Wednesday, March 27, 2013

Right foot/ankle surgery

3/26/13 -

Day 1 - Surgery Day - No weight bearing allowed on my right leg for 6-8 weeks, on crutches

Today I had reconstructive foot/ankle surgery to repair my nearly completely torn/frayed peroneal Brevis tendon at the Hospital for Special Surgery "HSS". I had both a tendon transfer from the peroneal longus tendon to the peroneal brevis tendon as well as a calcaneal ostemy. I tore the brevis tendon over 20 years ago and lately I had pain so it needed to be fixed. I was told 20+ years ago that I needed surgery, so I made it pretty long before having it fixed.

I arrived at the hospital at 6am and the surgery started around 830am.

The surgery was per performed by Dr. Andrew Eilliot, who is a specialist in the foot, ankle, and orthotics. I really like him because he takes the time to explain things to me, particularly about how my arch and heel mis-alignment is something that I was born with and that if I just fixed my peroneal Brevis tendon without fixing my arch/heel mis-alignment, I would once again tear my peroneal Brevis tendon because this mis-alignment pulls at the tendon upon every step (even walking). He said that he sees this frequently after a patient has only the tendon surgery somewhere else. He said that also getting the calcaneal ostemy done would give my new peroneal tendon transfer the best chance to live/survive another 50 years. That is why I decided to get both surgeries done. Without them, he said that I shouldn't run anymore or do weight bearing sports, because I will likely tear the tendon completely and fray it from 5-10% left to zero. He also said that the peroneal longus tendon "is also stating to fray, which means if you keep running without surgery, you will tear/fray this tendon too, then you will definitely not be able to run again. Ever.". So the surgery, for me, was the only way to go. Not being able to run or do other weight bearing sports (like basketball) just isn't an option for me. Period.

Surgery went well. I received a spinal epidural for the procedure. The same epidural that women receive when having a baby!

The doctor said that the tendon was "really really bad, basically gone". They did a tendon transfer and broke my heel to move it over and then put two pins in it.

They also have numbed my leg from above the knee down for a few days, so the pain is moderate now but is projected to be severe in a few days. Pain meds, 2-4 mg of dilaudid are available for me to consume if needed.

Procedure - Given spinal epidural, some versaid, 12.5mg of Benadryl (to combat my soy allergy), and 20 of propapol. Was totally asleep the entire surgery, where they performed a peroneal Brevis tendon transfer and a calcaneal ostemy to break my heel, move it over, and insert 2 large screws into the heel so it grows back together in this new position. Also took additional versaid and other drugs as needed during the procedure to remain "comfortable"

After surgery I ate a ton of fruit and drank a cranberry juice that I later determined had high fructose syrup in it, something I no longer consume. Bummer. My wife was there which was totally awesome. She took notes, because I couldn't remember anything the doctors told me after the surgery, I guess due to being still heavily sedated.

After the surgery had 2 Percocet and 0.5mg of dillaudid (IV) for the odd feeling of numbness in my foot

Discharged from hospital around 2pm. HSS is amazing. Extremely well run, everybody knows what they are doing and are efficient. They are helpful and made me feel very comfortable the whole way through.

When I got home, my kids Mikayla and Kaiya gave me a great welcome home by decorating the entire living room with colorful stickies.

All day and evening, I was unable to feel anything from about 1/2 inch above my knee down to my toes

Had mild Nausea in the afternoon

Drank a green machine smoothie I made in my vitamix blender the day before (kale, spinach, broccoli, peas, 1 large mushroom, baby carrots, apples, banana, pineapple, dates, water, and ice. I follow a plant-based (vegan) diet, which I strongly hope (believe) will speed up my recovery, particularly on the swelling side. .

Around 9pm took 2 Percocet for what felt like shin splints halfway up my right leg. I have a history of shin splints in this location, not sure why it was flaring up tonight.

Kept my foot elevated all day and evening. Slept on my back with my foot elevated all night. A little awkward as I normally sleep in my stomach, but not bad.

It was great having my mom in town from Wisconsin to help me out. We watched the first and part of the second episode of "House of Cards" in Netflix. I find it to be even better the second time (her first time).

Food/Weight tracking.
I plan on tracking my food and basic nutrients consumption as well as my weight for the next few months, as I basically can't exercise for the next 3 months. Will be interesting to see what happens, as I am used to exercising every day.

I weighed 180.1 pounds the morning of the surgery (using a Withings wireless scale which we find very reliable and beams right to my iphone and the web) and, according to my calorie/nutrient tracking, consumed 1923 calories today, as follows:

Breakfast - nothing consumed, not allowed to eat/drink anything after 5am.

Lunch - a can of cranberry juice and a bunch of fresh fruit provided by HSS, which was impressive that they could provide - grapes, banana, baby tomatoes, honeydew, cantelope, pineapple, and blueberries.
642 calories / 9g protein

Late lunch
Green machine - 352 calories / 11g protein

Dinner (appetite still low)
2 bananas/1.5 cups of fresh blueberries. 334 calories, 4g protein

Late dinner
2 cups of salted almonds, 3/8 pint of So Delicious cherry amaretto coconut ice cream. 595 calories / 14 protein

1923 calories (goal 2,000)
38g protein (goal 50, I usually consume 70-100 grams a day but was much less today due to not eating until lunch.

46g fiber (vs 25 or higher goal)
O cholesterol (vs FDA goal of 300)
Sodium 446g (vs FDA goal of 2400)
Sugars 204g (vs FDA goal of 50) - I strive to only consume natural sugars contained in fruits/vegatables and am regularly much higher the 50g, which is ok with me because it is all natural sugars. I don't agree with those who say that fruit in sugars is bad. I believe that we can't overdose on fruit (and my bloodwork confirms this)
Carbs - 371g (vs 300) - always high due to high fruit consumption
Fat 48g (vs 65)
Saturated fat 15g (vs 20) - I regularly run over 20 as many of the foods I consume are high in "good fats" - avocados, coconut, nuts, etc


  1. On April 23, 2013 I had surgery to repair my perneal brevis that was torn in 2009. At the same time I had a FHL transfer to replace a shredding Achilles tendon. The Achilles surgery seems to be healing well, but the perneal is still swollen after six weeks. I have burning pain up the outside of my foot up the outside edge of my calf. I still have hard painful swelling on the bottom of my foot that prevents me from putting weight on my foot in my Greg boot. I've been to PT 3 times and can do alphabet letters, ankle circles and leg lifts. Any suggestions to decrease swelling and improve ROM?

    1. I also have the pain in the brevis/longus tendon and am told this is totally normal, as is the swelling (which gets worse when I do more and the doctors/my PT said could last 4-6 months after surgery. I developed 2 post surgical blood clots in my calf, so I wear a very tight compression sock from foot to toe, which also keeps the swelling down. Regarding ROM, talk to your PT about improving it. Good luck!

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  5. Looks like pain is bearable for you! I hope you have recovered well and back doing the triathlon. Cheers!

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  7. My son was playing practicing football the other day with his team and he pushed himself too hard and ended up getting injured. He will most likely have to go in for surgery because his foot is in pretty bad shape. He has been in a lot of pain, but he is being very good about it. I just hope that we can get him into surgery soon and that once the surgery is over, he can start recovering quickly.

  8. I wish you the best for a speedy recovery! It seems that a lot went on during your procedure given the pictures you posted. I'm going to have to go in for foot surgery sometime soon. I don't think it will be as serious as yours, but I'll still have to go under. Do you think there are any precautionary measures I should take before going in?

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  10. Get well soon. This is really very much harsh and painful surgery and need much time to get recover to health.

  11. I will be having the same surgery done. I am scared for many reasons. One reason is I take care of my boys by myself. I don't know how long I have to stay off my foot...Also, I am afraid of the pain. I already take Norco 7.5 for my back and have for years. I am afraid the medication won't work because I am used to it...

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