I had pttd surgery 4/1/09. On 5/11 I went to my OS, cast was removed and x-rays were taken. My OS said that the incisions looked fine. I had one long (7 inches) incision where tendon was transferred, one 2-in fusion incision on top of my foot, a few inches down from the base of my big toe. Two other incisions are both on the heel from a calcaneal slide osteotomy. My doctor told me that I can start walking in the air boot as much as I can tolerate. He does not need to see me for another six weeks. Wow, I believe that he expects to see me walking into his office when I come back to see him six weeks later.
I had my first wash of my foot. As expected, the skin that was hidding under the cast for six weeks was all cracked up like dry dirt. It took me 40 minutes to just wash the foot and calf. I put some Vitamin E cream afterwards.
Well, my first full day a home is to start a new routine. Although I was allowed to walk with the boot (FWB), I was soo very afraid to put very much weight on that foot. So I walked with the boot and with the help of my walker. I could not let go of my walker yet. It seems that I actually put majority of my weight on my arms and shoulders. My guess is that i probaby only put 20 lb of my weight to the booted foot, even it does not hurt very much. I don't know how to let go and put more weight on the booted foot.
Today, I noticed my foot swelled a lot more than it was before. When using the air boot at home during the day, I don't elevate my foot as much as I did before. I also didn't ice like I did the first 6 weeks. Should I continue to ice and elevate as I did it before?
I start my PT Friday, 5/15. Maybe she can help me get rid of the walker. Otherwise, I am fine at home, still can't do much. Actually, I do less with a walker than with a knee walker b/c it is tiring to use a walker. Also, while using a walker, my hands are not available to carry anythings. And I can't stand very long to do whatever I need to do. Knee walker goes a lot faster and the attached basket allows me to carry whatever I need to wherever I want. I can stand/kneel longer. Still frustrated! The improvement is not as much as I had hoped.
I am just a little ahead of you - had my surgery on 3/14. I am in a boot and 50% WB. Although I don't exactly know how much weight I am really putting on my foot. When my cast came off 2 weeks ago my foot was really swollen so Dr. put a compression bandage on which I had for 2 weeks. Just saw Dr. and am still WB as much as I can stand. I use an ace bandage to help with swelling because I am much more mobile and do not elevate my foot. If I overdo the walking I pay for it at night and the next day! I use my crutches a lot and even go upstairs and down with them. I use my walker outside if I go shoping or movies etc. I feel safer on my walker but it is tiring. I too just got to wash my foot on Tuesday and it was gross. I used a very soft brush to help loosen some of the skin then Vit. E cream like you. The knee walker hasn't been much help to me. Good luck with PT. My Dr. is not in favor until walking in shoe and then very cautious as to PT person. He said he's seen a lot of patients with problems because PT wasn't familiar with foot/ankle problems and how to gently rehab, so I am not in a hurry. Be careful walking without any support the last thing you want is to fall!!!!. Take care. Mar
Canuck46, Thanks for letting us know how your WB experience. When I saw doctor 5/11, I showed him that I have a pair compression socks (thigh high) from a knee surgery. He said that it was good to use it. I was extremely careful, did not want to force and drag the sock overy incisions as I put it on the first night. Boy! it took me 25 min to put it one that night. The next day, it took me at least 15 min to get it off my leg. I think that I will wait for a few more days to wear it again as I really don't want to drag the tight sock over the tender incisions.
Just a few minutes ago, I tried walking (in boot) with crutches instead of walker. This time, I think that I like crutches better. This is the first time I use crutches in this NWB period b/c I fell from crutches two years ago when I had knee surgery. I think I will practice using crutches now b/c a lot of people on this board were able to drop to one crutch. My goal is to not use walker or crutches in two weeks. I am hoping to be able to walk (in boot) to a wedding (without walker/boot/knee walker/wheelchair) on 5/30.
I also would like to go to swim, but I think that I will wait until I am out of my boot b/c going to the gym, locker room, and pool will really be difficult with a boot and walker/crutches. I admire the pople who were able to do it on this board. Unless I figure out some safe ways to go to the pool, I will just stay home to recuperate.
I also have a formal wedding on 5/30 - I am hoping to be in a tennis shoe which I will decorate. If I am still in boot I will also decorate. Hope to just have a cane. I am very afraid of falling-been there done that and don't want to do it again!!! I know the compression stockings you are talking about - I am just wrapping my foot and ankle with an ace bandage which doesn't seem to bother my incision. Take care. Mar
Canuck46, I will try to use the ACE bandage also to see if it helps. I have not thought about decorating whatever I wear for the wedding. I also did not get a chance to shop for a nice dress before surgery. So I will just wear whatever nice dress I can find in my closet.
I have a question for for all my foot buddies here. The calcaneal osteotomy incision (about 2 in long) area (outside of of my heel) swells a lot more than the tendon transfer area. In fact, the long incision of the tendon transfer area not only not showing much swell, but also looks very good. The heel area swells so much like a bun. It looks like more swollen than the day the cast was removed (Mon, 5/11). I am afraid that it maybe infected inside. It has been 6.5 weeks since surgery. Is it possible that it is infected at this stage. I can't think if I have done anything wrong since 5/11. All I have done was washing my foot carefully and applying Vitamin E cream (not on incisions). On 5/11, I washed my foot extremely careful, just around the incision areas, not the incisions. Only the last two days I started putting the whole foot in the water to clean. I was told that I did have hardware (nails) put in at the heel. My OS said that the hardward stay in the foot, only to be removed if I have any problem. I am afraid that I do have infection problem at the heel area. Does anyone know what the doctors usually do if there is an infection? Is taking anti-infection medicine one of the remedies? I will call my OS tomorrow. Since tomorrow is Friday, and he does not have office hour I may not have an answer or to see him until Monday. I am afraid.....
I know what you mean about the heel area being more swollen. I'm still in a hard cast (three more weeks, grrr), but every time I get a new cast I take pictures and it seems like this area on me is not only more swollen, but I have HUGE scabs. We're talking scary looking things that I don't even want to touch for fear half my foot might fall off! (For anyone interested, I have pictures). This is the area that keeps rubbing on my cast and driving me nuts.
If you do have an infection, they will give you antibiotics to cure it. I know this only because I had another medical issue I was dealing with before my surgery and my doctor was really concerned about infection. It all turned out well and I never got an infection, but that's what he told me would happen.
I say keep cleaning it (gently!) and call the doctor tomorrow. It's always best to get an okay from them, just in case. I always get freaked by the fact that my largest incision (inside of foot, where they did the tendon transfer) is numb. All the other ones have either tenderness or I can at least feel something, but not there. Creepy.
Now, for the weight bearing - I was able to start WB three, or was it four weeks ago, and today I tried to get around for most of the day crutch free. It's evening now and my foot feels great. This is the longest I've gone total WB without any pain. I did go to the mall today (and got make-up, girl stuff!), but I used my crutches. I didn't want to get stranded standing for too long on my feet. Anyway, I think full WB by the 30th might be doable, but take it slow and let your pain guide you. If I felt any pain, I was back on the crutches. Even using my walker, if I felt pain, back to the crutches.
I really don't like walking in my cast because I think I lank around like the scarecrow in Wizard of Oz. It's just a weird angle and I look like a spaz. Not that I don't normally, but it's more pronounced now.
Thank you Socalgal for your quick response. In order to get a peace of mind, I definitely will call my OS tomorrow. He has surgeries on Friday, I just remember. Hopefully I can get hold of him, or maybe his PA.
My husband took picture of my foot on 5/11, the day the cast was removed. I compared the picture and my foot, I could definitely see it is swollen more than 3 days ago. I also wonder if it is possible walking in boots the last 3 days caused the extra swell.
Socalgal, how do you walk on/in the cast? You meant your hard cast is just like shoe/boot, you treat it just like a shoe or boot? Is it hard to walk on a cast? I believe that you are a few weeks, maybe 3 weeks, ahead of my recovery schedule. I am looking forward to the day like you--walking without assistance. By the time I do that, you will be in the next recovery stage, wearing regular shoes? Whatever recovery stage we are in, we hope it goes smoothly and with lots of improvements.
Well, last night before I went to bed, I took several pictures of my swollen foot. Then I wrote an email to my OS and attached pictures of "before" (taken 5/11) and "after" (taken 5/14) for comparison. This morning I called my doctor's office and talked to his PA. They saw the pictures and told me that was expected b/c I started walking in boot. They said anytime there is a change, such as walking with the operated foot, it will swell. The heel incision area usually swells more. I was told to not worry, just ice and elevate the foot. They also suggested using the ACE bandage to reduce the swell. Well, I believe that I will have a worry free weekend now.
Hey Yaohua - my heel area is also swollen and the most tender area. I think the ace bandage is helping but foot swelling is still there - maybe it is because we are not elevating since walking more. I'm trying not to worry about it - when foot feels too tight and painful I remove the bandage and boot and gently massage foot. My scabs are starting to come off so incisions looking a little better. You all have a great weekend! Mar
Yaohua - they gave me a little shoe to put over my hard cast and it helps with the walking. But it's definitely harder than walking in a cast. Like I said, I'm kinda a spaz and have a weird gait when I walk with the hard cast. I'm getting the hang of it and try to go without crutches as much as I can. I'm going to surprise my sister today at lunch with no crutches! (they'll be in the car, just in case).
I'm so glad you got ahold of the PA and now you can relax this weekend! Isn't it always nice to get an okay from the doctor? I think sometimes I freak myself out for no reason... why would I do that? Oh, well.
Could you please update your progress? I had similar surgery 10 weeks ago and I am currently doing PT. I would like to know when you guys are able to walk without WB. Are you considering 80% recovery now? How is the surgery affects your daily activity