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Old 04-17-2013, 09:40 AM   #1
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Amputation after Triple Arthrodesis

Hello,

This is in the nature of an odd question, so please bear with me.

I have undergone a series of 4 surgeries over the last 2 years, Perennial Tendon Debridement, moving of my heel bone, and most recently a triple arthrodesis. I have a phenomenal Orthopedic Surgeon whom I have a ton of confidence in.

Here is my dilemma. I have been an extremely active executive, with an outstanding employer that has provided me a great deal of time for these procedure and recovery. However, this latest surgery has honestly made (in my opinion) walking much more difficult and pain much more extensive. I feel like I have been diligent in following all protocols and therapy. However, I am at a point where the foot problems are starting to have a significant negative impact on my mental health, and is starting to have a negative impact on my employment. I should also note that the pain is pretty darn extensive, and while medication does help some, I do not want to spend my life on narcotics.

Being an engineer, I have done a bit of self evaluation on how to “fix” the situation. I believe I have reached the point that I would prefer to have the foot completely amputated and move forward to live and function with a prosthesis. From all of my research, it appears that the current state of prosthetics offer a very high level of functionality and quality of life. I am not terribly fond of the notion of losing a portion of one of my limbs, but I believe that if it allows me to return a high level of functionality and better quality of life, it seems to be the correct end state to shoot for. I should note that I am most definitely not a person that has my self worth and self value tied up in body image, so I don’t believe that will have a significant level of impact on my long term mental health.

I would love any feedback and thoughts you all might have. I am not afraid to have this conversation with my surgeon, but I also don’t want to come off as a complete nut job if I do.

Thank you all in advance!
Scott

 
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Old 04-22-2013, 12:48 PM   #2
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Re: Amputation after Triple Arthrodesis

Hello Scott,
Seems like we're in the same boat, I've had triple Arthrodesis on both feet in the last 7 months. The bones on my right foot haven't healed yet & I'm going back to the OR for more surgery. I can really relate to you & our situation. I've wondered if amputation would be better than what I'm dealing with now. I don't work so it's probably easier on me than you, I do, however have 2 very active kids & spend a lot of time at lacrosse fields. I'm as over this as you are. Amputation is a pretty scary option, I really don't know what to tell you, but it would be nice to talk to each other for support.

 
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Old 04-22-2013, 12:49 PM   #3
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Re: Amputation after Triple Arthrodesis

Sorry, posted same response by accident.

Last edited by Stupid feet; 04-22-2013 at 12:51 PM. Reason: Posted twice by accident :0

 
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Old 04-28-2013, 04:06 PM   #4
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Re: Amputation after Triple Arthrodesis

Hello to both of you. My situation is a bit different. I have had a couple midfoot fusions. The first was in 2010. The hardware failed 2 months into rehab. In 2011, I had a new midfoot fusion done. By midyear 2012, I knew there was something drastically wrong. My surgeon, though, took another 8 months to get around to saying that the second surgery failed. This time, the midfoot collapsed and caused the chopart joint to collapse with it. I have seen a couple different sugeons who both suggest a triple arthodesis as my next step. They have indicated that they could "fix things" for me, but the two don't agree on the details. I have been reading quite a bit about TAs, the successes and the failures or failure to eliminate pain. There are a lot more problems being reported than there are successes, but to be fair, people are more likely to be reporting their failures than they are their successes. Even with that in mind, the failures really scare me. So does the reality that I would be lugging a block of cement or a brick instead of a functioning foot.

At 60, I'm older than both of you I think, but I still hopefully have many years to go. I have had so many ortho surgeries, and I have had enough. It's not that I won't need more in the future, but if I can avoid some, or eliminate some by taking a different path, I am all for it. I want to regain some of the mobility I have gradually given up through the years. The sports, the hiking, the gardening, the photography, and so on, are all just things of the past now. I have grieved them and tried to move on, but not with complete success. I don't want to keep giving things up, and I would like be able to reclaim some of them.

I am giving very serious consideration to going the amputation route. One of the surgeons with whom I discussed the possible route of amputation said, "you don't need that, but I can do it" as a response to my asking him if he would use the ERTlL method if he was to do the amputation. Now I grant you that it was early in the discussion of the topic, but it bothered me that he said "you don't need that" as if he were deciding for me, not based on the fact that he really even knew me. It's clear that I need more information about what would be appropriate for my goals from this surgery in terms of activitiy level, pain, and so on. But I also need to know that the doctors, prosthetist, physical thereapists, and so on, have my back. This obviously is a significant decision - probably the most important in my life, or a close second - and I need to be comfortable with it on all levels.

What's the difference in recovery time and potential complications between an ERTL and traditional amputation. Does age really come into play in terms of the decision? Why the heck would I NOT want to have the ERTL? As to the issue of whether or not I want to go the amputation route, I know that if I had to decide today, I would want to amputate. But, the longer I think about, read about or discuss the subject, the more questions I have. Any guidance, suggestions, pointers, and so on would be greatly appreciated.
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Old 05-01-2013, 04:21 PM   #5
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Re: Amputation after Triple Arthrodesis

Thank you so much for the reply!!

I am about 6 months out, which I think is about 3 months too long!!!

I appreciate your sharing your experience, and I am so sorry it has taken so dang long for you to get to a decent place with it all.

Since my last post, I have tried the pain management route, i.e. meds and a Sympathetic Nerve Block. I cant really say that it has been effective. I am also TOTALLY bothered by the notion that a doctor I just met would prescribe 360, yes you read that right, three hundred and sixty Vicodin 10's to me on the first visit!!! (Along with a neurologic medicine for spasms of nerves). I am a non drinker, etc, and the notion on being on any meds, especially ones that onerous for that long is just not an option.

So with all that being said, I have an appointment with my OS this coming Monday morning. My wife and I are both going and we are going to flat out tell/request that we proceed with an amputation and start the rehabilitation process. I refuse to have an injury like this steal life away from me. It is my thought and belief that an amputation, while radical, is an absolute end game play. We know how long the procedure will take, the average amount of time to initial recovery, the average amount of time to functioning prosthesis use, etc. I guess it is the Engineer in me, but I want a final plan to get my life back, period.

I will keep you up to date on how the discussion goes. I love my OS and he has been supportive and helpful, and I anticipate him to no end. I think he will agree with my decision after some detailed discussion.


 
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Old 05-01-2013, 05:35 PM   #6
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Re: Amputation after Triple Arthrodesis

Thank you so much for the reply!!

I am about 6 months out, which I think is about 3 months too long!!!

I appreciate your sharing your experience, and I am so sorry it has taken so dang long for you to get to a decent place with it all.

Since my last post, I have tried the pain management route, i.e. meds and a Sympathetic Nerve Block. I cant really say that it has been effective. I am also TOTALLY bothered by the notion that a doctor I just met would prescribe 360, yes you read that right, three hundred and sixty Vicodin 10's to me on the first visit!!! (Along with a neurologic medicine for spasms of nerves). I am a non drinker, etc, and the notion on being on any meds, especially ones that onerous for that long is just not an option.

So with all that being said, I have an appointment with my OS this coming Monday morning. My wife and I are both going and we are going to flat out tell/request that we proceed with an amputation and start the rehabilitation process. I refuse to have an injury like this steal life away from me. It is my thought and belief that an amputation, while radical, is an absolute end game play. We know how long the procedure will take, the average amount of time to initial recovery, the average amount of time to functioning prosthesis use, etc. I guess it is the Engineer in me, but I want a final plan to get my life back, period.

I will keep you up to date on how the discussion goes. I love my OS and he has been supportive and helpful, and I anticipate him to no end. I think he will agree with my decision after some detailed discussion.


 
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Old 05-02-2013, 10:39 AM   #7
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Re: Amputation after Triple Arthrodesis

Thank you so much for the reply!!

I am about 6 months out, which I think is about 3 months too long!!!

I appreciate your sharing your experience, and I am so sorry it has taken so dang long for you to get to a decent place with it all.

Since my last post, I have tried the pain management route, i.e. meds and a Sympathetic Nerve Block. I cant really say that it has been effective. I am also TOTALLY bothered by the notion that a doctor I just met would prescribe 360, yes you read that right, three hundred and sixty Vicodin 10's to me on the first visit!!! (Along with a neurologic medicine for spasms of nerves). I am a non drinker, etc, and the notion on being on any meds, especially ones that onerous for that long is just not an option.

So with all that being said, I have an appointment with my OS this coming Monday morning. My wife and I are both going and we are going to flat out tell/request that we proceed with an amputation and start the rehabilitation process. I refuse to have an injury like this steal life away from me. It is my thought and belief that an amputation, while radical, is an absolute end game play. We know how long the procedure will take, the average amount of time to initial recovery, the average amount of time to functioning prosthesis use, etc. I guess it is the Engineer in me, but I want a final plan to get my life back, period.

I will keep you up to date on how the discussion goes. I love my OS and he has been supportive and helpful, and I anticipate him to no end. I think he will agree with my decision after some detailed discussion.


 
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Old 05-20-2013, 04:01 AM   #8
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Re: Amputation after Triple Arthrodesis

Hello again qualma,

I was thinking about you and wondering how things went at your OS appointment last week...?

I, too, am returning to see some of my consulting OSs. I want to be sure to cross all my Ts and dot my Is before making my decision.

Good luck to you!
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Old 06-03-2013, 02:40 PM   #9
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Re: Amputation after Triple Arthrodesis

Hello,

I am a nineteen year old amputee (below knee) and have had this for about six years. I can provide you with detailed information about the influence of a prosthetic limb on daily life and what kind of activities are possible etc..

If you're interested in any information at all, just reply or message me!

Kind Regards, Eric

 
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Old 06-03-2013, 03:23 PM   #10
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Re: Amputation after Triple Arthrodesis

Hi Emarcus,
I think there are several of us here that would to hear what your life is like after amputation. Including surgery, pain, social issues, mobility, etc. would you have had it done if you had a choice between pain & restrictions because of surgery, illness, accident and pain or amputation? I'm very interested to know how close your life Is to normal thanks for any information you can give us.

 
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