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Old 05-27-2007, 07:21 PM   #1
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Calcaneus shattered - Post Op

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.
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.

 
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Old 05-27-2007, 10:37 PM   #2
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Re: Calcaneus shattered - Post Op

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

 
Old 05-28-2007, 06:28 AM   #3
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Re: Calcaneus shattered - Post Op

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.

 
Old 05-29-2007, 12:49 AM   #4
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Re: Calcaneus shattered - Post Op

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

 
Old 06-08-2007, 09:58 AM   #5
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Re: Calcaneus shattered - Post Op

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.

 
Old 06-09-2007, 05:09 PM   #6
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Re: Calcaneus shattered - Post Op

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.

 
Old 06-12-2007, 03:16 AM   #7
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Re: Calcaneus shattered - Post Op

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.

 
Old 06-12-2007, 03:17 AM   #8
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Re: Calcaneus shattered - Post Op

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 will get better soon.

 
Old 06-12-2007, 05:40 AM   #9
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Re: Calcaneus shattered - Post Op

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

 
Old 06-12-2007, 05:54 AM   #10
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Re: Calcaneus shattered - Post Op

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

 
Old 06-13-2007, 05:18 AM   #11
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Re: Calcaneus shattered - Post Op

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.

 
Old 06-14-2007, 02:29 AM   #12
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Re: Calcaneus shattered - Post Op

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

 
Old 06-14-2007, 04:23 AM   #13
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Re: Calcaneus shattered - Post Op

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.

 
Old 06-14-2007, 04:53 PM   #14
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Re: Calcaneus shattered - Post Op

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.

 
Old 06-15-2007, 08:56 AM   #15
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Re: Calcaneus shattered - Post Op

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.

 
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