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Old 09-23-2007, 03:16 PM   #1
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Finally Got my Surgery Date - Talus OCD Drilling

Thank you to all those who have answered my many questions over the past few months. It certainly helped me in keeping my sanity through my first OS who strung me along for months by doing nothing which finally led me to going with my 'second opinion' doctor. I finally got my surgery date .. October 3rd. Since not being able to move my ankle and being in a boot since April 07, there is finally a light at the end of the tunnel .. now I am just petrified.

I have never had surgery before and I am scared of the unknown PLUS I am a big needle chicken. I guess the 60% chance of this debridement/drilling working isn't helping either (apparently my chances would be better if the area weren't so large), but beats the alternative if this doesn't work - cartilage out of my knee and attaching it to my talus plus having to break to my leg to get to it.

Are there any pre-surgery tips anyone can give me? I have to be NWB for 4-6 weeks and while I envision myself crawling around my split level house, not sure what to prepare for over the next 10 days. I do have some questions ...

1 - when I am allowed to take a shower, how do I do that? Take the crutches to the edge of the stall shower and stand on my good foot? (I did look at a shower bench and they are so low)

2 - how did you get in and out of your house? I have 4 big steps going up to my house in the front and 3 out of the back .. I supposed going down steps on crutches is easier so I suspect I'll come and go out of the back but I am so fearful out of habit that I am going to put my foot down.

3 - any other pre-surgical tips? (like getting through the night before??)

4 - how much pain can I expect after the block wears off? I'd like not to take the pain meds but not sure what to expect.


Lastly, after spending much time on here I haven't seen many success stories on drilling, many seem to have to go to the second surgery .. can I assume that those who were successful just don't come back .. and only those who weren't do?

Any advice you can lend would be great. I am waiting for my call this week for presurgical testing (apparently done within 7 days of surgery) and then need to be cleared by my primary care physician ... not sure why that is, he really only sees me for an occasional sore throat.

Thanks again for all your advice.
Kim

I have had way to much time to think about all this and another 10 days is going to drive me crazy

 
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Old 09-23-2007, 05:05 PM   #2
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Hi Kim,
It is nerve-wracking to have 10 days to think about things! I had 2 wks notice and threw myself into preparing to avoid thinking too much about what was to come. I did not have the same surgery you're having (had posterior tibial tendon repair and an osteotomy on foot/ankle) so can't answer any questions related to that, but can share some things that helped me.

Showering: There are tons of different kinds of shower chairs and benches available, whether at the pharmacy or at a medical equipment store. I found one I liked on Amazon and it came the week before my surgery. It was adjustable in the height, so you just need to find one like that. You'll definitely want one! A hand-held shower attachment is another must have. If you have a cast or splint, you'll want to get a cast cover...I got one from my doctors office, but they are available online. You can use garbage bags too, but they are a bit more putsy and can leak. Having a suctioned shower basket is good too, to keep everything within reach.

Ambulating: You won't put your bad foot down...if you do once or twice, you'll learn fast that it hurts and you'll avoid it! If you're not staying overnight in the hospital, before you go in for surgery, a physical therapist will meet with you to teach you how to use the crutches. If you stay inpatient, they'll do it the next day. I used a Turning Leg Caddy knee scooter that was a godsend! Much easier than crutches. You might look into that if you're going to be NWB for any length of time afterwards (medical equipment stores rent them and some insurance pays for them; mine paid 80&#37. I live in a building where there are 7 stairs inside and 2 outside and learned how to sit on my butt and haul the scooter up and down (or bump it down one step at a time). I also used crutches on stairs. It's a pain in the butt, figuratively and literally, but you find a way!

I made sure to stock up on some easy to prepare foods, like frozen meals and snacky stuff. I also bought heavy/bulky things ahead of time, like dog food, bottled water, soda, toilet paper, etc. I did a throrough cleaning of my house, knowing that I wouldn't be able to do as good of a job afterward. If you have a laptop computer, that is a good thing to keep nearby.

Pain meds: you may not like taking them and may not need them for long, but in the beginning, take them ahead of the pain. If you wait until you are in a lot of pain, it takes longer to stop it. Taking them regularly will keep you feeling better. Even though I had a thick cast/splint, I used ice packs and elevated all the time. I've heard that it's helpful to put the ice pack behind your knee...somehow it works for the ankle/foot!

I hate needles in the form of IVs too! I asked that they numb me before placing the IV and they did. Just burned for a minute, then I didn't feel the rest of it. I also turned away when they did it. Just let them know your feelings about needles ahead of time and they will be sensitive to that. Lots of people have the same feelings!

Sleeping the night before was really hard, and I had to be up at 5am to be at the hosptial by 6:30, so the night was short. Remember that this is a big step toward improving your life and try to think positively. There's more of a chance that this is going to work than not.

Lastly...let your family and friends help you during all of this! It's so hard to be dependent on others, but after surgery, the body just doesn't have the energy, stamina, tolerance or ability to do everything. Once you're back on your feet, the help isn't there, so enjoy it while you have it!

This got a bit long. HOpe some of it is helpful to you as you prepare. I'm sure others will have thoughts and suggestions as well.
Take care,
Krista

Last edited by sunny77; 09-23-2007 at 05:05 PM.

 
Old 09-24-2007, 06:40 PM   #3
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Re: Finally Got my Surgery Date - Talus OCD Drilling

I had microfracture/debridement on June 14th, and was able to shower and go out for dinner on June 16th. My husband had installed a hand-held shower extension, which helped a lot. I wrapped my leg with an ace bandage, then wrapped it in a towel, and then secured a plastic garbage bag with athletic tape. My leg stayed perfectly dry. I crutched up to the shower door, stepped in and sat on a towel on a plastic step stool, leaving my crutches outside the shower. (My husband actually got in the shower with me for my first try, since I was still a bit unstable.) It was awkward, but I got quite competent at it!

As for stairs, I slept on the sofa for the first 2 nights. My doctor had prescribed a Game Ready ice machine (ABSOLUTE life saver!), and it was all set up downstairs, so I just stayed down there. No need to risk a full flight of wooden steps if not necessary. But, by the 3rd day, I was fine going up and down the stairs. (Start your upper body weight lifting now!! Crutches are a definite upper body workout. My triceps have never been so strong!)

As for the night before, I can't really provide much. I went out for dinner with my family, had a pedicure, and went to bed. Didn't sleep much, but can't really say I was overly nervous. I actually didn't get REALLY nervous until they wheeled me down the looooong hallway to the OR. The anasthesiologist gave me something to settle down, because he noticed my heart rate went WAY up when I got to the OR. Then he added the general anasthesia, and it felt as if I woke up 2 seconds later, and the surgery was over! (Ask for a butterfly IV. That way, when they need to add/change meds and solutions, they just use the existing installment, and don't have to poke you again.)

After the surgery, they let me wake up in the recovery room, and my husband joined me. As soon as I could choke down a cracker and some water, they showed me how to use the crutches and sent me home. I slept for most of the 2 hour drive home (with my foot propped up on the dashboard). I hobbled on the crutches up the front steps and crashed onto the sofa for the rest of the night, skipping my pain meds, but packing my foot into the Game Ready. I was fine until 2 am, when the surgical pain meds wore off and the ice in the Game Ready had melted. I popped one of the pills prescribed by my dr. and the pain eventually subsided. That was the only bad pain I had thru the whole ordeal. After that, I only needed 1 or 2 more prescription pain pills before Tylenol was enough.

I had surgery on a Thursday and was back at work the following Tuesday (I would have gone on Monday, but had to go back to see my dr.)

I'm now a bit over 3 months post-op and am able to walk up to 8 miles with a little light jogging interspersed. The jury is still out about how it'll hold up in the long run (literally -- I'm an ultramarathon runner) but it's better than it was, so I have my fingers crossed.

Good luck to you! I hope it all goes well. Just keep in mind, there are people facing MUCH worse than what we're dealing with.

Last edited by Calrunner; 09-24-2007 at 06:40 PM.

 
Old 09-29-2007, 11:21 AM   #4
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Good luck on your Drilling Surgery this coming week. Stay positive for sure. I just hit the one year mark of that "other" surgery you spoke of only I used Cadaver Bone and Cartliage. Any surgery is stressfull but if you tell them in advance they will make consessions for you. Prior to surgery when they were doing the nerve block,they realized that I was stressed, my heart was beating so fast and they were able to give me something to calm me down, they also agreed to not add additional IV lines until I was knocked out...that was huge cause I woke up with two more than I started with. I thought I was the only chicken out there!
The day before surgery I took the day off work and I got books, simple frozen foods, soda in cans, a cast cover (invest in one they are great) and we changed the shower head to a hand held one. That really helped as I was able to crawl into the tub fill it with water and just allow the heat to penetrate the rubber cast cover, thru the fiberglass cast and it would mellow the otherwise pounding ankle. Its a tough recovery no doubt but you can do it. Don't push people away who want to help, take your time in doing things and be patient, you'll have good days and bad days. I wish you the best.... Do let us know how you make out.
Carol

 
Old 09-29-2007, 03:19 PM   #5
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Kim,
This is my first reply post, although I wished I discovered this forum before my first surgery! To be brief, I had OCD drilling, debridement of my ankle talus in January 2007, when Dr K at HSS saw the size (the MRI is not 100% reliable), he felt it was borderline to do a debridement instead of an OATS. He felt I had a good chance of success, so he continued with the debridement. Unfortunately, it didn't work. I just didn't make enough of new cartilage to repair the hole. So, I'm now 5 days post-op from the OATS procedure. Some hints that maybe other people didn't cover:
1. Get all your pain prescriptions from your doctor in advance, and have them filled out and with whoever you are going home with. Not sure where you're having surgery, but i had a 3 hour car ride, and wanted meds on the way.
2. Get a roll-about or other similar device -- it will help you stay non-weight bearing and won't hurt your arms. Unfortunately, I can't use one after the OATS due to the incision in my knee. I miss is very much.
3. If you are afraid of being sleepless, having anxiety...talk to the surgeon now and get permission to take a sleeping aid or an anti-anxiety pill. Have him prescribe it. My mother insisted upon this. She said in this day and age there is no excuse for being anxious. Thanks to her, I had a peaceful night before.
4. A bath chair from a medical supply place is a must.
5. If you are lucky enough to have live-in help, like a friend or relative, be grateful and take all the help you can for the first few days at least.
6. I don't know how anybody attempts steps on crutches. Just sit on your butt and go up backwards, with someone holding your ankle up, or crawl on your knees. You'll need a secure area at the top to hang onto.
7. Bring plenty of pillows (2 or 3 for your ankle) and 2 for your head for the carride home.
If I think of anything else, I'll let you know.
Carla

 
Old 10-01-2007, 06:50 PM   #6
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Thank you everyone for your thoughts, wishes and ideas. My surgery is Wednesday and I will hear tomorrow (Tues) between 4pm and 6pm what time to be there. Pre-surgical testing took some of the 'edge' off ... everyone was very nice and supportive and they explained everything ... not sure if that should have made me feel better, but somehow it did.

The only thing that did bother me was that I learned that I am getting an epidural .. I didn't know about that as I was told I would just be getting a block from the knee down, but apparently not. That and the twilight I will be in they said I won't feel or know anything.

So far I did get the shower bench, handheld shower head, raised toilet set, rolling leg caddy and we even rented a wheelchair - I figure when I am about ready to loose my mind, my husband can at least push me around the block to get some air. I think I have everything that you have all suggested and I am sure some more things might be needed, but I'll get those when I figure out what they are.

My fear still exists though that I will inevitably need the OATS procedure but I am keeping my fingers crossed that the 60 percent shot will work. My thoughts are that if I had a 60 percent chance of winning a million dollars, that's pretty good!

I'll be back after it's all done to report back .. thanks again for all your help!
Kim

 
Old 10-05-2007, 12:44 PM   #7
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Hi...
Hope your surgery went well...
I just had microfracture 3 weeks ago (OCD talus)...
I found this thing called IWalkFree hands free crutches. I was walking around on it day 2. You might want to see if you can get one. Easy to find online but it was a pain to get bluecross/blue shield to cover it. It makes it easy to stay off your foot.
I had very very little pain, took 1 naproxin the day after and that was about it.
The hardest part is being idle for the first 2 weeks... too bad tv is not a bit more interesting... lots of law and order for me...
Tim

 
Old 10-12-2007, 04:07 PM   #8
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Tim,

Thanks for the tip, I'll have to look for it!

10 days post op and just got my stitches out today but agree with you about tv ... another 5 weeks out of work for me and I figure by that time by brain will be mush. (good for you though as Law and Order seems to be on at least 6 times per day!)

How is your recovery going? Are you PWB yet?

Kim

 
Old 10-15-2007, 01:03 PM   #9
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Hi Kim...
Feels pretty good...
At 4 weeks I felt great and started weight bearing. After walking around for a week I got a bit sore so I'm using one crutch/both crutches/iwalkfree again. I read a paper which summarized the recommendations for weight bearing and some doctors say right away, some say 1 week some say 2, some 3, some 4, some 5 or 6. My doc said 6 nwb but I got so tired of not getting around that I just started walking after reading that 4 weeks out may be fine.
Once it got a bit sore I laid off... I counting on my body to tell me what is the right thing to do. Could be a mistake. I have my 6 week checkup next week so I guess we will find out then.
Tim`

 
Old 10-16-2007, 08:25 AM   #10
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Tim,

Glad to hear its going well for you. My OS also said 6 weeks as he took my stitches out but I need to call him in 2 weeks to tell him how it's going and I see him again in 4 weeks.

I wanted to start PT this week but since he took the stitches out, 2 of the incision sites are still bleeding a bit so my PT said we are going to wait until next week until things settle down before we start. In the meantime, I can wiggle my toes really well but the up and down in difficult and I can barely move it at all.

Is it normal for the incision sites to leak after the stitches are out? I was going to call my OS but didn't want to bother him .. it is getting to be less and less each day, so I think I will just wait until nex week to start PT.

I think I need to look for the Iwalkfree ... these crutches are killing me

Kim

 
Old 10-16-2007, 12:47 PM   #11
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Hi Guys,

So you had the OCD drilling procedure or the OATS procedure? Was this your 2nd drilling or first? Did Dr. Kennedy from HSS do the surgery?

I am about to under go my second drilling (maybe OATS) depending when they get in there. The first time I had the drilling I got much worse. It is at the point where I can not walk very well at all anymore and am in pain everyday.

Any additional advise would be appreciated. Hope you are having a smooth recovery.

David

 
Old 10-16-2007, 02:21 PM   #12
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Re: Finally Got my Surgery Date - Talus OCD Drilling

David,

This was my first drilling and my OS gave me a 70% chance of this working ... I'd like to avoid the OATS procedure if at all possible.

Good luck, I know how stressful this time must be for you as I just went through it prior to my surgery on Oct 3rd.

How is is that they don't know which procedure they are going to do, the drilling or the OATS? How big was your OCD when you had your first drilling and when was it? How much did it fill in?

Thanks,
Kim

 
Old 10-17-2007, 03:31 AM   #13
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Hi David and Kim,
This was my first surgery. I did it in Boston with dr. Slovenki at Boston Sports and Shoulder. He is supposed to be "the man"... He does a lot of this stuff.
Also, as Kim said, avoiding OATS unless the micrfracture doesn't work.

Kim...trying to get you the info on the hands-free crutches... see below, Mine is all covered with paint as I am rehabing a old house. It sure comes in handy in a construction zone ! .... The only bad news is that it is no picnic either: it's kind of heavy, but overall, alternating with the crutches, it has saved my armpits, saved my wrist (which is hurt from the rheumatoid) and saved atleast a bit of my sanity... (although i almost totally lost my sanity getting Blue Cross to agree to pay for it even with a perscription for it from my OS.
Later
Tim
ps Kim... I had put a link where you could find the hands-free-crutches but the moderator took it down... you will have to do a web search for it....

Last edited by timbo_heff; 10-17-2007 at 06:59 AM. Reason: posted commercial website

 
Old 10-17-2007, 06:28 AM   #14
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Hi Tim and Kim,

I am a rare case where I have been told the drilling worked, but during the drilling I think my OS burned my talus bone creating a larger new OCD in the front part of my foot. Now I am in much more pain then ever before. So I have been told by some drs they can go in a try to redrill the new portion if they can otherwise it is the OATS procedure.

I agree with you that insurance and these costs are insane. A year later and I am still getting hit with bills.

A question I have for everyone was how bad was your ankle before the surgery. I pretty much live on Celebrex and Alive everyday to help me walk.

Please tell me your symptoms as I wonder how bad everyone else was before the surgery. I wish I never did the first one, but can't look back now.

Would love all the information I can get. Anyone else out there use a OS in NYC?

Thanks,
David

 
Old 10-17-2007, 06:58 AM   #15
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Re: Finally Got my Surgery Date - Talus OCD Drilling

Hi David..
I had tons of pain before... felt like my foot was in a vise with occasional ice picks being stabbed in there...since the surgery I took 1 naxoproxin the day after and that was about it. If I hadn't pushed it at week 4, and walked on it that would have been it for pain. After walking on it, the pain was still only mild but enough to tell me to get back on the crutches.
Sounds like I was pretty lucky pain-wise...
Tim

 
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