One Step Foward, Two Steps Back (Literally...)

8 June 2018:  Four Month Follow Up

So...I started physical therapy about a month ago with some walk/run on a weight-adjusted treadmill.  Along with the therapy protocol, I also began stretching and range of motion exercises along with the running/walking.




Unfortunately, my pain in the foot increased with increase in intensity.  Not good.  My orthopedic follow up was a month after I started PT, and Dr. C had X-Rays taken to see what was going on in the joint.  The concern was the pin-point pain I am having around the joint, which was different than the general aching of the whole area.  The latter is acceptable, the former is not!

A Little Knowledge is Dangerous!

I do have a little knowledge of medicine.  A little anatomy here, a little physiology there.  Just enough to be dangerous.  So, when the radiology report says the following:

"Postoperative changes as described above with interval lucency surrounding the screw within the distal aspect of the proximal phalanx of the first toe. An element of osteolysis/hardware loosening is not excluded. Follow-up is suggested."

Words that attract my attention:  Lucency, postoperative changes, and hardware loosening. 

Not Good.  At least I know why I am feeling pain.  When my amateur eyes look at the comparative X-Rays, I can see what the Radiologist is talking about.  I can also do basic math and I do know that after 16 weeks, broken bones should show healing with no Lucency or hardware loosening.



One Week Post Surgery, 16 February 2018

 

Twelve Weeks Post Surgery, 4 April 2018.

Sixteen Weeks Post Surgery, 8 June 2018

Radiologist's Report:  "Postoperative changes as described above with interval lucency surrounding the screw within the distal aspect of the proximal phalanx of the first toe. An element of osteolysis/hardware loosening is not excluded. Follow-up is suggested."

Bottom Line

There should be no light gray or black around the screw, and the joint space should show more bone-growth.  This is Lucency, and it should not be there!  The joint space should not be visible by 12 weeks.  When compared to previous scans, there are 'postoperative changes'.  Dr. C stated that if these findings bear out with further scans, additional mobilization of the joint or revision surgery to further close the joint space with additional fixation hardware. 

Ugh.  Dr. C made it abundantly clear that I was to do NO running and try to limit walking as much as possible until our follow up July 13.  She did say that I probably increased my activity too soon and aggravated the joint hardware area. 

I know this because there are several risk factors for fusion failure:  Obesity (No), Smoking (No), Diabetes (No), Questionable Drug Use (No), Premature Weight Bearing Activities (Yes, possibly). 

So, I will find out in July what the next 'steps' are in the road to recovery.