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Old 09-11-2007, 08:08 AM   #1
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Triple Arthrodesis and Achillies Lengthing Surgery

Hi there. I finally got my surgery date for Sept 17th. I'll be having a triple arthrodesis and achilles lengthening procedure done,( total reconstruction and bone fusing)My Dr will be using a fixator (halo type apparatus) versus the cast for the first 4 to 6 weeks.He said he preferred this to the cast and would help the bones to fuse and heal faster. I'm beginning to get nervous about the whole thing but know this is the right thing to do. I've been dealing with this since March and glad that I'm finally going to have it fixed. Has anyone had a fixator and how painful is it going to be? I will be in the hospital for 2 days. He told me I will be off work at least until Feb of 2008 and even then I may not be able to continue working there. ( I stand and do a lot of walking at my job) He told me I should consider a sit down job in the future. Anyway would like some feedback from anyone who would like to share. Thanks

 
Old 09-11-2007, 09:22 AM   #2
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

Hi there,

I don't know anything about the procedure you're having done, but I thought I would throw in my two cents' worth about returning to work.

In mid-March I had my posterior tibial tendon repaired along with an Evans calcaneal osteotomy (cut my heel bone and put in a wedge-shaped bone graft). I was in a rigid cast for 4 weeks and a boot (still total non weight bearing) for 5 more weeks. I began putting weight on the foot and going to physical therapy at about 10 weeks post-op.

I am still off of work, and it's looking like I won't be able to return to my regular work - I stand & walk on a cement floor 8+ hours per day. Right now, at almost 6 months post-op I can only tollerate about an hour of walking and/or standing and then I'm just DONE. My doctor did tell me that it will take 9 months to a year before I will see the final results of the surgery and be at 100% capacity, so obviously I've still got a ways to go.

In light of all of this, I'm searching for a new job which will allow me to be off of my feet much more than my current job does. This may be what you'll need to consider as well, but again, everyone is different and you may be able to tollerate more time on your feet. You won't really know until you're several months post-op.

Good luck to you, and keep us posted.
Deb

 
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Old 09-11-2007, 03:34 PM   #3
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

I can't speak to the procedure, but returning to a job with alot of standing when your foot has been through alot of trauma may prove somewhat difficult. It seems your doc has tried to prepare you for it. I did not have surgery, but am recovering from a broken 5th metatarsal--it has been almost 7 months and the break is still not completely healed. I have learned that no matter how much time docs may project the healing process to be, your body does what it wants to. Feet tend to heal more slowly due to some areas of limited circulation. I am back to work (as a teacher) where I stand, but I have had to adjust how I do things and where I go in my building. Things are slowly getting back to what they were in February. Be prepared to do whatever your doc tells you to the letter. My doc has told me that I have been a model patient, but still complete healing is elusive at this time. While you recover, take the time, relax and learn a new hobby, read some books and see some videos. Hope all goes well with surgery. Be sure to update here on your progress!

 
Old 09-12-2007, 08:45 PM   #4
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

Iowagirl,
I can't speak to your particular surgery, though I do have a colleague who had the same procedure (no halo though) and is doing quite well now. Of course, her job is a sit down kind, so that helps.

I imagine this is a tough week for you, as the surgery is looming out there. As if you don't have anything else to do...these are a few suggestions. Before my surgery, I went to the store to stock up on bulkier/heavier things (ie, bottled H2O, soda, dog food, TP) as well as frozen/easy to eat things, knowing that it would be hard for me to manage those in the store and getting them from my car to my house while in a cast/NWB. If you haven't gotten your handicapped placard, it's much easier to do it ahead of time. My dr didn't sign the form until the morning of surgery, so I couldn't get mine until the next day, on the way home from the hospital...and I was painful then, but needed it.

Anyway...good luck with everything! Update us with how it all goes...it's a tough surgery, but so worth it (eventually).
Krista

 
Old 09-13-2007, 04:00 PM   #5
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

Hi - I too had the triple and achilles tendon lengthening with the external fixator - both feet. It sounds like you understand the complexity of the surgery and the recovery and that's a big step ! I had the second foot done a month after the frame was removed from the 1st foot. I had 10 wires through my leg and foot. Be sure to follow the surgeons directions: clean the pin sites as directed, weight bear as directed as well. One of the advantages of the ex fx is that you can weight bear ALOT sooner than conventional surgery. In fact if you don't bear weight as he allows you the fusion will be delayed and healing will be slower. My doctor put me on Fosamax and prescribed a bone stimulator. The wires look alot more painful than they really are. After the initial post op period you hardly feel where the wires go through the skin. At times the skin can get irritated around the wire especially after cleaning. My Dr told me to clean around the wires with alcohol. If your surgeon recommeds alcohol to clean with, one thing that he told me to do was to get a spray bottle and spray the alcohol around the wires and gently clean with a gauze pad. Some people use cotton but I found that the little cotton fibers would get caught around the holes and cause more irritation and possible contamination. I would recommend a chair to sit on for the shower and/or a small stool to rest your foot on. For leaving the house I had a pillow case that I covered the frame with. I ended up finding a pillowcase with a zipper on the end that was helpful - it stayed in place better. I started physical therapy a week after the surgery and kept going through the whole recovery period for both feet. You literally have to learn how to walk all over again. The changes I see and feel now are completely amazing and I thank God every day that I found a great surgeon and that he specializes in ex fx. It is a great way to go. I also recommend before and after pictures. Have someone take a picture of you standing front, back and the side with your inner arch collapsed and you will be amazed at the final result. Also, I found with my second surgery because my first leg was still weak and I had an ex fx on the other I started using a walker for that surgery and I had much better balance and felt safer than when I had the crutches. As far as the final result and standing for long periods of time - I can stand and walk distances that people without foot problems can do. I just went to a baseball game - I walked 6 blocks to the stadium and stood the ENTIRE game in the bleachers and just had mild soreness. I am getting my body back in shape and plan to run a 5 K by the end of the year. I am also leaving my temporary desk job to go back to my career in a busy ICU. I haven't lost balance on uneven ground either like alot of people said I would. I know that not everyone has such a great outcome. My Dr from the beginning was optimistic about my prognosis and although I was fearful I was comfortable with his skill and judgement. I DID have a bumpy road but the ultimate result is priceless. Please keep us posted and if you have more questions before surgery or during recovery just ask !

 
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Old 09-13-2007, 04:22 PM   #6
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

snwtygr
I am SO glad that I can talk to someone about this surgery procedure. I kind of know what to expect but am still worried about the unknown. How big was the fixator you had? Did it just go around your foot and ankle or did it go up to your knee? I am having issues with how to get around. I have crutches but also purchased a Rollator walker. It has a seat and hand brakes. Would I be able to rest my knee on this as I walk or will the fixator be in the way? Also, I have invested in a shower chair and commode lift seat and rails. Did you have alot of pain? I will be in the hospital for 2 days. How long was it before you were able to start bearing weight? My Dr. said it could be as little as 4 weeks after or as long as 8 weeks after, depending on how well the bones start fusing together. What was your initial diagnosis? Mine is PTTD with severe pes planus and overpronation. My Dr. said that this type of surgery is the best way to go and that I won't be using my PT tendon at all after the surgery. I know I've asked alot of questions but am getting very nervous about the whole thing. I hope to hear from you soon. Thank you everyone else for your replies also and will let you know how I'm doing. Take Care

 
Old 09-13-2007, 07:19 PM   #7
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

Your surgery date is right around the corner. I wish you well.
You have received good advice here. I had a little nest set up before my ankle fusion with everything I would need to clean my pin sights. You do have to be very thorough about cleaning them. Don't worry about how those sights will heal after the fixator is removed. They actually end up being close to flush with the rest of your skin. I was afraid mine would end up like big holes in my leg and foot. Luckily they look like normal scars.
Good luck with your surgery. Think positive and have faith in your surgeon.
You may want to read something positive like a meditation or The Secret (book from Oprah's book club).
Keep us all posted.

 
Old 09-15-2007, 06:39 PM   #8
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

Hi
I had one half ring around my foot with 6 wires and 2 other rings around my tibia - each with 2 wires. The top ring was about half way up my calf. I got used to having it really fast. My surgery was at an outpatient center. It was 4 hours and I was able to go home 2 hours after it was over. I had a marcaine pain pump in my leg that lasted about 48 hours. My pain wasn't ever severe and I did just fine with vicodin for the 1st week. I was partial weight bearing after one week and that is when I started PT. Sometimes the most pain I had with the ex fx was when I was weight bearing and I would have pain at the pin sites and the skin would rub against the wire. The 1st couple weeks I had it elevated ALOT. Swelling would happen very quickly with my foot down and that would increase the pain. Remember to elevate and use ice. My original problem was severe pronation, calcaneal valgus, achilles contracture, severe flat feet. My feet were so flat my inner ankle bone was touching the ground and I could almost completely flip my foot over and walk on the "top" of my foot. My ankle wasn't there. I pretty much had calf then foot.
Good luck and keep us posted !

 
Old 09-16-2007, 07:16 AM   #9
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

[QUOTE=stepbystep89;3207711]Your surgery date is right around the corner. I wish you well.
You have received good advice here. I had a little nest set up before my ankle fusion with everything I would need to clean my pin sights. You do have to be very thorough about cleaning them. Don't worry about how those sights will heal after the fixator is removed. They actually end up being close to flush with the rest of your skin. I was afraid mine would end up like big holes in my leg and foot. Luckily they look like normal scars.
Good luck with your surgery. Think positive and have faith in your surgeon.
You may want to read something positive like a meditation or The Secret (book from Oprah's book club).
Keep us all posted.[/QUOTE]

 
Old 09-29-2007, 10:34 AM   #10
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Smile Re: Triple Arthrodesis and Achillies Lengthing Surgery

My surgery is over and I'm home. I stayed in the hospital for 4 days due to not getting my pain under control. At first I was given Extra strength Vicodin along with Valium and shots of demoral but didn't seem to help much so the Dr then had me switched to Morphine shots every 3 hrs which did the trick.I Had my surgery on the 17th so it's been almost 3 weeks and I'm doing great. I had my first post-op appt on the 24th and everything looks real good and the drains were removed. I go back again on Oct 2nd and will get my stitches out and have more xrays taken to see how well I'm healing. I'll have to keep the halo on for around 8 weeks and then move into a cam walker still non weight bearing though. I know I still have a long road ahead of me but am glad I had it done. He said my Post tib tendon was very stretched and would have been just a matter of time before I was completely walking on my ankle. I'm taking Vicodin Ex 2 pills every 6 hrs and 1valium before bed to help me sleep. I already fell once and landed on my bum but managed to keep my foot up in the air. (What a sight that was)Scared my poor husband to death but managed to get myself back up. Anyway just thought I'd let you know how I'm doing and will try to keep the updates coming.

 
Old 09-30-2007, 09:23 AM   #11
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

I'm glad things are going well for you in your recovery! I just returned from a cub/boy scout campout and one of my scouts had the same procedure just about a year ago. He wore the halo for almost two months, but this weekend it was apparent that it was a total success--he was running and climbing and hiking with speed I had not seen in him before. I'm not sure of the specifics of the situation which led to the surgery (I know part of it for him is anatomical as his younger brother will have it done this winter), but for him it has brought an obvious change in his quality of life and activity level--so important for kids!
Good luck with the rest of your recovery!

 
Old 10-01-2007, 07:26 PM   #12
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

I'm glad you are doing well.
I had the same experience with pain management when my external fixator was placed. I also had a tough time with my foot cramping in the middle of the night. There are some meds that help with that if the same thing happens to you.
Keep us posted on your recovery.
By the way - I am from Iowa too. I grew up north of the Quad Cities. I had my first surgeries on my ankle in Davenport.

 
Old 10-09-2007, 07:45 PM   #13
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Question Re: Triple Arthrodesis and Achillies Lengthing Surgery

i have my date set for 11-14-07 for surgery. i have a hard job(pipefitter) , and play alot of golf. my doctor claims i will be off work for 12 weeks. i have had second thoughts about this due to some of the messages i have read. iam very active and its going to be hard to be down like this. but iam going threw with it.iam not ready to slow down with life, got kids active in high school etc, go go go go. my goal is to back to work in feb, and golfing this spring.

 
Old 10-16-2007, 10:52 AM   #14
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

pipesngolf
I had this surgery on the 17th of Sept and am recovering nicely. I am currently seeing my Dr every other week. I had my stitches removed last week and he said everything looks real good. Recently I have had some increase in pain along the pin sites (mostly the ones on my shin) but other than that have been pretty much comfortable with any amount of pain.Have any of you that have had this surgery experienced this? I was doing great until I started showering without a bag over my foot (my Dr told me I could get it wet...Maybe I'm getting it too wet?)I clean all the pin sites about 3 to 4 times a day with peroxide and then put iodine on all of them. I am still taking Ex-strength Vicodin 1 every 4 hrs. ( the first week was taking 2 every 4 hrs.)Tylenol doesn't seem to cut out much pain yet. I still use ice religously Two ice packs every 4 to 6 hrs one under my foot and the other behind my knee.That also helps with any pain. Will you be having an external fixator as well? I am glad I had the surgery and hopefully will get rid of the pain I'd been having for months prior to surgery. My Dr told me I will not be able to return to work until March of 08. I may have to have the ex fx on until mid Nov or even Dec depending on how fast I can make new bone. I go back to the Dr next Wed. and will have X-Rays taken to see how I'm progressing. Hopefully will have good news. I'm still not able to bear any weight and probably won't be for awhile. I also will have to have another surgery to remove the ex-fx and then have a removable cast put on. Take Care and let us know how you are doing.

 
Old 10-16-2007, 07:17 PM   #15
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Re: Triple Arthrodesis and Achillies Lengthing Surgery

My recovery has been up and down from the time I had my ex fix placed to now, a little over a year later. I have been through periods where my pain level decreases, and I am able to increase my activity. Then, it seems like I have a setback either due to the weather or due to the activities I try.
If you notice your pain increase began when you started getting your foot wet in the shower, you should let your dr know. Even if you don't go see him, he or his nurse can let you know if it is related to getting it wet or not. Also, you should pay attention to what your body is telling you. Maybe you are trying to do too much too soon. If you have a fever, you might have an infection. It is good to keep a pain journal, so you will be able to tell a doctor the details if he needs them. I just write down my pain level in the morning, afternoon and evening. If the pain wakes me up or keeps me up I write that down too. It makes it easier to notice patterns, so you can alert your dr if needed.
Hopes this helps.

 
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