3 Weeks Post-Op and I can curl my toes!

I am finally getting a lot more feeling back in my toes. I can curl my toes slightly and can raise my big toe. These are two big accomplishments for me!

There are still a few numb spots around my toes, but I am now hopeful that it is temporary and will go away soon!

I have also put the smallest amount of weight on my heel for balancing purposes around the house and it doesn't hurt at all, it just makes my foot tired.

5 more days until I'm off my scooter! It can't come soon enough.

First Post-Op Appointment

My first post-op appointment after my sesamoidectomy went well. 

Me and all of my scooter buddies in the waiting room. 

I was so excited to go in to see how my foot was doing, but I was especially excited to take off all of the bandages and let my foot breathe for a little while!

This is my foot after it was first unwrapped ~ 2 weeks after surgery.

You can still see the faint purple marker lines from where I wrote "yes" before the surgery - as in, "yes, this is the right foot to slice open." Also, as you have probably noticed, the nurse said "It looks like you have skittles on your toes!" It was my attempt to get my notoriously dry doctor to chuckle before surgery, but instead he said - "What happened?"

My foot still looked pretty swollen - especially my toes and ankle, but it felt really small to me. I can't explain it. I guess since it had been smashed under all of those bandages my foot looked a little slimmer than usual. 

WARNING. Gross pictures ahead.

Here is the incision site:

Yuck! That's a lot of stitches!

After the nurse unwrapped my foot, they took me back for x-rays. I was definitely nervous about this part because I was afraid they would ask me to put weight on my foot. They didn't, which I was so grateful for, but they did ask me to point my foot up towards the sky, and that hurt a lot. It was like an electric shock.

Here are my x-rays. Compare them to the diagram beneath it to see if you can tell that my lateral sesamoid is gone. Can you see the bright white spot in the red circle? That is my medial sesamoid. If you look close enough, you can see a dark spot to the left of it where the lateral sesamoid used to be. 

When the P.A. walked in, she looked at my x-rays and said "YOUR SESAMOID IS MISSING!" Then we both freaked out about where it could have gone. That was fun.

She walked over to my foot and started touching it. This made me very nervous, but I didn't really feel any pain. Then she started gently rubbing my toes, and this felt like HEAVEN. I was still a nervous wreck, but for the most part nothing hurt. I can't tell you how wonderful and weird this felt. On one hand, the pressure felt amazing, but on the other, there was still numbness on several parts of my foot. The combination of these two sensations was crazy and very hard to explain. 

She grazed the incision site once, and there was a shock of pain, but then it went away.

She said the numbness and tingling was normal, but that I should start touching my toes and wiggling them to remind my body that they were there. 

And then, like music to my ears, she said, "let's see you back in 10 days and hopefully get you off of that scooter and into a boot!" Woo hoo!!! I can't wait. That's also when they will take the stitches out. If it goes as planned, this means that the time on my scooter will only be a total of 3 1/2 weeks instead of 4, which doesn't sound like much until you're actually in my situation! It's as sweet as an early Christmas present. 

This is my new setup. The bandages are gone with the exception of one layer over the incision site. Then they put this silky sock over my foot to keep any debris from getting close to the stitches. I can finally move my ankle! 

My foot gains a little more feeling every day. I am continually challenging myself to find positive things to focus on rather than the "what ifs" and the frustrations that come with getting around on a clunky scooter in a small apartment. Here are some of my positives: I am on my way to healing! I have great doctors taking care of me who know what they are doing! And I am gaining an appreciation for the smaller things in life like taking a shower whenever you want and being able to clean a sink full of dishes (thank you hubby for doing so many of these small things for me!). 

More to come after post-op appointment #2. 

Thanks for reading!

Day 12 Post-Op

Recovery seems to be going well. I am finally getting the hang of my knee scooter and have been off pain meds for about 5 days now.

I added a little carrying pouch to my scooter so I could transport things more easily around my apartment. If I'm ever out in public, little kids seem to think my ride is pretty sweet.

I can't WAIT to get to my post op appointment this Friday (in 3 days) to see how everything looks, and especially to get all of the bandages off for the first time. My foot is yearning for freedom!

I noticed that the bandaging is keeping my foot turned inward, and it has been bothering me a lot. My uncle is a physical therapist and thinks it is probably purposeful and is keeping the distance that my tendons have to stretch smaller so they can heal faster. That sounds good to me. But still, it's annoying.

I set my foot down very gently on the ground to check things out. I put the tiniest amount of pressure on my foot and was amazed at how different it feels. I thought I would only feel changes around the ball of my foot and toes, but I could feel change all the way up to my ankle. I wasn't expecting that.

The way I described the feeling to my husband was that it felt like my size 8 foot had size 4 muscles. It was a very tight, uncomfortable, and painful feeling.

I can't yet tell if any of my previous pain is gone, because I really only felt it when I was putting pressure on that foot. Two and a half more weeks (fingers crossed) until I can put weight on my foot!

One Week Post-Op

It's been one week since I had my lateral sesamoid removed. I am making a point of celebrating today, because it has been a challenging recovery - maybe more emotionally than physically. It is very hard to let others take care of you. I am making each week a big mile marker so that I have something to look forward to.

I've been off my pain meds for about 48 hours, though I considered taking some yesterday when I accidentally slipped off my scooter and landed on my bandaged foot... OW. That hurt pretty bad - it felt like a shock wave rippled through my body up to my shoulders. The pain lasted for a few hours, but after sleeping it off I feel like I am in a good spot. I considered going in to get x-rays, but I'll be doing that any way at my first post-op appointment in one week, so I think it will be ok to wait.

The pain meds still seem to be taking a little bit of a toll on me as my appetite is not back and my stomach is giving me a little bit of a hard time.

My pain level is pretty low right now - it's mostly just discomfort and some tingling that remains. My toes feel like they're asleep, and it's probably partly due to how tight my bandages are wrapped. My heel and ankle actually feel bruised because I can't bend it. The bandages have stayed super tight against that part of my foot for a week now and the pain is setting in. It's hard to rest my foot on any surface simply because of the bruising on my heel.

I was able to shower two days post-op. I just have to make sure my foot is completely covered with trash bags and tape to ensure that no water makes it to my bandages. Also, I have to sit on a shower chair and use an extendable shower head, which I found at Target for a pretty good deal. Showers are nice and help lift my spirits a little.

Here is a picture of my foot when it's ready for shower-time.

The red part is actually the string from the trash bag, NOT blood...

I still haven't seen any part of my foot and won't until my first check up one week from now. I'm interested to see what it looks like...

I needed a little bit of happiness for my foot because the boot they have me in is totally unflattering. So... I jazzed it up a little...

Now when I look at my foot, it makes me a little happier. Also, I keep reminding myself that I CHOSE to have this surgery, and that total healing is on the horizon. I just have to keep pushing through.

In the meantime, my family and especially my HUBBY deserve HUGE PROPS. They have been amazing at taking care of me and our little 9 month old, Molly. 

If you are considering this surgery, make sure you have a helper who can be with you almost 24/7. It is a lot more difficult to do things than I imagined. One of the challenges for me has been using the scooter in a small apartment. It's really hard to go anywhere, and especially to turn around in the bathroom.

My best friend Mollie sent me a care package in the mail which really cheered me up. I'm mentioning it because I KNOW she'll be the first one to read this blog post and she totally deserves a shout out. 

So overall, the hardest part for me has been accepting the help of others and giving up some things that I usually do with my little one, like rocking her to sleep and preparing her food, which, don't get me wrong, it's nice to have others do it for you, but when you can't do it, you kinda wish you could. 

If you're looking for more information about this operation, I found another great blog for you to read that has brought me a lot of hope: http://kimsfootstory.wordpress.com/.

She's been through the surgery and is a couple of years past the full recovery, and testifies that there is no more pain!! Woo hoo, Kim! You go, girl!

I'm here for anyone who has questions or concerns about this surgery/condition/or anything else I can help with. You are not in this alone!

Thanks for reading. 

Day 3 - Post Op

The surgery went very smoothly. I found out more information about what they actually did. It was coded as:

Lateral sesamoid removal and plantar plate restructure

My doctor and his staff were phenomenal. The best of the best. Before they took me back to receive anesthesia, my parents brought my daughter back to me and my husband, and my doctor picked her up and played with her. It was so cute.

I had to get pricked twice before they got my IV in, but it wasn't too bad. 

While operating, they wanted me on my stomach so they could go in from the bottom of my foot. This meant that I would have a breathing tube in and would be completely asleep during the procedure.

When I went in to the operating room, California Dreamin' was playing on the speakers. I felt kind of a warmth wash over me and I asked if they had started the anesthesia. I think the doctor said yes, and the next thing I remember I was waking up in the recovery room. 

Dr. Brodsky said that everything went smoothly and there were no surprises. Now I have this lovely thing on my foot where it will stay 24/7 until further notice. 

I painted my toe nails all different colors to try to make my doctor laugh, and to give him something interesting to look at. He looked at my toenails questioningly and said "what happened here?"

You probably can't tell much from the pic, but my toes are swollen and there is a lot of gauze underneath my foot. 

The pain has been more intense than I was expecting. At first it was kind of a tingling/burning sensation. 

When I woke up the first day post-op, I told my husband that my foot felt like a blowtorch and all of the fire was coming out of my big toe. Thankfully, the pain has greatly decreased from that point, but it is still hurting pretty badly. 

The pain ranges from stinging to burning to throbbing to numb tingling. It's a little bit of everything. 

I go back and forth from my roller scooter to crutches. The roller scooter is more comfortable but less convenient in small spaces as it is hard to turn around. 

I keep my foot elevated most of the time as high as I can get it, and I try to keep it straight up and down. If I turn it to the left or right, the pain sets back in pretty quickly. 

I wasn't able to sleep much the first night, but I remembered I hadn't been taking my Phenergan along with my hydrocodone. The combination is supposed to increase pain control and help me sleep. I slept a lot better after implementing this for night 2. 

I am drinking a ton of liquids and eating whatever I want, although my throat was pretty scratchy after having the breathing tube removed. 

When I try to move my toes around, there is a searing pain in the ball of my foot. I guess I should probably steer away from doing that for a while. 

The numbness is slowly decreasing and I am finally able to feel more of my foot. For the past few days my foot has felt how your mouth feels when you have it deadened at the dentist. I would say as of day 3, probably 30-40% of my foot still feels totally numb. 

The pain meds make me kind of loopy, but I'm trying not to miss a dose. It definitely helps to stay on top of the pain.

My first post-op appointment is in about two weeks. Dr. Brodsky said they probably won't remove the stitches until the second post op appt in about a month since the tissue on the bottom of my foot is so thick and will require more time to heal. 

As far as bathing goes, I'm allowed to shower using a shower chair and a shower hose as long as my foot is completely wrapped in a trash bag or waterproof covering of some sort. I'm hoping to embark on the challenge today. I think a shower could lift my spirits!

It's hard being on the couch all day, but I am so grateful for all of the help around me. My husband, mom, dad, and grandmother have really been great! They are wrangling my little 9 month old all day so I can rest and get well. I can't wait until I can run around and play with her as much as I want!

More updates to come. What specific questions do you have for me? Thanks for reading. 

Removal of Lateral Sesamoid in Foot (Avascular Necrosis/Stress Fracture of the Lateral Sesamoid)

Several of you have commented that you would like more information about treating a fractured/dying sesamoid bone with surgery. I have decided to go through with surgery, myself, and will be updating everyone through this blog. My surgery is tomorrow (July 10).

Here is what I know so far:

Condition

Stress Fracture on Lateral Sesamoid in my left foot 

(One doctor said this is a form of avascular necrosis. The bone has been decaying and fragments of it are finding their way to other parts of my foot).

It is more common for the medial sesamoid to have a stress fracture than the lateral sesamoid.

What is a Sesamoid?

A sesamoid bone is a bone embedded with a tendon. Your kneecap (patella) is an example of a sesamoid. It helps give movement to other bones.

Onset

My doctor said with this particular bone, a stress fracture usually occurs over a long period of time - lots of jumping, running, etc., rather than from a specific event. For me, this was probably a combination of things like drill team in high school and P90X Plyometrics. 

Symptoms

The pain became gradually intense/severe with burning and stinging sensations. The pain dissipated with anti-inflammatories and rest, and remained a dull, aching pain for three years. Any light to moderate physical exercise would cause more intense and prolonged pain. 

The pain wraps around the side of my foot. I feel a majority of the pain on the ball of my foot, but sometimes I feel it in my big toe and even on the top of my foot.

Conservative Treatment

For three years I have tried treating my injury with anti-inflammatories, refraining from physical activity, and wearing orthotics. Sometimes these methods would alleviate the pain, but it has never gone away and still causes me pain every day. 

Further Treatment (Surgery)

After three years of pain and several different opinions, I have decided to go through with surgery. Here is what I know about the surgery as of now:

They will remove my lateral sesamoid and re-route the tendons that went over that bone to go over the medial sesamoid.

The surgery is outpatient surgery. I will receive anesthesia and will be on my stomach for the procedure. They will make a small incision on the ball of my foot. The surgery should last about an hour.

Pain medications prescribed: Hydrocodone for pain and Phenergan for nausea.

Recovery

I will be on a knee-roller (crutches are also an option) for 4-6 weeks then a walking boot for 4-6 weeks. 

I will post again with more updates hopefully a day or two after surgery. 

Please feel free to leave any comments or questions you may have! I have greatly benefitted from everyone's feedback and support. It is very helpful to share stories with others who have similar pain. Together we will find healing!

Update on My Condition and New Findings

Hello, friends!
I am so glad that so many of you have found my blog! I hope it has been helpful in at least some capacity.

I wanted to update everyone on my situation now that our baby is here and almost 4 months old! I have a few minutes of my own to write so HERE GOES!

I still have pain in my left foot from what I believed to be a P90X injury in 2011. The pain is less severe than it has been, but pain, nonetheless, and I'm very tired of having it! Quick recap - The first orthopedic doctor I saw said I have AVN (avascular necrosis) of the sesamoid, which means there has been a loss of blood flow to that bone. His take was that if I wait it out, the bone would be absorbed by my foot and heal itself (really?), OR I could have surgery.

I wanted another opinion so I saw another specialist last week (there was a VERY big gap in time from the first appointment until this one because of the arrival of our new baby!). The specialist's name is Dr. Brodsky at Baylor Dallas. Apparently one of the best! I am very grateful that my physical therapist uncle recommended me to him.

After reviewing my xrays and MRIs, Dr. Brodsky said I have a stress fracture on my sesamoid bone. He said most likely it was repeated pressure on that point that eventually fractured it (probably P90X plyometrics- talk about killer!). He said there are two non-urgent options:

1. Get a custom-made orthotic to relieve the pressure on that part of my foot.

2. Have surgery.

He said even with the orthotic, it is advisable to refrain from high impact activities (running, jumping, etc.), and that if I want to eventually regain those abilities, I should have the surgery.

Yuck.

But at least there is hope!

He said the surgery is easy - in and out with only a local anesthetic. I would be on crutches for about a month and then in a boot for 3 or 4 months.

So, I feel like I should definitely have the surgery, but my question now is timing. A four month old baby does not make things much easier! But it would probably be easier with one baby than down the line when we have 2 or 3.

Anyways, there's my update! Thanks to everyone for sharing your stories - I know I have benefitted from hearing other perspectives and reading your encouragement! One of the ladies who posted has started a Sesamoid Support group on facebook if you're interested. I think it's pretty cool!

Stay strong, be positive, and be grateful for the little things! Praying healing for everyone out there.

Taylor

Avascular Necrosis of the Sesamoid

I wanted to write about a condition I have been dealing with in order to help others who are facing the same thing. After a lot of searching, I realized there's not a whole lot of good information out there and I want to prevent others from being discouraged, and let you know that you're not alone! So if you've stumbled upon my site while searching for help, here is what I have learned.

Condition: Avascular Necrosis of the Sesamoid
(This means one of the little sesamoid bones in your foot is decaying).

Onset: After visiting an orthopedic specialist, I found out this is a very random and unpredictable injury. In my case, I landed on my foot the wrong way during a P90X Plyometrics workout.

After the initial injury, the onset of pain was gradual, until one day it became unbearable. I discontinued my workout program and stayed on the couch frequently with an ice pack. Ibuprofen alleviated the pain slightly, but not much.

I did not immediately go to the doctor. I didn't want to be a wimp and thought I could wait it out.

After a year of waiting and altering my workouts (swimming in the summer and short walking stints in the winter), the pain had gone from a 10 to a 6, and I was tired of waiting for it to go away completely.

Diagnosis: Required foot x-rays which helped the doctor know to do an MRI. The MRI showed that one of my sesamoid bones was in fact decaying. I did not want to pay for an MRI or any doctor's bills, but the diagnosis actually gave me peace of mind because I finally knew what was going on in my foot!

(If you happen to be in the DFW area, check out Texas Orthopedic Specialists. I had Dr. Modlinski, and he's GREAT! He also looks like Jon Hamm, which is a plus).

Treatment: Two options: 1 - Wait it out and let the bone die or 2 - Surgery.

As with many situations, surgery should only be a last resort. The doctor recommended that I give it 6 more months while wearing some specialized pads on my feet (shown below). He said my bone was in "hospice care" and our goal was to make it as comfortable as possible while it was dying. When it's dead, your body absorbs it (weird!) and makes do with it being gone. But until the eventual death, it's a painful road.

After he told me to wear these foot pads, I was a little skeptical and disheartened. I hadn't been able to run in a year and suffered emotionally from not being able to workout and have those good endorphins going through my body! How would foot pads make that much of a difference?

At first, they didn't. But I kept on, every day, and sure enough they are helping a lot right now. Here is my experience with the pads:

My doctor recommended "Dancer's Pads" which have a cutout that you place around the sesamoid area to alleviate pressure.

The first ones I tried were the ones the doctor gave me: HAPAD Dancer pads. (I only wear one on the hurting food and wear nothing on the other).

My experience with these was not so great. They are a really dense material and not very comfortable or plushy. But, what is great about them is that you can stick them directly to your shoe and it stays there until you decide to remove it. You can get one for every pair of shoes and never have to worry about remembering to wear them. My doctor did recommend them, so even though they didn't work for me, they might work for you. You can order them here for $7/pair.

Since I wasn't super happy with the HAPADs, I kept researching and found Dr. Jill's Gel Dancer's Pads.

These are available in two different thicknesses - regular or thick. I thought since my pain was so bad I would order the thick. It seemed to make sense to me. When I started wearing them, I loved the texture and comfort but the thickness was really hard to deal with. They rubbed on my foot in a harsh way and actually pulled some skin off (ouch!). But, I loved everything else about them so I ordered the regular thickness and they worked GREAT. 

They are reusable as long as you wash them with soap and water after each use (I didn't believe that they would remain sticky, but I've been using the same pad for 3 months and it still works just as well as it did on day one).

I also love that you can order only one foot instead of a pair. 

The only downside is that you have to remember to put it on your foot every day, unlike the HAPAD that stays in your shoe. 

Overall, this is the winning pad for me! I wear it every day and it has brought my pain from a 6 to a 3. You can buy it here for $11.99 for two. I can also work out easily in this pair with little extra pain. 

Here's one more helpful thing I found: 

It's a sesamoid relief sleeve. I ordered one so I could have something to wear when I was barefoot around the house. There are also two sizes available for this product (small and large). I bought a small first (I wear a women's 8.5). I love the design but the big toe sleeve is a little too small for my foot. When I do wear it, it works for a period of time until my big toe says "no more!"

I ordered the large which fit a little better but not perfectly. I still love this sleeve though, because it gives me options. You can buy it here for $16.95.

Final thoughts:

This condition HURTS really bad. No one else I know has gone through this or even heard of it, so I don't have anyone to sympathize with, but if you are going through this, message me! Ask me a million questions! I'll help you as best as I can. It has taken a while (about 15 months), but my foot is getting better every day.

Hang in there, be smart in your exercising, and find a pad that fits your foot! This will make all the difference in the world.

Hope this has been helpful. :)