Foot Anatomy 101

Good Evening! Several friends have asked me to specifically explain my foot problem. There are really two issues and the first one listed below is much more significant. The "toe issue" is not a new issue and it existed prior to the latest surgery. The idea of getting to the foot to lay flat was the goal of the last surgery and it doesn't look like the foot responded successfully.

What is wrong with the foot? .... basically two problems:

1. The foot will not lay flat to the ground. The entire foot tips to the right, so there is about a
1 1/2" gap between my big toe and the ground. (This gap could easily increase with time, as it has in the past.) I put weight only on the back half of the foot and cannot get the foot to lay flat & make contact w/the ground. The foot is also very rigid and no matter what we do, the foot naturally wants to lay on the side. When the foot tips to the outside, this is called "supination." Therefore, this make walking very hard, can't wear a shoe, painful, etc. It is not normal to continually walk on the side of your foot. Imagine your foot staying tipped to the outside the entire time - this is me!

2. Little Toe issue - The big toe will never move again, because it is "fixed" with hardware inside in one position. All 4 of the "little toes," normally work in conjunction w/the big toe. Since the big toe doesn't work, then my the four little toes decided to quit working also. They are all very "droopy" and just hang lower than they should be & serve no purpose at the moment. Your toes normally aid significantly in walking, but since none of mine are working it is a big problem. They hurt constantly because they are so stiff and there is no movement. We need to do surgery to bring them all upward and place them in the correct position .... they likely will still not move, but at least they'd be in the correct spot.

I'm sure this is more information than you wanted to know, but hopefully it gives you a better picture of the current issues. I am thankful to be working with a doctor that is willing to continue with a complex medical case. I also have a former physical therapist that is now a great friend and it has helped a lot to be able to discuss things with her throughout the process of making medical decisions.

Prayer Requests:
- wise decision making when I meet w/the surgeon on January 10th.
- my walking will improve and become easier each day.
- patience .... to not let my mind get ahead of the healing.
- we'll be able to make an appropriate decision about when to begin physical therapy.
- that I might be able to return to my house for a few weeks, before we operate again.
- that my current surgeon and I will be able to come up with a "workable" solution very soon.
- work .... that my employer will continue to be gracious and understand my situation.
- if additional appointments need to be made, that this will happen in a timely fashion.

Wishing you a great New Year!

Patience Needed!

I am starting to walk with the foot in the "boot shoe" and am using a cane. The first several days of this were very rough and I struggled to even put any weight on the foot. Gradually, the foot does get a little stronger each day and I am able to walk a little more. I have soaked and creamed the foot time and time again, and it is looking better. The swelling continues with walking, but then does go down over night.

I am still very concerned about the positon of the foot and where we are headed in the future. It is becoming increasingly difficult to be patient, when I know more surgery definitely is ahead. Pray for patience. Pray that I will be content and thankful for the blessings of each day .... it is easy to let my mind get "four weeks ahead" of the foot, on this deal. I have this week off work, but it is hard to be content with not being "out and about" doing fun things.

I e-mailed my surgeon yesterday about my concerns about the foot positioning. My surgeon
e-mailed me back this morning - which has never has happened before (always normally go through an assistant). I am going to take digital pictures of the foot positioning at home over the next two weeks & will continue to try to walk. There is not a lot we can do differently at this point, other than work on increasing mobility. I return to the surgeon the second week in January, so we'll make some decisions about how to proceed at that point.

Hope you are having a great holiday week!

Cast off, but keep praying!

Got the cast off .... yeah! The good news is that everything has healed inside the foot very well. The two pins on the outside edge of the foot were removed and one "leftover stitch." The foot is still extremely swollen, so this is going to take some time to come down. The big toe and foot appears to now be straight. No signs of infection, just puffy toes and a thick foot.

The bummer news is that more surgery is going to have to happen on the "droopy toes" sooner than I would have liked. The toe problem was another issue that I had prior to the last surgery, but I had hoped we'd need to correct them later and not sooner. The way the toes are now, they get in the way of trying to walk - hard to explain, but they do. There is no movement in any of the toes, so they all need to be pulled up and fixed in a permanent position.

The disappointing news is that at the moment, the foot doesn't lay flat or make contact to the ground .... as everyone had hoped. It is straight, but not flat. There continues to be a gap on the left side of the foot, and only time will tell whether or not this improves on its own, will stay the same or get worse. I need to put weight on it for several weeks & see how things progress. My experience in the past has been that if the foot doesn't make contact w/the ground after surgery, then it continues to remain too high (wrong position) & continues to creep up. The swelling needs to decrease and I need to put weight on it for a bit, before we decide how to proceed.

We'll likely begin physical therapy and/or discuss how to fix the toes in three weeks. The pain issue will be known w/more time, too. We took digital photos today to try and gage if the positon of the foot changes in the near future. I'm trying not to get discouraged about this yet .... the surgeon thinks that it is better than it was, but "not perfect." Myself and everyone else had pictured the foot laying flat on the ground today and that was not the case, so I'm trying to think optimistically. Improving the toe issue will aid in walking, but won't solve the foot positon issue (tipping to the right). Thankfully, God has all this under control.

All this to say ..... keep praying! We are not "out of the woods" on this one yet. The need to have the toes "fixed" was not a surprise today, but the idea that what we just did (surgery wise) might not have fully worked was something new. The foot needs to respond appropriately (e.g. stay in the correct positon) & the skill of the surgeon must happen together, in order for the foot problem to be solved. At the moment, I am still very confident in my surgeon, his staff and continue to enjoy working with them. Time and more prayer are definitely needed!

I did find out that my surgeon is a Christian and has three kids in Christian schools in St. Louis, which was neat to discuss with him. (He happens to go to attend an Evangelical Free Church also.)

Merry Christmas!
Jenny

First Steps on Friday ....

It has been a busy few days at work and there is only one day left with kiddos. Yeah! I was concerned about having enough stamina to make it through, but it looks like I am going to make it! I have off the entire week after Christmas, so this will be time to hopefully move back home, get to "know" my house again and practice taking some beginning steps.

I am down to three days and two hours, before my cast comes off .... Friday at 10:30am. Can you tell I am excited? We will do x-rays and hopefully I will begin with a walking boot. Please continue to pray that everything is still healing properly and we are still "on track." The bones need to be healed thoroughly in order to allow me not to have to continue with the hard cast. My artificial hip has also been painful over the past few days (opposite side of the foot problem), so I am hoping this improves once I can begin to put weight on the foot.

On Sunday afternoon, I tried to ride around in a motorized scooter at the mall and do a little Christmas shopping. It didn't work out, as I had hoped. The motorized cart had a huge basket on the front that was much to large to get in and out of stores. Between things on the floor, clothing racks and people, it wasn't happening for me. Thankfully, I had a great surprise this morning when my partner and administrative assistant both offered to go pick up a few things for me. Both individuals went to two places for me and this helped significantly .... I was thrilled that they helped me in this way!

Many thanks for your continued prayers and cards! I'll write more after the appointment with my surgeon on Friday morning. Patiently waiting to try walking on Friday!

Red cast and holiday bow!

Just wanted to let you know that everything continues to go as planned. I was able to ride around West County mall on Sunday afternoon in a motorized scooter, so that was a nice outing and change of pace. I am back to work and see about 100-125 fifth graders everyday at the Village. I have about fifty kids each day ask me if I broke my foot. We have four visit days this week and next, so pray for stamina! I sit for the majority of the day, but it is still tiring for me (7:30-5:30 is a long day all of a sudden).

Everyone is getting a kick out of the red cast with holiday bow tied around it. One parent told me today, "I've seen a lot of things, but NEVER this!"

I am having a small issue with swelling, because my foot is down so much during the day. The foot really should be above my heart for small amounts of time during the day, but this is not possible at the moment. Therefore, the foot/toe area swells and eventually it swells above the knee with purple coloring. Swelling is normal, but it makes for a tight and uncomfortable cast. Thankfully, the itchy feeling continues to be minimal.

I cannot wait until the cast comes off in 15 days .... the end is finally in sight. Continue to pray for reasonable expectations, that the foot will remain in the correct positon long term, and that pain will be a thing of the past once weight on the foot happens. I have the week off between Christmas and New Years and will use that week to practice walking & will hopefully be able to return home. Although it won't happen for some time, a new pair of shoes is calling my name somewhere!

Healing Well ... yahoo!

Quick update from my appointment today with the orthopedic foot surgeon . . . Thankfully, all continues to heal well! Since there were many "snow cancellations," I was able to go for an appointment early afternoon ... I was excited to be able to go earlier.

Awesome news ..... NO INFECTION! The fact that no infection has developed is a huge deal .... for our 8th surgery, this is a miracle in itself. The Chicago surgeons thought that it was nearly guaranteed that I'd develop an infection & then would need plastic surgery to correct the scarring that would develop.

The past few days have been rough with the cast being extremely uncomfortable inside. I initially thought it was just itchy, but as days have passed this has gotten worse. For some odd reason, the cast material about halfway up inside the cast had become "bunched up" and was too tight. This was causing pressure, increased swelling, purple coloration and appeared like it was beginning to cut off circulation somewhat. This was all relieved today, when we changed the cast and it already feels significantly better. I now have a red, candy-cane colored cast and bought fun green/red polka-dot ribbon to tie a bow around the toe area.

We removed the stitches today and the surgeon continues to feel that it is holding in the correct position. He showed us x-rays from surgery and we could see the new hardware that was placed inside. We took new x-rays today and everything continues to hold in the correct position. He was extremely careful today to hold the foot in the right spot, while removing the stitches, as to not let the tendon come out of place. The two pins that are now in place will also be removed in three weeks.

I have this cast for another three weeks and two hours and then I can begin to put weight on the foot in a walking boot. I will then wear a walking boot for 2-3 weeks and then will begin physical therapy. December 22nd is our final "cast off" day - yahoo! My surgeon is going to take digital camera pictures at the next appointment. If for some reason the foot would shift in the next few months, he wants to be able to visually show that it was once in the correct
positon. I think we need to send the picture to all those surgeons that said this couldn't be fixed! It is going to take some time to get back into a shoe and have it feel comfortable, although it will happen eventually.

The four small toes continue to be extremely stiff, "droopy" and have no movement on their own. They are all lower than the big toe, so the positioning on these toes will need to be corrected eventually. This is a minor surgical procedure - involves no cast and just a surgical shoe. Obviously, we won't do this immediately - likely early March sometime. The "droopy toes" is not a new problem and is something that will be more of an issue since the foot will be flat.

It is amazing how much better the new cast feels already. I'm very thankful for no infection, such a patient and intelligent surgeon and his caring office staff. The end is in sight .... yahoo!