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Ok, I apologize in advance, because as I'm writing this I'm in a ton of pain and still upset about my Ortho visit yesterday, so please bear with me.
I had a trimalleolar fx w/dislocation (my L foot was backwards) Sept 12th 2016. I was sedated whilst they reduced it back and I was told I would never walk on it without ORIF. I had to wait 17 days for the ORIF surgery due to swelling. On surgery day, right before surgery I was given a popliteal nerve block with a pump attached. I was told the nerve block would last me a few days as far as keeping me nice and numb and comfortable.
It lasted 5 days, and when I told the anesthesiologist that called me daily to check on me that I was still numb, he said go ahead and remove the nerve block wire. I thought the fact that I was still numb was normal. The entire last 6 weeks has been horrible, with my 4th toe and pinky toe and outside of my foot 100% numb but also in pain, which feels like someone holding a flame near my toes and foot. The outside of my foot is numb as is the bottom of my foot. You know that feeling when you break out in chills all over? I've had that feeling constantly but only in my left leg from the knee down. It's been excruciating and the first time I called the nurse to tell her about it, about 10 days after surgery, she said oh it's just your toes, the surgeon isn't going to do anything about that..... hmmm... so that got me upset and I had read about Gabapentin helping with nerve pain. Being a Medical Assistant myself, I requested Gabapentin and she conceded and said she'd ask the doctor. I got 100mg 3x a day and Tylenol for the pain. It wasn't doing much but it was taking the edge off. The next week I called and asked for an increase and now am taking 300mg 3x a day.
So yesterday I went to my 6 week post op appt. First thing they did was take off my cast and send me to xray. I have been on zero weight bearing but had accidentally put weight on my foot a week ago and have been in a lot of pain.
After the xray I went back and waited to see the surgeon. It wasn't my usual surgeon but someone else which I didn't really mind. But I was here with a lot of questions and concerns, and before I could talk about them he said 3 sentences... xrays look fine and we'll see you back in another 6 weeks, and a guy will come in and give you a boot.. then he walked out of the exam room. I was in shock and speechless. When the Medical Assistant came in with a large airboot and saw my tiny feet he proceeded to use that one. I said hello, my foot is very small, isn't that a large? He stopped and said yes, I guess I'll go exchange this for a small.. he didn't look too happy about it. When he came back I asked if the surgeon was coming back in as I had a lot of concerns and questions... I was told no. This is where my anger really comes in.. I insisted he call the surgeon back in!
So this surgeon, who had come in earlier with his 3 sentences, comes back in and sits down and looking very irritated, asks me what I need to say....
I said first of all my pain level is an 8.. I reinjured my foot a week ago by putting too much weight on it and he said... "ankles are fickle and wax and wane, you're fine." I said hmm.. well I'm in a lot of pain and let me show you what's going on. He never once touched my ankle to exam me so I showed him which toes are 100% numb and how the outside of my foot was mostly numb, including the bottom of my foot and partial numbness all the way up my calf. I showed him I couldn't move my ankle AT ALL. I told him about the shooting pain and the fact that the Gabapentin and Tylenol and my OTC Aspercreme w/lidocaine wasn't working and I was spending my nights unable to even let the sheets or blanket touch my toes. His response was that I should call the anesthesiology dept and tell them as the nerve block may have damaged some nerves, causing my pain and numbness from the knee down and that if this is the case then I am looking at least 10 months recovery. He also said he'd refer me to a Neurologist at my next 6 week appt if I was still having nerve pain issues. When I asked for pain medicine he said they don't prescribe anything for pain, only for the 1st week after the original surgery. I said I reinjured it and my pain was at an 8 and so he said all he could do was increase my Gabapentin to 400mg 3x a day and then left the room. The Medical Assistant came back in and I said umm... I have been zero weight bearing up until today.. what are my instructions with this new airboot? What am I supposed to be doing the next 6 weeks? How much weight should I be bearing and for how long? What about Physical Therapy? So he went and asked the surgeon all these questions and returned and said this.... the surgeon said do what you want when you want and you decide what to do... and no physical therapy needed. I said well from everything I've read, patients are usually given PT and not only for the foot but the whole leg due to atrophy. I also said that with my nerve damage and severe pain, that I had read that early intervention could greatly help me with that.. so I sent him back again with a firm request for PT.. he returned and said no, the surgeon didn't feel it was needed and reminded me to call the anesthesiology dept.
So here I am with an airboot on, with no instructions, my knee scooter, and me in tears thinking ok, I need to become my own doctor now and go home, and research and ask what I should be doing for the next 6 weeks. I did a quick try of putting some slight weight on my foot and it was a definite no go.. too much pain! I guess I am just wondering what happened with those of you who had a trimalleolar fx w/dislocation and ORIF at your 6 week follow up? Any advice would be greatly appreciated. I took the airboot off last night when I went to bed and was in too much pain to sleep so had to put it back on. It's heavier than my fiberglass cast and awful to sleep in. So yes... any advice would be greatly appreciated!!
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