BC Foot and Ankle

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During Your Hospital Stay

The Day Before Surgery

  • Have a calm, relaxing evening at home.
  • Do not eat or drink anything after midnight. Your surgery could be cancelled if you eat or drink before surgery.
  • Take your usual medicine. If you need to take medicine after midnight, take it with a sip of water unless you were told not to take it by your doctor or by the PreAdmission Clinic staff.

The Day of Your Surgery

  • Take your usual medicine with a sip of water unless you were told not to take it by your doctor or by the PreAdmission Clinic staff.
  • Have a shower or bath.
  • Wash your foot and ankle well with soap and water.
  • Do not shave the area. We might cancel your surgery if you shave the area.
  • Dress in loose, comfortable clothing.
  • Do not wear make-up, nail polish, perfume, jewellery, or contact lenses.

At the Hospital – Before Surgery

  • Go to the Admitting Desk in the hospital. They will direct you to the pre-surgery area.
  • The surgeon meets you just before your surgery and marks the leg to be operated on with a felt pen.
  • The anaesthetist also meets with you to talk about the kind of anesthetic you will have. You will be given a general, spinal, or local anesthetic. This means some people are awake during the surgery and some people are asleep.

At the Hospital – After Surgery

  • After surgery, you are moved from the operating room to the recovery room. You stay in the recovery room for about 1 to 3 hours.
  • You will probably leave the operating room with a partial plaster cast and a bulky dressing from your knee down to the end of your foot. Otherwise, you might be wearing a soft dressing or your walker boot.
  • You might have metal pins sticking out of your cast, so be careful! We will let you know if you have pins. Watch that you do not catch the pins on bedding or clothing.
  • If you are staying in the hospital overnight, we take you from the recovery room to a nursing unit.
  • If you are having day surgery, you will be sent home once you are awake and your pain is under control.

Pain

You will have pain that can range from mild to severe. We give you medication to help control the pain. Call your nurse at any time if you need something more for pain, or you feel your pain medication is not working.

The pain medication could be in a pill, given with a needle, or given through an intravenous (IV) pump that you can control with a push button. Tell your nurse right away if the pain medication makes you feel sick or you feel itchy all over. The nurse will give you medication to control this.

We monitor how much pain you are having. We use different tools for measuring how much pain you are feeling: the ‘faces pain rating scale’ or the ‘numbered pain rating scale’ (see below).

We ask you “On a scale from zero to ten, where zero means no pain at all and ten means the worst pain ever, how much pain are you having right now?”

This helps us understand how much pain you are having and decide if you need more pain medication.

It is important to ask for pain medicine before the pain gets too bad. When you have your pain under control, you recover faster and it is easier for you to move around.


Swelling

After foot or ankle surgery, it is common to have swelling in your foot. While you are in hospital, we check your foot for swelling. Let us know right away if the cast or walker boot feels too tight.

To reduce swelling and pain or prevent swelling from getting worse:

  • Elevate your foot.
  • Move the joints above and below the area operated such as wiggling your toes, and bending and straightening your leg.

How to Elevate Your Foot

  • Rest your leg on pillows so your leg is about 15 centimetres (6 inches) above your heart.
  • Keep your foot elevated most of the time (at least 22 out of 24 hours each day) for the first few days after surgery. This is when the pain and swelling will be the worst.

After the first few days you can start to put your foot down for longer periods of time, starting with 1 to 2 minutes at a time and slowly increase the amount of time.

If you have had major foot surgery, it might be 2 weeks or more before you can leave your foot down for more than 5 to 10 minutes at a time.


Numbness

During surgery, a local anesthetic is often placed in the nerves around your foot. You might notice numbness but no pain until the anesthetic wears off. Do not worry, this is normal.
The numbness can last between 12 to 20 hours. Tell your nurse or surgeon if the numbness lasts more than 20 hours.

Note: Do not wait until the numbness wears off before starting to take pain medication.

Mobility

Your physiotherapist teaches you to:

  • use the walker or wheelchair so you can move around safely
  • use crutches if you are able

Remember – You will need to use a walker, crutches, or a wheelchair for the first 2 to 3 months after surgery.


Weight-Bearing

Your surgeon decides how much, if any, weight you can put on your surgical foot.

Many people are told they are ‘non-weight bearing’ after surgery. Some people are told they can put ‘feather weight’ on the foot. Other people are told they can put some weight (‘partial weight’) through the heel of the foot if the surgery was on the front part of the foot.

Whatever instructions you receive about weight-bearing, make sure you follow them carefully. This will affect how well you heal.

  • Non-Weight Bearing – means you cannot put any weight through your foot. In other words, your foot cannot touch the ground at all when standing and walking.
  • Feather Weight-Bearing – means you can let your foot rest on the ground but you cannot put any weight on it.

If You Have Day Surgery

Many foot surgeries can be done as ‘Day Surgery’. If your surgery is done as Day Surgery, you are sent home as soon as you are awake and your pain is under control.

You will have either a cast or walker boot on your foot.

We usually use local anaesthesia for those having Day Surgery. Your foot will feel numb for up to 18 hours until the local anesthetic wears off.

Before you leave, we give you a prescription for pain medication as well as instructions on how to use the medication to manage your pain.

Start your pain medication when you get home and take it regularly as directed. Start taking the pain medicine while the foot is still numb. This should help to lower the total amount of pain you feel when the anesthetic wears off. Do not wait until the numbness is gone before starting your pain medicine.

What to do if the pain medication does not lower the pain:

  • Try loosening the walker boot and bandage.
  • Make sure you keep your foot elevated at least 15 cm. (6 inches) above your heart.
  • Apply an ice pack to the area.
  • If the pain still does not get better or if you have numbness or bleeding that gets worse, go to the Emergency Department of the hospital where you had surgery.
  • If this is not possible, go to the nearest hospital Emergency Department.