8 plate and Osteotomy in Foot Hospitalization

They were right...this procedure was so much easier than getting the fixator on. 

pre-op

choosing cast colors

wheeling into OR listening to jokes

The anesthesiologists were great about our request to put her under before giving her an IV because she is terrified of needles. Of course, the procedure was an hour longer than we expected it would be and it was because it did take them longer to put her under. Her hands were so cold it took them a long time to get the oxygen saturation monitor to work. They actually had to put one on each hand. The anesthesiologists were very personable and were telling her jokes which she loves. They totally respected our wishes but did explain afterwards that at her age it is better to use an IV because the mask takes a lot longer. 

beginning of recovery

unveiling cast

This time they used a continuous nerve block vs. the shot that wore off after 16 hours with the fixator. It worked (and is still working great- we came home with it and will remove it at the end of the week.)

I didn't get pictures of all the x-rays yet but Dr. Scott was able to do the 3 items: 

• 8 plate in knee to straighten her leg which will come out in several months, 
• an osteotomy (break the bone) in her 1st metatarsal and put a pin in it to straighten her foot (the pin will be removed in 4 weeks), and 
• an osteotomy in her 5th metatarsal to make it even with the rest. He used a plate there that won't have to come out since he knows she is so freaked out about having the pin removed. 

before

pin and plate

We weren't in recovery very long before we were moved to our room upstairs where we stayed one night.

Moving up to room

Mary was in no pain and even got up 4 hours after surgery and walked! That took 4 days last time. It isn't as major of a surgery but I think half of it was just having the experience of how to deal with something big and heavy on your leg and already knowing her to use a walker. 

working with PT 4 hours after surgery

Walking!!!

I was nervous going into the night because that's when the pain meds for her knee where the 8 plate was put in would be wearing off and that was miserable last time. But she didn't feel any pain until 1:30am but even then it was very manageable with 1-2 doses from the PCA. She didn't really sleep until 3am but most of that was just because she was in a noisy hospital with people coming in and out a lot.

We were woken up at 6:30am by the Orthopedic Resident who was reassuring that there was no rush to leave but advised we needed to be cleared by the pain team and PT. Unlike last time, I was confident we could leave and didn't feel the need to stay. 

Good appetite for breakfast unlike last time when she didn't each much the 5 days she was in the hospital

Her knee was bugging her in the morning but not horribly. By the time PT and the Pain Management team came by, we tested the drug she was being moved to from the PCA for her knee and we had our prescriptions it was 1pm. It was a good idea to give her a dose of meds for her knee before we left the hospital so the car ride which is longer from this hospital wasn't uncomfortable.

Getting IV out- last thing before leaving

Dressed and ready to go home

She fit in our own car this time. We didn't have to borrow our friends car this time

At home we gave her regular Tylenol an hour before the stronger knee medicine from the hospital would wear off and when the stronger knee med wore off the Tylenol didn't seem to be giving her much comfort so we gave her Ibuprofen which did seem to work. The nerve block is working great on the foot which is where the most pain will be but the other med is for her knee. I started to get worried again. I realize this is all so much easier now that we have experience but I am also apprehensive with the knowledge from last time about pain and was starting to miss the hospital. The ibuprofen worked and she was comfortable and actually fell asleep at 10pm. 

She did get physically wiped out from going up the stairs and getting ready for bed.

Every day the pain should be less (should be much better by day 4) and we do have the stronger meds to use for her knee but are trying to avoid it because of all of the unpleasant side effects. 

The new (to us) hospital was fine and Mary said she would go to either. I prefer the one closer to home but this hospital was ok. 

We have an appointment in two weeks to cut the cast below the knee. That will make this process even easier. Unfortunately we did find out that I misunderstand about the "walking cast". I thought it would be one of those boots but no, it's a hard cast that she will be able to bear weight on. Mary was pretty disappointed when she heard that...