Friday, April 8, 2011

Recovery Days 5-7 - Post-op fasciotomy - Surgery Fights Back with Swelling and Numbness


While days 1-4 went relatively peachy, 5-7 encountered myriad issues that warranted a couple calls to my surgeon's office in order to find out what constituted "normal". Moral of the story was, unless something is really fucked up, it's probably within normal variations of recovery.

The first problem arose the night of day 5. On day 4, I had accidentally knocked the inside of my right lower shin/ankle pretty hard, sending a strange sensation up my leg. I thought nothing of it, however, until numbness came on in the exact spot about 24 hours later. The numbness basically encompassed the upper half of my ankle bone, extending for a swath of about three square inches upward until one of my incisions. I knew numbness was one of the side effects of surgery, but I was under the impression that if numbness had happened, I would know right away post-surgery. This numbness, however, had taken me by surprise 5 days down the road. Worried, I called the office and spoke to a fellow. She explained that while it is somewhat unusual for the numbness to come on five days after, it's not unheard of and not too worrisome. If the numbness was actually caused by the hit to my ankle I sustained, feeling in that area could come back rather quickly, but if it had nothing to do with it and was a natural outcome of the surgery, sensation in the area could take anywhere from 4 months to a year to fully be restored. What was reassuring, however, was the doctor's assurance that the numbness in that area does not hinder recovery at all, and the numbness that doctor's worry about pertains to the foot, which thankfully so far, I do not have.

Days 6 and 7, however, brought a new challenge - moderate swelling in my right foot. Along with the numbness that I also experienced in the right lower leg, it was also apparent that my two legs were simply not recovering at the same rate, which I also found worrisome. The pain in the calf (which is what hinders one from doing strong heel to toe strikes) was strongly persisting in the right leg while quickly waning in the left. Cue another call to the fellow at the surgeon's office. She explained that the swelling in the foot is the most common and very expected, as it is the primary weight bearer, and that a combination of icing, elevation, and compression stockings would help alleviate the symptoms. And in terms of one leg recovering faster than the other, she added that it is the most common complaint from patients, and is simply natural - eventually they will catch up to each other.

I also had one more overall complaint for the doctor - It almost felt as I had regressed from Days 1-5, and I was not as comfortable on my feet nor proficient at ankle pumps as I had been earlier. Once again, the fellow dexterously assuaged all my doubts by saying that as patients feel more comfortable on their feet, they probably push their limits too far, causing the legs to stiffen up temporarily and recover.

So, what's the conclusion? First of all, that this fellow I spoke to should definitely be employed in some sort of suicide prevention program. I could have called in saying both my legs had fallen off, and she probably would have found a way to calm me down and make me feel that it was a normal process of recovery post-surgery. In all seriousness though, it made me realize that post-op recovery is not going to be a linear progression, and I need to be emotionally and physically prepared for the ups and downs that are coming. I just hope that at the end, I'll be back to where I want to be....

7 comments:

  1. hi Sam,

    It's completely understandable that you're analysing every little detail of how your legs are feeling, but that is being too hard on yourself considering how soon it's been since surgery.

    I met a total stranger the other day who is one year post-op. She initially had the keyhole version done, but the scar tissue formed in a way that negated it's effect and had to have the full fasciotomy done like we have. She said she didn't start running again until 3 to 4 months!

    This really put into perspective how unique each individual's recovery can be and made me chuffed that I was running after 4 and a half weeks. My peronius longus muscles on both legs are proving to be a bit pesky at the moment, but my physio and others have told me this is probably because the surgery basically hit the 'reset' button with my legs and different muscles were working in different ways now. Lots of deep tissue therapy at the moment!

    I have a numb patch on my left leg over the tibia, next to the lower incision. When I close my legs I always fail the 'how many fingers' test when it's done by someone else.

    Tom.

    ReplyDelete
  2. And when I say 'close my legs' I definitely mean eyes ha!

    ReplyDelete
  3. Hi,

    On March 24, I had my anterior and lateral compartments released (1 leg only). The first few days after surgery I felt pretty good and after about 2 days I could get around the house without crutches. On day 6 I went back to work and by the end of the day my leg and ankle had swelled so much that I couldn't walk. Since then I have been unable to fully extend my knee and can not put my foot flat on the floor while standing. It's extremely frustrating that a few days after surgery I could slowly walk and now I can't even put my foot on the floor! On Friday, the surgeon fitted me with a compression stocking and this has definitely improved the extreme swelling, however, the muscle tightness from my ankle to knee has not improved. I'm finally starting PT tomorrow, as my surgeon would also not allow me to go until at least 2 weeks out from surgery. Hoping I have some range of motion back and off crutches by the end of this week (3 weeks post op).

    I hope your recovery gets better! I can't imagine having both legs done at once!

    ReplyDelete
  4. Yeah, from my experience it seems that legs post-op are all too happy to punish any attempt at pushing oneself with swelling. And swelling, for me, also accompanied a much more restricted range of motion - But as I just wrote, once the swelling went down, range of motion immediately returned - and yeah, compression stockings do definitely make the problems slightly more manageable -

    Please keep us updated on how PT goes!

    Sam

    ReplyDelete
  5. Also, Tom, I'm curious as to what you meant by keyhole version? What kind of incisions did you receive for the surgery?

    ReplyDelete
  6. The keyhole surgery wasn't me, but the random runner I came across the other day. She didn't go into detail as to what the keyhole version entailed, but from what she said I assume that a small hole was made in the muscle sheath in an attempt to reduce some of the pressure. Obviously this didn't work and the sheath just healed back together, requiring a full compartmental release.

    I had that, the same as most people, and have four, three-inch incisions on either leg.

    ReplyDelete
  7. Hi Sam-

    I was wondering if you could email me your physical therapy office? I am in the cambridge area, and had bilateral anterior compartment releases about two weeks ago, but my doc didn't say anything about physical therapy, so now I am worried!

    email is mwalsh10@hotmail.com

    Thanks!

    ReplyDelete