By: Dr. Mindi Dayton
My surgery was Monday, November 20th. The morning started like almost every other “surgery” morning for me. Up, showered, and out the door by 6:15 am to get to the hospital. Only difference was no amazing cup of espresso first thing when I woke up like usual. (You are not able to eat or drink anything after midnight the day of surgery.) Paul, Jesseka, and I function as a team, and always have two of us in surgery together, so I am used to driving to surgery with Paul in the morning. This day however, Jesseka and Paul were my surgeon team, and I didn’t need to be there to check in until 8:45am, but since Paul was my ride home, I went in with him and hung out in the doctors lounge and worked until it was my time to check in.
Check in when smooth. I “registered”, got my arm band, and headed to the outpatient surgery waiting room. From there I was taken back to change into my gown. It is important to take all of your jewelry out/off and I recommend just leaving it all at home so that it is safe. All necklaces, earing, rings, etc. must be off prior to surgery. During the changing process I also was given chlorohexidine wipes to wipe down my surgical foot and leg. I was then taken to my pre-operative room, where my IV was started, medical history was confirmed, antibiotics hung for the IV, and I was given a dose of gabapentin.
The room was quiet and comfortable, and I just flipped through Facebook, worked through emails, and patiently waited. The team was pleasant and accommodating. I waited on my own as Paul was in surgery, but he stopped in to say hi😊. I had another friend that works in the OR stop in on a quick break to converse and before I knew it was time for surgery. Dr. Kaldenberg-Leppert came in to sign my right foot and confirm I didn’t have any last minute questions😉 .
The circulating nurse then came to take me to the OR and we made the walk down the long hallway to OR 8. This felt very comfortable as this is the OR I always operate in and I had the “A” team for anesthesia, circulator and my all-time favorite scrub tech, Deb (this was a special request I had… one of the benefits of having surgery where you do surgery). We saw the Treace rep outside the door ready with instruments and implants to make my case go as smooth as they all do.
Once I got into the OR I knew the routine! I made sure to position myself just right on the bed with my heels just at the bottom, so I was right where Jesseka and Paul needed me! I had worn our FACI team color of underwear (purple!) but I am not sure anyone got the team spirit I was showing! Beth, the anesthesiologist gave me some versed (the med that makes you sleepy and helps you forget everything!) right as I was sitting down on the table, and I pretty much remember laying my arms out on the arm boards and then that was it… OUT!
The next parts I do not recall, as I was sleeping, but this is our standard process and I have no doubt my team didn’t deviate. For a block we start with an ankle block right before we make an incision. We use 30 mL 0.25% bupivacaine plain. The lower concentration allows us to use more volume, and block prior to starting the procedure and again at the end of the case. Then, at the end of the case we use an additional 30 mL’s to block right around the surgical site, and we use 4 mg dexamethasone within the muscle by the surgical site to help control pain and inflammation too.
I can attest, this block works great! My forefoot all the way to the heel was numb for about 12-18 hours. It started waking up in the heel region first, and then finally the toes. As it was waking up, I felt some slight tingling, but nothing that was uncomfortable.
After surgery I went to the PACU (post anesthesia care unit). They wheel you into the PACU on a bed and then this is where you do your initial recovery. I woke up very tired, but not feeling any pain at all in my right foot. I believe I was in the PACU for about 35-40 minutes (I only know how long because they told me), and then to phase 2 of recovery. Here I was given water and offered juice, crackers and granola bars. I sat in a recliner with my foot elevated and ice behind my knee and they checked my vitals a couple of times. After some time, I was told that I could go home! I was pretty awake (just slightly groggy), and largely with it (at least I think I was) so as soon as Paul was done with his last case, I was able to come home and settle in.
Once we got to the house, I used my crutches to get from the truck to the back door, where we have two steps to get into the house. I was a little hesitant to try the crutches on the steps at this time and it felt really odd to try to put weight on my right heel since it was completely numb and I felt unstable doing so (and maybe a little fearful), so I decided to get into the house on my butt. I just rotated around then, and Paul helped me up from the ground and I assumed my position on the couch for the rest of the day!
