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Old 09-14-2008, 09:25 AM   #1
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PTTD Post Op - A few questions

Just a few questions now that I'm home:

1. I have some bruising on my upper thigh. Is this from the tourniquette?

2. Most of my pain is overall "achey" - about a 4-5 which is tolerable. Throw in a few fire-y incision pains and I'm still okay. What's really hurting tho is a pain? spasm? in my lower arch/beginning of heel. I'm assuming this is from the screw? It starts about hour 2 or 3 of Norco. Comes in waves. I can take a Valium for it and it helps sometimes. Icing doesn't seem to matter here and it sometimes helps when I put my foot DOWN (un elevate). I would say this pain is a good 7-8 on the scale.

My question is, of course, is this normal? Anyone else have this? What did you do for it?

I can deal with it if I have to (I'm not writhing or anything) but if it is the first sign of INFECTION, I want to know. Or if my SPLINT IS TOO TIGHT....

This is really the only thing that's killing me. If it's not better, I'll be calling the doc on Monday, fo sho!

Thanks!

 
Old 09-14-2008, 10:21 AM   #2
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Re: PTTD Post Op - A few questions

The bruising on your thigh is likely from the tournaquet...they inflate that thing to a point that there is little blood flow below it. I had bruising on my first surgery too. I'm not sure what your pain is related to...there are so many things that can lead to it, especially so early on. If you are really concerned, I would call the doctors office tomorrow AM and check it out with them. Sometimes there can be issues with the splint being too tight or with other things causing the pain.

 
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Old 09-14-2008, 10:33 AM   #3
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Re: PTTD Post Op - A few questions

But you didn't have pain similar, Sunny?

 
Old 09-14-2008, 05:31 PM   #4
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Re: PTTD Post Op - A few questions

My first one, if not elevated, throbbed and hurt a lot and my toes turned purplish and it felt like my foot would burst inside the splint or cast. Otherwise, I think it hurt in general if the pain meds were wearing off or it got bumped. Over time, yes, some achiness was there too. For the second one, I had the popliteal block and was numb until midnight the day of surgery. I had a lot less pain and swelling overall and it didn't bother me too much to have it down (no throbbing, puple toes, etc). I was on pain meds for a shorter period of time than the first time. Everyone's pain is different, as is tolerance. There has been some major trauma done to the foot...so you're certainly going to feel something. Whether it's par for the course or something not quite right...that's something you need to work with your doctor on.

I should mention that my procedures were a little different than yours. I had the posterior tib tendon repaired (no transfer) and an Evans osteotomy. My surgeon does not use any hardware to keep the bone block in place. The tension between the two bones holds it in place and avoids the need for a screw or plate. So, I can't help with your question about pain from the screw.

 
Old 09-14-2008, 06:03 PM   #5
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Re: PTTD Post Op - A few questions

The spasms (I swear it felt like contractions! (I was just coming up off that bed!!) have mostly stopped. That just had to be trauma. Nasty nasty. And not something to try to fight through - can't be done! (Note to pre-ops!)

No screws? You lucky devil! When I begged my doc to not lengthen my Achill because I had heard how painful it was, he just laughed and said it wouldn't matter after he broke my heel! THAT was the whipper! That's a deep deep pain.

Anyhoo - I traditionally have a very high tolerance for pain. (Altho I would say that most of us on this board probably do as well - we've been living with it quite a while, right?) But I also have a very high tolerance to pain MEDS! So getting the right one was imperative. I spent two nites in the hosp due to pain mgmnt. The silver lining is that now I can say what DOESN'T work, right!

There's one called To-something... that was great! I thought it was prob just a hospital drug but I think I saw a post that someone had a Rx. It was great great great! Anybody know the name of it? That's worth a separate thread title because I don't think it's common.

As good as I'm feeling about this first week post-op, I can't imagine doing the other foot. I know your story is on the board but can you tell me how and why? Maybe you can direct me to that post. I remember reading alot of yours & Emma's stuff in July.

I asked the doc about the "good foot" as the underlying problems are the same. He said once I started moving around and really stressing the good one, I could wear a brace to stabilize.

Has anyone else done this?

Ooooh, my friend just brought me Banana Split Pie! Don't know what it is but that certainly goes in the "Silver Lining" column!

Gotta munch!! MQ

 
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Old 09-14-2008, 08:17 PM   #6
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Re: PTTD Post Op - A few questions

Toradol maybe?

I didn't have any problems with my "good" foot until I had surgery on my other foot. I started to have pain in it within a month of surgery. Obviously it took the brunt during the 6 wks of NWB and 4 wks walking in the boot, so maybe there was so predisposition, even though I wasn't having pain or evidence of a flat foot. Not sure. I tried to do a lot of the exercises I was doing to rehab the left on the right, to see if that would help, but it didn't. I asked about my other foot early on, wondering what I could do to support it during rehab on the surgery foot and he told me that if things were going to happen, they would and there wasn't much I could do to prevent it. I was not happy to hear that! Given that I had tried all the conservative therapies on my other foot and failed, my doctor and I decided to go forward with fixing the other one so I could get on with life and not stress the surgical foot more. I had almost 10 months in-between surgeries.

My left foot, after being fixed, never had any problem holding up during the surgery of the other foot. I healed really well on the left; my right one is having some issues, but it will get there. I'm able to run, do the elliptical, work out, whatever. Both feet had almost the same procedures done. There's another blogger here who is young and undergoing the same issues...good foot went bad during rehab of the first foot. Usually PTTD only occurs on one foot, at least that's what I found when I was reading up on it online. It was a long year plus...and I definitely missed working out and being active. It's great to finally be moving again! I knew what to expect the second time around and actually had less pain, swelling and all. But I wouldn't wish that on anyone...it's bad enough one time around! I guess it's worth it in the end though!

Hope you enjoyed some of that banana split pie! Enjoy!

 
Old 09-15-2008, 07:45 AM   #7
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Re: PTTD Post Op - A few questions

I think I may be the other young blogger on here that Sunny was talking about. I am 24 years old and had the following sugeries on my right foot in January: achilles lengthing, FDL tendon transfer, & a sliding osteotomy with one large screw in the back of my heal. I too had the popiteal block which was absolutely great! I stayed overnight for one night after surgery so I had a morphine drip while there. I took vicodin and perocet for the pain (not at the same time obviously lol) I did have some swlling issues but the ice behind the knee and elevating it more always helped out. I really overall had a great recovery from the surgery other than a few bumps in the road here and there. I did not experience any pain with the screw until I started walking and running again. My screw was taken out at the end of july and now my foot is doing wonderfully.
Unfortunately my left foot which is my "good" foot was fine until probably about a month after surgery and then I started to have issues with that foot as well and I am currently going through the non surgical methods which I think are being done for two reason one: to give my other foot a little more healing time before it has to be the sole supporter and two: for show for the insurance company.
I am sorry to hear you are struggling a little but i promise it gets better. Feel free to ask us anything.

Kristin

 
Old 09-15-2008, 01:39 PM   #8
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Re: PTTD Post Op - A few questions

Quote:
Originally Posted by sunny77 View Post

I should mention that my procedures were a little different than yours. I had the posterior tib tendon repaired (no transfer) and an Evans osteotomy. My surgeon does not use any hardware to keep the bone block in place. The tension between the two bones holds it in place and avoids the need for a screw or plate. So, I can't help with your question about pain from the screw.


Sunny, I guess I didn't realize your procedure was so different from mine. I had the transfer, the sliding osteotomy with a large screw in the back of my heel. I must admit that reading your posts made me feel like a weenie at times because you returned to work so quickly and had very little pain and I really struggled. I have to say the majority of my pain was definitely from the screw in the heel and the heel being sawed off with a chain saw and moved over. (well, not exactly, but that's how it felt )

I do feel better knowing your procedure was a tad less traumatic than mine. And of course you are younger, which helps as well.

emmie

 
Old 09-15-2008, 10:30 PM   #9
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Re: PTTD Post Op - A few questions

Emmie,
I definitely had pain with both surgeries...I was on pain meds for 3 months the first time around! Going back to work at 3 wks wasn't easy, but I think being younger and always being a person who gets bored easily and is often on the go made it happen sooner for me. My foot was also sawed open, just on the side instead of the bottom...they stretch the foot open to put that bone block in, so there's a broken bone to heal as well. My surgeon doesn't use hardware, but many others doing the same procedure do. I had to be really careful not to fall or anything early on, as bumping it the wrong way could have loosened/moved the bone block before it was healed enough to stay put. I guess I just got lucky in terms of not having hardware...and after hearing how hard it has been for many here, I am really glad that my surgeon does things the way he does! Still...despite the differences in procedures, all of these osteotomies are traumatic and painful. We all just heal differently, have different pain threshholds and different goals at different times. It sounds like you've had additional problems that haven't helped you move forward, and that's hard to swallow after undergoing everything you have. So, it's okay to be where you are!
Sunny

 
Old 09-16-2008, 10:16 AM   #10
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Re: PTTD Post Op - A few questions

Hi Emmie - good to see you posting!
When I was diagnosed in June, I was on vaca and knew I couldn't have surgery until Sept. That gave me alot of time for research! At that time, you, Sunny and CopChick were the hot bloggers and answered so many of my questions! By the time I got home to Dallas, I cracked my ortho up with all my questions and preferences! So far, I've had no surprises that weren't conquerable!

Re: "good" foot. My doc said "sure" brace it! But I felt like he was just placating me. Gonna do it anyway - how can it hurt? Not like I'm losing points on the Sexy Scale since the other one is casted/booted anyway....

I'm on Day 6 and am just now knocking it back to just one Norco every 4 hrs. Had to take a Valium (which is my "bump" between Norco) after spending more than my allotted 10 minutes dangling my foot from the High Potty Seat praying for the Ever Elusive Poop. You'd think I'd given birth from all the celebrating my huzzie and I did! Small victories....

My doc said if my soft splint ace got "bunched up" or whatever, just come in and they would re-wrap it. I'm going to do it the end of this week for the sole purpose of making sure my incisions aren't infected. There were a couple of horror stories about that on here. I'm certainly having pain but is it normal pain? Who can tell? Back of my heel hurts all the time. That's the Achill, I guess.

I'm sure not up much.... I'm basically going to the bathroom and moving from the bed to the chair in the den. Big Whoop. Rolled outside yesterday for a stretch! Sound about right? Going back to work? Sheesh....no way! Heck, I'm too dizzy to even read!

Well, thanks again for your support! Glad to hear you are all well on the road to normalcy!

MQ

 
Old 09-16-2008, 12:58 PM   #11
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Re: PTTD Post Op - A few questions

Hi
I would like to second MasonQ's thanks. I am two weeks out before surgery. I am so not looking forward to it. I keep telling myself it will be all worth it when I can hike next summer. My next thought is that maybe I should put up with it for another year. I keep thinking that I must be a baby when it comes to pain-so many of you sound as thought you've had several years of pain before resorting to surgery. AHHHH!!
Thanks for helping to keep me sane!

 
Old 09-17-2008, 07:04 PM   #12
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Re: PTTD Post Op - A few questions

Uff Da (what a great name!!!) -

I can't tell you how many times I talked myself in and out and in and out of this surgery. My tendon was ruptured and I KNEW I had no choice but it really didn't hurt THAT much, did it? Surely I could wait....

Read thru this board. So many people, by their own choice, by advice or by insurance requirements have done the non-surg route. Not always, but mostly - it was an inconvenience, painful waste of a year.

It isn't an easy surgery or recovery but I truly believe that it is the best choice. Just do it - get it over with - laugh when you can and pop pills the rest! There's lots of great ideas of projects to do while you are horizontal, plenty of information on the surgery process, gobs of suggestions about the best "toys" for your recoup mobility and, most importantly, a bunch of strong, well-spoken, intelligent people who know that knowledge is power! Even when the going got tough, these people sought advice, got answers and got on with it!

You can do this!!
UFF DA!!!!

 
Old 09-18-2008, 08:13 AM   #13
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Re: PTTD Post Op - A few questions

The non-surgical route is never easy. If you don't tear your tendon you have to go through that to prove to the insurance companies that it is not getting any better. I went through 10 months of non-surgical methods on my right foot and currently it has been about 6 months of non surgical methods for my left foot (partly to give the right one a little more time, I am only 9 months out of PTTD surgery, sliding osteotomy w/one large screw, FDL tendon transfer, & Achilles lengthing) and partly again to prove the insurance companies that it is not getting any better.
If I had it my way I would be doing the surgery! My first one we were hesitant on doing surgery due to the fact that I am only 24 (a little young for this) Now that I have one foot that over pronates/no arch and one that has a beautiful arch I am afraid (besides for the pain I am having in my bad foot) that without surgery I will have problems with my hips and knees when I get older. I am ready to just get this all over with and have everything fixed and finally be back to normal instead of being the girl that always has something on her feet.
I do have to say I had a great experience with the surgery though. I was out of work for a week, did half days the second week, and then the third week I was back full time. I was jogging again at about 6 months post op and had the screw removed at 7 months post op. Now that the screw was removed I have zero pain.
I am currently in a walking boot with my other foot (should be a non weight bearing cast but I have to be in a wedding this weekend) then because of appointments he will be unable to see me again till the 29th of Oct, so that is when the cast will go on. Any questions please feel free to ask!!

 
Old 09-18-2008, 08:53 PM   #14
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Re: PTTD Post Op - A few questions

I've been so busy cleaning up after Gustav. We were hit very very hard in Baton Rouge. Power out for over a week and tons of trees down. I had trees skim my house but none on it so I am grateful. I am starting a new thread about my diagnosis today.

 
Old 11-13-2008, 06:14 PM   #15
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Re: PTTD Post Op - A few questions

I am 7 days out of PTTD surgery, (not sure which one) osteotomy with one screw, FDL tendon transfer, & Achilles lengthening. Surgery went well, and after 3 days was mostly off pain meds. I know take 1 or 2 Vicodens a day. Getting around on crutches is not much of a problem.

I basically have two questions / issues:
- I have no problems laying on the couch with my foot up. Most of the time there is no pain until (for some reason) the evening. However, putting my foot down is incredibly painful. I think I read somewhere its all the blood rushing to your foot, but boy, it feels like it is going to explode. I have to keep putting it down, then back up, down, up, quite a few times. Is that normal? It is my biggest issue right now. I can also stay on crutches only about 10 minutes because of that.

- There is a lot of pressure at the ball of my foot. Is that where the other tendon came from? I am not really sure why it hurts there, but have any of you also experienced this?

Thanks!!

 
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