Tuesday, November 23, 2021

My Lisfranc Adventure

On September 28, 2021, I tore the Lisfranc ligament in my right foot. This chronicles the treatment of that tear.

The Accident: Tuesday, September 28, 2021

My wife and I were taking a break during our nightly Korean Drama. I was walking up the stairs from our basement "theater" when my right foot slipped off the step. As pain shot through my foot I grabbed onto the railing and crawled up the stairs.

It was only a slight sprain, I thought. I limped back down the stairs and finished the KDrama.

Wednesday, September 29, 2021 (1 day after accident)

I did "normal things, all day, driving the car several times during the day. In the evening I made several trips down the stairs to move the volumes of the World Book Encyclopedia from my main floor office to a bookshelf in the basement. We watched another KDrama episode.

As we were getting ready for bed, my wife became alarmed at how swollen my right foot was.

Urgent Care Visit: Thursday, September 30, 2021 (2 days after accident)

At 8:00 a.m.--as soon as the Urgent Care center next to the hospital opened,  my wife loaded me into the car and drove me to have the foot examined. After x-rays of the right and left foot had been taken, they put a boot on my foot, made me sit in a wheelchair, and wheeled me across the parking lot for an MRI.

The diagnosis: a Lisfranc injury. I would need to go see an orthopedic specialist.

Here I am, sitting in the Urgent Care center after having two x-rays (one of each foot) and before being wheeled across the parking lot to get an MRI.

Walking boot for right foot
The Urgent Care center sent me home with this walking boot on my right foot.

Friday, October 1, 2021 (3 days after accident)

I ordered a knee scooter from Amazon after reading that I would be unable to put weight on my right foot for some eight weeks--possibly much longer.

We purchased these crutches when my oldest son broke his leg in a trampoline accident. Since that time we have loaned it to our across-the-street neighbor twice and to a grandson once. Now I got to use them.

Move to the ground floor: Saturday, October 2, 2021 (4 days after accident)

My son showed up at 11 a.m. to move my computer from our basement to my main floor office. He also moved the television from the basement to the main floor.

Knee Scooter: Sunday, October 3, 2021 (5 days after accident)

The knee scooter arrived. I assembled it and began using it around the house.

Knee scooter
This knee scooter is my main method of getting around the house.

First doctor visit: Tuesday, October 5, 2021 (1 week after accident)

The arrow points to the position of the torn ligament

I met with Dr. Karl Weenig, an orthopedic specialist. He confirmed that I had a Lisfranc injury and would almost certainly need surgery. He scheduled an appointment with a surgeon for Thursday.

Dr. Weenig was walking on an iWalk device--much like a peg leg. It turns out that he was recuperating from having torn his Achilles tendon. 

First visit with surgeon: Thursday, October 7, 2021 (9 days after accident)

My son drove me to see Dr. Collin Barber, who, after examining my foot, had me schedule foot surgery. Because the hospitals were so crowded with COVID patients, it would be 13 days until I could have surgery. On the way home we borrowed a wheelchair from my mother-in-law.

The doctor gave us a temporary handicap parking permit, good until January 4, 2022.

My wife drove me to IOC Home Medical, where we bought an iWalk device.

Grab bars for the bathtub: Wednesday, October 13, 2021 (15 days after accident)

Marlin Lewis, the Told Handyman, showed up at our house to install two grab bars in a bathroom on the main floor. This would allow my to shower without standing on both feet. He did a great job!

New grab bars in the tub/shower
Note the two horizontal grab bars in the tub enclosure.

Question about antibiotics: Wednesday, October 13, 2021

When I visited with the Dr. Barber last Thursday, his aide met with us and asked me to install the FollowMyHealth app on my iPhone. If I had questions for the doctor, I could ask them using the app. I used the app today. Here is what I wrote:

Yesterday I had a root canal at the endodontist's office. One week from today I will have surgery on my right foot.

Two of my brothers who have had knee replacements told me that when they go to the dentist they need to take antibiotics for a week before they go to the dentist.

My situation is just the opposite. I went to the dentist eight days before my surgery. It went without a hitch. The dentist said there was no intrusion into any tissue in my mouth.

My question is this: do I need to take any antibiotics before the surgery: I'm guessing that I don't need to, but I thought I would ask, just in case.

Thank you very much!

Here is the aide's response:

No antibiotics are necessary before surgery. If you have any other questions about surgery or recovery, you'll have a chance to talk to the doctor before surgery.

Foot surgery: Wednesday, October 20, 2021 (22 days after accident)

My son drove us to the Mountain Point Medical Center for surgery, scheduled at 9:00 a.m. Dr. Barber performed the surgery. I was home by 2:00 or 3:00 p.m.

This is me in the recovery room following surgery. Note the big splint on my right foot.

Question about foot elevation: Friday, October 22, 2021

I asked this question using the FollowMyHealth app:

I'm curious about the length of time those with Lisfranc surgery will typically (in days and weeks) elevate their feet.

The aide replied:

Elevation can help with pain control. It doesn't help the bone heal faster. You can just elevate it as needed. It could be about a month or up to a year.

Question about splint padding: Thursday, October 28, 2021

I asked this question using the FollowMyHealth app:
I have noticed in the past day or so that the padding in my splint seems to be sliding down. It used to come clear up and be even with the top of the stiff part of the splint.

It now looks like the padding is only halfway up to the top of the splint. Also, it feels like a bunch has slid down and is under my heel. It feels like when  sock slides down your ankle and bunches up in the heel of one's shoe.

Is this something I should be concerned with? Or should I just wait until Tuesday's appointment?

I am not walking or standing on that foot; I am using my knee scooter to get around the house.

Other than that, everything seems fine to me.

Sorry to bother you.

Thanks in advance!
The aide replied:
That should be ok as long as it's not causing you pain. It'll be just fine to wait until Tuesday's appointment.

First venture outside: Sunday,  October 31, 2021 (Halloween)

The neighbor three houses away had set up a "fire organ" in his driveway. My wife talked me into scooting down the two steps at our front door. She carried down the knee scooter, and I gingerly took the scooter to his house, where I attempted to play (with errors--sorry about missing the Picardy third) the opening of Bach's Toccata and Fugue in D Minor. (I was still on pain killers from the surgery.)

Splint and stitches removal: Tuesday, November 2, 2021 (5 weeks after accident)

Today is exactly five weeks since I sustained the Lisfranc injury. It is also exactly 13 days since Dr. Barber performed the surgery on my foot. I visited Dr. Barber for a follow-up today. He:

  • removed the splint
  • said the healing looked very good
  • removed the four stitches
  • put steri-strips over the (former) wound
  • wrapped the foot in a compression bandage

I was told to stay off the foot until at least December 14, when I will visit with the doctor again.

A tech put the "boot" that I was given at the InstaCare on my foot for the trip home.

I don't need the boot when moving around home. However, I should wear it in bed at night and whenever I go out.

Visit to the optical shop: Wednesday, November 3, 2021 (36 days after accident)

Sometime during the past week one of the nose pieces of my glasses had fallen off, so my wife drove me to a nearby vision center. I rode my knee scooter up a zig-zag wheelchair ramp to the front door. The missing piece was replaced in less than five minutes. On the way home, we stopped at the drive-through of Kneader's restaurant and picked up lunch.

Question about sleeping with the boot: Thursday, November 4, 2021

I asked this question using the FollowMyHealth app:
I'm having a very hard time sleeping with this boot. Do you have any suggestions? Special socks, etc., etc.? How tight/loose?

Any suggestions, thoughts, or recommendations are welcome.

Thanks in advance!
The aide responded:
Is it hurting you? You can try thicker socks. If it's the outside that bothers you, you can try wrapping it in a pillow case.

Church: Sunday, November 7, 2021 (40 days after accident)

With the splint removed, I ventured out to attend church for an hour. (My wife loaded the knee scooter into the car trunk, then unloaded it at the church.) We used our temporary handicap parking permit. Fortunately, there were no stairs at the church. I repeated this on the 14th and 21st.

Moderna booster: Monday, November 15, 2021 (48 days after accident)

Received my Moderna booster for COVID-19. Very few people were there. I barely felt the needle, and had no side effects--not even a sore arm. (I also had no side effects in January and February when I had the first two shots.)

Endodontist visit: Tuesday, November 16, 2021 (7 weeks after accident)

My wife drove me to the endodontist, who completed the final root canal that was begun before surgery. It went well. (Dr. Holmes is a great endodontist!)

Question about steri-strips: Friday, November 19, 2021

I had a question about the wide steri-strips that had been placed over the wound on November 2. I asked this question using FollowMyHealth:
How long should I leave the Steri-Strips on my foot? It has been two weeks and three days since the stitches were removed.

At my wife's suggestion, I have trimmed the edges as they have lifted. Now all that is left is the center part—about an inch wide—which remains despite the hand-held shower nozzle. (I try not to spray it for more than a second or two indirectly.)

Should I go ahead and pull/soak the rest and remove them?

Thanks for your advice!
The aide responded:
The doctor suggests keeping it on until it comes off by itself.

Happy Thanksgiving!

Question about red rash on foot: Thursday, December 9, 2021

I sent a photo of my foot using FollowMyHealth:

Here is what I asked:
What causes the red rash around the scab on my foot?
The aide responded:
It's normal to have some redness while the scab is still healing. If it spreads inches away from the scab it may be a different issue and you would have your PCP follow up on it.

Visit from my daughter (herself a doctor): Saturday, December 11, 2021

I showed my daughter my foot. She assured me that it looks fine. 

Only three more days until my next appointment with the surgeon!!

Second follow-up with surgeon: Tuesday, December 14, 2021

Today was my eight-week followup with Dr. Barber. (Actually, tomorrow is the eight-week mark, but Dr. Barber does only surgeries on Wednesdays, so today had to do.)

The x-rays show the pins in my foot:

X-ray of right foot, December 14, 2021

I had hoped (unrealistically?) that I might be able to discard the boot and walk. Unfortunately, that wasn't the case. The doctor said that I should now walk on my right foot, wearing the boot, using crutches:

Yours truly with crutches and boot, December 14, 2021

The crutches aren't nearly as convenient as the knee scooter with its basket. (However, crutches do make it somewhat easier to navigate stairs, which knee scooters can't do.) I've decided to wear a backpack to carry my ChromeBook and other miscellanea around the house.

When I asked him if I could play the organ, he said "Yes." (He didn't ask me if I could play the organ before the accident. On the day of surgery, I had asked him if I could play football after the surgery. That time he asked me if I could play football before. I had to answer "no.")

Next appointment in six weeks, on January 25, 2022.

Played organ at church: Sunday December 19, 2021

The regular organist was out of town, so I was asked to substitute at church today. I showed up imagining that I would have to play manuals only. However, I tried the pedals with my right foot wearing a stocking. It didn't hurt one bit, so I played with both hands and both feet!

(Note: The previous week the regular organist was sick and asked me to play. That time I had to turn her down. My knee scooter couldn't navigate the stairs to the organ. [Also, I hadn't asked the doctor for permission yet.] This week, on crutches, I was able to climb the stairs to the organ.)

Another Follow-up visit with Dr. Barber: Tuesday, January 25, 2022

At the doctor's office today, they took two x-rays of my right foot.

X-ray from the left side of my right foot

Another view of my foot, showing pins

You can see that my right foot is still swollen

Dr. Barber said my foot is coming along fine. He wants me to return in three months. I no longer need to use crutches or a walking boot. I probably won't want to run or jump just yet, he said.

Sometime it can take as long as a year for the swelling to go away completely.

Onward and upward!