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Old 09-22-2009, 07:15 PM   #1
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Question Lapidus, shortened metatarsal, gastroc recession

Hi, all.

This is my first post. Everybody seems so kind here, so I thought I'd join your community.

I have Morton's Foot. Lucky me! LOL! I had a Lapidus bunionectomy, shortened 2nd metatarsal, and gastroc recession on my left foot Aug 11. I'll get my right foot done in December after the left foot is totally healed. I've had 2 doc appts since my surgery and my surgeon said the xrays are looking great - meaning the bones are still in alignment. The 2 scars on my foot and 1 scar on my calf are healing great - I massage them a few times a day with cocoa butter-vitamin E lotion. My surgeon told me not to use neosporin because it kills the good germs and bacteria that are needed for healing, along with the bad ones. Who knew? I guess the doctors. LOL!

My question is about the gastroc recession. I really didn't feel any pain in my calf until the last week or so, when my doctor said I could stop sleeping with the boot on. I wear the boot most of the day, so the gastroc muscle is stretched all day. But at night my foot sort of naturally straightens out with my toes pointing. My doctor said I wouldn't need physical therapy to get back in shape, but I'm wondering if I should. He told me to do some ankle and toe stretches, but nothing for my calf muscle. Has anyone else had this procedure, and did you have the same pain I'm having? And did you have PT?

Thanks!

Jill

 
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Old 09-29-2009, 10:25 PM   #2
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Re: Lapidus, shortened metatarsal, gastroc recession

I just found your post. I had gastroc recession surgery a week before yours. My doctor also said I didn't need pt. He gave me the wall stretches to do, and then calf raises. At this point the only real pain I'm getting is after I've been sitting or laying for a while and then stand the muscle takes a few steps to loosen up. I can still feel some tightness/soreness when I'm walking and push off the toes on that foot, but I don't even really notice anymore. Yesterday I biked for a few minutes and went light on the elliptical for 5 minutes and now have a little bit of bulging that I'm concerned about. Did your doctor mention that at all?

 
Old 09-29-2009, 11:23 PM   #3
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Re: Lapidus, shortened metatarsal, gastroc recession

Hi, cj1986. Was the gastroc recession the only procedure you had? I won't be able to actually go on a bike or elliptical for a few months because of the other work I had done. My foot has to stay in a straight position (meaning no bending the arch) because of the plate, pins and screws I have above my arch. The bones have to form a union or I will have to go back and get it all done again - and that doesn't sound like a good option to me! I read something online about bulging and that it can happen, but I don't know if it's permanent or not. You should give your doctor a call and see if you need to ice it or massage the area. I see my doctor in 2 days and will hopefully get rid of the boot and move into a surgical shoe. I almost tripped down an escalator because my boot caught on one of the stairs and I was a little off-balance because I was holding a cup of coffee.

 
Old 09-30-2009, 07:48 PM   #4
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Re: Lapidus, shortened metatarsal, gastroc recession

Hi all, this is my first post. I had a lapidus on 6/11 with the calf lengthening. I was 9 weeks in bed NWB.When I went back to dr one month post cast removal swelling was so bad he sent me to lymphedemia people who gave me good compression stockings. swelling is better but the pain and limping still persist pretty bad. I called DR and am starting PT in 2 weeks although I walk and stretch daily.I should say I limp around about 2 miles/day. I am concerned that pain is not better (even worse). I don't see or feel my screws but wonder what experience others have had. Is it still too soon to be somewhat pain free or pain less? Thank you.
sorefoot

 
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Old 09-30-2009, 08:15 PM   #5
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Re: Lapidus, shortened metatarsal, gastroc recession

My recession was my only surgery. I'm 23, and am extremely active. I've always had foot problems stemming from flat feet, and tore my arch in college. I didn't stop playing sports and ended up partially tearing the ptt. I had topaz surgery 2 years ago, and that helped with the pain in the arch, but I still suffer(ed) from heel pain after being on my feet for an extended period of time. My current surgeon is Dr. Kelikian out of Northwestern. He thinks the cause of the pain and contributing factor was the tight/short calf. Being so young, he doesnt want to even consider doing any reconstruction yet...and even if he did, he'd do the gastroc recession. We decided it was better to start with a less invasive procedure that may relieve the pain, then to start messing with bones and such. I'm sure eventually I'll need that work done, but am terrified I'd end up with more pain then I'm in now... so I dont mind putting it off.

After my surgery I was in a cast for a week, then moved right to a boot. He told me at that point I could lose the crutches and I thought he was nuts. Th pain was awful, but once I started attempting to walk I was amazed at how fast it started to feel better. Once I pushed through the initial pain, it healed so fast. I tried calling my surgeon today and all the assistants just kept saying for me to come in. I don't mind doing so, but I want to speak to my surgeon about it first. I just want to make sure the muscle didn't somehow push through the incision in the sheath. It would just be nice to hear what he thinks one way or the other, and to see if there's anything I should be doing such as massaging it or wrapping it... or if this is something that needs to be treated. Doctors... what can ya do? haha.

Are you on crutches too, or just the boot? I was ECSTATIC to lose the cast. I'd never had it before, and the night before I got it removed I was ready to cut it off myself, the itching was so bad. Good Luck ditching the boot!

 
Old 09-30-2009, 08:26 PM   #6
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Re: Lapidus, shortened metatarsal, gastroc recession

Sorefooted - wow, you were NWB a long time! And in bed the entire time? I'm at 7 weeks now and have been working for the last 3 weeks. I'd go stir crazy if I was still in bed. I don't bend my foot yet, so I can't say if I'd have pain walking yet or not. I'm only walking in the boot at this point. On occasion, I'll twist my foot a little and it hurts bad. My doctor told me to let pain be my guide. He told me tht if it hurts - stop. My foot is still quite swollen, and he said it's doing fine and not to worry about it. He said the more I start to use the muscles, the swelling will go down. Good luck!

Last edited by jane806; 09-30-2009 at 08:26 PM.

 
Old 09-30-2009, 08:47 PM   #7
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Re: Lapidus, shortened metatarsal, gastroc recession

cj1986 - You ARE young! I'm 53! I'm very active, too. My favorite exercise is running and I miss it so much. I thought I'd gain a ton of weight after I had surgery, but because of a lack of appetite, pain meds that upset my stomach and not being able to get in the kitchen much the first few weeks, I actually lost about 5 lbs. I'm hoping to start walking soon, but I'll find out after my appt tomorrow.

When I went for my first appt for my bunions in early June, I was expecting the easy bunionectomy and thought I'd be back on my feet in a few weeks because I'm very healthy, fit and eat well. The first surgeon looked at the x-rays and said my metatarsals were in pretty bad shape and that I'd need to see their foot and ankle specialist surgeon, who also operated on his ankle after he broke it. The first surgeon said you can't get a better reference than that! I saw the foot specialist a week later and he said I had Morton's Foot and told me the 3 procedures I'd need, and that it was going to be a tough recovery. I'll be getting the same things done to my right foot in December. He told me our goal would be to get me running again, but I have to give it time - like at least a year. I'll be good with that.

I had surgery on my left foot (the worst one) on Aug 11. I was in a splint cast and crutches for 2 weeks. Then I got the boot, but still with crutches, for another 2 weeks. At my 4 week appt, he told me to slowly start walking with the boot, no crutches, and if I had to get up to go to the bathroom at night, I wouldn't have to put the boot on. Tomorrow is my 7 week appt, and hopefully I'll get rid of the boot! I've been walking around the house with slippers on and it feels pretty good as long as I don't bend my arch.

I've been putting cocoa butter/vit E lotion on my scars on my foot and calf a few times a day and it seems to be helping them heal rather well. I was hoping I wouldn't get any of those bulges I've seen on other people's surgery scars. So far, so good!

I'll update on my appt tomorrow.

~ Jill

 
Old 09-30-2009, 10:54 PM   #8
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Re: Lapidus, shortened metatarsal, gastroc recession

I had to wear the boot around the house for 2-3 more weeks after the cast, and was then allowed to wear a gym shoe around the house only. I was totally out of everything about 5 weeks after surgery. Wait till you put a shoe on... feels funny. Have you noticed on visual atrophy in your leg. My leg looks ridiculously smaller than the other. Doc measured it and said I lost 1-2" inches of muscle.

My doctor recommended these sillicone bandages to help prevent thickening of the scar. They were about $25-$30 for 12 at the local drug store, but they're supposed to stay on up to a week so a box lasts 8-12 weeks. I cheaped out (bad i know) and just got a scar healing lotion with vitamin e.

 
Old 10-01-2009, 06:15 PM   #9
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Re: Lapidus, shortened metatarsal, gastroc recession

No more boot!! They gave me a surgical shoe but want me to transition into a shoe as the swelling goes down. The x-rays show that everything is still lined up and the bones are forming unions, so no more boot! I also scheduled my next surgery for Dec 8 to get it done before the end of the year. I've already paid my deductible for the year, so my doctor said he would do the surgery in December if the first foot showed healing progress.

cj - my left calf is definitely smaller than the right. I noticed it when the splint cast came off at 2 weeks and was amazed how quickly it happened. I'm going to go back to the gym this weekend to ease myself into shape. I was told to walk as much as I can, letting pain be my guide. My doctor didn't say anything about the silicone bandages. He said the incisions are looking good, so I'm going to stick with the vitamin e lotion for now. I was also told I could have swelling for the next 6-12 months and that it's normal. What wouldn't be normal is if I woke up in the morning after sleeping all night, and my foot is more swollen than when I went to bed. Good to know!

 
Old 10-01-2009, 08:21 PM   #10
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Re: Lapidus, shortened metatarsal, gastroc recession

Congrats on losing the boot! You're leg will feel so much lighter without it. I understand the need for the quick second surgery. After my first foot surgery I ended up needing an unrelated surgery and ha to schedule it for the day after college graduation, 2 weeks before the end of the year, just so that I was still under my parents insurance and had met my out of pocket for the year. Surgery is a lot better when its free! haha.

The doctor finally called back today. (Just to vent...for what I pay, I don't think I should be made to feel bad by his assistants for wanting to speak with the man that cut my leg open). But anyways...he said he thinks it might be scar tissue, but since its more on the side of the leg we'll have to see. As long as it wasn't higher up in the calf and sensitive to touch (i.e. a blood clot), it shouldnt be to big of a cause for concern. I'm not so convinced on the scar tissue description because of the shape, feeling, and proximity of the bump, but I'm also not too worried. I decided to still have him take a look at it on Tuesday just for some reassurance. If it is scar tissue I want his opinions on what I should do to help it, or if I'm limited on any activities. It happened the day after my first workout which prompted the concern.

 
Old 10-02-2009, 02:26 PM   #11
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Re: Lapidus, shortened metatarsal, gastroc recession

Good idea to see the doctor, cj. Better safe than sorry. I tend to err on the side of safety.

I've made it through most of the day with the shoe and I can tell my foot is going to be a little sore tonight because I've been walking a lot. It feels naked! I might have to ice it tonight - I haven't iced it in weeks. I was also told to take ibuprofen for the swelling. I had just read right before my appt that ibuprofen can inhibit bone healing (forming unions), so I brought that up, but they said it'll help with swelling, so I should still take it. I guess there isn't any "perfect" medication.

Last edited by jane806; 10-02-2009 at 02:26 PM.

 
Old 10-03-2009, 06:58 AM   #12
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Re: Lapidus, shortened metatarsal, gastroc recession

Hi all,
thanks for your info. Does anyone have pain 3 months post op and is it okay? I walk and stretch a,lot, swelling is manageable. wearing great shoes or sneakers but still limping. Take care..

 
Old 10-03-2009, 03:38 PM   #13
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Re: Lapidus, shortened metatarsal, gastroc recession

New Member here- thanks for the insights from everyone who has had these surgeries, nothing better than getting info from those who have been there. I am a radiologist- now I am on the other side of the xrays!

Background, I had a RT 5th bunionette-ectomy in 97 while in the Navy, probably not the ideal procedure for a Morton's foot, bilateral....Hoping the left won't turn on me and cause problems!

I have just had 2nd MT shortening osteotomy and a first TMT fusion on 9/24 a week after a RT hip arthroscopy...Loved going from 50% WB to NWB. Seeing surgeon for postop visit 10/6. I am hoping to go to partial WB, possibly a little overly optimistic, but I heal well, and definitely ditching the Jones splint.

I have been googling "return to driving after --foot surgery" and found this forum- you all have done a nice job.

My surgeon's general preop instructions say no driving until wearing street shoes. General experience from anyone for that and returning to driving? I have thought about getting a left foot accelerator, but not sure if that is necessary. I can gas with the right and brake with the left, but just a little worried about instincts in an emergency braking situation. Not scheduled to work, which is mostly sedentary until 10/26 for a week then off for a week of vacation.

Pain-help me calibrate- seems to be well controlled, only a single percocet today after being out and about (my stepson and Nanny driving!) with kids from 945-130 this morning. I have had a few day spike in pain late in the day with an oxy 20mg late evening- I think I am probably up more than I should be during the day, no significant swelling. Thoughts?

Again, thanks for everyone's posts, they have been helpful.
Ingrid

 
Old 10-03-2009, 04:02 PM   #14
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Re: Lapidus, shortened metatarsal, gastroc recession

Sorefooted - I think pain and swelling is normal for 3 months post-op. My doctor keeps asking if I want more pain meds, but I've weaned myself off everything and hope to stay that way! He said that as I do more with my foot, I'll feel more pains and that if I need to take something, I should. No time to be a hero!

Ingrid - You've had a lot of work done! I was on oxycontin (2x/day) & percocet (4-6x/day) for 10 days, and then on vicodin (2x/day) for the next 4 weeks. The doses were the minimum you can get. If you need them, you should take them. I didn't find it hard to stop taking them at all. As for driving, my doctor said none in the first month, but mostly because I was on narcotics! I was also in a cast or boot for the first month, which would have made it impossible to drive if it was my right foot.

 
Old 10-08-2009, 06:54 PM   #15
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Re: Lapidus, shortened metatarsal, gastroc recession

Thanks all, appreciate the good advice. Went from Jones to boot- and a greenlight to heel weight bear. We all know that as a doc, I will have a complication if I don't behave!

Has anybody have significant (but temporary) pain on going from spint to boot? I think it was the change from plantar flexion to slight dorsiflexion. It has gotten better since Tuesday. Bummer that it is Celebrex or narcotics for pain relief, but gotta keep making good bone!

To those limping, if it non-painful, it may still be a lot of early recovery with muscle imbalance and disordered coordination/proprioception - our post op parts haven't healed enough to be able to accurately tell our brains what they're doing. Keep doing pt and moving!
Ingrid

 
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