Free once again- no walking boot!

Yesterday we saw Dr. Scott and Mary no longer has to wear the walking boot and is clear for all activities!

At this point he really wants her to start using her leg and doing PT so we can see where she is at. He is hoping she gets the last 10-15 degrees of range of motion in her knee back from PT.

We asked about why Mary's knee "locks up" once she has been sitting. When she stands up she has to push down on her thigh so she can begin to walk. He thinks it is re-aligning her bones. 

Mary wanted to know when the 8 plate will be removed and he is guessing a year from now.

I asked about the 2 marks on the front of her shin (one was discovered after the last cast was removed and the other one showed up later - it might be a scratch) he is guessing they are from poor blood flow in that area.

Good news is he doesn't want to see us for 2 months unless something comes up.

before surgery April 2014

2 months after surgery June 2014- I can't tell from the x-ray that the foot is straighter but it does look straighter in real life

Picture in the parking lot- this is as straight as she can get her leg at the moment. 

She was off riding her bike that afternoon

We haven't been pushing her to do a ton of PT while she had the casts and walking boot but now she will have to focus on it again to help her regain a good gait.

No gain in shoe size

We went shoe shopping today to be ready in case she gets the walking boot on Tuesday. Mary's foot is straighter which was the purpose of the surgery but we didn't gain any length. Mary and I were hoping she would. We both handled it better than I thought we would. Her feet are still 4 sizes different...

Watch What You Ask For

Two weeks ago, Dr. Scott said Mary would get a true walking boot at her next appt. Mary REALLY wanted one so she could take a shower, not have to sleep with something on her leg, etc. so she was nervous he would change his mind and wouldn't give her one after all.

At her appt. today, they cut off her cast and we found a sore at an old pin site. It wasn't there 2 weeks ago:

Old pin site

They took x-rays of her foot:

close up of bone wedge- the darker part. The top has healed more than the lower part.

Then we talked to Dr. Scott. 

• He wasn't too concerned about the sore at the old pin site. 
• He said she would get a walking boot!!! 
• He said she could swim but that means getting in the pool not really playing around. 
• He said no bike which she had been curious about but that going for a walk was ok. 
• He also said she could wear a regular shoe around the house but we have decided to be cautious and stick to the walking boot just in case. 
• We go back in two more weeks.

Then off to get the walking boot we went. They pulled out the exact same one a girl we know who is Mary's age has but it was too big so she ended up with a Pediatric walking boot. It's not too obvious BUT it does have a giraffe on the side. Mary was thrilled to have a real boot initially because she wanted it so bad but both of us were disappointed by the Pediatric boot. It does look "babyish" with the giraffe on it which bugs Mary. I offered to duct tape it or something but she isn't interested.  To me it symbolized the whole problem we were trying to fix this time around...her left foot is not an average size for an 11 year old. We think she has it for only two weeks and I know we will both survive but we were both disappointed.

Giraffe on the side

She did thoroughly enjoy taking a real shower tonight so like all things there are pros and cons...

8 plate incision- week 6

bone wedge incision finally out of a cast- week 6

And I reminded myself I the real goal was to make her foot straighter which would be nice. Gaining size is an added benefit. (Although Mary and I really want her little foot to get to a women's size 5/kids size 3...I don't know if that's realistic or not since before surgery it was a kids size 13...)

Pin Removal and Walking Cast

We saw Dr. Scott on Tuesday (4 weeks after surgery) and:

• they cut off Mary's cast

1st cast - from surgery

unveiling of the pin

• took x-rays of the 8 plate in her knee and the pin and plate in her foot

8 plate

pin and plate

• pulled the pin from her foot (Mary was dreading this part but she did great. She said it was fine and it just hurt a little bit afterwards.)

the pin

• she can now bear weight so they gave her a walking cast and

Dr. Scott held her foot to get it in as much of a 90 degree angle as possible

Yes, she chose the exact same color combo. It was the "cast guys" 1st time doing 1/2 stripes but I think she has started a trend

The little cast show so she doesn't slip

She can walk without crutches once she she can do it

• she was so happy to be able to walk and get her independence back!!!

By the time I got home from work she was outside without crutches practicing volleyball!

• We go back in 2 weeks and she will get a walking boot after all! She will be so happy to be able to go swimming!!!

Post-Op Appt.

Exactly 2 weeks after surgery (Mon. April 28) Mary had her post-op appt. with Dr. Scott. Luckily, it was one of those appointments where everything we were expecting and hoping for happened. 

She had x-rays taken and Dr. Scott was very pleased with the progress. As a result, they cut her cast down below her knee. This allows her more mobility and independence so she returned to school on Tuesday.

It doesn't seem that she lost too much range of motion in her knee but she starts Physical Therapy again on Friday.

8 plate in knee to help straighten her leg and stop knock knee

Side view of 8 plate in knee

Bandage over 8 plate incision site

 8 plate Incision site, 2 weeks after surgery

Cutting cast below knee

Ton of stuffing under the cast

Side view of pin in foot to straighten her foot (it will be removed in 2 weeks) and the plate that is going to help make the bones level

Top view of pin and plate in foot

Update: Week 2

Mary has had a great week. She hasn't needed any meds since Monday (1 week after 8 plate and foot surgery). She still isn't completely mobile on her own yet. She scooches (vs. walking) up and down the stairs and needs help lifting her leg when she sits down. She has started using her crutches some this week. 

Good news is her doctor had to change her appt up a day. So on Monday (2 weeks after surgery) she should have her cast cut down to below her knee. She will have her knee back and the cast won't be so heavy. Mary will get some practice moving around with the shorter version and she will return back to school on Tuesday.

Mary really likes getting outside and going on walks. She uses her wheelchair for that.

So far so good. 

Transition Off Nerve Block

We turned off the nerve block at 8:30 am on Friday (Day 4). They said the medicine typically takes 6-8 hours to get out of the system. Mary wasn't experiencing much pain all day but she did take Tylenol and Ibuprofen in the afternoon. 

We removed the nerve block catheter completely at 6:30 pm. It was as easy to do as they said it would be. The hardest part was removing all of the tape but since they gave us the spray that dissolves the sticky tape that was even easy.

The only uncomfortable feeling after the removal of the catheter was the annoying itchy cast feeling. It took her longer to get to sleep because of the itching but she had another good night. 

So it seems that the nerve block was a huge success and we would recommend it. It only affects the area needed for pain without sending medicine throughout the rest of the body causing unpleasant side effects. It controlled the pain wonderfully and was easy to remove. 

It seems like the hardest part is behind us now. Now we are looking forward to becoming more and more mobile. Mary is getting around with her walker because she has a long cast and a wheelchair for walks. In 10 more days the cast will be shortened which will let her start using crutches and working on bending her knee that is currently in a cast. She is beginning to move her leg more on her own but still needs help lifting her leg at times and to go downstairs.

It is nice not to have to worry about the catheter tubing and carry the bag of medicine around.