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Old 12-27-2009, 07:37 AM   #1
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Question 9 MONTH POST OP CHECK UP for PTTD

On Dec. 29th I go back to my OS for my 9 month check up for foot reconstruction of PTTD. I'm scared for what he will say.At first he told me it would take a year, but at my last appt. he said that by 9 months he could tell if it worked or not. I asked if it doesn't work then what and he told me fusion. I don't want to hear this !! I've worked really hard to get back to where I am. I don't have too much trouble with the foot per say but there is numbness on the outside of the ankle from the bone to the heel. Do you think this is nerve damage? Also, sometimes the muscle above the heel still knots up at times. Anyone else have these problems?
Thanks for your support
Rose

 
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Old 01-10-2010, 07:02 AM   #2
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Wink Re: 9 MONTH POST OP CHECK UP for PTTD

[FONT="Verdana"][LIST=1]
UPDATE: The appointment went well. The Dr. said that things looked good...no fusion needed yet. He said that I would know when the time came for fusion. I go back in April for my 1 year appointment. Thanks for the support on this board. It is really great to know that there are people who have gone through what you have and know what it's like to have to deal with this issue.
Rose[/
LIST]

 
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Old 01-10-2010, 12:08 PM   #3
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Re: 9 MONTH POST OP CHECK UP for PTTD

Rose15,

Could you comment on this? I have pttd on both ankles. A DPM I like(trust) says to do a talnonaviculal fusion on one foot because he sees some arthiritis and suggests a subtalar implant on the other foot because less or no arthritis. I went to two OS who said do FDL transfers and perhaps osteotomies. WHat were the drs telling you about your foot/feet and how did you make the decision on dr and on the treatment? I am not able to walk very well without major othrotics now and it still hurts so badly that i will not go out to a mall and avoid going anywhere where there are hard surfaces.
How well can you walk now? WHat does it feel like to have reduced motion in your toes etc.? How successful do you feel your outcome? http://www.healthboards.com/boards/images/smilies/dizzy.gif

Footprint

 
Old 01-12-2010, 04:43 AM   #4
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Re: 9 MONTH POST OP CHECK UP for PTTD

Footprint.. I too went to a podiatrist first for ankle pain... I messed around with this guy for about 2 years with this problem. He then injected me with a cortosone shot and my postibular tendon ruptured which was shown on an MRI. He said that I had to have surgery right away. He said he could reattach the tendon and put in a titanium plug in the subtalar to hold up the arch. I'd be off work for about a month. I said I wanted a second opinion and found a wonderful chief OS surgeon at a university medical school. He told me that this was not a quick and easy fix, that the tendon could not be patched. There had to be a tendon transfer from 4-5th toes and no inplant plug. Had to have an osteotomy and a stainless steel screw. At that time I was in the beginning of Stage 2. The OS said that the rupture was probably caused by the cortisone shot... as you are never supposed to inject cortisone in the tendon (only apply it topically) but I could never prove it. He never pushed me about having surgery. He said we could treat this conservatively with an Arizona brace which I did and wore it for 2 years but I finally had to resort to surgery. The reason I put it off so long was that he told me that I'd be off work for at least 6 months...this was not an easy fix. So I had my surgery last April. I left the hospital in a hard cast.. 2 weeks later the stitches came out and cast was replaced. I wore this for another 8 weeks while the bones healed. Then came the boot and partial weight bearing. I went back to work at the end of August (I am a teacher) and I thought I'd die the first month...I had to bring the boot with me and put it on when my foot started to bother me. I brought ice packs and iced and elevated during lunch and tried to stay off of it when I could. I have to say everyday it gets better... although I have good and bad days still. I think a lot has to do with the weather. But getting back to what kind of surgery to have, I still think that I'd have gone with the osteotomy vs. the titanium plug. But that is just me because of the bad experience I had with a podiatrist.

 
Old 01-12-2010, 09:26 PM   #5
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Re: 9 MONTH POST OP CHECK UP for PTTD

Rose815,

Thank you. I hope you are feeling closer to success everyday. Your information is helpful.

Could you respond just a little more on the movement remaining in your foot ankle and toes?(or what loss in movement function, if any)
Ability, for example, to walk and stand to give a speech or a talk while standing a a function/party? Walk the mall, or even go on uneven surfaces like a hike? Will these things be possible after a fuller recovery? Does the surgery prevent all of the toes from moving independently and is that bothersome?

Sorry for all the questions and length of this post. I was an active person and would be thankful to be able to do such activities. At the moment it is " orthotics on-get to the car- out of the car - get to my desk and hope i don't have to stand or walk anywhere - leave work and go home and wait for the next day- oh and search this message board too - lol".

I am going to have to decide on something. The ironic part is that many years ago an OS injected me with cortisone, and now the podiatrist i selected (after seeing two OS and two other podiatrist) seems to suggest a tx plan with the most likely outcome of success. He recommends a subtalar implant on one side. On the other, he recommends a possible fusion of talonavicular due to some arthritis, and if not arthritic, then a subtalar implant, but specifically says for me not to have osteotomy or FDL transfer. (It is confusing because i thought the calcaneal osteotomy helped reconfigure the foot to help eliminate the stresses on the ankle post tib that contributed to the condition in the first place). The OS's quickly advise to perform the surgery with calcaneal medializing osteotomy and fdl transfer.
Thanks again.

Footprint

 
Old 01-14-2010, 04:44 AM   #6
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Re: 9 MONTH POST OP CHECK UP for PTTD

[QUOTE=footprint;4161876]Rose815,

Thank you. I hope you are feeling closer to success everyday. Your information is helpful.

Could you respond just a little more on the movement remaining in your foot ankle and toes?(or what loss in movement function, if any)
Ability, for example, to walk and stand to give a speech or a talk while standing a a function/party? Walk the mall, or even go on uneven surfaces like a hike? Will these things be possible after a fuller recovery? Does the surgery prevent all of the toes from moving independently and is that bothersome?

Sorry for all the questions and length of this post. I was an active person and would be thankful to be able to do such activities. At the moment it is " orthotics on-get to the car- out of the car - get to my desk and hope i don't have to stand or walk anywhere - leave work and go home and wait for the next day- oh and search this message board too - lol".

I am going to have to decide on something. The ironic part is that many years ago an OS injected me with cortisone, and now the podiatrist i selected (after seeing two OS and two other podiatrist) seems to suggest a tx plan with the most likely outcome of success. He recommends a subtalar implant on one side. On the other, he recommends a possible fusion of talonavicular due to some arthritis, and if not arthritic, then a subtalar implant, but specifically says for me not to have osteotomy or FDL transfer. (It is confusing because i thought the calcaneal osteotomy helped reconfigure the foot to help eliminate the stresses on the ankle post tib that contributed to the condition in the first place). The OS's quickly advise to perform the surgery with calcaneal medializing osteotomy and fdl transfer.
Thanks again.

Footprint[/QUOTE

Hi Footprint,
My foot looks totally different. It is actually straight with somewhat of an arch. As far as movement I can move it up and down like on a gas pedal, and as far as laterally there is limited movement to left and right but it still can move. I still do the exercises with the therabands that I got in PT. I also do toe curls with a wet towel daily. I have no movement in my 4-5th toes as this is where they took the tendon from. But this doesn't seem to bother me. As I said I'm a teacher and am on my feet alot all day. When I first went back I couldn't stand for long periods of time and had to elevate it a lot. But now I can stand for almost the entire day again. It is just a slow recovery. I am very active and not a patient person. You know when you've done too much, believe me. As far as the mall, I didn't do the mall until after Christmas, then I walked for like 2 hours straight. It's not so much that my foot hurts, its the gastronemesis muscle in the calf that gets tired. I guess from muscle wasting from the casts. Uneven surfaces still bother me. My goal was to dance on the beach... now I hope that I can walk on the beach and get to put my feet in the ocean. Would I do this again? Absolutely, do I need my left on done? yes, but there is no way I would get it done until my right one heals completely. There are others on this site that are having one done less than 6 months after the other one is done. I don't see how they can stand it. Let me know how your doing and what youve decided to do.
Take care
Rose

 
Old 01-14-2010, 07:28 PM   #7
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Re: 9 MONTH POST OP CHECK UP for PTTD

Rose15,

Thanks again. I am going to review my options and get some second opinions before deciding.

Footprint

 
Old 01-17-2010, 06:27 AM   #8
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Re: 9 MONTH POST OP CHECK UP for PTTD

Dear Footprint - I'm 5 weeks post-op from the FDL transfer & osteotomy for my PTTD. My advise is to get a top notch OS to do your surgery - you'll be glad you did. Remember, you get only 1 shot to do it right the first time.

When I say top notch OS, I'm referring to someone the Professional Athletes would go to. In Philadelphia there is 1 nationally recognized foot & ankle OS, and in Baltimore there are 2.

Trust me, I did a lot of research and talked to numerous people & Docs before having my surgery.

This Board has a lot of good information you can dig up by searching.

Rose815 - thanks for posting the updates. Please continue to let us know your progress.

Good luck
Jack

PS: At my post-op visit, I met a lady who had a DPM try surgery for her PTTD. She then went to a OS who attempted a fix. Finally she found the top notch guy who knew what he was doing and had the skill to salvage her mutilated foot. How different her life would have been if she went to him in the first place. I left that day thanking the Lord that I had the best guy to do my surgery.

 
Old 01-23-2010, 06:28 PM   #9
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Re: 9 MONTH POST OP CHECK UP for PTTD

[QUOTE=rose815;4162814]
Quote:
Originally Posted by footprint View Post
Rose815,

Thank you. I hope you are feeling closer to success everyday. Your information is helpful.

Could you respond just a little more on the movement remaining in your foot ankle and toes?(or what loss in movement function, if any)
Ability, for example, to walk and stand to give a speech or a talk while standing a a function/party? Walk the mall, or even go on uneven surfaces like a hike? Will these things be possible after a fuller recovery? Does the surgery prevent all of the toes from moving independently and is that bothersome?

Sorry for all the questions and length of this post. I was an active person and would be thankful to be able to do such activities. At the moment it is " orthotics on-get to the car- out of the car - get to my desk and hope i don't have to stand or walk anywhere - leave work and go home and wait for the next day- oh and search this message board too - lol".

I am going to have to decide on something. The ironic part is that many years ago an OS injected me with cortisone, and now the podiatrist i selected (after seeing two OS and two other podiatrist) seems to suggest a tx plan with the most likely outcome of success. He recommends a subtalar implant on one side. On the other, he recommends a possible fusion of talonavicular due to some arthritis, and if not arthritic, then a subtalar implant, but specifically says for me not to have osteotomy or FDL transfer. (It is confusing because i thought the calcaneal osteotomy helped reconfigure the foot to help eliminate the stresses on the ankle post tib that contributed to the condition in the first place). The OS's quickly advise to perform the surgery with calcaneal medializing osteotomy and fdl transfer.
Thanks again.

Footprint[/QUOTE

Hi Footprint,
My foot looks totally different. It is actually straight with somewhat of an arch. As far as movement I can move it up and down like on a gas pedal, and as far as laterally there is limited movement to left and right but it still can move. I still do the exercises with the therabands that I got in PT. I also do toe curls with a wet towel daily. I have no movement in my 4-5th toes as this is where they took the tendon from. But this doesn't seem to bother me. As I said I'm a teacher and am on my feet alot all day. When I first went back I couldn't stand for long periods of time and had to elevate it a lot. But now I can stand for almost the entire day again. It is just a slow recovery. I am very active and not a patient person. You know when you've done too much, believe me. As far as the mall, I didn't do the mall until after Christmas, then I walked for like 2 hours straight. It's not so much that my foot hurts, its the gastronemesis muscle in the calf that gets tired. I guess from muscle wasting from the casts. Uneven surfaces still bother me. My goal was to dance on the beach... now I hope that I can walk on the beach and get to put my feet in the ocean. Would I do this again? Absolutely, do I need my left on done? yes, but there is no way I would get it done until my right one heals completely. There are others on this site that are having one done less than 6 months after the other one is done. I don't see how they can stand it. Let me know how your doing and what youve decided to do.
Take care
Rose

 
Old 01-23-2010, 06:32 PM   #10
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Re: 9 MONTH POST OP CHECK UP for PTTD

Please discuss the amount of pain from time of surgery and following weeks..Total and complete recovery takes about how many months? Realize this is different in every case...Thank you..

 
Old 01-24-2010, 07:49 AM   #11
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Re: 9 MONTH POST OP CHECK UP for PTTD

I agree with cat farmer...my OS is top notch...chief of surgery foot and ankle division at a medical school in western PA. He does the Steelers, Penguins and Pgh Ballet. I also did my research to find the "fixer" who tries to fix the other doctors mistakes and came up with him. Like catfarmer says you only have one shot...why not go for the best?

 
Old 01-24-2010, 07:59 AM   #12
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Re: 9 MONTH POST OP CHECK UP for PTTD

Zacbit, from the time of surgery till now the pain was decreasing steadily. Right after surgery there was no way I could not go without pain pills w/ tylenol on the side. I mainly used the pain pills at night so I could sleep. Used a lot of pillows to elevate and ice. I wasn't good with crutches in the beginning so I used a walker. Got real good at hopping on my left foot. My husband was only with me for 3 days and he had to go back to work. Once the casts came off and the boot was on there was still pain but I limited my amount of pain pills as I didn't want to become addicted. I guess I have a high pain tollerance. There were days that I still needed them though, don't get me wrong. There are still days like that now and I'm out nine months. It just depends how long I've been on my foot and how much I walk. Did the mall yesterday and after 4 hours of walking I knew it was way too much. I get frustrated with myself because I think that I should be able to do everything by now and after an episode like this I know that it's not happening. My OS said that it would take at least a year for the healing process. I didn't believe him at first, but now I sure do. My advice to you is to do your research and find the best OS surgeon you can. You only have one shot at this...find the best.
Take care
Rose

 
Old 02-07-2010, 10:29 AM   #13
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Re: 9 MONTH POST OP CHECK UP for PTTD

Thank you for the info...Do you know if there is every complete recovery? After a year, is there still pain with too much activity...other limitations? This is a nightmare problem...Most other problems fixed with surgery are healed and history in a matter of weeks...seems like this is never ending...Thank you..hope all is still well with you..I am still waiting on surgery until my husband can help me...wearing a brace that is wonderful...Take care..

 
Old 02-10-2010, 10:43 AM   #14
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Re: 9 MONTH POST OP CHECK UP for PTTD

Quote:
Originally Posted by ZacBit View Post
Thank you for the info...Do you know if there is every complete recovery? After a year, is there still pain with too much activity...other limitations? This is a nightmare problem...Most other problems fixed with surgery are healed and history in a matter of weeks...seems like this is never ending...Thank you..hope all is still well with you..I am still waiting on surgery until my husband can help me...wearing a brace that is wonderful...Take care..
As I said I'm not at the year mark yet...but there is still pain with too much activity. If I've been on my feet all day there is no way that I can go walk the mall for 3 hours. Also I think weather has a lot to do with pain. When it changes like rain or snow I have more pain than usual. I agree with you that it is a nightmare situation. I really didn't believe my surgeon at first when he said that this is not a quick fix. I thought after the swelling went down I'd be back doing everything as before. What kind of a brace do you have? I wore an Arizona brace for 3 years until I was told that I couldn't put off surgery any longer. It did help with the pain. Doing this for 3 years helped me to build up my sick days so I wouldn't lose any pay while being off. I'm glad your husband will be with you. Mine could only take off 3 days to be with me. He works for the railroad and is away quite a bit. I learned to do a lot real fast. My advice is to practice with crutches, walker, or knee walker before surgery so you get used to doing things on your opposite foot. The worst part for me was having to wait until my husband was home to get into the shower. There was no way I'd try to do that without him there. Also, once the cast was off and the boot was on I still couldn't drive because it was my right foot. Being house bound about drove me nuts. Take care and let me know what's happening with you
Rose

 
Old 09-11-2010, 01:25 PM   #15
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Re: 9 month post op check up for pttd

Quote:
Originally Posted by rose815 View Post
As I said I'm not at the year mark yet...but there is still pain with too much activity. If I've been on my feet all day there is no way that I can go walk the mall for 3 hours. Also I think weather has a lot to do with pain. When it changes like rain or snow I have more pain than usual. I agree with you that it is a nightmare situation. I really didn't believe my surgeon at first when he said that this is not a quick fix. I thought after the swelling went down I'd be back doing everything as before. What kind of a brace do you have? I wore an Arizona brace for 3 years until I was told that I couldn't put off surgery any longer. It did help with the pain. Doing this for 3 years helped me to build up my sick days so I wouldn't lose any pay while being off. I'm glad your husband will be with you. Mine could only take off 3 days to be with me. He works for the railroad and is away quite a bit. I learned to do a lot real fast. My advice is to practice with crutches, walker, or knee walker before surgery so you get used to doing things on your opposite foot. The worst part for me was having to wait until my husband was home to get into the shower. There was no way I'd try to do that without him there. Also, once the cast was off and the boot was on I still couldn't drive because it was my right foot. Being house bound about drove me nuts. Take care and let me know what's happening with you
Rose

 
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