Hi all. At home May 12, 2007 I shattered my left calcaneous/heel into so many pieces they could not be counted. I fell 12 ft off a ladder onto concrete. Emergency Room for 5 hours, two or three morphine and dilaudids later doctor said they are sending me to an Orthopedists. I could not believe my appointment was so long just to see about how to fix it (5 days). Ortho doc came in and said you have a bad injury. He said either let it heal like a bag of bones and have to fuse it later or surgery now and arthritis for sure, cane for 6 months and the rest of my life as needed. I picked surgery. Surgery was finally able to be done 10 excrutiating days after the injury - not because of swelling but because of scheduling. Was I somehow wrong to wonder what in the heck they were doing waiting so long to fix my foot!? Every professional acted like it was not a big deal. It might have been nice to tell me that this was normal for this type of injury. They had to have known I was freaked out by everything - I probably should have asked more things but I was scared, in pain, out of it. :blob_fire
Surgery was May 22, 2007. My Ortho said that he and a colleague operated on me and the surgery went BETTER (thank GOD) than he expected. They put in a plate and 10 pins. I must say the reconstruction looks very good.
I am scared about the next few weeks and months and fear of the unknown has always killed me. Does anyone have these fears? It would be nice to hear some other stories.

ru,

As you have seen for yourself, many of the docs are technicians. With most broken bones its put on a cast, schedule a follow-up, and they and their patient goes about their business. A calcaneous fracture is in a different league. The pain levels, wait times, and recovery are much longer. But the docs just handle it in the same manner. That leaves you a lot more issues, anxiety and worry time. Your 10 day wait was actually shorter than average, with a three weeks being within the norm. The standard Non Weight Bearing time (meaning not even touching the foot down) is 12 weeks. The cane would come in a few weeks after that. Arthritis and whether fusion is needed depend on if the joint was damaged severely. There's some chance due to the nature of the injury, the films should tell the likelihood, but the indicator will be how well you are doing months after being back on your feet.

For the next weeks and months your biggest activity might be just being patient. Having a confidant to share with and possibly (yes even for us guys) a shoulder to cry on is very therapeutic. The best things you can do are keep the foot elevated fanatically to promote healing, stay involved in normal activities to help keep you sane during the wait and do as much exercise for your general stamina, legs and then foot as the doctors allow. Some of us started physical therapy immediately. The guidance, motivation and feedback are invaluable. Push for it with your doc.

You are not alone in that information helpful to you is available from the docs on a 'by request only' basis. I'd recommend reading up on the injury. There's a few years worth of posts on this forum alone. Before going to the doc, write your questions down. When you go bring someone to help ask, listen to and remember the replies.

There is one plus. With life slowed down you will have more time to appreciate the sights sounds and smells around you. And you've always wanted to read Shakespeare, no?

TC

WOw! Thanks, that was very insightful. Sounds like you have been there. I have been trying not to feel sorry for myself but it is hard. My wife is a great shoulder to cry on. I would definitely like to appreciate the sights sounds and smells around me as soon as I figure out how to stop the worry. I have promised myself as many people before that if I make it through in one piece without much pain I will change a few things. How could I have ever taken so many things for granted?
Thankfully, pain and swelling are beginning to subside so I am finding little things to bring me up. Stitches out June 5th and then cast for 4 weeks I think.

ru,

The best cure for worry is to change your focus. There are those that say to think happy thoughts (aka: behavioral modification). In the real world what can work is setting goals, being disciplined about them and then content that you are giving your best effort. Your assignment is to keep the foot elevated, be active enough during the day to be sleepy at night and eat properly. Later, with the doc or physical therapists OK, you can work on your range of motion on the foot, followed by strength then mobility. The bottom line is that nature does the healing and it is going to take time. All you can do is pitch in and create the best conditions for it to happen. When you do you can be satisfied that you've done all you can for the best outcome.

Progress will often seem slow. Every time I complained to my wife "I can't even do this...", she would come back with: "Well two weeks ago you couldn't do that." And you'll have a laundry list of new worries - the foot swelling, hurting and turning dark when you keep it down, tingling or shocks as circulation returns to nerve endings, and more. Ask about those as they come, then move on to the next. Before long you'll see a newbie here saying: "Oh my God I broke my heel!" and you'll be able to help them out.

As for taking things for granted, that is the prize. When you get to the point where you put things off just because you don't feel doing them, get in too much of a hurry and don't even notice other people limping, then you'll know things are back to normal.

TC

Any advice is highly appreciated- Hi there, I haven't been on the forum for a few weeks now as I had been devoting time to try to deal with my post op (15 pieces, used 1 plate and 5 or 6 pins and some carbonate something to put in the space between the fragments to help them heal back together) and still try to lead as normal a life as possible (which is rather hard). Rouletteyou, coincidentally I had the operation the same day as you but in the UK. I logged onto the forum a few days after I had the accident back in late April and I was discharged from the hospital 3 days after the accident. A very insightful guy gave me some very valuable opinions but I was in so much distress I forgot his name on the forum now but had the gut feeling he was TCChair (thanks again). Currently my situation is up and down. I stopped taking Tromadol and Diclofanac as it grossly upset my stomach and days I wanted to vomit all the time. I am now on Paracetamol with Codine 30/500mg and with 400 Ibuprofen. The pain can be so intense especially when I wake up in the morning (still taking sleeping pills to help me through the night). I realise that if I went out one day (with some crutching around and on the wheelchair with a foot rest) I would pay the price the next day or two. The doctor told me I should expect around 3 months before being able to walk again (with a limb and the help of a crutch) so if his prognosis is correct, I have another 2.5 months to go. From someone who had shattered a heelbone before, what should I expect in the coming few months and is there anything I should do to help myself (I will try to take up a new hobby now that I can't do outdoor activities much and be positive whenever possible)?? The pain level sometimes scares me. I am trying to be positive (I can be when the pain is bearable but I become quite negative when the pain become ridiculous). The doctor said despite my serious injury he would place me on the top end of recovering to ''normal' but still, I am scared. Is there anyone who could share your post op experience with me? I am elevated my foot as much as I can already (at night, my foot is elevated higher than my heart). Also Rouletteyou, I wish things will go well with you. I will check the forum from time to time so if you need to talk remember, I am having very similar situation as you right now.

Mluk, I see suffering was widespread the WORLD over that day. Try to keep your head up each day. I am starting to get along ok but had a small setback. I went to the doctor for my 1st post op office visit and the stitches were not ready to come out. Too much oozing coming out of the wound so he said to come back the following week which was yesterday. Guess what - they are still not ready to come out. Its been 19 days since surgery. His strategy now is to have me out of the boot or cast for hours each day so it will dry up and heal better - He also put me on KEFLEX as a precaution in case of infection. One thing about these injuries, they keep you hopping! Literally and figureatively.

Hi there, I hope having your foot out of the cast a few hours a day would help the wound dried up. I didn't have that problem and the surgeon used dissolvable stitches. The last time I was given the new cast (2 June) my wound looked ok so hopefully I don't have to worry about an infection. My situation is up and down. today isn't good. This morning I had some intense shocking/ pulling pain. Really hard to describe it but you probably know what I mean. Hope you are fine over there.

Hi there, I hope having your foot out of the cast a few hours a day would help the wound dried up. I didn't have that problem and the surgeon used dissolvable stitches. The last time I was given the new cast (2 June) my wound looked ok so hopefully I don't have to worry about an infection. My situation is up and down. today isn't good:eek: . This morning I had some intense shocking/ pulling pain. Really hard to describe it but you probably know what I mean. Hope you will get better soon.

Mluk,

So you got your hardware. It would be screws holding the plate rather than pins. You can see the threads in the x-rays. They used to always use donated bone (sometime from the patient's own hipbone) to repair the joints. Sounds like you got calcium carbonate - artificial bone from coral.

It's not unusual to have intense pain for weeks following surgery. But once it has been a month it is time to have the doc explain what he feels is causing it to persist. Next visit, be prepared to give a succinct description of: The sensation in objective terms such as 'sharp', dull', 'pressure'. The exact location(s). When it occurs: activity, time of day. What relief you experience from: medications, resting, elevating, ice, sleep.

This is where you write down your questions, the information he might need and bring someone with you. These will help ensure that you cover the subject, use the limited time fully and make sure he doesn't dance around any issues. You will want answers so you know what to expect - for example relief when swelling subsides? - and getting the doc to address the pain in case it indicates complications or becomes a long term issue on it's own.

Unfortunately pain does go along with the healing process: when the foot is lowered, when you start bending it to regain your range of motion (ROM) and when you start weight bearing again. It's no picnic, but survivable. Which brings us to the steps involved. Docs are frequently reticent to spell that out or the time table involved. The standard for a broken heel and ORIF (Open Reduction with Internal Fixation) is 12 weeks completely non-weight bearing (NWB). Keeping yourself occupied and not getting depressed will be a challenge. From there the return to walking unaided can range from a week to a month. That doesn't seem to predict final outcome, just varies a lot among individuals. Then it takes work to get back to walking normally. A lot of docs inform you only of the immediate situation to avoid your worrying about each subsequent level. I believe that if you know what's coming you will be better able to concentrate on the present and not add the being in the dark to your worries.

What you can do now: First off the doctors are the professionals so only proceed with their approval, being it medications, icing, exercises. You will want to keep up your overall stamina. Get the OK to do upper body work and really exert yourself. The vast majority of Heelies (as we're known) believe that formal physical therapy (PT) is a must. This can start with at home visits and progress to an outside facility. You should be allowed to work on your legs to maintain their muscle tone and as important provide proper circulation to the foot. Circulation in limbs does not work well without muscle activity. Next will come the foot itself. This should be directed by a proffesional. They provide expertise in what will be effective and as importantly will goad you to work hard and allay any fears you have. They also will gauge your progress and success which strangley, people have difficulty seeing themselves.

Looking at your post again it appears that the doc is pretty open, so do hit him up about the prognosis on the pain. His putting you on the "top end" bodes well when predictions of joint fusion and other additional surgeries are made when the initial diagnosis is poor. I see you are elevating at night, good, it's the most important thing that you can do now. If the pain in the morning is from putting the foot down that is quite normal and takes many weeks to subside. If it is hurting 'no matter what', again insist (respectfully of course) on answers from your doc.

That shocking pulling stuff is standard, either blood supply returning to muscles or nerves waking up. Both will make quite a ruckus.

TC

rouletteyou,

You and Mluk should keep in touch. No one else will understand what's involved with a broken heel. Having a kindred spirit will be invaluable. Don't either of you judge your progress by comparison though. There are too many variations, large and small, that could just equal out in the long 'run'. And speaking of 'hopping' that's a big no-no. So far I don't know of anyone causing injury in a fall but many have caused pain and worse scared themselves half to death trying that.

TC

TChair, I really really appreciate your post and it certainly will help me organising myself in terms of trying to maintain overall stamina, elevating my foot as much as I can and asking the right questions when I see the doc next time on 2nd July (when I was told I would be given an air boot). Would you share your view on this?- my doc actually said last time if I somehow can stand the pain, I can even try to put weight on my foot now (3 weeks after surgery) when I am still in a cast. I tried that and either it is something to do with the circulation or the tightness of the cast (it feels that way though I cannot be sure) I found it impossible. Or am I just too scare to exert myself? Did you try putting weight on your foot when you were still in a cast? Or have you heard of someone (or if someone else is reading this) can you tell me your experience? My doc said my bone will go back to as solid as before though I expect some possible lost in mobility (aversion and inversion movement). Really appreciate any thoughts. thanks very much. Alaso Roulettyou, I hope you are doing fine.

mluk,

I hope some others do see your request and jump in with advice and info. The more input the better. Maybe start a new thread and refer to starting weight bearing in the title?

Wow on getting the OK to start using the foot. I'd heard of only two people allowed as early as 8 weeks and just recently one at 6. But I guess your doc meant it when he said you were on the "top end". You will be way ahead in getting the foot and leg back in shape since half the recovery problem is making up for having not walked for a long period. Both fear and pain are factors that will make it a slow start. Most of us went for short but frequent 'steps' each day rather than trying to 'sprint'. So just touch down with limited weight many times so it becomes more physically and mentally comfortable to try for more. The veterans call it "baby steps". Most everyone started off with the cast or boot still on. Few went straight to barefoot or could fit into shoes very soon. You will go through a progression of just putting weight down, followed by stepping, then balance. So it will be easier to start while still wearing external support. The air boot is very rigid like a cast but with air pillows inside and best of all removable. You can loosen it or take it off for comfort. Again you luck out not having to keep a cast dry when bathing.

When I did a repeat of my fall the front bones broke instead, so that says something for the heel being strong again.

Rouletteyou lucks out also since you will be leading the way and can report back on your experiences.

TC

Tchair, once again big thank you for your reply and advice. I now will try daily putting a bit of weight on my foot (with the help of the crutches) and see what happens. I am going to monitor my daily progress and setbacks with what you suggested (medications, pain level, sensations, areas, activities...) so by the time I see my doc on 2 July I have a ''history'' what is going on. I got myself a waterproof cover (Limbo, not sure if you have it in the US) which I can cover my foot so I now can go for a shower (easier than washing at the basin with a cloth) Yes, it is a good idea to start a new thread next time. It is very comforting to talk to people who had this injury or are having the same experience as me.

Glad you are doing ok mluk.
Well, had to go to ortho today. My stitches came off on part of the wound because of dead skin letting go. They said I had hematomas happening. They ripped off a bunch of dead skin, blood etc off the wound because of no healing. Well, now I have a deep cavern on the side of my foot almost down to the freaking hardware in my heel. Luckily there is no infection as my doctor put me on some antibiotics last week as he could see problems possibly arising. Now they want to put a wound vac on me tomorrow. That is if my insurance will approve it. The people that make the wound vac called me today and said my doc said he wanted it on me tomorrow but the insurance had not given them the OK yet (if ever). They wanted me to say that I would be responsible for costs in the event the insurance says no so they could get it tomorrow to the office. The costs of the wound vac is $93 a day and I'll need it for 10 weeks or so I think. I said no way! How is that for insurance directing health care in this country. This is a crazy freaking journey - I am 1 full month into this odessey and it feel like 10 years.

rouletteyou, I am sorry to hear about your situation. I am unfamiliar with the US health practices and insurance (my operation was through the national health service in the UK) but I really hope your insurance company will accept the costs of putting a vac for your foot. Sincerely hope all will turn out fine and I will be online from time to time as well.

Insurance has'nt approved the wound vac. I guess they get to pack it until it is better. It is going to be ugly for a few weeks. No physical therapy until it is healed all the way either.

rouletteyou, so for the time being does it mean you have an open wound right now? If so how are you coping and is the doc doing anything about it in these coming few weeks? I am in my cast until 2 July (this is a new cast which the nurse put on since they last saw my wound and they thought it looked dried and fine). I am putting a little weight on my foot and my performance varied day to day. Maybe it is just me imagining it (strongly hope so) that sometimes I felt maybe my wound is a little wet. Really hope this is all psychological, assuming if my wound was dried and fine it should remain so. Take good care.

I am glad you are out of the cast July 2. I am a little phobic of them. I really would think that if something would be wrong with your wound it would have already happened. I wont say you are on easy street but you are on your way. Head up and drive on. I have faith you will be ok.
No wound vac means that they see me twice a week to change the dressing. What they do is pack the wound hole that has no tissue full of antibiotic soaked dressing and gauze over it. They leave it covered and only open to change dressing to lessen chance of infection. The idea is to have the wound heal from the inside to the outside instead of the out to in and have it breakdown again. The said granular tissue should be gin to grow within two weeks and then it will get a bit easier.

rouletteyou, Itake great care and that you will be on the road to recover. I have been putting little more weight on my foot yesterday and last night the pain was horrific and couldn't sleep much. But I admit at least my wound is dried and fine (should still be). Do you believe in taking supplements? maybe a little calcium tablet might help you? Also remember to drink lots of water to clear your system.:)

ru & mluk:
I had a catastrophic heel shatter 2 years ago. Horrible prognosis - yet great outcome. You guys are so early in your healing. Every one of these injuries is unique - injury, treatment, outcome.

re: RU - Infection is a very big concern in your case with regard to healing;
re: MLUK - In the US, hard casts are not used in type of injury: UK may different; also, research has shown that non-operative treatment has the same outcome; I don't believe it.

Good luck. I urge you to ask me anything that can help you.

TCHAIR - you are a good man. I got late to HB.com in my recovery (5 months) - at that time I was so worried about walking normally - things changed in the next 3 months that I would sprint 100 yards to show off to my friends that I was miracuously back - Check out my old posts.

Update - Insurance approved wound vac finally. Less chance of infection with this I am sure as well as a better way to heal. It really is a pain in the butt to have it but the alternative is worse.

Mluk - I had a doctor tell me they just got done with a 30 year experiment with vitamins and it proved no sigificant difference between taking vitamins and not taking them. As far as supplements such as protein for muscle grow or maybe calcium - it cant hurt

Hi all,

I quick post then I'm away for a week.

jk,
Good of you to check back in. I can sprint too! But I'm getting to old :) I looked at some of those comparative studies, but they were all retrospective, simply looking at patient reports. They don't have any indication of the original severity of the injuries. In other words maybe the ORIF cases would have been much worse without surgery?

ru,
Speaking of 'butts', I hear that the wound vacs make farting noises. Who says this injury can't be fun.

mluk,
You'll have ups and downs as some tendons loosen up and others tighten up and start working in concert. Plus the bones and joints have to work back into their normal routines. Do range of motion exercizes, do legs for strength and circulation and don't stop those just because you're walking some. Going through the motions with limited or no weight will make it easier to do the real thing.

TC

Hi there, my conditon is up and down but is definitely better in the last couple of weeks, a month after the surgery. Sometimes I am able to do baby steps without my crutches but not for long. Again depending of my activities (sometimes just walking with crutches only) the pain can still be bad. Last week I took a minicab for a couple of jobs in C London (I was working with my foot up) and at night and the day afterwards the pain were shocking in times. I am looking forward to seeing the doc tomorrow and hopefully things will go well. Still loads of questions to ask (TChair, thanks for all your tips and advice and hope you had a nice break!). I understand I should be having my air boot tomorrow and will have physiotheraphy sessions periodically through NHS. Will visit the site soon and let you know how I am doing. Rouletteyou, how are you coping over there? Jk4507, thanks also for offering advice and will certainly ask more when I know what is going on with my progress.:cool:

Rouletteyou, I hope you are doing fine at your end. How is your wound now? Just to say that I started a new thread as I am now in the airboot stage but I will still check this one from time to time and see how you are doing, or please post on the new thread. TChair and JK4057, if you have a chance any advice is highly appreciate. My new thread is ''Shattered Calcaneous- Post Op- air boot stage'':)

Well I got a wound vac 4 wks ago. All dead tissue gone now and good tissue coming in. Last of dead tissue came off 4 days ago while changing out wound vac dressing. Nurse saw a screw head from the back of the plate and screws that were put in. Funny thing is tissue has grown 4-7mm (which is very fast)everywhere but the screw head. Doctor has decided to drive on as we have been since no infection and they are checking it every three days. Next time I break something it better be a finger!

MLUK hope everthing is moving along well.

jk4507 - I hear you ran a 5k without so much as an ouch. Good Job

Good to hear that things are looking up for you. |How are you coping? Did the doc tell you when you would be on air boot? I just start with air boot on Monday and I will have to walk with it for 6 weeks minimum. The swelling is still present and I am currently walking with airboot with a crutch walking distances at my neighbourhood and hopefully my stamina will build up and the pain and swelling will go down. Good luck with everything.

Yes. I ran a 5K on July 4th.

I ran the the 1st 3K. Walked the next 1K. Sprinted the last K.
I did the 5K on a whim. No training. Nothing.

Before the 5K/10K start, one of my best friends pleaded to me to not do it.

Some thoughts:
- I was definitely worried that my hardware was going to unravel; screw getting loose; i would've stopped if i felt that happening
- But I did feel this - landing on my right foot felt different - not painful - than my left - I ran very slow until the last K. If I trained for this, I never would've stopped.
- I was ecstatic when I finished - my quads were very sore for 2 days - but NOT my right heel/ankle.
- Fortunately, my right foot never landed on a rock/uneven surface; if that happened, I would fallen down for sure

So... I'm 21 months post-surgery. and in 12 months - I'm going to finish the 10K.

MLUK, I am doing alright. At this rate the bones will heal before my wound. The newest is my doctor is now talking plastic surgery to close the wound because of uneven healing in the wound. This is crazy but I know it will be over sometime.
Sounds like you are moving along. You will be back to normal soon.

rouletteyou, I had to change my username as I violated the posting policy without realising (approved by the moderator with my new username). I am glad you are doing better now. I am still at the thread 'Shattered Calcanoues- Post Op- air boot stage' so when you get to that stage maybe I can share what I experienced with you.

rouletteyou, sorry I misread your reply. I wish things will be fine with you and if you do need a plastic surgery hopefully the result would be good (I assume you are given antibiotics currently?). I think for my progress it will be a while before I can get back to 'normal'. Today is the first time I went to the city on public transports to work since April (I was working at home mainly after the accident) with my airboot and a crutch. It really hurts tonight. Very best of luck. I find now with my change in lifestyle with me staying at home most of the time, reading, doing things I normally put off when I was 'well' and picking up b&W film developing again (i.e. something I like/ find relaxing) has helped me to ease my mind although I am still anxious how my foot mobility will be in future.

Hi all. At home May 12, 2007 I shattered my left calcaneous/heel into so many pieces they could not be counted. I fell 12 ft off a ladder onto concrete. Emergency Room for 5 hours, two or three morphine and dilaudids later doctor said they are sending me to an Orthopedists. I could not believe my appointment was so long just to see about how to fix it (5 days). Ortho doc came in and said you have a bad injury. He said either let it heal like a bag of bones and have to fuse it later or surgery now and arthritis for sure, cane for 6 months and the rest of my life as needed. I picked surgery. Surgery was finally able to be done 10 excrutiating days after the injury - not because of swelling but because of scheduling. Was I somehow wrong to wonder what in the heck they were doing waiting so long to fix my foot!? Every professional acted like it was not a big deal. It might have been nice to tell me that this was normal for this type of injury. They had to have known I was freaked out by everything - I probably should have asked more things but I was scared, in pain, out of it. :blob_fire
Surgery was May 22, 2007. My Ortho said that he and a colleague operated on me and the surgery went BETTER (thank GOD) than he expected. They put in a plate and 10 pins. I must say the reconstruction looks very good.
I am scared about the next few weeks and months and fear of the unknown has always killed me. Does anyone have these fears? It would be nice to hear some other stories.





I too fell off a ladder and had a compound fracture of my right calcneous. I have three plates and nine screws in my foot. This injury occured on Oct. 6, 06. I was in bed for a month, in a wheelchair for two months, on crutches for 4 months. Everyone heals differently so it's hard to say what your healing process will be, but I can tell you it will be longer than you think. I still can't walk flat on my foot and have quite a bit of pain. I can't stand longer than thirty min. without the pain starting. I am learning to live with this pain and have adjusted my lifestyle and I am just greatfull I can walk at all

I broke my right calcaneous on Oct.3,06. I had a compound fracture and have three plates and nine screws in my foot. I was in bed for a month, in a wheelchair for two months and on crutches for three months. I live in NE Oregon and we get alot of snow so it was very hard to get around. Everyone heals differently so it is hard to say what your recovery will be, but take it from me it will be longer than you think. I'm a year out and I still have quite a bit of pain. I can't stand for more than thirty min. at a time and if I do a lot of walking or standing during the day then I pay for it that night. I hate to be the voice of doom but I wish someone had told me how long the recovery would be. I injured my heel on the job(thank god) so I have been covered by workmans comp . I have gotten to the point where I have had to adjust my lifestyle and just have to be greatful that I an walk at all. Hang in there it does get better but you will never be the same.

Well, it has now been a little over 6 months since I fell and shattered the heel bone all over the place. This is what I have learned.

Infection is a cold hard b#!ch.

A wound vac sucks, literally, but it works after many weeks

Patience is not a virtue, it is vital to sanity - the alternative is depression

I like living with pain slowly subsiding rather than not living at all.

You can stand pain, more than you thought.

No one understands this injury - people will never understand what you are going through and will continue to go through. It is not like a broken arm,leg,foot,finger or anything else.

People will say asinine things

It is up to you how screwed up you are from this. I have faithfully done all the exercises,range of motion,ice,heat, and stretches. I am making good progress and will continue to only if I want to.


People look at people under 40 with canes and stare and stare and stare.

My wife is great and has put up with alot of cranky bulls##t and stuck around. Good thing I had 15 years in with her already!:D

As I write this and have a stab of pain it sure is alot better than what I felt when I was flat on my back with my foot in the air waiting on surgery.

I could have broken my neck,knees or back. Thank you God.

Physical Therapists may smile when you get to the appointment at first but dont let them fool you. The pain will come hard and fast just like they like it!


I will get to where I am going

Hi I'm new. R heel fx 11-11-07, ORIF 11-19-07 with a plate & 8 screws. Same day as your last post, Rouletteyou, 4 weeks ago.

I'm looking forward to the asinine comments. Could you please give a quick explanation of a wound vac? You are one unlucky sucker with a pretty damn good attitude.

It's been quite comforting to find this MB & thread. I almost cried (Ok, I am always almost crying anyway these days) when I read "nobody will ever understand what you're going through" and "my wife has put up with a lot of cranky bulls##t and stuck around". Almost cried in a good way.

My doc put me on a HTN patch for improved circulation, I don't have HTN. Anyone else? How far into the process did you all stop narcotics completely? Any numbness in your foot/toes? My big toe has been quite numb since day 1, doc pretty much blew it off. Will I be able to wear any shoes I want? I'm not a big fan of heels anyway, I can't imagine them ever being tolerable again.

I'm really afraid I won't be able to step on and off the fire engine and ambulance 30-40 times a day. Of course there's lots of other crazy foot-stressing situations I'm gonna get in but the on-and-off the equipment is constant. Doc said start thinking about changing careers. I really don't want to do that. What do you think about that type of heel stress? PS this is not OJI, I was on my way home from work.

I've read the entire thread, so much comfort knowing I'm not alone in my misery (is that bad?). I really am lucky to have my wonderful boyfriend & my mom. They have taken some really undeserved stress & abuse from me.

Hey does anyone have consistant nagging discomfort EVERY minute you're in bed? I've grown to hate my bed. I understand the lack of distraction makes me focus on my discomfort, but it's something else. I'm only taking the Darvon & Lortab at night now.

I have more thoughts & questions for later. Any replies would be very much appreciated.

Bjorkfuna:confused:

Greetings bjorkfuna,

You have a lot of pertinent questions and astute observations. That's a good sign because those who fare best think ahead, plan and take a proactive role in their own recovery.

The wound vac is employed when the skin doesn't knit up well and/or infection sets in. Outside of a few left in a cast and uninspected for weeks, those problems are obvious within the first couple of weeks. The vac creates negative pressure at the incision/wound site to promote maximum circulation. Docs are very wary of infection following ORIF surgery because it is on an extremity, the injury and surgery result in a lot of swelling and immobility of the limb dramatically reduces circulation. The HTN would be a means of mitigating that problem. I don't recall others getting it but different docs take different tacks.

What you can do yourself is keep the foot elevated 24/7 if possible, but with some practice putting it down low now, because that's a hassle to get used to after it's been up so much. You want to do as many leg exercises as possible that your doc allows. Every hour you put into that now could cut out a day of healing and getting back to walking. Then on top of that do aerobics or something strenuous to maintain your over-all stamina.

Then you want to do as many range of motion exercises as allowed to break up scar tissue, get joints moving properly, stretch shrunken tendons and rebuild muscle tone and reflexes. Going to physical therapy is highly recommended. At PT they will know the best methods and progression. They will also help motivate you and boost your confidence.

As you can see this isn't just a routine break where you soon forget all about it. It is not uncommon to need pain meds for three months or more. The initial discomfort diminishes only slowly until you get back to using the foot again. You’re using the pain killers now to keep the pain under control, get some sleep and participate in some normal activities. That will probably hold true as you prepare the foot for walking and again when you start weight bearing. If you want to minimize use the best you can do is get tired enough to sleep (re: push those exercises) get comfortable ( I slept better on the couch with my foot propped way up then used a pillow rolled around a hollow tube.) and with PT take the meds before rather than trying to 'catch up' afterwards.

You might be realizing that you will be depending on others for many weeks to come. I'd tell them to help and cooperate but that trying to baby you will wear them down too quickly.

The nagging night pain is the usual. Elevation can help (note certain things being repeated) and most of us used ice packs, in fact several that we rotated through. You can use padding rather than freezing and on the ankle can cool the foot nicely. Recently some have found wraps and compression stockings helpful, but you always want to check with your doc beforehand.

The toe numbness is also common as are the shocking sensations when the swelling goes down and allows the nerves to start waking up again. The important part of that subject is not getting an answer. To your doc, this is all routine but to you it is new and important to get the best recovery. You must get him used to answering all of your questions completely.

For starters, how about your career? Is he basing his comments on general outcomes (which might not apply to you at all), what he saw on your films and during surgery or just playing it safe in case things don't turn out well. You deserve explicit details including whether this is a prognosis for you or just him covering his butt.

There are many questions and some of vital importance. Subjects that concern you now are your ability to sleep, medications and physical therapy. Later it could be pain, instability, when to return to work and at what increments. You will have questions about arthritis, hardware and more.

Write down your questions has they come up. Bring the actual list to your appointment. Have someone come with you as an advocate. Make sure that they understand their role. One reason is that having a witness present makes for better performance in general. When answers are incomplete the advocate can follow up repeating the question or asking for the reasoning and pertinent details. Another is that a patient who is quite normally anxious can be labeled and dismissed as a worrier while the person with them cannot and can actually bolster them.

I think most heelies end up being concerned with the most comfortable shoes and throw style out the window. Many decided from the start that they were not giving up their careers ranging from mountain guide to construction and have made it back. The strength of the bone is not an issue and apparently not range of motion (which docs focus on). The major factors seem to be whether the arch is restored, the joints work freely (even if within a limited range) and the tendons do their job. The docs will say give it a year and that seems to hold true. Many issues will come and go in that time period. The swelling which continues for many months is an example. Various parts (such as wobbly ankles) must wait their turn to be put to use and move towards recovery.

The heelies have a saying: two steps forward, one step back. Count them as progress, hurdles that you have cleared and an indication that you are striving for improvement.

tchair

T-Chair: Your reflections are always clear and informative.

My injury: Shattered Rt Heel on 9/1/2005, ORIF two weeks later. Plate and 6-8 screws. Prognosis was typical for this injury - BAD; likely arthritis and probable joint fusion surgery to alleviate the expected pain; limp expected.

My Outcome: I ran a 5K on 7/7/2007; I'm not picky anymore with new running/regular shoes; No arthritis and no pain. The only issue I have is when I step on an uneven surface (like a TV remote control) - I will fall down.

I'm not sure why I had this success - all's I know is I got scared straight by my doctor and posts that I read here
- so I became completely resolved to getting healed
- positive focus; move that joint around; PT that thing like crazy

I would love to answer any specific questions. So ask away....

I ran a 5K on 7/7/2007....
PT that thing like crazy....

JK,

Glad you're checking in. I think your showing that there's hope for recovery is as important as any advice I can give. I used to fall down if someone stopped short in front of me. It was like I had no brakes, then I had to pretend to tie my shoe as a cover up - had forgotten about that 'till now. I remember telling my wife when you did the 5k last summer, as I did when others went back to snow boarding, hiking and the like. The response was "Ho Hum". She couldn't understand what I was so excited about.

I shattered my heel into 20 pieces on June 5, 2007. Its been 249 days, and today I turned 43 and went snowboarding for the 12th time this year.

Shattering the heel, while skateboarding barefoot on a 12 foot vertical skatepark wall, at night, was the worst physical injury that I have ever had. Yea, sure, I deserved it. Nobody surfs with shoes, and nobody skateboards barefoot. Especially at a skatepark, and for sure not at night.

The summer was awful. On the couch, trying to work as a commmercial real estate appraiser, being a dad to my 3 year old. I was so depressed. I forgot to say that I was on crutches all summer in 2006 from knee surgery. I have been down.

I know you are also down if you are reading this. Shattering your heel is a real bummer. Get the surgery. I have a plate and 12 screws which I want to get out next Christmas if possible. The first four months almost killed me. The pain, the swelling, etc. Nobody understands the pain, or cares. Except the docs and others who have suffered.

After 6 months I could walk pretty good and went surfing in Hawaii over Christmas. Not dynamic, but I was doing it!!! Keep the foot lose as possible, do the therapy, and start making plans for the future. You will be back doing most of the things that you love, unless its long-distance running. I will not skateboard barefoot at night on a 12 ft. vert wall, but I will snowboard, skateboard with pads and shoes, ride dirt motorcycle, hike, and just about everything else that I feel like. Get the surgery. Its worth it.

Doc said it was a 6 out of 10 injury.

The doc said "a little more surgery than you thought, eh?"

Its been a tough road for sure. The worst. But through tons of therapy and hard work, I think I am going to make it.

Your gonna make it. I promise.

After my crash, I was looking anywhere for success stories about people who shattered their heels. Mostly, its bad news on the web. Why would you go back to these boards once your better and have "moved on"? I promised if I got better that I would let others know that its not the end.

Don't get me wrong - it still hurts, gets stiff and swells. But I am pushing it hard. Trying to get back into shape and snowboarding for fun. I plan on racing my skateboard to victory on April 18th at the Indian School drainage ditch outlaw race in Albuquerque, New Mexico. All those guys with two good heels are going down.

Oh yea. Look for a Rolfer in your town. Its serious massage for lack of a better word. My Rolfer worked on my foot the other day for an hour and a half and "shook something loose". Look into Rolfing to break down the scar tissue, along with physical therapy.

Take your future into your own hands. I am getting this metal out of my foot for a full recovery. I figure I have 43 more good years left and I want to get my share of fun out of this life. Plus, I can't slow down. My son is only 3 years old !!!

Use this time down to relax, get affairs in order. You'll be back in no time. I must say, this has been a long 8 months. Once you can walk again, you'll find yourself doing stuff like racking the leaves - just because you can !!!!

Please bring your attention to the posting policy.

All rules apply. The rules are enforced on this website.

People it has been almost 8 1/2 months since the surgery. Here is the deal-

1. I have one nasty scar from the hole finally healed over on my foot but I am glad I have a foot! My days as a foot model are over !! Ha - If you knew me you know I would've had to pay someone to take pictures of my foot before or after.

2. All my hard work through physical therapy for 2 1/2 months and then working on my own for the last 2 months has paid off quite well. My calf muscle is almost back to normal. My foot muscles have a little way to go. Physical therapy is the real deal.

3. I stopped walking with a cane about 1 1/2 months ago. Pretty good considering I was told I may need it for the rest of my life.

4. I barely have a limp and uneven surfaces are getting better. I think it will be strong enough to mow the yard this season. I can even lift about 50lbs and walk for quite bit if I walk straight legged without bending the ankle.

5. I am back to travelling for my job and walking all over airports although I can think of many other things I would rather do.

Yes I still get very sore
Yes I have an ankle and foot that is a half size bigger(still in same shoes!)
Metal will probably always be in - some discomfort but not a problem compared to the pain I had in the beginning. Only occasional pain meds.

There it is
Remember, keep the head up. This is a good time to see exactly what you are made of. It is OK to be weak. it is not OK to stay weak.

Kenny Thanks for coming back, I fell off a roof (I am a carpenter and a good one) the day before yesterday. I have been in carpentry my whole life and this is the worst. I landed on frozen ground after a 30' slide and a 14' fall on my side. I broke my r arm and pulverized my right heel. The pain is unbelievable. After reading these posts today I was so depressed, then yours. I will quit reading now unless you respond or someone else is positive. I don't see surgeon until wed (6 days away) I will know more then.
Thanks
Jon

Kenny,

It's great to read a post from someone who healed way quicker than I did (plate, 6-8 screws) after surgery in mid 9/05. I'm 44 now.

- Walked normal - 10 to 12 months later
- Ran a 5K - 22 months later
- Started playing competitive tennis 26 months later (although this could've started 6-12 months sooner)

One thing you should know is that the hardware in your foot is permanent. No question about it.

John

Hi all,

I quick post then I'm away for a week.

jk,
Good of you to check back in. I can sprint too! But I'm getting to old :) I looked at some of those comparative studies, but they were all retrospective, simply looking at patient reports. They don't have any indication of the original severity of the injuries. In other words maybe the ORIF cases would have been much worse without surgery?

ru,
Speaking of 'butts', I hear that the wound vacs make farting noises. Who says this injury can't be fun.

mluk,
You'll have ups and downs as some tendons loosen up and others tighten up and start working in concert. Plus the bones and joints have to work back into their normal routines. Do range of motion exercizes, do legs for strength and circulation and don't stop those just because you're walking some. Going through the motions with limited or no weight will make it easier to do the real thing.

TC

I shattered my left calcaneus in August '05 (13 screws-1 plate). I am working fulltime and dealing with differents levels of pain on any given day. I find that if I am on a ladder (a very low one) I have a great deal of pain that evening. A foot surgeon (not my ortho) told me that when the calcaneus shatters it expands even with the hardware. The space for the tendons running along the side of the foot is diminished and this is the source of my pain. The surgeon made this diagnosis after injecting an anesthetic into the talus joint with no subsequent relief. I would like to know if the pain will decrease over time or will this be my way of life. I was also told that I am fortunate to be walking.

Robert,
Not having an even surface to distribute your weight (ladder) for an extended period of time would be a problem for me too. I would be very careful using a ladder - pain and the tendency to fall on a non-flat surface .

We suffered our injuries at the same time. I played singles tennis last night for 90 and my right heel is sore. I forget that I am not 100%.

I agree with your doctor; my take is that our tendons have to deal with this Home Depot hardware we have installed and the consequences are better for some, worse for others.

Kenny Thanks for coming back, I fell off a roof (I am a carpenter and a good one) the day before yesterday. I have been in carpentry my whole life and this is the worst. I landed on frozen ground after a 30' slide and a 14' fall on my side. I broke my r arm and pulverized my right heel. The pain is unbelievable. After reading these posts today I was so depressed, then yours. I will quit reading now unless you respond or someone else is positive. I don't see surgeon until wed (6 days away) I will know more then.
Thanks
Jon

My husband shattered his right calcaneous November 2000. He saw several surgeons who told him that the bone had broken into 10 small pieces and could not be pinned. He has rehabilitated himself after 7 years and has improved mobility. He can move it up and down but he has no side to side motion. He still suffers from a great deal of pain (some days are worse than others.) I would like to hear from people who have had similar injuries, but were able to get the surgery. How much does this surgery cost? How long is the recovery time, and what future treatments can be expected afterwards? Thank you for any response.

Hi JLS,

Your husband shattered his heel over 7 years ago. Multiple doctors told you that surgery was not necessary. You said it could not be be pinned.

The heel bones formulate a complex "egg" structure - when shattered, it is impossible to reconstruct.

The reason ORIF surgery is usually performed is because displacement (of bone fragments into the joint) has occurred.

I would recommend to at least get an x-ray to get a better picture of what's going on.

Robert,

What your doctor says has a ring of truth to it and he's the expert and has seen your foot. There's also likely some degree of bone miss-alignment, scar tissue and joint damage. I'm of the opinion that the body heals and adapts better than people imagine - so long as you help along the way.

Every spring I find myself outside on a ladder again. The first year after ORIF I couldn't get up a ladder, the second year I got up, but down was nearly impossible. Now that it's been many years I don't even think about it. If you are favoring the foot by allowing the other one to do all the hard work during normal activities, then when on a ladder it must do its full job and you will pay the price. Take notice of whether your injured foot is doing its share and consciously push it to do more of the balancing, pushing off and such. Just as over time you can condition your body for strenuous activities I believe you can to a large degree recondition your foot. At least that's been my experience.



jls1987,

"The surgery": Open Reduction with Internal fixation (ORIF) deals with positioning the bone fragments before they fuse back to a single body. That's not something they can go back and do after the fact. They have other remedies starting with (yes this late in the process) physical therapy, orthotics, correcting joints by shaving the bone or inserting donor bone to restore the arch (Re: Bohler's angle). Joints can be fused, tendons can be shortened and lengthened. You would need to have a doctor assess the present situation and determine what choices might be available. As John said, an x-ray and diagnosis are called for.

In the last few years they've had great success with External Fixation for those impossible situations. So those coming along will have better options than were available to us: fixing small fragments, eliminating the plate and screws, even avoiding surgery in some cases.

TC

As a result of a head on collision 02/06/08 I suffered a calcaneus heel fracture and was treated with surgery 02/26/08, resulting in a plate and 8 screws. As of 04/18 my doctor put me in a walking boot. The weird thing I deal with constantly is nerve damage to the upper part of my foot where there is no sensation on the bottom and no movement in my toes...has anyone else experienced this?
I also have ankle pain when walking with the boot, normal maybe? My doctor has advised that after a month in the walking boot he would like to see me back in the office and then I could possibly explore some physical therapy...has anyone began a therapy routine for this type of injury and if so how well has the therapy worked for you?

charliezangel ,

You tagged onto a thread that is getting long and old. The other heelies and I didn't spot your post right away. So my first advice is to start a new thread. A title such as "Calcaneus heel fracture" would be fine.

Nerves get compressed during the injury. The swelling that is still present can also be doing this and blocking the blood supply to many tissues including nerves. Pain, numbness and lack of movement in the toes is usual for this injury. Most of us experience these issues well into the weight bearing stages. A very few have long term problems. You have to ask your doc if the degree of these problems are out of the norm for your stage of recovery.

In general the docs do the surgery, look at the x-rays and do nothing further unless you bring something to their attention. What they do/decide is based on your input. It is important to ask about each issue specifically. Write them down and bring the list to ensure that you remember to ask and do get answers. Sometimes you have to press for those answers. If it is "too early to tell", then ask when is a reasonable time to wait and see, then be prepared to get concrete answers at that time. Ask the doc if he mentioned nerve damage as temporary trauma or excessive or a long term problem. If it is either of the later then ask for a referral to a neurologist.

Ankle pain is normal at every stage of recovery: in the boot, after the boot, when getting back to walking normally. Again you'll only know if yours is in the normal range by covering it with the doc as you go along.

The force that broke the heel would also have pulled tendons and banged up joints. Getting them to work properly again is a gradual process. You have been off of the foot for months which drastically reduces muscle tone, tissue flexibility and joint motion. Most of us started limited physical therapy within weeks of the injury. We did exercises for our leg muscles, then range of motion for our foot and much more under the care of therapists. This injury is nothing like breaking any other bone including others in the foot. Physical therapy is a must, and I believe the sooner the better. I would insist on PT right away. If the doc balks at that ask about muscle atrophy, if it would not be better to have your foot more prepared to bear your weight and have a medical professional their to supervise your efforts.

TC