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Old 03-15-2010, 03:42 PM   #46
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Oops, one other thing--your leg is straight, your toes are bent, you're lifting the bag--but[I] not with your leg[/I].

You're lifting the bag by bending your ankle. Your leg stays put.

Sorry for any confusion.

Lisa

 
Old 03-15-2010, 05:24 PM   #47
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

If your walking 4 miles.. does your foot hurt AT ALL? I mean, is it like back to feeling normal? I don't have torn tendons. My foot tendon is frayed-stretched- plus since my arches gave out my foot is collapsing and ankle going inward. I am "chicken" to do this..I have been contemplating it now for a good while in hopes it won't be as bad as they say; and really, I am waiting and hoping for another "simple" surgery-instead of this one (but doesn't seem to be any other kind..). The last surgeon came recommended and I feel he will be fine, I just have to do it- then deal with the work issue on how I am to do it all, there and here at home, with not much help. I was out last year 5 weeks for another surgery and hate to be out again-but I will have to do it eventually and I don't want to wait too much longer. I am able to walk all day on it, but it hurts-but I can get by. Some days it swells and other days, it does pretty well actually. Sometimes it wakes me up at nights hurting and other times it is fine. I just feel that I am not "that" bad to do such a long horrible surgery-altho it is not what the drs. tell me. I mean, I AM able to do stuff, don't get me wrong-but I can't go walking 4 miles..I have to get up and down a whole lot in my job daily and I am able to do it without much pain some days, and others-even though it hurts, I just keep going. I wish there was an easy way instead of the surgery. I tried wraps, the supports, the braces on both feet for a year - the ones that go up to your ankle..-o that was fun..-and just continue to wear my special orthodicts in my shoes. Now since my foot is flattening out, my dr. said I will need to get another 1/2 half size in shoe and make sure the toe area is rounded and large. On top of this I have the bunion beneath the big toe which hurts me and a smaller bunion on the side of the bone for my little toe. I am hoping when I do this-that he will just do it all. I am afraid of the hard cast..as long ago a podiatrist put me in one and I think that it is what stretched my tendon like this-my foot swelled so bad that I went to the ER and demanded they just cut the thing off. I never went back to him. I think it would be easier if I were retired and didn't have to work and all with my foot mending- but in another 8 months, I will have almost a month vacation at work- and that would surely help...I can do it-providing I can be in a boot- and not the hard cast. I think they tell you to keep the foot up for 6 weeks? I've got to motivate myself to do this... Thanks for your input.

 
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Old 03-16-2010, 01:05 AM   #48
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Hi LisaBdot,

I am 4 months post weils osteotomy. I actually asked about a cane today as I feel that I need one to take the weight off my left hip a bit more. After favoring my right foot post surgery, my hip is very painful and I am having my tendons cut next week to try to flatten the toes.

I am very unhappy with the whole thing, but only time will tell I guess.

All the best to you,

Panda06

[QUOTE=LisaBdot;3682022]Hey all you lovely, smart people!

I'm two months post op, doing so much better than I thought possible at this point. Getting around reasonably well at 50% or so PWB in a boot with a walker most of the time. Some of the time I still use the Roll-a-bout (I can't carry much when I'm using the walker--a lunch plate in the totebag is so messy). I almost never use anything for pain anymore, and while I'm still swollen all of the time, iceing daily isn't an imperative (did get some Jobst hose, though). Pretty much everything I was concerned about at my last post is not overwhelming, and I'm grateful.

My PT's wife had the same surgery by the same doc one week before me. At my last PT appointment, she came sashaying in, WALKING!--NO CRUTCHES! I am elated to think that may soon be me. My PT says it will likely depend upon how the osteotomy looks in an X-ray, and that the PWB will actually have helped the bone to heal more quickly (more weight-bearing exercise, more bone growth). Too late to not get my hopes up, but I see my surgeon again Monday...

It occurred to me today that, at this point, I might actually do as well or better with a cane than the walker. Then I'd have at least one free hand. Might be moot by Monday, but right this minute, I'm sort of chafing at the bit. I crave that little bit of extra freedom. Did any of you use a cane at some point?[/QUOTE]

 
Old 03-16-2010, 03:57 PM   #49
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Lisa, thanks so much for the post about the implants. I have heard of them but haven't really done much research. I sure hope ortho's start doing them as that sounds like a better solution. Since my so called good foot has been hissing at me lately I'm going to do some research myself. Your post was very helpful.

thanks!

p.s. Re: returning to work: in my case I keep the books for our business and can do it from home so my "returning to work" was a LOT less stressful than most. Just rolled into my office and put my big ole foot on top of the desk. It looked quite interesting to anyone walking in but since it was only my husband and Boston Terrier it was all good.

 
Old 03-21-2010, 09:53 AM   #50
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

I've got some catching up to do! Here goes:

Sally, the reason I asked how old your daughter was is because I recently came across one line in a long article about subtalar implants. It suggested that, in some cases, putting the implant in a child's foot (and then removing it when a young adult) might allow the foot to finish growing properly, without a flat foot and all the junk that goes along with it. I took notice because flat feet run in our family.

Kitty, yes my foot still hurts. No, it doesn't feel normal. Don't be discouraged by that, though. Personally, I needed the whole unvarnished truth--good and bad--when I was making my decisions, so I can't give you any less. My foot will never be perfect, but it is so much better than it was. I wish I hadn't waited so long to have the surgery.

On pain: What's weird is that my foot hurts in different ways on any given day. Mostly unpredictable, too. I do know when the weather's about to change though. That pain in some way reminds me of a tuning fork (I don't know any other way to describe it). I thought my titanium screws were hurting, but my PT, on palpating the site, said it was swelling pressing on the bursa. That was actually a relief--I didn't really want to sign up for any more cutting--those screws can stay right where they are as long as they aren't causing any trouble. Right after the surgery, and for really a long time, I'd get what felt like electric shocks zipping up my incisions. I've been told that's from nerves trying to connect, finding new pathways, and healing. Sometimes that still happens, even at almost 2 years out. But I do still have just general aching in my ankle a lot of the time. The improvement--and it is HUGE--is that before the surgery, walking even a half mile made me think I might just have to finish on my hands and knees. Now I can just walk as far as I need or want, as long as I'm wearing good motion control shoes. My surgeon wants me to wear my orthotics, but I found some shoes I like that seem to work better without them.

I mentioned earlier that my 76 year old mom is having an osteotomy and tendon transfer this month. I did an awful lot of research trying to find some other solution for her. My surgery took 4 hours. I think that's probably not a great idea for a 76 year old. Her stated goal is to not have pain and be able to wear pretty shoes again. I still have pain and I'm still not wearing pretty shoes (but maybe just because I'm too chicken to try).

My surgeon (an orthopod with a fellowship in foot and ankle) told me that I didn't[I] have [/I]to have the repairs--people who are much less active than I get by with going in and out of the boot and wearing various orthotics. If you did nothing, though, eventually you might have to end up with having the ankle fused. But no one has put my mother in a boot or even made her a nice hefty hinged ankle/foot orthotic (it stays in your shoe and you slip your foot in from behind, then wrap the velcro strap around your calf to hold the shin-guard-looking part in place) which keeps your foot properly aligned. I wore one for quite a while. It's not terribly uncomfortable, it really helped prevent pain, and you couldn't see it as long as I wore pants. I'm frustrated that no one has offered these options to my mother.

I did a lot of reading about subtalar implants. I'd wanted that to be an option because the recovery is much easier, but I don't think she's a good candidate--among other things, your flat-foot must be flexible (meaning that there is some visible arch when you are not standing on it). Mom's feet are flat as flounders in any position you put them. I've read that the implant is not a good fix unless you have the tendon transfer as well (like getting new tires without aligning the car--the tires are not going to last long). But again, I saw one line in an article that mentioned what [I]sounded[/I] like a much less invasive tendon fix. Apparently, some surgeons are "taking in" the loose posterior tendon in much the same fashion you'd take in a stretched out waist band. Since Mom's tendon has most likely come completely untethered (suggested by the fact that her pain level has actually gotten much less just lately), repairing it in that way is probably not an option.

But I gotta tell ya--a subtalar implant does sound intriguing. I'd like to consider it if I need to have the other foot fixed at some point. Some people who've had incomplete correction after the osteotomy and tendon transfer (I do still pronate) will finish-up and fine-tune with an implant. One problem lies in that podiatrists are the ones doing them. Orthopods don't believe in them. Personally, I'm uncomfortable with the idea of anyone but an orthopedic surgeon with a fellowship in foot and ankle cutting on my feet.

A little more on subtalar implants--

There are at least two kinds. One (Conical, Kalix, MBA, STA-Peg, STJ, Valenti are some of this type) has been called a "doorstop" to keep your foot from pronating. In the past, it has been done without fixing the posterior tendon problems, and so has been called a temporary fix. Adults seem to find them uncomfortable, and because of that, many people have had them removed.

The newer type (HyProCure is one) has a different mechanism, is put in a different spot in the foot, and some say it seems to be well-tolerated by both children and adults (including runners). Tendons are also now being repaired in this surgery by some surgeons.

It has been suggested that one find a surgeon who has a track-record with [I]both[/I] kinds of implants if you wish to consider a subtalar implant. Orthopedic surgeons usually don't do implants. Podiatrists are doing most, if not all, of them.

Some interesting articles--

Assessing The Pros And Cons Of Subtalar Implants
Podiatry Today
VOLUME: 19 PUBLICATION DATE: May 01 2006
Issue Number: 5
Author(s): By Donald Green, DPM, Mitzi Williams, DPM, and Chul Kim, PMS IV

Keys To Preventing Complications With Subtalar Joint Implants
Podiatry Today, VOLUME: 23 PUBLICATION DATE: Jan 01 2010
Issue Number: 1 January 2010
Author(s): Patrick A. DeHeer, DPM, FACFAS, and Eugenia Malenkos, DPM

Panda, I've noticed (and my PT agrees it's so) that when one part of my body gets out of whack, many other parts are going to be affected. I think it's interesting that my failed foot is the same one that had a bone spur on the big toe. I think favoring that foot may have had something to do with the posterior tibial tendon shredding, which then threw my gait off even more, which made my hip hurt, which caused back spasms, blah blah blah. Think dominoes (the little rectangles, not the big circle with cheese).

Kitty, Your arches gave out and your foot is collapsing and your ankle is going inward [I]because[/I] the tendon is stretched. The tendon is what is supposed to hold the arch. You can baby the foot until the tendon heals, but it's going to be stretched out forever unless repaired. Because your foot is pronating, it's really easy to keep reinjuring the tendon.

Make it VERY clear to your surgeon that you want all repairs done at the same time. I had a bone spur that was supposed to be repaired during my foot surgery and wasn't. I had to do it later. He said he forgot. He said I "threw that in at the last minute." Hmmph (not so). I had no choice but to have it fixed because it was throwing my gait off. Doing it later significantly lengthened my recovery time. I was not happy about that.

Discuss your fear of a hard cast with your surgeon. I don't know what all surgeons do, but mine just put on a "splint," which is kind of like a cast that's only on the bottom of the leg and foot. Oh golly, I can't believe I can't remember exactly how it was applied! But in any case, it wasn't completely enclosed. My understanding is that they do that because they expect swelling.

Again, discuss with your surgeon the possibility of delaying for 8 months until you have a month of vacation. Maybe you [I]can[/I] get by until then. One month of vacation will certainly go a long way in your recovery. I do know that many people (Emmie was one of them) went back to work very soon and managed just fine. But, if you've just had-it-up-to-there and are [I]READY[/I], then go for it right now.

I started a thread on this board to collect, in one place, everybody's best [I]Tactics for coping while non-weight-bearing after foot surgery[/I]. Maybe some of the suggestions there will help you think through the logistics of getting back to work soon, and coping in general, even with very little help.

In spite of some lingering pain and swelling, I AM glad that I did it. If I had to do it again, I wouldn't drag my heels (no pun intended) as I did last time. It is all doable. You are stronger than you think you are. It just takes planning, and you can do that.

All the very best,
Lisa

 
Old 03-21-2010, 09:58 AM   #51
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Oops, one more thing.

I keep forgetting to pass this little nugget along. For those of us with PTTD, it would be a very good idea to never, ever, EVER squat and then stand up. Puts [I]enormous[/I] stress on the posterior tibial tendons. That from my orthopod.

hugs,
Lisa

 
Old 03-22-2010, 12:53 PM   #52
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Hi LisabDot,

I didn't know that squatting hurt the PT tendon. I've been the "squat queen" at the gym for the past couple of years. I struggled with lunges because my foot pronated so much. I thought squats were better, because I could plant my feet and just push through my heel.

I thought I was [U]so[/U] smart about exercising, but maybe those squats were the last straw for my flat foot. Up till last year, I had been able to avoid extreme pain (and surgery) by wearing my orthodics 24/7.

I appreciate you mentioning what you learned from your ortho. Going back to the gym is something I am anxious to do, but now [U]I'll leave the squats out.[/U]

Does anyone know any other exercises that can do damage to what we've just had repaired?

Happy Healing to Everyone.
Carol

 
Old 03-22-2010, 10:43 PM   #53
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Hello Everyone,

I am new to the blog. I am hoping you can provide some direction regarding the calcaneal osteotomy for youth and surgeons in the Houston area.
When my son was 6 yo I took him to DPM which diagnosed him with severe case of flat feet and he recommended surgery. That dr wanted to insert a bone graft (the bone that is to point down into your foot is pushing into the side of his foot) and lengthen his achilles tendon. I felt he was too young for surgery so I opted for the orthodics. Whenever I turned around, he would remove the orthodics because he was in pain. Well, time has past so quickly and needless to say the appearance of his feet has only gotten worse and appears the pain has also.
My son is almost 12 yo that has been diagnosed with (severe case) of flat feet. Both ankles are turned inwards and my son's feet point outwards. He does not complain often, but I can tell it hurts because he will lean over trying to compensate for the pain. I believe he does not want to tell me he is in pain because he is aware I am looking into alternative methods of treatment..."SURGERY".
We have visited another DPM in Houston which suggested conservative treatment with orthodics and we have also visited an pediatric orthopedic surgeon. The surgeon suggested we do not do surgery if there is intermediate pain and not chronic pain. The problem is, I can tell my son is in constant pain...he does not like to play baseball or walk long distances.

Do any of you have anything to add that may help? Also, can you recommend any doctors weralso consult with regarding this problem?

Thank you in advance.

 
Old 03-23-2010, 05:29 PM   #54
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Carol, are you seeing a PT right now? Have your PT watch you do your squats. I was talking particularly about squatting down to pick something up off the floor and then standing right back up again. Maybe exercise squats are different. Or maybe if you're not going all the way down it won't be a problem? Have you felt significant pain when doing them or right afterwards? I know for a fact that some of the damage to my tendons (shredded in four places) happened just that way. I thought that I had hurt my ankle again when I fell over, but actually, I fell over because I damaged my tendon again. My doc's lips went white. I do wish he had thought to mention this before I did it...

all the best,
Lisa

 
Old 03-24-2010, 07:29 AM   #55
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Hi LisaBdot,

Thank you for responding to my post. Don't you just love this message board? It's like having a bunch of terrific friends who are traveling the same path as we are.

I am going back to my surgeon tomorrow, and hope to get his OK to start PT.
I'm at 10 weeks post-op and had the All-American procedure: osteotomy, PTT transfer (stage 2 PTTD), fusion, achilles lengthening, and bone wedge.

I really blasted my foot for most of my 53 years.... PE teacher, aerobics instructor, long distance runner, waitressing, and now as an elementary fourth grade teacher. I was born with my flat foot and custom orthodics kept me functioning and mostly pain-free till a year ago. My flat foot, ankle, and lower calf just slowly began to ache and kept getting worse. Then, I started limping, and finally, went to a series of doctors and tried 2 braces before agreeing to the surgery.

My doctor told me there was an 85% success rate for this procedure to leave my foot [U]better[/U] than before. YAHOO!!!

I wish you all a full recovery and a speedy return to all your activites!

Carol

 
Old 03-25-2010, 08:56 AM   #56
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Carol Your post was what I needed today. I waffle about the need for surgery. The dr wants to do it before it get to worse. this gives me a little wiggle room and I am squirming all over it about do this surgery. I am having a subtalar fusion and PTT debridement. It sounds very minor next to what you had done but I know that's not the point. I'm just worried about what I'm getting myself into. See now I've talked myself back into a state of uncertainty. I will forge ahead anyway.
Sally

 
Old 03-26-2010, 10:44 AM   #57
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Dear Anxious Mom,
I wish I had the surgery back when I was a teen. I always had a hard to time standing. I remember when I was in elementary school I was always leaning against something... the wall, a chair, whatever. I always had a low level pain but honestly I didn't know that there was a problem. That sounds weird but when you grow up with it you don't know any other way. I just thought that everyone had a little pain in their legs. it got much worse after puberty when I started to grow and get heavier. Then I did complain because my feet had sharp pains by then. I spent years in PT, in immobilizing casts with crutches, custom orthotics, braces... my doctors never recommended surgery but I sure wish they had. I have been dealing with achey legs my whole life. I was the wallflower always sitting at the parties and nightclubs because my legs hurt.

I am 43 now and just had flat foot reconstruction on one of my feet. I have high hopes. The surgery I just had was pretty involved but i have read that the flat foot surgery for kids is much much easier and they heel a ton faster. Your son may not be complaining much because he doesn't know what it feels like to not have pain which was how it was with me. Find a couple of good orthopedic surgeons and get consults and options. I sure wish my parents had looked beyond the first podiatry practice we went to. we followed their recommendations for years and thought that that was all there was.

Hang in there! And tell your son to hang in there too. Good luck.

 
Old 03-26-2010, 03:18 PM   #58
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Hi Sally,
How's the decision making going today? No matter what we have done to our feet, it's a BIG deal! Our poor feet are necessary for so much of the pleasures we get from living. They help us go to the bathroom, get a drink of water, a tissue to blow our nose, or take a walk in the spring air...and on and on....

I went back to the doctor yesterday and got the OK to lose the boot, and put my sneaker back on. I am almost at 10 weeks, and was thrilled. However, my foot still feels pretty useless, and it is quite uncomfortable to try to walk. I [U]am[/U] trying, but still need my walker for a lot of support..

I start PT next week and I believe that will help me learn how to use my new bionic foot. (2 plates and 7 screws) If it sounds like I'm bragging - I am.

I hope you can come to terms with your decision to have your surgery. If you've asked around and found an experienced doctor, then that's a big piece of the puzzle. If you're not sure about your doctor, go get a second and third opinion. Don't be scared to slow down and take more time if you need to decide.

All the doctors I saw were very clear about the fact that surgery is a big decision, and recommended taking plenty of time to think it all through.

I will know next January - 1 year after the surgery - if I'm better off, but I'm confident I couldn't stand the pain I was in any longer and it [U]was[/U] worth the risk for me.

Take care, and please share your thoughts and concerns on my favorite site. The people here are so helpful.

Happy Weekend!
Carol

 
Old 03-26-2010, 07:30 PM   #59
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Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Carol, Yes, this [I]is[/I] one of my favorite sites. I got so much more useful nuts-and-bolts information here than I ever did from my surgeon--don't get me wrong--I chose him very carefully and trust him completely. But, let's face it, bedside manner is not a surgeon's forte. He had nothing to offer me for how to get through my days post surgery. I got that from all you lovely people here.

Anxious Mom (and Sally, too), There is never going to be a great time to have foot surgery, but for sure it gets more difficult to find a good time as the years go on. Think about how disruptive it would be if he waited until college. If you think surgery is in his future, my opinion is to do it soon. Do your research, get your questions onto paper, and start seeing some docs.

A little heads-up: If you are hesitant to schedule his surgery during summer vacation because he loves to be in the water, there are cast covers that are made for swimming. They're similar to the ones for the shower, but much stronger--pretty cool. Your pharmacy can order them for you.

All the best,
Lisa

 
Old 03-29-2010, 04:31 AM   #60
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Wink Re: Anybody use a cane? (2 months post-op calcaneal osteotomy/tendon transfer, PTTD)

Hi Everyone!
I can't tell you how much comfort I have taken in your shared experiences this winter. I have learned so much and am so grateful for your candid q&as. I am scheduled for this surgery on April 7th. The house is "ready", the crutches have been broken in, and the scooter is on its way. I have an excellent surgeon with good pt recommendations in Columbus, Ohio. I am anxious to "get on with it" and reclaim my active life. I'll be checking in regularly to reread the healing progression threads.
I think I'll pour a glass of wine and head upstairs to pack up the pretty shoes.

 
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