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Old 04-27-2008, 10:37 AM   #1
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Failed Talus OCD Drilling - Need OATS

I'm sorry to say that I just found out I need to join the OATS club and need your advice and expertise ... your help and advice got me through the drilling, and I just learned on Friday that I now need OATS...

I had drilling of an talus OCD (7mm x 9mm x 5mm deep) back in October 07 and since I'd say January, the pain when walking has gotten worse than it was before the drilling.

We took an MRI of my ankle and it did fill in with cartilage, but my OS said that the quality of the cartilage matters and that it must be soft and that is what is causing my pain as he doesn't see any other reason I should be in such pain. Just to make sure though, he gave me a shot of lidocaine in the joint and said if I didn't have any pain, then the pain was definitely the OCD ..needless to say I had the best 6 hours of the last year and walked like a human, went up stairs like a human and pain free for those 6 hours (but boy did I pay the price when it wore off - yikes!)

I need to go back to my OS to talk about details but what I do know so far is that I will need an osteotomy and he said a cast/NWB for 8 weeks and he will be taking the plug from my knee.

For those of you who had this, can you help me with the following questions:

1- how long were you kept in the hospital and how did they control pain? (for drilling they kept me overnight and gave me morphene shots in my hips every 4 hours .. don't want that again.

2 - for those of you who had drilling ... how does the pain compare to that?

3 - Did you go from a cast to a boot? and if so, how long for each?


I honestly don't know what questions to ask him as I was not only stunned from hearing this, but partially excited that my foot felt so good with the lidocaine in it.

If anyone has a list of questions they put together that would be great as I honestly don't know what I don't know.

Thanks you all for your help once again ... I was hoping not to join this club, but looks like I will be a member

 
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Old 04-28-2008, 03:15 AM   #2
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Re: Failed Talus OCD Drilling - Need OATS

Hi Kimberp

My son age 16 had failed OCD Drilling in April 2006 and had a 9mm allograft inserted in April 2007 via Osteotomy Diagonal through medial profound of Tibia with three screws)

Daniel had anesthesia put a very small catheter in behind his knee which blocked out the nerves in his ankle. Not sure what you do about pain in the donor knee site. Because of his age the OS wanted to use a donor cadaver bone instead of a autograft. Both are pretty common surgeries now and the cartilage is hyaline catilage so once its healed your good to go. He was 6 weeks NWB which if I remember was actually closer to 7 weeks. He started PT in June for about 4 months and stated ice skating again in October. When I look back I think the second surgery was a little more discomfort than the first but the recovery was lees painful over the months. The cut through the Tibia heals very quickly (6 weeks like a broken bone and its fine.

Best wishes for your surgery and a return to Full Activity.

 
Old 04-28-2008, 10:59 AM   #3
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Re: Failed Talus OCD Drilling - Need OATS

Hi Kimberp

I'm 14 weeks out from OATS, knee to ankle graft. I had 2 plugs, 10mm and 8 mm taken from my knee. I was in the hospital 2 days and never had morphine. They gave me shots of demerol and lots of oxycotin. I was such a zombie that I couldn't stay awake long enough to feel pain. But my pain was not too bad. They did put a drainage tube in my knee which was gross and probably the most uncomfortable thing I experienced. However, I had no bruising, small swelling because they did that. My foot had a nerve block before the surgery and it lasted a long time. I then had to ride in a car 2 days (9 hours) to get back home. I was still looped on drugs and so it wasn't too painful. Just keep up with the pain medication and don't try to be tough and you'll do good. I really have to say I didn't ever experience terrible pain, just hot burning.

My Dr.'s seem to be pretty extreme compared to others on this site. Maybe because my defect was so big, but I was NWB 12 weeks. I had a cast 6 weeks and then a boot for another 6 weeks. It was absolutely wonderful to get out of the cast and into the boot. So far my knee is good - it gets stiff in the morning and is tender to kneel on, but walking is fine, I don't notice it.

Let me know if I can help with any other questions!

Abby

 
Old 04-28-2008, 07:50 PM   #4
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Re: Failed Talus OCD Drilling - Need OATS

SkatersDad - I have to admit, I've read all the stories on how Daniel is doing and am glad to hear that he is back to his youthful active self. Thanks for the information on his experience .. the more I know the better I can ask questions.

Abby - Unfortunately for me, we found out at the time of my drilling that for some reason I cannot get the nerve block done. 5 doctors dug around in the back of my knee for what seemed like hours and last thing I remember was crying asking them to stop .. I ended up getting an epidural. (I ended up finding out the my nerve was too 'deep' for them to reach) so unfortunately the nerve block is out for me, which I assume means another epidural.

The drain in my knee does not sound pleasant but I am glad to hear that the pain isn't tremendously worse .. I am also a bit concerned about having a cast since when I had the splint after the drilling, I experienced some panic attacks as I felt a bit claustrophobic ... not sure how I am going to handle that .. perhaps ask for anxiety meds for 8 weeks?

I made an appt with my OS to learn the details on Friday and hope to plan the surgery for mid August.

I will keep everyone posted on this continuing 'saga' but am glad to hear Abby that you are doing well. I have been keeping up on your experiences and what I have read had certainly helped.

Thanks again SkatersDad and Abby and I will certainly keep reading (and maybe posting more questions after Friday!

Kim

 
Old 04-29-2008, 07:13 AM   #5
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Re: Failed Talus OCD Drilling - Need OATS

hey kimberb, sorry to hear that you need OATS.
I haven't had OATS myself but from what I've gathered on this board,

- some people stay in the hospital for a few days afterwards to recover
- people are generally NWB for 3 months (12 weeks)

I'm not sure about how bad the pain is but with the medication I think you can endure it. Goodluck.. let us know how it goes. we're here to support.

 
Old 04-29-2008, 01:20 PM   #6
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Re: Failed Talus OCD Drilling - Need OATS

Thanks Airjaw

I'm glad to hear you haven't had to join the club.

Kim

 
Old 04-29-2008, 01:57 PM   #7
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Re: Failed Talus OCD Drilling - Need OATS

Hey Kimberp,

You know , the only side-effect from my surgery is that my foot is very numb. Also the outside of my leg. This could be from the surgery itself or the nerve block, or the tourniquet they put around your leg during surgery. The surgeons themselves are kind of baffled because they said they didn't really cause injury to the nerves. But they are pretty hopeful it will all return to normal in the next year. As I think about it, I guess I wasn't really considering the risks of these blocks before surgery. Even though the risk is low, the trade off of a few hours of pain relief compared to possible nerve damage to me is not worth it. If I were to do surgery again, I would ask them not to block it. So in the end, I think it's probably good you're not having it done.

I don't suffer from claustrophobia, but I have to say, I definitely experienced some panic moments with my cast. Even the slighest swelling would be so uncomfortable that it drove me crazy. Pain medications really helped ease the tight sensation and big bags of ice on my cast. I know you're not suppose to put anything down your cast, but I had this blunt metal BBQ skewer I would scratch with. I would get it really cold and just set it in the foot of my cast and that was a big relief to the hot burning feeling. I don't think I'll tell my Dr.'s about that ......

Anyway, good luck on Friday!

Abby

 
Old 04-29-2008, 02:50 PM   #8
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Re: Failed Talus OCD Drilling - Need OATS

Abby,

I'm sorry to hear about the nerve issues you are having... do you think that is why you are having that 'hot burning' feeling? (I know they say burning is usually nerves.) And you said, in retrospect maybe I should be glad my nerve is too deep.

I have a few more questions (sorry, I am the type that needs to know every little detail

- how big is the incision(s) around your ankle?
-and your knee?
- when I leave the hospital, the cast is just up to my knee and my knee is just bandaged? Do I need to keep my knee straight for any length of time while the stitches are in. (if you tell me the cast will go above my knee, my panic will really kick in

- if the stitches are under the cast, what happens when the stitches need to come out? Do they cut the cast off and put on another one?

Sorry my anal retentive side is showing ... just not really into surprises and the more I know the more I'll be mentally ready for this.

Thanks for all your help and sharing your experience .. it really is helping!
Kim

 
Old 04-29-2008, 04:27 PM   #9
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Re: Failed Talus OCD Drilling - Need OATS

Hey Kim,

There's the burning/electricity that comes from nerves and then there's a hot burning that is just from healing after surgery. The hot burning went away at about 5 weeks. My nerve burning is definitely less than it was and so that gives me hope that it will resolve over time ...

Both my incisions are about 3 inches. The ankle one looks like it may almost be invisible/no scar. The knee one however is an ugly scar. I think the difference is that they wanted me to move, exercise my knee right away and I think that caused the scar to thicken/stretch out while it was healing. My ankle incision was in a cast - no air - no movement and so it healed really well.

Don't panic - it's a below knee cast with just an ace bandage around your knee. But you can't get your knee wet or shower it until it heals over because of the risk of deep infection.

You will get your cast off at 2 to 3 weeks to take out the stitches. They cleaned my leg with a cool alcohol wipe - very refreshing! Then you get a new cast! So you can choose a different color ... My leg only had 20 minutes to the air, but it was wonderful....

Happy to answer questions. It helps so much to know what to expect. Especially - this is a big surgery, not to take lightly.

Abby

Last edited by akirka; 04-29-2008 at 04:27 PM.

 
Old 04-29-2008, 07:34 PM   #10
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Re: Failed Talus OCD Drilling - Need OATS

Abby,

Thanks for your patience with me

I am happy to hear about the scars not being as big as I'd thought they'd be .. but have to admit, not looking forward to the burning.

It's interesting that you ended your message with the fact that it is a big surgery because that is the last thing my OS said to me, but for some reason I am equating a big surgery with a longer hospital stay so I am not sure I am taking this as seriously as I maybe should be (does that sound strange?) Or perhaps I am trying to minimize it in my mind so I really don't panic??

Admittedly having a cast is still bothering me and I will ask for anxiety meds, but my fear is that if they don't work it will be only me (I guarantee my husband will sleep through it) at 2am when I wake up in a sweat ... and search through my husbands power tools in an attempt to take it off myself. (the logical part of me knows not that it is a stupid and dangerous idea, but in the midst of a panic attack, not sure that logic will kick in)

Thanks again for all your help and support. I no longer feel like I am the only one going through this and someone actually understands this and how it completely consumes your life.

Thanks again
Kim

 
Old 04-29-2008, 07:43 PM   #11
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Re: Failed Talus OCD Drilling - Need OATS

Hey Abby,

I forgot to ask you in my last post ...

did your OS have any concern about your Achilles tendon? Since I was in a boot for 6 months before my drilling he had a concern that my achilles may have shrunk and mentioned tendon lengthening surgery as maybe the reason why my ROM didn't come back.

Now we know that it wasn't the case because the pain stopped my ankle before the achilles was stretched at all, but when I had the lidocaine injection on Friday, my ankle did move to the point where it felt like the achilles was limiting the ROM.

Was that ever an issue with you? I'd hate to go back for a third procedure!

Thanks,
Kim

 
Old 04-29-2008, 08:35 PM   #12
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Re: Failed Talus OCD Drilling - Need OATS

Hey Kim,

Thanks for asking Abby so many great questions! I too need to know all the details. I am having my OATS on May 19. I wish you the best of luck Friday and I will be anxious to hear how you are managing when you are able to type. I will also be looking for any and ALL advice.

Abby,
Glad to read you are doing well (aside from the nerve stuff). Take it easy in PT, don't push too hard and keep updating.

Margaret

 
Old 04-30-2008, 07:07 AM   #13
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Re: Failed Talus OCD Drilling - Need OATS

Margaret,

Sorry to hear that you are a 'club member' too.

I am glad my questions are helping you as well. Did you have a list of questions you asked your OS before planning your surgery? I have started to put together some for Friday but I know as soon as I leave, I'll think of 10 more.

Please let us know how your surgery goes and I wish you the best of luck. I know before my drilling I got a little anxious a few days before the surgery .. if you need to talk, we are here!

Thanks,
Kim

 
Old 04-30-2008, 11:55 AM   #14
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Re: Failed Talus OCD Drilling - Need OATS

Hi Kim and Margaret,

It is cool to be able to talk to people that understand! This is such a weird injury - it's hard to explain to others.

This is a big surgery because it involves 2 joint surgery sites. So you have double the issues for risk of infection, non-union, and just a long time in therapy and healing. If you think about it, most orthopedic surgeries are outpatient so a 2 day stay nowadays is a long time. And most surgeries today are arthroscopic so an open surgery in 2 places is pretty big. But it's not brain surgery so I don't want to overexaggerate!

There's a guy at my office who ruptured his achilles 5 weeks ago and had surgery. He just got out of his boot today and is walking around. So I'm starting to walk around and I had my surgery 9 weeks before his - so that's another reason why this is a big surgery.

My achilles has never been an issue but my foot was only totally immobilized 6 weeks. After the hard cast came off, they wanted me to stretch my foot up and down everyday and that kept my tendon from getting shorter. I won't lie, I stretch against the wall now and later my achilles is sore but I'm sure it will get back to normal soon.

I went to the gym the other day to exercise and it was a crackup! I wanted to ride the bike 10 minutes on level 0 but I was going so slow that the machine would turn off/pause and screw me up! It was all I could do to bike fast enough to keep it on and that was a grandma pace. Then I went to do leg lifts at the weight machine, the lowest weight setting being 10 lbs. I thought, no problem, but I couldn't come close to lifting 10 lbs! I thought I knew how weak I was but I didn't have a clue. So it's hard to even take PT slow and easy, but you've got to start somewhere I guess!

Talk to you later!

Abby

 
Old 04-30-2008, 04:24 PM   #15
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Re: Failed Talus OCD Drilling - Need OATS

Abby,

Thanks for the reality check, you make some good points. I guess part of the reason I didn't view it any differently than the drilling is that I was in the hospital for 2 days for that (to manage the pain since I couldn't have the block) so in my own way, I viewed them the same. Thanks for setting me straight!

I admit I had a chuckle to read your adventures at the gym as I can certainly understand. At PT after the drilling I attempted the bike and the same thing happened to me .. I just gave up and looked at the clock to gauge how long I was on for, and I could only handle 5 minutes at a time.

Are you in PT now? Should you be trying to lift 10 lbs? (sorry my mother hen is kicking in I'd just hate for you to overdo it .. but I understand as it is certainly something I would try too.

Kim

 
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