Leave of Absence

Well my work schedule is Mon-Fri so as of clocking out this afternoon I am now on a Medical leave of Absence. Short Term Disability has been filed and according to HR I am not allowed to be at work till my Dr says it's okey dokey.

This brings some mixed emotions. I am glad I work for a company which gives these options. I am More fortunate than a great many people in similar situations. I have done a major surgery when I was a stay at home parent and my wife had to do darn near everything for several weeks including getting kids back and forth to school which was one of my normal task (that was a blown disk at L5-S1 not pleasant don't do it) It was very rough and cost far more than bills reflect. if it had not been for the help of friends and family we would not have made it. I am so very glad I am not in that spot again.

On the flip side I don't like being off work and the uncertainty of exactly when I get to go back. it is scary. I have spent all week trying to make sure everything I can do is done to prep my work site for my absence.

I am also the current Worshipful Master of my Masonic Lodge. This week with out NSAIDs and next week after surgery are definitely no go's for getting up to lodge and anything going on. Fortunately my officers are all the Models of what Masons should be and have picked up the slack. I posted the following on Facebook and mean every word of it:

"I am very grateful for my officers and the members of my lodge who have made sure the light of Masonry is tended to. It is not that they tended the flame when I am unable, it is as I am unable that I see they have tended it all along.

There may be times we think that we alone feed the fire and keep the flame alive. I am fortunate to see how many others tend the flame of knowledge and keep it alive that I might find my way back home."

I am not happy to be at home on a LOA I am not happy to be having my foot sliced open and remodeled. I am glad I am occupationally and financially able to take care of the Lemons life has thrown my way and mix them with Soda, Sweet Iced Tea and Rum. (forget lemonade)

Pre-op

Well I did Pre-op today. My blood pressure was a bit high and I reminded them that I wasn't supposed to take anti-inflammatory and was ask" well you know you can take this this and this right?"

I did not growl This is not my first major skeletal surgery. I have survived an old fashioned laminectomy and diskectomy at L5-S1 with 60% nerve impingement. I have done a rather unpleasant rotator cuff decompression, repair and impingement surgery with bone planing. I have also done a rather extensive septoplasty with bone ad soft tissue removal in all 8 sinuses.

I know damn well my foot will hurt differently than any of those, none of those hurt the same way. However I know damn well what I can take before surgery and what I can handle at work the week before surgery. and work requires I deal with a bit of pain and not take some of the drugs I want.

Acetaminophen helps .. a little and the Tramadol tends to make me slightly fuzzy minded which I don't like at work. Hence at the end of the work day when I did my Pre-op.. I was hurting a bit more than was comfortable.

sigh I will eat my narcotics next week and drool.

Anti Inflamitories

6 days and a wake up before surgery.

NSAIDs. Oh how I want one right now. My Pre op info says not to take Non-Steroidal Anti-Inflammatory Drugs or Aspirin for one week before surgery. Something about blood thinning properties and yadda yadda,

Oh Holly F**% Bunnies! I didn't even know or realize how much they were helping!

Tramadol is my current best friend I am still allowed to have it.

Best advice don't do this to your foot. I am sure I will say this again.

Making changes

Shower seat, Remote shower head and Peg leg acquired. The Wife is out hunting a small microwave... 8 days and a wake up till surgery..

Here is the Peg leg!

My yard is all hill and my house is all stairs and narrow so the normal knee scooter is just a joke. 

To top of the day of prep for having my foot ripped up and re-assembled I did some work in one of our bathrooms

New shower head and hand shower along with my new shower seat.. Oh Joy. 

Really Red Wasp.. Hate with wings.....

LisFranc

A Frenchman named Lisfranc is not to blame for my pain but he was the first to define why my foot hurts. He was a Surgeon in Napoleon's army. Remember in the 17 - 1800's the surgeon was not really who you wanted to see. The specialty surgery of the day was amputation.

Well Lisfranc noticed that cavalry men who had been shot/knocked/fallen out of their saddle and got their foot caught in the stirrup had a peculiar injury to the mid foot. While he was getting good at cutting peoples foot off across the mid foot joint he had lots of time to look at the bones and tissue connecting everything.

Well due to his attention to the stuff and people he was cutting up on a semi daily basis he was able to define that the first metatarsal is connected by a ligament to the second cuneiform bone which is now called the Lisfranc ligament.

I have found that in modern medicine the whole joint complex around this ligament is oft referred to as the Lisfranc joint. Unfortunately the event that has lead me to this dive into medical history and terminology is tearing the ever living shit out of the ligaments in the Lisfranc and surrounding joints of my left foot.

If you have run into this blog by some search I am guessing you have done something similar. As this injury is only reported in 1 of every 55,000 foot injuries and is further missed on standard x-rays up to 80% of the time you are probably going WTF?!

But look at those numbers; less than .2 percent of all foot injuries requiring medical attention in the US are Lisfranc, Of those (from what I can find) abut 60% are surgical, so we are down to .12%. Now if you are like me and in the 10-20% that is pure ligament (we'll call it 15%) we are down to .018% of of foot injuries.

This means that all of us who have purely ligament Lisfranc injuries requiring surgery should have gone and bought a lottery ticket instead of what ever we were doing when we hurt our foot.

For me I was on the second/third or fourth rung of a ladder and opened a compartment. Inside was a small but active nest of Red Wasps. They, being very defensive and aggressive creatures constructed of Hate and given wings, they were pretty sure I should not be there and I agreed.

I managed to defy gravity and levitate 3-4 feet straight backwards at which time I violated the first rule of cartoon physics and looked down (I must have) If you ever watched the Road Runner you know that when Wile E. Coyote (Genius) looked down real world physics came into affect.

So down I went and my left foot turned into PAIN.

A Dr visit and a few x-rays later I was assured no bones were broken and I should keep it wrapped do the RICE routine and the _sprain_ would heal

Well it did slowly get better .. to a point. and then it stopped getting better, and then I tripped and put my weight on it.. Oh the Good Lord knows that I may have created new sins by the words I said at that time.

So I called an Orthopedist who said we need to have you put weight on it and take a new x-ray.. or 30

There is a moment of disbelief when the Surgeon says "We are going to cut from here to here and put screws and plates in here"

So that is where I am now, Surgery scheduled, primary arthrodesis (bone fusion) of the Lisfranc joint as my age activity level and injury give this process the best chance of success. (I was offered open reduction fixation but the given factors are against it)

My surgery is on the 31st as I prepare and go through this I will update. I am looking to use a knee crutch rather than a scooter do to the configuration of my house and am hoping to have it this weekend.

Wish me luck!