So, here's the verdict...just got home from the doc. The good news: the cast is off. The bad news: the ankle is just as loose as it was 5 weeks ago when the cast was put on, and he said no amount of physical therapy would help (i already knew that!) :mad:

So, I get to go under the knife again. This time my doc is going to use me as his guinea pig to try a new procedure that he was taught at a conference last week. I had him write down what he was going to do and it says "Split peroneal tendon lateral ligament reconstruction with possible tendon allograft". It sounds alot to me like the Chrisman-Snook, but he said that it is a totally new procedure that just came out.

He is hoping that he can use my own peroneal tendon to split and use for the repair, but if mine is too scarred or too small, he will have to use an allograft from the bone and tissue bank. He said he will be prepared for both, but hopes he can just use my tissue, because there is an infection risk using the cadaver tendon.

Anyways, now I am just looking at dates to see when the best time to schedule this will be. I am looking at the week of August 14th or so, because that is 2 weeks before school starts. That will leave me with only 2 weeks at school to be on crutches (he said 4 weeks nwb). I really need to be able to be on my feet at school because we have clinicals (which start in October) where you're walking around all day long. So, I can't afford to have it done during school.

He was going to put me back in a boot, but decided just to let me wear my ASO lace up brace in a shoe because he doesn't want my leg to atrophy any more than it already has. He did say to pull out an old boot for a couple of days if I need the extra support.

Well, I just wanted to let everyone know how my appt. went.

Megan

Well, it doesn't sound like there are surprises, except for wanting to use you as a guinea pig. I'd have mixed emotions about that one, but it would all depend on how competent I felt the doctor was and my relationship with him. Do you get a discount or extra special treatment for being a guinea pig, there's got to be something extra in it for you.

I wish you all the best with your surgery. Keep us updated on this new procedure.

~Ellen :cool:

Megan,

The only positive thing I can say to you is...at least you weren't surprised. But I also wanted to chime in to remind you that my doc also used a part of my peroneal tendon to reconstruct the ligaments in the ankle. Of course mine was already split. Last appointment he said he was really impressed with it, and told me that the body tends to accept it's own parts more then foriegn parts... (like America and cars huh?? LOL) When he got inside it was a real mess for me, but he told me that having the part of the peroneal tendon really made his job a little easier! So.. it seems from the description and what he wrote down for you, that your surgery is going to be very similar to mine. The only difference I believe is that you have no tendon damage right?? I guess that would make up the difference in our NWB time period...I will be 1 day short of 7 weeks when I get the cast off next Thursday!!

Well, I just wanted to let you know that I feel for you and I am soooo sorry that you had to wear the cast for all that time without any improvement :( Hugs are being sent your way! Dumb squirrels LOL Hope you are in good spirits..

-Britt

I am not too concerned with my doc wanting to try this new procedure on me. I am very confident in his skills, and was very pleased with his work that was done previously. I also have a really good doctor-patient relationship with him because I have been going to him for quite some time. He is supposedly the best foot and ankle ortho in the area...I personally believe that he is.

I am really surprised that he didn't want to get an MRI before he does the procedure, but he is certain all that I did in the bicycle crash was just blow out the Brostrom, which meant tearing the ATFL and CFL...again! I'm just hoping that he will be able to use my tendon, because of all the risks involved with the allograft.

He did say that I will have a much bigger incision this time. My scar from the brostrom is only about 2 inches...he said this one will be around 6 inches, and run behind the fibula and down to the fifth metatarsal. I am going to have an ugly scarred up ankle...guess my dreams to be a foot model are over...LOL

I do have one question...has anyone that has had ligament reconstruction surgery done it with an epidural instead of general anesthesia? I am a little hesitant to do it under general because a couple of months ago, I had a colonoscopy done under general and instead of waking up 15 minutes later, I woke up 8 hours later in the ICU...so I am just a little scared. I have had general other times though with no problem. My doc did say he would be willing do it with an epidural instead, but the thought of that scares me to, because I have had many lumbar punctures before and they are extremely painful--so I am just between a rock and a hard place with this.

I am going to call in the morning to see about a date. I am looking at either the first week in August, or the week of August 14th.

Epidural or General, I have had nothing but problems with Epidurals (2 C-Sections). If you previously had no problems with a General, what did they do different the last time that you had a problem with it? Something was different. I know the last time I had surgery under a general was the first time ever I woke up with a headache and nauseous, but I was at a different hospital with a different surgeon. In talking to my Primary Care Doc, she said it could have been just a different med used. But if I were you, I'd be concerned to, waking up 8 hours later in ICU.

In regards to lumbar punctures and an Epidural, who did your LPs? Generally anesthesiologist are pretty good at putting in Epidurals.

It would be nive if you could talk to the anesthesiologist prior to surgery to help with the decision.

-Ellen

When I had the problem with the general a couple of months ago, the only thing that was different than before is that they used a different drug to induce me. They used Propofol (Diprivan), which is used in the induction of general anesthesia. The anesthesiologists could not explain what happened to me. They even called in a neurologist, who could come up with no explanation. The only theory they have is that I am one of those one in a million people who have a strange reaction to the drug. My OS did tell me that all I would have to do is tell the anesthesiologist about my experience with that drug, and they wouldn't use it. I have had general on many other occasions with no problems at all though.

When I had the LP's done (a few years ago I had pseudotumor cerebri), they were done by an ER doctor, an anesthesiologist, a radiologist (under x-ray), and a neurologist. I had an awful experience each time, even when they were done under sedation. I also had horrible post LP headaches each time.

At this point, I am leaning towards the general, that is if I can talk to anesthesia before to see about what drugs they will use. When I asked my OS about using an epidural, he kinda shot me a strange look and then said "I would be willing to do that"...he then said he would be willing to do it under a regional block. I would just prefer to be out, so I wouldn't have to hear him drilling into my bones.

Wow, I have PTC, side bar conversation - are you okay now? My LP was done under fluroscope, so it was pretty painless, but I can totally relate to the headache afterwards, but that might have been due to the reduce pressure when they removed fluid.

I totally agree with you, who wants to hear the drilling and all the noise associated with surgery. I would opt for the General, be sure to talk to the anesthesiologist and ask for a different drug. The more knowledge he has about a reaction you had, the better he will be able to take care of you. Plus, I assume this might be a lengthy procedure.

Oh, the thing we go through in life.
Take care! -eko

Megan~
Sorry you have to do this, again. I know you "knew", but until they say it, there is always a part of you hoping you won't have to. If you can get it, get the early one, so you will have the extra week or so, and not endanger your ability to do clinicals. You wil have so much going on, and really won't need the pain/tiredness/weakness, etc... Like you, I prefer general, and hope you can talk with the anesthesiologist. Maybe you can call ahead, and find out what was used last time, discuss what other options you have... Regardless, keep us posted. You're in prayer. Kim

Ellen,

My PTC is now in "remission". I took meds (Diamox) for about 3 years, which didn't work for me. I was contemplating getting a shunt put in to reduce to pressure, but my doctor suggested I try losing weight to solve the problem. I lost about 80 pounds, my symptoms totally disappeared. I believe as long as I keep the weight off, I won't have a problem with this again.

I've been weighing the pros and cons of both anesthesia options, and I am still kinda in the balance. Like I said before, I prefer the general, but am just kind of scared due to my previous experience, even if they use different meds...I will still be nervous. I will be in the same hospital that the "botched colonoscopy" was done...the staff there knows me very well..LOL so they are familiar with what happened before and know my history. Perhaps I will have the same anesthesiologist. I don't believe what happened before was anyone's fault..my body just did not handle the medications well, so I am not scared to go to the same hospital...I happen to work at this hospital also, so that helps a bit, as I know everyone.

I forgot to ask yesterday how long he thought the procedure would be. I know my Brostrom took 2 hours. I would assume this one would be longer, but I am not for sure.

Kim,

Thanks for your thoughts and prayers. I am busy trying to psych myself up for this. It will be a relief when it is done, as I will have a functional ankle again! I called my doc this morning to get some dates, but had to leave a message with his nurse and she hasn't called me back yet. The only thing I am disgusted about is that my best friend is moving back home to TN from florida and I was supposed to fly down there and help her move on August 11th...now I won't be able to go. Oh well, this ankle needs help more than she does..LOL

I'll keep everyone posted!

Megan

Well, here's the verdict: just talked to my doc's nurse, and she has me down for surgery Tuesday, August 8th. I was hoping to get it done the week before that, but that was the first thing he had. So, that will give me three weeks before my classes begin. I am hoping this works out! Looks like I will have to miss my trip to Florida though... :(

Megan,

I am so sorry you have all of these problems. I had General Anesthesia when I had my surgery and I also had a nerve block. I am a big baby so they gave me valium to calm me before they put the IV in and put the GA into the IV when I got up into the room before the surgery they asked me to sign some papers about getting the block, I was scared but I did it. It was honestly the best decision I ever made! For the first 24 hours I felt nothing! The Anestesia mixed with the elevator ride down to the recovery room did make me sick, but after I threw up I was fine! It was really great. It sucks that you didn't get the date that you wanted. I really wasn't particular about the dates, I just wanted to get it done ASAP so that I could have some time left in the summer! Unfortunately, mine wound up the day before my b-day...which of course ruined my birthday, but other then that it really was the best day to get it done. I'll have more birthdays LOL

Well, I hope that everything else works out and that whatever you and the anesthesiologist decide works out for you. I would hate for you to have to be in any more pain then you have to be.

Get Better Buddy, :)
Britt

Thanks, Britt!

I had the nerve block also last time. It was awesome...for about 24 hours that it. After it wore off, I was in excruciating pain, but a double dose of Lortab really seemed to help! After that, I stayed on top of taking my pain meds, and not letting the pain get out of control. Out of the the surgeries I have had (thyroid, ankle, gallbladder), the ankle was definitely the worst pain wise. I wasn't too nervous about this surgery until I talked to the nurse and got the date...now I am feeling a bit queasy, and have two and a half weeks to worry about it.

When I have had surgery before, they have always given me versed before they take me back to the OR. It has a great calming and amnesic effect. The IV's don't bother me anymore...I've had more of them lately that I can count. I ended up having to have a central line put in my chest for the gallbladder surgery back in April because I am a hard stick.

I am hoping that I am able to talk with the anesthesiologist about my options when I go in for pre-testing.

Well, I have rambled on enough about my problems...LOL :)

Megan

Megan, I read through the post and didn't see this discussed. Is it an option for you to have a local and MAC (monitored anesthesia care)? I had a general with my first surgery in November because I didn't want to hear the drilling/sawing etc. but had a really hard time coming out of it. This last surgery (1st mtp fusion) I had a local and MAC and it was GREAT!! I laid on the bed in the OR and the anesthesiologist said she was going to give me something to relax and I woke up in recovery. It is like a twilight and they control the dose throughout the surgery so if you need to be put inder more they just do it. No intubation! I would highly recommend it and I was very concerned going in! Sophie:angel:

Sophie,

I did ask my OS about a local with sedation, but he said that he wouldn't be willing to do that. He said my choices are only general or epidural. His recommendation was to go with general though. He said that the local wouldn't be an option because this is a pretty big surgery and the local wouldn't provide the quality of anesthesia that is needed for a procedure of this nature. With the last surgery, I had the general, but was not intubated. They used what they call LMA (laryngeal mask airway) anesthesia. With this type of general anesthesia, they induced me with versed and fentanyl to put me to sleep, then put the airway into the mouth. They are then able to pump in the anesthetic gas (sevoflurane) without actual intubation. I am assuming this is what will be done again if I go with the general this time.

Megan,
Sorry you didn't get the date you wanted. I hope this is enough time for you to recover. I'll keep you in prayer. Kim:)

Well...today is two weeks from the big day! :eek: I am actually really nervous about this surgery...and having to wait is not fun. Well, I guess it's really not that I am that nervous, it's just that I have spent so much time in hospitals lately due to some other issues, I am not looking forward to having to go again. At least this should be outpatient and I won't have to stay!

I've been a bad girl and haven't been wearing a boot, brace, or any other type of support on my ankle. It just feels so good to wear two shoes. My ankle is rolling again like it did before the first surgery, but it'll all be fixed in 2 week! And yesterday I even rode my bike...yes I know I am crazy..didn't see any squirrels though!. I am just sick and tired of sitting around doing nothing. I figure I better do all I can do the next two weeks, because after that it's back to the sedentary lifestyle that I know so well..LOL

I am thinking about getting a wheelchair to use for a while after the surgery, at least I could use it when I am downstairs to get from the couch in the family room to the kitchen, to the bathroom and such without using crutches because I am so awful on them. My dad went out and bought us a new 50" plasma TV over to weekend...so I guess I will sit on my behind for a month and watch movies on it! I've been trying to do a little strength training by lifting weights to ready my arms for crutches...gotta tone up a little bit!

I also need to get a new cast cover for the shower...all my old ones have holes in them. Britt, did you mention that you used the XeroSox? I am thinking about ordering one of them.

Well, I've done enough rambling for now!

Megan

Megan,
I feel you about the nervousness. I actually told my mom and the doc to surprise me with a date so I didn't have to constantly worry. Of course they couldn't do it, but when I found out when I was going to have the surgery it was already only 2 weeks away! It went by soo fast, until the night before then it felt like the whole 2 weeks was crammed into a few hours!

I am beginning to think that me and you are sharing brain waves or something LOL! I, too, did not use any braces or anything leading up to the surgery! I knew I was going to have it anyway, and that everything was going to be fixed so I took advantage. For those two weeks, I went swimming, tanning, and to the beach (at the end of May.. it was still chilly but what the hay?). I walked as much as possible because I knew that it would be awhile before I could walk, and I also drove at every opportunity I got because I knew I wouldn't be doing it AT ALL! I felt like a rebel then, and it felt gooooooood! :p

The plasma tv sounds great.. and 50 inches.. haha I could probably watch that without my glasses on! LOL If I were you I would take advantage of it! I was at one point considering a wheelchair too, but then I realized my house is not that big..it probably would take me more time to move things in the house so a wheelchair could fit through than it would to just crutch around the house! At my boyfriends, though, I cheat a little bit, I just use his rolling desk chair to get around. The crutches are mostly used from the chair to knock the lights on, close the door, reach something high on a shelf, or mess around with the tv! haha. Laziness kicks in when I am at his house!

Last thing, yep I used the Xero-Sox and for 30 bucks it sure helped a lot. It's so much easier than the garbage bags and duct tape. You just put it on and pump the air out of it! You should ask the guy at the medical supply store to help you with size though. I wasn't able to go into the store, but my mom did (we are the same shape and size) and he showed her how big to get it. The only thing I don't like about it is it makes my leg sweat a little bit, and they recommend using it for only 45 min. at a time, which is a pain when I went in the pool (floating around, not submerged) trying to get my bathing suit on, the sox on, and then in/out of the pool, dry and out of the sox before 45 min. were up...it was a hassle. But for showering it rocks!!! I even decorated mine with silver Sharpies, it ran a little the first time it got wet but after that it was fine...and decorative!! LOL

Again, I've been rambling! I hope your nerves calm for you, and that the next two weeks fly so that you can just get past this and on the road to recovery!

Happy Healing!!
-Britt

I definitely know where my royal heinie will be for the next month or so: laid up on the couch watching this TV! We just had it delivered and it is awesome! My whole family has been fighting over who gets to watch it, so I think I will just wait until they go to bed and I'll watch me a movie!

My mom approached me earlier and she asked me if I just wanted to postpone the surgery for a while...a couple of years to be exact! I told her I don't think so! In a couple of years if I don't get this fixed, I am gonna be a cripple! I already have arthritis in this ankle from repeated injuries, so I am definitely not going to walk around on an unstable ankle for a couple more years before I have it fixed! My mom is a really nervous person and hates doctors, hospitals, surgeries, etc...they freak her out. She is one of these people that doesn't go to the doctor unless she is absolutely going to die, so to her a floppy ankle is no big deal. I think if she had to walk around with her ankle dislocating with every step she took she might understand me a little better. Anyways, my doctor told me that I should have the surgery within three months at a maximum, to prevent more arthritis from setting in.

I think my mom's big issue is the fact that I have to go under anesthesia again..because of the issue I had before. She keeps stressing to me how horrible it was when they couldn't wake me up from the anesthesia, and she is scared to death it will happen again. I am definitely not going to budge with the date...August 8th it is! I just want to get this done and behind me!

11 days! :eek:

If my OS knew what I have been doing, he would kill me! I went again yesterday evening for a long bike ride. I rode about 15 miles last night...it feels so good to sweat and burn some calories, and I just rode through the pain. LOL Bad idea though, the ankle protested and I was up all night with it throbbing. Oh well, might as well do as much as I can, while I can! At least that's my philosophy.

The past couple of days, I have been having alot of pain and swelling on the medial side of my ankle. My OS diagnosed me with a partial tear of the post tib tendon about 6 months ago (MRI confirmed the tear), which has now caused my arch to collapse, and we have tried all sorts of orthotics, with not much improvement. My mom and I were talking about it, and I think I am going to call my OS today to see if maybe he could fix the tendon during the surgery. I mean, he's gonna be in there anyways, so why not fix it? And if it's left untreated, thats just leaving me having to have surgery again...even if it's a year or two down the road. Would asking him about it be a good thing to do?

I didn't mention anything to my OS about it causing me alot of problems when I saw him last week, but that's because the instability was the main problem...we had kind of just placed the post tib tendon problem on the backburner for the moment.