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Old 02-15-2010, 08:27 PM   #1
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Tips on adjusting/recovery after simultaneous double cheilectomy

Hello all,
I've been searching through various sites/threads and have had trouble finding info from people who have had a cheilectomy on both feet at the same time.

I was told that I would be off my feet for a full two weeks but I read that someone was "heel walking" within 4 days. I'm trying to imagine and prepare for the challenges if I really can't walk for 4 days. Should I plan on needing a wheel chair? Am I going to have to crawl around on my hands and knees? And then there's the whole bathroom and shower challenges??

I'm planning on having both feet done at once for two reasons, first because it will be less expensive then to do them seperately and secondly because I need to get back to work as soon as possible (I'm a general contractor and don't have sick pay or a lot of money saved up for down time).

Assuming the surgery goes well, how long before I'll be able to drive?
How long before I can limp around, even if on my heels?
Should I get a wheel chair? And should I plan on any other "accessory" items to help with the day-to-day tasks?

Thanks,
-Mike

 
Old 02-16-2010, 05:37 AM   #2
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

I only know one person personally who had both done at one time. He could walk but it was very slow going. I'm surprised they are saying you will be NwB for two weeks as it is normal to walk from day one with this procedure. Are they doing other things beyond a simple cheilectomy (cleaning out of spurs and chips?). I had one with an osteotomy to remove the bump on top the toe and walked out of the surgery center on crutches. They put you in a surgical shoe - a flat board with cloth upper and velcro closures.

As for showers/baths, there is a gismo called a "cast cover" that you wear over the foot/leg to keep it from getting wet. My surgeon provided one but you can buy them at most large drug stores.

Once you are out of the surgical shoe (when you get your stitches out normally), you should be free to drive. You may need to wear the shoe a little longer if you still have swelling. I was in it about 3 weeks but since it was my left foot, I could drive all the time.

Be sure to 1) DO YOUR EXERCISES! and 2) get some sturdy soled shoes that you can slip your foot in rather than having t o bend it too much.

Good luck and keep us posted.

 
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Old 02-16-2010, 07:46 AM   #3
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

Hi Titchou, thanks for the reply. I'm not sure what all the technical terms are for what they're doing but I have limited movement in my large toe bone on both feet so they are shaving the spurs off the larger bones back to the original shape so that I'll have full movement again. I think that part is the cheilectomy. Then I do have some bone chips they are cleaning out at the same time. I think they're able to do it all from the top of the foot, which I hear is good since there are a lot of nerves in the bottom of feet which makes recovery quite a bit more painful.

I meet with my Dr. this afternoon and will be asking more of these questions so I'll post what I learn. My surgery is scheduled for March 1st.

 
Old 02-16-2010, 09:11 AM   #4
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

Looking forward to what he says! Keep us posted.

 
Old 02-18-2010, 10:36 PM   #5
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

Mike, I didn't have both done at the same time but I had one done in November, the other in Dec. My surgeon requires a minimum of 4 weeks in between surgeries and will not do a bilateral cheilectomy because in his experience those patients do not do well. Of course there are always exceptions to every rule but in general that is true.

In retrospect I would have waited a year between surgeries. The pain/recovery has been tough and I would dearly love to have one dominant foot right now that would be relatively pain-free.

One thing I have learned through this experience is that there is a wide variance in post-op courses. You will hear from some on this board that they sailed through their recovery while others have a more typical course. And then some of us have the slow route to complete recovery. Also, it's often different in each foot. With my right foot I was on narcotics for 2 weeks; with my left foot after 3-4 days Aleve was all I needed.

I am an RN, my husband is a physician. My surgeon is a foot/ankle orthopedist at a sport medicine center who counts our pro sports team members among his patients. So, we're no dummies and we had access to the best surgeons/medical care. And I still can't walk pain-free nor can I stand for long periods of time. I've found Merrells to be the most comfortable shoe (I also HAVE to wear shoes in the house now). I have some hypersensitivity of the skin and occasional stabbing pains in my toes, which often wake me in the night. I do have RA so that complicates my recovery and my surgeon has told me to expect it to take at least one year before expecting to be "normal" (whatever that is).

I walked out of the surgery center in a surgical shoe, but on strict elevation for 2 weeks, then gradually increasing my activity as tolerated.

I'm not telling you this to scare you but to give you another perspective to think about before you commit to having both done at the same time.

 
Old 02-19-2010, 06:44 PM   #6
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

Hi JanB37, thanks for the reply and the good advice. After meeting with my Dr. Tuesday and thinking it through I have also decided to do one foot at a time. She said basically the same thing as far as people that do both don't do as well. She said when you only have one done at a time you have the good leg to rely on so you can truly baby the one that had surgery and give it a chance to heal properly.

As for the recovery time, I agree, there seems to be a very wide range of recovery times reported. My Dr. also told me 2 weeks to stay off and then slowly using it as much as I can handle the pain. My plan is to do the first and then wait to schedule the second until the first is almost completely healed, at least enough to completely rely on it.

I hope your recovery goes well and thanks again.

 
Old 02-20-2010, 06:57 AM   #7
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

Mike, It sounds like you have an wise, excellent surgeon. I'm happy to hear you are aren't having a bilateral procedure.

Best wishes for a successful surgery and recovery! Be sure to check out those Merrell clogs when you're ready for a regular shoe :-)

Jan

 
Old 02-22-2010, 09:04 AM   #8
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

Here's a link to a great thread on how to prepare:

http://www.healthboards.com/boards/showthread.php?t=608502

 
Old 02-27-2010, 09:27 PM   #9
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

Mike, I had a cheilectomy just on one toe. I THINK my recovery was a piece of cake, but that's comparing it to the previous calcaneal osteotomy and tendon transfer. That was work.

Monica, that IS a great thread! I don't know if I can still post to it, but I was just getting ready to post something similar. Before I had my first surgery, I found Healthboards and read every single post that had anything to do with PTTD. I took notes, and thought about putting together a list of every great idea presented here. I didn't get around to it, though, until now when my mom is going to need the same surgery.

I'm going to try to get it on the board tonight, but not sure where, yet.

Mike, all the best.

hugs to all,
Lisa

 
Old 03-05-2010, 08:14 PM   #10
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

Hey everyone. Thanks all for the great input. I thought I was supposed to get an email when there was a post to my thread but I'm not which is why I'm late in replying - I just thought I'd check and here were several new ones!

Anyway, I'm on day 4 of recovery from the cheilectomy on my right foot. So far so good! The procedure went very well. It took about an hour and half. I vaguely remember the Dr. coming by and showing me a photo or Xray of my foot after the procedure but I was still pretty knocked out and don't remember much of the conversation. I was sent home with Vicadin but my foot stayed numb for almost 36 hours after the procedure so I didn't have much pain anyway. I was concerned because my foot was still numb after so long. I called Kaiser (my health care provider) and the nurse told me it is common to last up to 24 hours, sometimes as much as 48. They did a "ray block" to numb the area along with a sedative to knock me out during the procedure.

Before I had the work done I purchased a BioChill system. This was by far the best decision I could have made for my recovery! It's basically a cooler that holds ice water and it pumps the water through a pad the sits right on my foot. My Dr. applied the pad in my dressing when she bandaged the foot right after the surgery. There are two short hoses that exit the dressing that have connectors which connect to the hose coming from the cooler/pump. There is a controller that will vary the amount of time the pump is on and off. I leave it plugged in and running all the time and I'm convinced it is why I've been relatively pain free since I left the hospital.

So, for all of you heading toward a surgery...get one of these ice water pumps!

I took the Vicadin for a couple days after the surgery expecting the pain to get worse as the numbness wore off but it never did so I dropped the Vicadin and just used ibuprofin as needed. And today I didn't even need that so I'm off drugs completely after 4 days.

I'm also making sure I keep my foot elevated and on this ice machine all the time. In a 24 hr period I'm probably off the ice machine for a total of 2 hours and up and around (on crutches) for only an hour total. Plenty of cabin fever and boredom but I'm committed to recovering quickly so I figure I need to stick with the program.

My first post-op Dr.'s visit is Monday the 8th. I'm supposed to get stitches out and start trying regular shoes on the 15th (a week from Monday).

I'll keep updates coming as things progress.

 
Old 03-06-2010, 11:17 AM   #11
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

You're doing so well! Congrats. Isn't it a relief to be past the first one? Now that you know what to expect, the second one will be a piece of cake, I bet.

I wish my surgeon would have been onboard about the ice-device. I love that your's put it right in your splint--makes such sense. I borrowed one from a family member and used it without telling him. He's against them. Apparently one of his patients used one and got frost-bite. She ended up losing half her foot. I still, for the life of me, can't figure out how anyone could become frost-bitten using one of these things, but it is a cautionary tale. I felt cautioned and I was careful.

ALL the best,
Lisa

 
Old 03-06-2010, 04:59 PM   #12
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

Hey Lisa. I asked my doc about the chances of frostbite, too, but she assured me that the way she puts the water pad "thingy" on it was not a concern. Still, I was checking the color and temp of my foott often just to be sure.

 
Old 03-06-2010, 08:57 PM   #13
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

Mike, so glad you're doing so well. I tried a compression cuff (borrowed from a friend) on one foot but found the compression part painful so stopped using it. I like your idea better, wish I had known about it.

Smart idea to follow the program...in the end you'll be glad you did!

I'm doing MUCH. MUCH better. No doubt in my mind my RA slowed my recovery, esp in my rt foot, but I have hope now that in the end all will be well.

Mike, Thanks for checking in and updating us on your progress. Sending you healing wishes!

Jan

 
Old 03-07-2010, 08:57 AM   #14
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

All I could think when my surgeon told me about that patient is that someone must have made some kind of Tim Taylor "improvement" to it. Even if you put the pad on bare skin, I can't see how it could cause harm. It's just very cold water!

So I used it, it helped a lot, and I didn't share with my surgeon.

Do you know when you get to start PT? The stretches are scary but crucial. I'll share my best stretch:

It's natural for me, when sitting at the computer, to put my toes on the floor with my heels raised, and with my butt perched on the edge of the chair. In fact, that was the first real sign that I had a problem with that toe (it became too painful to sit that way). When I got the go-ahead from my PT, I resumed sitting that way.

I'd get in that position, wait for the discomfort to ease, then pull my feet a little farther under the chair (increasing the stretch), and like that until I felt that I had achieved maximum stretch. Then I'd keep my feet in that position for maybe 20 minutes at a time, then pull them out and let them slowely relax into neutral. I did that many times a day. My surgeon was startled that I got back so much range of motion--My PT and I credit this stretch.

The best thing about it is that I could do it without thinking so much (you know, "pull this direction, hold it this many seconds, do 3 reps, repeat twice a day, blah blah blah"). Yeah, I did those, too, but what a bore. I hate boredom.

All the best,
Lisa

 
Old 03-07-2010, 02:35 PM   #15
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Re: Tips on adjusting/recovery after simultaneous double cheilectomy

Great PT tip, Lisa. I'll keep that in mind when I get the stitches out and get to start using it again. I'm definitely anxious to get back to full steam.

 
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