Thursday, October 27, 2016

SURGERY DAY! 10/27/16

Hello! Today was surgery day!

I went to bed and was prepping to get up at 4:00 in the morning. My surgery was scheduled for 7:00 in the morning however I had a consultation prior with Dr. K at 6:00 and my hotel is in Anaheim which is about an hour away. I arrived at the outpatient surgery center on time and went inside. I had to fill out and sign some paperwork. I was then brought back into a bathroom and given a locker to put my things in, a gown to change into, foot booties, and a hair cap. I then had to pee into a cup for a pregnancy test because I am a woman. I then took everything off except for my underwear, I was able to keep those on (bra off though). They work under x-ray through the entire procedure so no metal at all, no piercings or jewelry. I then walked out and sat down in their bed and got a warm blanket put on me. They put an IV in and had fluids going while they went over more things with me and had me sign some more papers. I met the nurses, anesthesiologist, Dr.K, and his doctor that he was training who was just watching the surgery who is eventually going to join his practice! They asked some questions and then got things ready. There was a total of 6 people in the surgery room.

Dr. K talked to me and said I actually have a more mild case of brachy than a lot of others do. He mentioned that he has done over 150 of these surgeries which made me feel extremely comfortable. He talked about what he would do in the surgery. He makes a short incision to be able to make an osteotomy in the metatarsal. That's basically a break in the bone. He said that 4 pins would go into the bone and then a fixator on the top. He then would put a wire in through the tip of the toe to keep it straight and from flexing up or down how these toes tend to do that when you lengthen your toes. This is because when you are stretching your toe you are also stretching the muscles, skin, blood vessels, ligaments, and tendons. Tendons are very stiff and rigid and take longer to stretch. You need to go slowly and let it stretch so that it doesn't bend up or down. It will eventually adjust and be straight along with stretching afterwards. I then walked into the surgery room and laid down on the table. They are doing my right foot today, and next week my left. They then laid my arms out they strapped me down to the table and put oxygen over my mouth and nose and said that you will start to feel sleepy. I don't even remember getting tired and the next thing I know is I'm waking up. They also blocked my foot which means that they completely numbed my foot so I couldn't feel anything afterwords for a while. I laid there for a while as they took my vitals every so often. They gave me crutches and they gave me a DVT machine. They wanted me to get an ice machine as well but my insurance wouldn't cover that and I brought my mothers friends from her knee surgery which I got very lucky I had the option! I highly suggest you get one of these as well even if your insurance doesn't cover it. You can rent it for 2 weeks for about $300, Dr. K patients get it cheaper. They sat me up and made me walk with the crutches to the bathroom to change. There was a wheel chair in there to sit down on and change and the nurse offered to help me change but I felt fine! I changed and peed (they make you pee due to the fluids given to you, you have to anyway). I then opened the door sat down and they came and wheeled me out. The pharmacy is downstairs from the surgery center which is really nice! They prescribed me Vicodin.

They wheeled me down to the parking garage and I headed home (hotel home). They told me to keep my foot raised to help reduce swelling. My foot is all wrapped up and they said do not unwrap it or get it wet until the doctor takes it off and tells me I can. I put my DVT machine on which is a machine that basically massages your calves every so often to help prevent blood clots (deep vein thrombosis) which is caused from siting around and not moving as much. This machine is very VERY important. Blood clots tend to sit in the lower extremities such as your calves. If one forms and gets loose it can travel to your brain and cause a stroke, or it can travel to your heart then into your lungs and you can die from that. This machine helps prevent that and it also feels pretty good! I also put the ice machine on it but because my foot is so wrapped up so much my actual foot wasn't really getting the cold to really help like it should so when I get the wrappings off I will use the ice machine to make the swelling go down a bit.

When I got back to the hotel I got set up to relax in bed and elevate my foot. My foot was numb for hours and it started to feel a little on fire when the feeling was coming back which is completely normal. So far I'm really not having much pain at all! Just a little dull ache and heat at the wire through my toe. It's probably a 2 on a pain scale. I have a high pain tolerance however so it may be a little worse for you. My foot is wrapped tightly and is kind of pushing my pinky toe on top of my brachy toe which is a little uncomfortable but I can get over it for now and it will relax when I get the wrappings off. I have a tiny bit of blood and fluid leaking out of some spot but nothing crazy or abnormal. I have a background in the health field, I'm a cardiac sonographer and my mother was a nurse so, so far everything is normal and looking good! They said that with this surgery you can walk to an extent. Start off on your heels and slowly as the time goes on you can put more weight on your feet as you feel comfortable and as long as their is no pain. I will start turning my fixator in a week and because I don't have a crazy amount of length to go because mine isn't as bad/short as others so I may be done turning either while I'm still here or a week after I get back! So I may only need to turn for a month! We shall see. I'm so excited. I will get a call tomorrow to see if he wants to see me before my next surgery for my left foot on 11/4/16 or if he just wants to see me before the surgery. Hopefully it's before so I can get this damn wrap off!! So far so good!! He's very nice and knowledgeable. I'm very happy. And this is a nice trip to be away from crappy Chicago weather!!!!

Before surgery!!

In the hotel room after surgery on my first foot! Have the DVT on and Ice
Machine next to it. My poop emoji pants! Super wrapped up!!


Me pulling back the bandage a little to see my toes.
This is the K wire in my toe a tiny bit of blood and my pinky
pressing over my brachy toe which is bugging me a little!!

Pre Surgery 10/26/16


Hello everyone! My name is Miranda and I have Brachymetatarsia!

About a year ago I never knew that it even had a name and I just thought I had a short toe on each foot! I started to research it and learned that it had this crazy long name! I then started looking more and more into it and found out that you can actually fix it with surgery. So I then started researching surgeons. This is when I found my surgeon that I chose to go with. However with where I'm located I have to travel for my surgery. I did not want to skimp out and wanted someone who specializes in this type of surgery because there are quite a few of major issues that can happen with it if not done properly, so I wanted someone who knows all about the surgery what can happen and how to troubleshoot anything that could happen. This is what brought me to Dr. Alireza Khosroabadi.

Dr. K is located in Southern California. He has locations in Arcadia and San Fernando CA. I called their office at (818) 408-2800 which is their San Fernando location number and talked with their staff about how to start the process of everything especially with the fact that I was out of state. They were very nice and accommodating. They gave me their email and told me to send them pictures of my ID, Insurance Cards, and Pictures of my feet standing and sitting with them flat on the floor. They checked that I was covered under my insurance which I was 100%. I had primary under Aetna which covered 0% but I had a secondary under Blue Cross Blue Shield which in turn covered it 100%. They then made sure I was a candidate and that Dr. K felt like he could do the surgery on me. They then ordered X-Rays for me to get done on my feet. I uploaded the images and sent them over and got the OK to go set up my appointments! They looked into seeing where the surgery would take place due to it being an out patient surgery I would not need to be in a hospital. I ended up in a surgery center in Tarzana, CA. I set up my surgery date for a few months out because I needed to prepare my travel arrangements. I set up my first surgery for the right foot on 27th of October 2016. Then my second surgery for the left foot on the 4th of November 2016. The Dr. wanted me to stay out here in Cali for almost an entire month to monitor me and make sure I'm doing okay! I then booked my flights, rental car, and hotel for me and my mother. I'm lucky that my mother doesn't work so she was able to come with me because I am getting both of my feet done while I'm here. They then sent me instructions to get my pre-op done which I got done about a week before my first surgery. This consisted of simple blood work, an EKG, a physical, and my medical history including any medications I am on. I was cleared for surgery a day later. I only had spoken to these people over the phone and through email but felt really confident in them. Dr. K has been on many TV shows in regards to toe lengthening surgery and other surgeries he does so I felt extremely confident in him and his staff. He also has a website just about Brachy which has some blogs on their too where you can see before and after pictures and other peoples experiences. http://www.fixmyshorttoe.com/contact.php

I then flew in on the 26th of November and went to In N Out right away! YUM! No eating or drinking after midnight like always with surgery. You do go under anesthesia so if you drink or eat anything after midnight you could aspirate and choke and die when getting intubated (tube stuck down your throat). I confirmed my appointments over the phone and then went to bed preparing to wake up early for surgery!! I surprisingly slept well being how nervous and excited I was!
Left foot x-ray.
Right foot x-ray.

Brachy toes!

Brachy toes with a little weight on them!

Flight to Cali!! So pretty!
Left foot x-ray. They did the same thing on
the right foot as well. Can't see anything really.