Tuesday, September 20, 2011

The Day of Surgery

Right foot before surgery.
[Note: The bunion is the bone protruding from the left inside part of my right foot,
just below the big toe. Notice how the big toe leans to the right.
The pain I was experiencing was coming from inside the joint
where the bunion is.]

Two weeks ago, I saw my podiatrist and he suggested I have a surgical procedure done, which is called an Austin Bunionectomy, to correct the bunion on my right foot. For me, this meant outpatient surgery where they would shave the side of the bunion off, shorten the bone below the big toe joint and re-set it, placing a pin inside the bone to hold it in place. I was told that unless there were complications, this pin would be permanent. This would create an alignment of the big toe bones which could possibly alleviate my pain if everything went well through recovery. I agreed to have the surgery done and it was scheduled for today, Tuesday, September 20, 2011.

I was told to arrive for my surgery today at 9:15am and that surgery would start at 10:15am. I was not to eat or drink anything besides water or soda after 2:00am today and not to drink anything after 7:00am this morning. I made sure to eat my supper around 11:00pm last night so that I wouldn't be very hungry this morning. Because of other medications that I take in the mornings, I was told I could have water (or in my case, I was allowed to drink Crystal Light-flavored water) to take my medications, but to only have a small amount just to wash down the pills. I was asked to remove the nail polish on my right foot and not to wear any jewelry, cosmetics or perfumes. If I wore cotton underwear, I would be allowed to keep them on.

I arrived at the outpatient surgical center at 9:00am. I went inside, filled out some paperwork and waited to be called back to be prepped for surgery. At around 9:30am, they called me back and I was asked to completely undress except for my underwear and put on a gown. They checked my blood pressure, heart rate and we discussed my medical history and allergies. Then a nurse started an IV line in my left arm, just above the wrist. I was hooked to a bag of fluids and waited for the doctor to come in and go over what would be done today. The doctor came in and marked an X on my right foot and verified the procedure being done. I waited a few more minutes and then the anesthesiologist came in to talk to me and get permission to have a general anesthesia done (which means I would be put to sleep for the procedure). 

Next, they wheeled me into the operating room at 10:20am. Right away they put me on the operating table and placed straps around me to keep me from falling off the table. They injected my IV line with a round of antibiotics, and a small amount of sedative. As I watched them prepare the room and my foot for the surgery, around 10:30am, I was given the rest of the general anesthesia and was immediately asleep for the procedure.

Shortly after the surgery, I was wheeled into the recovery room and woke up around 11:30am. A nurse got me a cup of coffee and I came out of the sedation pretty quickly. I felt no nausea or pain. With a little help, I was able to dress myself. They had already wrapped my right foot with gauze and a layer of ACE bandage and a nurse placed a surgical boot on my right leg. The surgical boot also has an inflation device inside, but I was told not to inflate it yet because of the swelling that was occurring in my foot. I felt no pain whatsoever. I could tell that my foot from the ankle down was numb. It felt just like it does when I sit on my foot for too long and it falls asleep. I could wiggle my toes, but felt no pain. Within 15 minutes I was helped out to my car and my waiting family member. I was immediately able to put my full weight on the right foot and walk with a little assistance (since I was still recovering from the sedation).

Upon leaving the surgical center, the doctor gave my family member a prescription for Demerol 50mg (1 or 2 tablets every 4-6 hours) and Phenergan (for nausea). I was also told to keep my boot, bandages and foot completely dry and to wear my boot at all times. I am allowed to loosen the boot to put ice on it when needed. My family member drove me to the pharmacy to get my prescriptions filled and then we went directly home.

We arrived at home around 12:30pm and immediately I ate a sandwich and took my first dose of Demerol. I was told it was important for me to take the Demerol with food, and as soon as I got home. They didn't want the numbing to wear off before I took my first pain medication. They said the pain would come as the numbing wore off.

Its now 2:40pm and I'm having no pain or pressure. My foot is still completely numb. I have been able to walk by myself to the bathroom and back with no problem (and no crutches).

Since I had already had one Austin Bunionectomy 3 weeks ago on my left foot, I kinda knew how to prepare myself ahead of time for the long hours in bed with my foot elevated. I had made sure to fill a pillowcase with several thick blankets to use to prop my foot up to keep it elevated. This is much more comfortable than using a stool, and pillows seemed to fall off each other when I tried that last time. They recommend that you keep your foot elevated at least 6 inches above your waist, when sitting, to keep the swelling to a minimum. I also purchased an inflatable donut in the pharmacy section of the local Walmart to take pressure off my tailbone when sitting for such a long time (which really helps). I also prepared a cooler to put by my bedside with drinks and sandwiches and ice packs. They recommend that you ice your foot (over the ACE bandage but inside the boot) for 15 minutes out of each hour. I found that the freezable, reusable gel packs worked the best. I also made sure to have my phones by my bedside along with a trash can (in case I were to get nausea and vomiting), some books, my laptop and of course, the remote to the TV!!

After my previous surgery on the other foot 3 weeks ago, I came home very tired. I rested for the first few hours after the surgery. But this time, I am not tired or sedated. So I have been just passing time with my foot elevated and keeping a check on my foot for any feeling of pain (by wiggling my toes). Its important to take more pain medication BEFORE you feel a lot of pain. Its my understanding that if you allow the pain to get severe, it is hard to get the medication to catch up and take away the pain that has already begun. Therefore, taking the pain medication at the first sign of pain can help alleviate the pain level from growing to a level of discomfort. Usually doctors measure pain on a scale of 1-10 (1 being the lowest, 10 being the highest level of pain). So in my blog, I will note my pain levels based on this score.

It is now 3:00pm and my pain level is a 0 and I have no nausea. I plan to take a nap now and I will check back in later to let you know how things are going!

~Laura.

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