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... 




The Initial Injury

I wanted to create this blog about my fractured sesamoid bone because as I researched I wasn't finding a ton of info. The info I did find was a bit depressing and bleak. Im not sure how my situation is going to pan out but I figured the more info and stories out there maybe the better.
I am a high school PE/Weightlifting teacher in San Jose, CA. I broke my medial sesamoid bone while I was teaching my students a game on the tennis courts. I had NO prior pain in the ball of my foot. As I was demonstrating this game I stepped back and pushed off and felt immediate pain that stopped me dead in my tracks. After I caught my breathe I decided to keep playing as I figured it was a bad sprain. Immediately after the game I got some ice. I had to walk around with flip flops on for the next week because the swelling wouldn't allow for shoes. Since the pain wasn't getting any better I decided to make an appointment with my doctor. His a pic of both feet..it's pretty clear that the right is swollen at the ball of my foot where your sesamoids are located...