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Old 08-16-2007, 07:35 PM   #1
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Anesthesia for OCD Ankle Athroscopy - which one?

Thanks to all that have helped me choose the right OS to move forward with my OCD of the talus. After now 10 weeks in this boot and having no improvement (after a misdiagnosis of RSD by another OS), unfortunately it was confirmed today that we will try the debridement and drilling. Given my OCD is large, he is giving me a 70% success rate .. I am waiting for my date for sometime mid September.

I have some questions now that the shock is now wearing off...

1)we started talking about the anesthesia and he mentioned general, epidural or a 'block' that would numb me from the knee down .. which is best? I am leaning towards the block .. I think, but would like opinions.

2) he said after the drilling I would be 4 weeks NWB but would start PT soon after as that will help me heal. I understand from reading the threads that the movement after will help form the new cartilage, but what exactly does NWB mean? I understand I can't put any weight on it, but does that mean I am bed ridden for 4 weeks? Did everyone go on short term disability?

3) what is involved in pre-op testing? Sorry this is probably a basic question but I have never had surgery and I am the worlds BIGGEST CHICKEN when it comes to needles.

Sorry for so many questions .. for some reason this all became real this morning although I should have known this was coming. I can't even imagine what I'd be like if this were the open OATS procedure that will happen if this doesn't work.

Thanks for your help!
Kim

 
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Old 08-16-2007, 08:04 PM   #2
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Re: Anesthesia for OCD Ankle Athroscopy - which one?

1. I would definitely go with general anesthesia!I had a Brostrom repair done at the end of June,had general,and it was great.I was out like a light,and other than being groggy and having a sore throat,I had no side effects.My anesthesiologist said general would be best because otherwise I would have to keep myself completely still,and also that blocks and epidurals take longer to wear off.

2. NWB means that you are not allowed to put any weight on your foot,so you have to use a walker,crutches,or wheelchair.So no,you don't have to be bedridden,you just have to be careful.

3. I can't help you with the pre-op testing as I didn't have any.Sorry.

Hope that helps a little!

 
Old 08-17-2007, 04:22 AM   #3
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Re: Anesthesia for OCD Ankle Athroscopy - which one?

I had an akle fusion using both anesthesia and a block. I loved the block because when I went home (out patient surgery), the block was still active for my pain. That was awesome. As far as NWB, I used a little wheel cart that you rest your leg on with a bent knee. It is far better than crutches or a wheel chair. Where I am at, you can rent it. You should check into that. It is great to get around and have free hands. Goodluck!

 
Old 08-17-2007, 04:52 AM   #4
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Re: Anesthesia for OCD Ankle Athroscopy - which one?

I had my knee surgery with epidural, and my sinus surgery under general anaesthesia... if I ever have a choice, I'll go for the epidural. I don't like the grogginess or the icky-sicky feeling after a general. Hubby had general with a block for his shoulder surgery, and he said it wasn't bad (also kept the post-op pain down for a while, as it lasts for about twelve hours).

I never had pre-admission testing either; they just sat me down,, verified personal information, asked about allergies, etc. I had no needles. Females usually need a pregnancy test, but at my clinic that's a pee-in-the-cup thing.

 
Old 08-17-2007, 05:58 PM   #5
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Re: Anesthesia for OCD Ankle Athroscopy - which one?

Thanks everyone for your answers, definitely gives me more to consider.

After reading this forum I have read about so many debridement/drillings that didn't work only to have the bigger procedure later on ... I am tempted to go for the bigger procedure (bone taken from my knee and put in my ankle) but it is so much more involved, OS wants to try the drilling first.

My only hope is those that had successful debridement/drillings are happily going on with life and not reporting that back here in the forum.

Thanks for listening to me vent .. I know I am not alone in my frustrations in reading through the messages here and just want all this over with and to be able to walk pain free (or maybe not pain free, but with no limp) and do all the things I want to do. I don't want to climb a mountain or anything but it would be nice to be able to get back to the gym or play tennis and golf again.

Thanks again .. and if anyone has had success with d/d with a large OCD please feel free to let me know .. maybe it will help prevent my getting an ulcer before my surgery in Sept .

 
Old 08-19-2007, 08:48 PM   #6
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Re: Anesthesia for OCD Ankle Athroscopy - which one?

I was going to have BOTH general anesthesia and a nerve block (knee down) when I had surgery in May. They used a saw and mallet, among other things, and I did not want to be conscious whatsoever! I don't like the way drugs like Valium and Versid make me feel either. The reason I wanted the block was for pain control after I woke up. They can last up to 12 hours and I was hoping to avoid having to take a lot of pain meds during that time. Unfortunately they did not have an available anesthesiologist who knew how to do the nerve block, so I didn't have that done. I ended up staying overnight in the hospital, doped up on morphine...wasn't too happy with the hospital for not having someone available, since I told them I wanted it ahead of time. Anyway, the general was not an issue at all for me and they gave me some Zofran, an anti-nausea drug, before I woke up, to make sure I wouldn't have stomach problems, which I did not. It's a personal choice when it comes down to it. The only pre-op testing I had was the pregnancy test (once in the clinic and once in the hospital...that week in-between could have changed things ya know.... ).

One thing that was very helpful for me both before and after surgery was a Roll-A-Bout knee scooter. You put your knee/calf on this scooter like thing and steer...better than crutches! I was NWB for 6 weeks after surgery and couldn't have made it through without this. Rented it from a local equipment company and my insurance paid for part of the rental fee each month.

I was off for 3 weeks, but was able to work just fine after that. Elevating the foot as much as possible and taking pain meds was important. I would have gone nuts if I couldn't have worked! By the 3rd week, I was stir crazy. Get out for short periods of time after the first week or two if you can. It keeps one sane! Ask your doctor about a temporary handicap placard too...they are a lifesaver, whether or not you are driving.

Good luck as you move forward!
Krista

 
Old 08-19-2007, 09:16 PM   #7
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Re: Anesthesia for OCD Ankle Athroscopy - which one?

Kim,

I did have pre-op testing done. I'm also a HUGE needle chicken, but it really was no big deal. At my primary care doc's office I had an EKG done and they had to sign off on a form that my asthma was under control. Then I went to a blood work center and had blood drawn... I think they took 3 vials for different things.

During my surgery, I had general anesthesia. I'm with Krista - don't make me be awake when you're sawing my bones open and pounding in grafts with a huge mallet!! NO THANKS. My mom had knee replacement surgery done under a spinal, and she said it was so freaky to hear them sawing your bones and to feel the movement. I think I'd be ill!! Since my stomach is sensitive, I was given anti-nausea meds after I came out of the anesthesia. I went home on an out-patient basis and that part of it was fine.

I did learn quickly that when you're new to NWB and are doped up on pain meds, your balance is WAY wacky. I fell twice on my crutches and ditched them in favor of a walker for around the house. It was much easier and gave me a lot of stability.

If you're going to be off work more than a week, definitely apply for disability. I don't know about laws in different states, but here in California you can receive benefits starting on the 8th day. Your doctor will need to sign off on it for you, so get that done before your surgery. Also be sure to fill your prescriptions before surgery. You don't want to have to run around getting those things done when you feel lousy.

As to the NWB, be very careful, try not to rest your foot down on anything, even when you use the restroom. Take it easy as much as you can and be sure you have some big pillows or something to prop your foot up on so you get some elevation.

It's not easy being NWB, but be patient and take care of yourself. Follow the doctor's orders to a "T" and you'll have the best chances of a successful recovery from your procedure.

Good luck to you!
Deb

 
Old 08-20-2007, 09:32 AM   #8
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Re: Anesthesia for OCD Ankle Athroscopy - which one?

Hi All!
I had OATS using cadaver bone in September 06, my OS prescribed both the nerve block and general. I like so many others am freakish with needles and I was scared of the nerve block after reading what it involved. In the pre-op room they quickly noticed my fear and they put something in my IV and I remember nothing about that procedure, just becoming conscience and it was done and off to the OR for the big procedure, whatever they gave me truly put me at ease as I recall laughing in the OR just before I was put under..... The nerve block was incredible, I woke up the following morning (still in the hospital) thinking what a breeze this was and there was no reason to be stressed! When it wore off... WOWWWWW... Thank goodness for morphine and other drugs. If I had to do this again I would only go that route, I'll take the effects of anesthia and pain medicine over pain anyday!
I wish you success in your drilling.
All my best to everyone
Carol

 
Old 08-20-2007, 03:51 PM   #9
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Re: Anesthesia for OCD Ankle Athroscopy - which one?

Hi Kim

Just had to say, i was diagnosed with a huge OCD of the talus from an MRI scan. I also had a collapsed foot , all through injury. My surgeon said apart from moving my heel over, and repairing my tibialis tendon, he would also do the debridement/drilling bit on the OCD.
The op went well, and when i came round, he told me it wasnt an OCD really, it looked just like one, and was certainly big...but it was a chondral flap ( a flap of cartilage pushed out from between the bones) and yea that isnt great, but it isnt anywhere near as bad as an OCD. Dr told me MRI can be very decieving and this happens alot! I'll keep my fingers crossed for yours!!

I had pre op checks.... an ECG ( heart monitor) and listening to my chest , and thats about it. The anaesthetic had no after effects on me, i woke up and felt totally normal in minutes, lol.

Good luck with it all.

Mazzie

 
Old 08-20-2007, 06:49 PM   #10
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Re: Anesthesia for OCD Ankle Athroscopy - which one?

Mazzie, Carol, Krista and Deb,

Thank you so much for your advice. I have to admit though, as soon as I read about the Rollabout I didn't even finish where I was and went right to a site to read about it and have to say it is perfect timing ... after walking around on crutches for 10 weeks now, my opposite shoulder is now starting to bother me and it sounds like this is the solution .. so THANK YOU for that tip!

I agree with you all and I want to know NOTHING that is happening and certainly do not want to hear ANYTHING. I want to be put out even before the IV goes in, remember I am a big needle chicken

I will certainly keep you all posted and let you know how it goes after it's done, I am just waiting for my date.

Thank you again for making me breathe a little easier and for your good wishes.

Kim

 
Old 08-20-2007, 07:58 PM   #11
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Re: Anesthesia for OCD Ankle Athroscopy - which one?

Hi Kim,

Let the anesthesiologist know you're a needle chicken, and he can give you something to calm you down and relax you. Mine did and it really helped! I actually didn't even have to ask - I guess he saw the panic on my face and offered it to me on his own.

Good luck, and keep us posted!
Deb

 
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