The Pain Meds Post

Its 4 weeks today since I had the surgery. I have to say, it feels like an eternity, in good and bad ways. In an odd way it has gone by quickly, but in another dimension its has been forever!!!! It is also my Birthday! Yikes!!! 

So, following on from Mondays post - I decided to totally stop the codeine. My plan is, pain meds as needed, but for now, only paracetamol or brufen. I have to say, yesterday was yuck. Now, here is the thing - am I feeling/having symptoms because I know about them, or am I really having them? I mean, Im not going through full blown withdrawal from heavy dependency, but I am definitely feeling the withdrawal. My legs are the main thing, the heavy "ache" in them, and then the evening restlessness. I also had really bad diarrhea - not sure if that was the withdrawal, it certainly is a symptom with heavy opiate withdrawal but as I said, 30mg of codeine a day over the whole day is not considered to be a heavy dependency (that is what I had gotten down to).  

I also wondered if the fact that I was on Tramadol previously has factored into the withdrawal symptoms? 

Last night wasn't great. I took 1 Panadol night - they have a "sleepy" antihistamine in them, and I do find that they help me sleep. I also took ½ a zanax for the restless legs. I dosed off after about an hour, but then would you believe I woke, and could not for the life of me settle again. I read, I tried to listen to meditations, I read again, I just lay and did breathing techniques, I tossed turned, went to the loo, and eventually I took another panadol night and another ½ zanax. I also have an app on my phone that has nature sounds, but also "binaural" sounds, so I set the dreamless sleep binaural sound, and would you believe - oscillating fan and I actually cant remember how long it took but I did end up getting to sleep thankfully. I slept all the way through to 7am this morning. 

Painwise Im actually doing fine. Its weird, I keep thinking, "ooh, I must take my meds", but I actually dont need to. Thats great isnt it?!? Im not pain-free, but its more than manageable. To be totally honest, the worst thing Im suffering from at the moment is achy legs, and not to be able to go for a walk, or swim or have an epsom salts bath is the worst!!! But Im hoping that that will pass with time. Its funny, there is always a little voice in the back of my head saying, maybe if I took just one 15mg tab, it would just ease it a little - but the logical me knows that that is the voice that drives it from being pain relief to addiction. I know my mood has definitely dropped as well - again, codeine is a great mood upper - known to be, well, any of the opiate group are, so when you remove it, the mood drops. 

Im really documenting this to show that it is a reality of post surgery, and one of the downsides. I googled codeine withdrawal yesterday, and found a thread with so many people talking about how they developed a dependency, and a lot of them were like me - post surgery, or with bad back pain, and it just spiraled. It is so easy to "trick" a doctor into keep on giving the pain meds, and I really feel that this is something that needs to be addressed. My GP's never questioned the repeat prescriptions for Tramadol for a year and a half and I know we should all take responsibility for our own health, but there should be a point where it is red flagged. 

 All along the way, since the surgery, since I had to deal with the pain nurse in the hospital, I have had this fear, or awareness of opiate dependency - especially after the Tramadol..... and I feel lucky that I had this fear to stop me spiralling. I am a bit too much of a controller to let it overcome me. I should thank myself for this - as it is probably that which has stopped me from becoming addicted to alcohol, drugs or letting my love of food turn me into a super obese person (Im overweight but never get past a certain point!). I have addiction on my fathers side, and Im very aware that it is something that can go through generations. 

Otherwise, I have nothing to report. Tick/Tock, Tick/Tock........ 

The Pain Meds Post

Its 4 weeks today since I had the surgery. I have to say, it feels like an eternity, in good and bad ways. In an odd way it has gone by quickly, but in another dimension its has been forever!!!! It is also my Birthday! Yikes!!! 

So, following on from Mondays post - I decided to totally stop the codeine. My plan is, pain meds as needed, but for now, only paracetamol or brufen. I have to say, yesterday was yuck. Now, here is the thing - am I feeling/having symptoms because I know about them, or am I really having them? I mean, Im not going through full blown withdrawal from heavy dependency, but I am definitely feeling the withdrawal. My legs are the main thing, the heavy "ache" in them, and then the evening restlessness. I also had really bad diarrhea - not sure if that was the withdrawal, it certainly is a symptom with heavy opiate withdrawal but as I said, 30mg of codeine a day over the whole day is not considered to be a heavy dependency (that is what I had gotten down to).  

I also wondered if the fact that I was on Tramadol previously has factored into the withdrawal symptoms? 

Last night wasn't great. I took 1 Panadol night - they have a "sleepy" antihistamine in them, and I do find that they help me sleep. I also took ½ a zanax for the restless legs. I dosed off after about an hour, but then would you believe I woke, and could not for the life of me settle again. I read, I tried to listen to meditations, I read again, I just lay and did breathing techniques, I tossed turned, went to the loo, and eventually I took another panadol night and another ½ zanax. I also have an app on my phone that has nature sounds, but also "binaural" sounds, so I set the dreamless sleep binaural sound, and would you believe - oscillating fan and I actually cant remember how long it took but I did end up getting to sleep thankfully. I slept all the way through to 7am this morning. 

Painwise Im actually doing fine. Its weird, I keep thinking, "ooh, I must take my meds", but I actually dont need to. Thats great isnt it?!? Im not pain-free, but its more than manageable. To be totally honest, the worst thing Im suffering from at the moment is achy legs, and not to be able to go for a walk, or swim or have an epsom salts bath is the worst!!! But Im hoping that that will pass with time. Its funny, there is always a little voice in the back of my head saying, maybe if I took just one 15mg tab, it would just ease it a little - but the logical me knows that that is the voice that drives it from being pain relief to addiction. I know my mood has definitely dropped as well - again, codeine is a great mood upper - known to be, well, any of the opiate group are, so when you remove it, the mood drops. 

Im really documenting this to show that it is a reality of post surgery, and one of the downsides. I googled codeine withdrawal yesterday, and found a thread with so many people talking about how they developed a dependency, and a lot of them were like me - post surgery, or with bad back pain, and it just spiraled. It is so easy to "trick" a doctor into keep on giving the pain meds, and I really feel that this is something that needs to be addressed. My GP's never questioned the repeat prescriptions for Tramadol for a year and a half and I know we should all take responsibility for our own health, but there should be a point where it is red flagged. 

 All along the way, since the surgery, since I had to deal with the pain nurse in the hospital, I have had this fear, or awareness of opiate dependency - especially after the Tramadol..... and I feel lucky that I had this fear to stop me spiralling. I am a bit too much of a controller to let it overcome me. I should thank myself for this - as it is probably that which has stopped me from becoming addicted to alcohol, drugs or letting my love of food turn me into a super obese person (Im overweight but never get past a certain point!). I have addiction on my fathers side, and Im very aware that it is something that can go through generations. 

Otherwise, I have nothing to report. Tick/Tock, Tick/Tock........ 

So, I thought I would come here and do another blog - break the day up!!! 

Things Ive realised today. To really and truly have the pain under control, I need to keep the foot E.L.E.V.A.T.E.D.... not just up, but yes, TOES ABOVE NOSE. 

Of course I have known about this, but, when you are in the midst of it all, it is harder to actually be compliant - but after a few hours out yesterday, I now realise that, yes, this is really really important in the pain control. 

So how have I come to this conclusion?? Let me explain. 

One of the things Ive been stressing/worrying about this time around is medication dependency. For the past year and a half I have been taking Tramadol - at first for pain relief, yes, but then, when I tried to wean off it, the restless leg syndrome kicked in (no pun intended), and to be quite honest and frank, I ended up taking a maintenance dose knowing that I was going to be having the surgery and knowing from the last surgery that I came off the Tramadol and it was fine. Yes, I regret the day I started taking them again for the pain caused by the left foot, but I did, and lesson learnt. 

So, I insisted this time that that was it with Tramadol - no way will I ever take it ever again. What a horrible drug, and one that I think is prescribed far too freely. 

Anyway, I was put on coedine. Now I have to say Ive never had a problem with coedine before, and certainly never felt like I was dependent or needing it, but as a worrier, I know after all the warnings here in Ireland (you would not believe how difficult it is to buy any over the counter medication containing coedine here) that there is a real chance of my body becoming physically dependent on it, and believe you me, I do not want or need that in my life. In fact I really want to be free of all meds by this time next year, including blood pressure and reflux meds. 

So, as of today, I am starting  my wean down from the coedine based meds. This means keeping my foot absolutely elevated so as to not have to resort. So far today I have only taken 15mg with paracetamol (Tylenol?), so Im doing well. I will take some at bed if I really feel I need to, but I am going to do my best not to. I want to be free of the coedine tablets by the weekend, and only using them when pain is higher. Up to now I have been taking them at scheduled times to keep ahead of the pain, but now I feel is time to work them down and only use as needed (I would REALLY appreciate anyone elses opinion on this if you would be good enough to leave me a comment!!!). 

Onto the other thing that has been bothering me - I really really miss cooking. I love cooking and I know Im good at it. I mean, really good at it - now posh, restaurant quality, but good family meals, and no matter how hard they try, my family are just not quite getting it!!! I was a member of Slimming World (not hugely successful I might add, but was working at it), and love to create healthy dishes, but now that Im at the mercy of my family, I have to basically take whats given to a certain extent. Then, the boredom eating - oh my gawd, the boredom eating is awful, in that I just want to eat, constantly, and I know its because Im bored.... 

Lordy, I sound like such a whinge bag, and Im really not. Most of the time, Im a very positive, forward thinking person, but today Im fed up and another 2.5 weeks are spanning ahead of me - ugh. 

Today, here in Ireland the sun is shining, and I cant go out in it because there is nowhere for me to go to lie down with my leg elevated enough. So I am looking out my bedroom window at everyone enjoying the sun. And we are having a BBQ for dinner, and no, I have had to say I cant partake because I am afraid to have my foot down after the pain from yesterday and having to take extra meds. 

So at the end of this blog, I am going to write down 3 things Im grateful for - 

1. I am grateful knowing that all this will pass, that I am healing and that I will have the pleasure of having 2 better feet at the end of it all. 
2. I am grateful for those around me, who love and support me and care for me. 
3. I am grateful to be able to look out my window and see glorious sunshine!!! 

Til the next time, over and out. Oh and here is me writing this piece, and showing said elevation!!!! 

The Shit Side of Enforced Arse Sitting!!!

Today I thought I would talk about the shit side of all this. The mind and arse numbing boredom, the frustration having to do the slightest little tasks, the pain searing through your foot and you know you arent due any more pain meds for another 2 hours. Oh and stretching your legs - that one - how awful the pain is when you do a full leg stretch but you cant just do one leg. 

Having to rely on everyone for nearly everything - its really heart breaking. Biding your time to ask for something because you know that the person is busy, or has just sat down, or has been in work all day, or any scenario. "no thanks" becomes a common phrase - or "if you wouldnt mind" or "I hate to ask you but".... 

Waking up in the morning, knowing you should feel grateful for another day dawning, but all you can see is an expanse of another day ahead of you. Breakfast/Lunch/Dinner. Everything revolves around food. And Im fat, so Im well aware that Im probably going to end up fatter - thats for dealing with at a later date because I just havent the mental energy to deal with it now. 

Watching copious amounts of Netflix/live streaming, Youtube videos, doing meditations, reading, Facebook, and more Facebook. 

And sitting around on your numb arse, trying to find a different position, but there just isnt one that means your foot is elevated. 

But you know what, at the end of the day, this will all be worth it. I have to believe that. I have to believe that next summer, I will be strolling around on the beach for pleasure with my dogs. I will be able to walk up the mountains, and take pleasure in it. I will, I will, I will. 

And hey, arent I so very lucky that I can have all this surgery done - that there is hope for me at the end!!! 

Over and out. 

FRANKENFOOT PART 2

Wow!!! I cant believe that my last blog on here was July 2015. I guess life just keeps moving onwards and as I didnt have much to report, this blog went to the wayside. 

It is Monday the 22nd August 2016, and I am 19 days post op on my left foot. 

What did I have? 

- calcaneal osteotomy 

- cotton osteotomy

- tibial tendon transfer 

So, compared to the right foot, I had slightly less done. They didnt need to stretch the achilles tendon, nor did they do a bone graft for the cotton osteotomy, they used bone from the bone bank. This meant an easier recovery as the hip graft was a painful area for quite a while! I also didnt have a general anesthetic - they did a spinal block with heavy sedation... also did a nerve block, but more about that later. 

Now, so far, the differences? Well, post surgery, sadly the nerve block wore off too quickly which resulted in me having a HUGE amount of pain the night of the surgery and the next day, all of which resulted in the "pain nurse" having to basically sit with me for the day, and then pump morphine into me to get past the pain, to reign it back in (in the simplest of terms!). God I loved that man that day. He was an absolute angel, and was so attentive and caring. The day after was better, although I was really sick with the pain meds, so couldnt really eat anything. On the 3rd day, because they had decided the day before to give me laxatives because of slack bowels from opiates, I had severe gut pain for half the day, and I mean, akin to food poisoning pain, which amounted to me being toilet bound 6-8 times in one hour... not so easy on crutches, and trying to keep the foot elevated..... I discovered that they had more or less overdosed me on laxatives - and when you think I had eaten very little, it was no wonder my bowels reacted the way they did. They eventually gave me Immodium - ridiculous. 

I got home on Sunday - (surgery was done on Wed 3 Aug 2016), and went straight to my Mums like last time - Im actually still here as I write this - but due to go home tomorrow to my own house. Post surgery has been pretty much the same as the last time so far - apart from post GA (general anesthetic) grogginess, which I didnt have this time!! I definitely have been much "fresher" headed. Pain hasnt been great. Im acutely aware that I dont want my body to become dependent on pain meds - coedine specifically, as I used the surgery to come off Tramadol - having become physically dependent on that... ugh.... So, Ive worked out a way of weaning off the coedine - and hopefully so far it seems to be working. I aim to be only taking paracetamol and brufen by this time next week, with the odd coedine when I need it. 

I went back to Dublin on Wednesday last for the two week cast change - and it all went fine - very odd not to see the any of the consultants team this time - but the "plaster" nurses seemed happy enough with the surgical sites. 

So, here at day 19, all is going as it should. I have aches and pains in my hips, back and legs, because of having to stay in certain positions due to having to elevate the foot, but on the whole, all is manageable. I have my knee scooter again, and that is just brilliant - I recommend ANYONE having any type of foot/ankle surgery to invest in one, either to rent or buy - (you will make the money back no problem selling it on!). 

Ive been doing some "bed yoga" which I found on Youtube - worth doing for the stiffness. 

JUST A LITTLE ASIDE - HOW IS FOOT NUMBER 1 TODAY - 18 MONTHS POST OP?? 

Well, how many times am I asked this question?? Its not as easy a question to answer as it seems. Since I got back on my feet, after the first surgery, I havent been able to "test" it as much as I would like because of the left foot being so bad. I know I have had to compensate a lot because of the left foot, and waiting 17 months for surgery on that one definitely hasnt helped the recovery of the first foot - in my humble opinion. So, in all honesty, its not perfect - I would say it is about 80%, which, in the grand scheme of things is fabulous when you think about it!!! I really dont think its ever going to be 100% right. It has pronated again, but the whole foot hasnt pulled over - I just dont have a perfect little arch, which is disappointing, but the difference is, I know I will be able to wear a shoe with a bit of heel if I need to without crying at how horrible it looks, nay, not being able to full stop!!! 

My ULTIMATE goal with both feet is just to be able to walk again for pleasure without extreme pain. I know realistically this means this time next year - so that is the goal - walk on the beach for pure and utter pleasure. Walk through the forest with my dogs, just for me time... not too much to ask is it?? 

I will check in again after the cast comes off. There really isnt much to say in the next 4 weeks! Its just patience, patience and more patience!!!