgery to fix what I thought was a ruptured ligament. After consulting with several doctors, I finally met Dr. Pomeroy and within minutes and a few glances at my chart, he had figured out the real problem with my foot. I was diagnosed with a ruptured tendon and given special orthotics that were designed to stall the surgery for a few years and help heal the injured tendon. Eventually I would need the surgery on BOTH feet as I have severe flat feet and despite injury. Both feet would need repair as the tendon that supported my arches would give way under the pressure and I would eventually be in a great amount of pain as a result. Fast forward from that first appointment in December to May of this year.

Almost a year to the day since my initial injury with no progress and the decision was made to have the surgery in June so as to be able to attend classes in the fall. The surgery requires eight full weeks of complete bedrest with the foot elevated above heart level. This presented several issues as I lived alone on the second floor of a lovely apartment. Within two weeks I was moved back home with my mom and frantically making preparations for the surgery and its aftermath. As I would be unable to cook, care for my dog, or even bathe myself so I was set up in the guest room on the first floor of the house. 

My surgery date came all too soon and I went to the hospital and got set up. The doctors inserted a leg catheter with a local anesthetic to numb my leg both pre and post operatively. The pump had enough juice to last for two days following the surgery, which turned out to be a god-send. Before I knew it, I was put under and then waking up in the recovery ward of the hospital. Still loopy and in pain, the wonderful nurses made sure I had enough meds and water to help me wake up from the anesthesia, though I was not fully awake until hours later.

 The procedure started at ten am and I was home by dinner time. Getting out of the hospital was the easy part of the day, for lying in wait was a set of stairs (made up of four steps) once I got home. I had not prepared myself for how truly difficult moving and getting myself inside would be. Still groggy from the anesthesia, it took my mother and I 15 painful minutes until I made it the very short distance from car to bedroom. A tip for all of you out there, getting up from the floor with crutches and only one leg is incredibly challenging, particularly when you are groggy and dizzy. Finally safe and home, I began the long eight week recovery period of my surgery in a splint with my trusty cat Mitzi by my side.