Saturday, September 5, 2020

Partial Sesamoidectomy Update

 Sorry this has taken so long to update. I have to say, I've had many surgeries in my life but none that have been as unsuccessful as this. Never did I think a small break in my foot to obviously such an important bone (never knew what it even was) would cause my workout routine to drastically change. It's been two years now and I'm still having trouble doing anything that stretches the ball of my foot. Reverse lunges are next to impossible, I avoid jumping and sprinting is out of the question (which I'm ok with since I'm nearing 50 :))I think the most frustrating part is that I'm a high school weightlifting teacher and now I have to modify or have someone model the lift I am teaching for the day. I am able to still take my classes on runs but my foot is sore after. The incision was on the side of my foot and when it healed there is a nerve that seems somewhat caught in the scar tissue. I definitely have permanent swelling in that area.

Sometimes I wonder if I should've insisted on the doctor taking out the entire sesamoid but since I'm not a podiatrist I figured I better go with what my doctor thought. I also think that if I would've moved the foot around sooner maybe that could've prevented some of the scar tissue from developing. I remember trying to jog again, it felt so good but also so painful. I don't think I will have surgery to take out the rest of the sesamoid because the down time is just too long and there's no guarantee it will be better..could get worse. Anyone who has broken their sesamoid understands when I say how ridiculous it is that a break in such a tiny bone can change everything you do physically. I look at it this way though, things could be much worse!!

Feel free to send me any emails to julie_zaccheo@yahoo.com. 

Tuesday, August 28, 2018

Almost 5 weeks!

Sooo..it's been a while since my last update. I'm not gonna lie, it's been ROUGH! I'm guessing my lack of patience isn't helping either. I have had many surgeries in my lifetime. I've had 3 c-sections, 2 hernia surgeries, 2 shoulder surgeries and now this partial sesamoidectomy. I have to say the partial sesamoidectomy recovery is by far the worst recovery yet.  At least with the other surgeries there was a predictable healing timeline...with this sesamoidectomy it seems like a crap shoot!! I am still wearing my medical shoe to walk around in and I have a scooter at work. Thank god for that scooter, it's a humbling experience and my high school students think it's hilarious. They are used to me doing all of the workouts with them and taking them on runs and now all I can do is bark out orders...I'm actually really good at that though! This has been harder on me mentally than physically I think. To not be able to even take a normal step at this point is super depressing and feels like there is no light at the end of the tunnel. I try to remind myself everyday that someone else has it worse! I should be so lucky that's it only my foot!! I have an appointment this friday. I believe the doctor will be taking an X-ray to make sure that the broken piece that's still in there hasn't moved. I am icing 3-4 times a day and trying to keep it up. Nighttime is the worst because of all of the swelling that has accumulated during the day. Keeping my fingers crossed for a positive future post!!

Clearly the right foot has a lot of catching up to do...that's as far as it goes!

Scar is looking good...swelling still there.

Friday, August 3, 2018

1 week Update-There will be pics!!

It's been a long 7 days. I am going crazy sitting on my couch, one can only watch so much Netlix. It's been great to catch up on shows but I am dying to just go for a walk. I will be excited when I can just take a normal step forward. I saw the doc yesterday and heres how it went. He cut the bandages off to see how the healing was going. They did ask me if I was going to be ok seeing the bruising and the incision..and  me being a science buff I told them "Yeah, this is what I've been waiting for!" I wanted a pic because I figured if I show my family I would get better service around the house! He took the bandages off and was very happy with the way I was healing. I was on my feet more than they told me I could be so I was worried that it would be bad. It was bruised and a bit swollen. The incision looked pretty good though. The main problem I am feeling is the swelling (lack of circulation) in the forefoot and toes. My feet look like they did when I was 9 months pregnant. If this symptom weren't there this situation wouldn't be that bad. I am still icing, it gives great relief. Prior to surgery I was icing about 5-6 times per day and doing contrast baths 2 times per day. It's basically a waiting game at this point. I am scheduled to get my stitches out next Thursday August 9th. Here are  the pics from yesterday:



Saturday, July 28, 2018

Day 1 of Recovery

Well, what can I say other than I hope I'm on the road to recovery. The numbing medication is slowing wearing (24 hours later) so I might think about taking a pain pill. I have to keep my foot up as much as possible for the next 3 days as well as icing every other 30 minutes. No crutches. I can walk in my medical shoe but it just doesn't feel like something I should do. I can't get it wet for 2 weeks so I will be bathing my the plastic sleeve I purchased. My foot will stay wrapped until my next doctor's appointment. I will continue to blog my recovery as this is the part people really want to know. I'm trying to stay positive and hope that I made the right decision.

July 27th...Day of Surgery. Pics included.

My surgery time was 9:30 but they were ahead of schedule so after some general anesthesia I was under the knife. I asked my doctor if some pictures could be taken during my surgery, I love that kind of stuff! Well, he delivered on that. He also took a pic of the bone he took out that cracked in half again while he removed it. He informed me that everything went as planned and that the other piece of the sesamoid look healthy. The incision is made on the inside of the foot near ball of your foot. It's tricky right there because of the nerve that runs along there. The pics are below. If you are at all queasy you may not want to look...
Getting opened up

Actual removal of the broken lower half which then broken into 2 pieces..see below

2nd Doctor's appointment June 8th, 2018-No Improvement

For the second doctors appointment I took a second set of X-rays to see if there had been any improvement on the two pieces growing back together..none. My foot was still just as swollen so we decided to do a cortisone injection. I was feeling desperate. My podiatrist told me there were surgical options..A Sesamoidectomy or a partial sesamoidectomy. I clearly had some research to do. He told me that this was a last resort option and we should stay in the boot for a while longer. I put the boot back on and out I went. I decided to get a 2nd and 3rd opinion. The second doctor was an orthopedic surgeon that I had been referred to. She took X-rays as well (which showed the fracture) but also wanted to order an MRI to see where the swelling was coming from. My 3rd doctor was an orthopedic surgeon from Stanford. I had the MRI results sent to all 3 doctor's..I wanted to compare notes, I mean this is my foot that I need for the rest of my life! So, the 2nd doctor told me that most of my swelling was in the lower broken piece with basically no cartilage left. That piece of bone also had some arthritis. The upper portion seemed healthy with no arthritis. There were also no signs of AVN (Avascular Necrosis: bone death as a result of loss of circulation). So her opinion, since I'm quite active, was to do a partial sesamoidectomy (remove the lower piece). She said if the upper piece looked unhealthy then she would take that out as well but wouldn't know until my foot was opened up. The 3rd doctor (A foot and ankle surgeon from Stanford) reviewed everything and suggested I stay in the boot for up to another 6 months, very conservative. He said I could order a hapad metatarsal pad that sticks to my custom orthotics to allow the sesamoid bone to float (relieve the pressure). I was on the fence at this point. I had seen pictures of sesamoidectomies, so gruesome. There was basically little or no info on partial sesamoidectomies which was what I was leaning towards. My podiatrist (my initial doctor) told me he thought I should do a partial sesamoidectomy. He explained how he thought my main source of pain was coming from the lower piece (just like surgeon #2 said) and that this procedure should get me on the road to recovery. He didn't want to take the healthy piece out, he said leaving me as anatomically intact was important. What do I do?? Well, after much debate I scheduled my partial sesamoidectomy for July 27th...

The Doctor's Appointment-May 10th, 2018

May 10th, 2018 was my first doctors appointment with my podiatrist. I was expecting him to look at my feet and just tell me it was a bad sprain. When he saw where the swelling was he said he needed to take an X-ray because it could be my one of my sesamoid bones (first time i had ever hear of those bones). Taking the X-ray was a bit painful because of the way I had to hold my foot. As I waited for results all I could think about was how I was going to run the half marathon that was the following weekend. When he came back in his first words were "Well, you're not going to be running for a while!" He told me I had fractured my medial sesamoid bone right in half. Obviously I had a million questions for him at this point. As he answered my questions all I could feel was this sick feeling  in my gut and that this was going to be a long process. Here are the X-rays...
Bipartite sesamoid was ruled out due to the fact that this was an acute injury and the left foot has no bipartite indication.
Next step was to put me in a walking boot...aweful! My next appointment would be in 4 weeks...