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Old 04-11-2011, 04:23 PM   #1
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Questions Concerning Post Surgery of Posterior Tendon

Hi!To All,
New to this thread,found it to very informative.Had my posterior tibial tendon surgery March7th 5 weeks ago.Can anyone give me any information regarding how long the Cam boot is worn?Has anyone who has had this surgery been able to go back to running?Never ran competively,but truly enjoyed it most of my life.Also,there is a difference between shoes that have arch support and ones that have ankle support.Are there any shoes out there that can do both?To all the girls out there,can high heels ever be worn again later on in life?
Greatly Appreciate any info

Last edited by immobilegirl; 04-11-2011 at 06:02 PM. Reason: Ambigious Title

 
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Old 04-11-2011, 06:29 PM   #2
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Re: Questions Concerning Post-Surgery

Did you have other proceedures along with the ptt surgery? Didn't your doctor tell you how long you will be NWB and then in a boot while weight bearing? Each doctor has his/her own protocol. I had several other proceedures. I was NWB for 8 weeks, followed by wearing a boot whenever my foot was on the floor for about 6 or 7 weeks. I am now 8 months post op and doing well. I really don't know about running because, I am thrilled to walk without pain. I am cleared to to most activities except high impact ones. I have never been a high heel person, so I don't know what to tell you about them. You should talk to your doctor about that down the road. If anything, I would think that you would want to stick with a lower heal on occasion when you are going out for a few hours. The repaired tendon is never as strong as it had been prior to injury. How far post op are you?

 
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Old 04-14-2011, 09:06 AM   #3
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Re: Questions Concerning Post-Surgery

Hi roxygirl,
From an older post you wrote I noticed you had youre surgery done at HSS.Mine was also.Although originally from NYC we are currently in upstate NY.I mention this because the podiatrist I intially saw told me the only 3 surgeries he saw,2 of them had their foot amputated,he didnt go into specifics.That was enough to get me to travel back to the city.
I too had the tendon transfer as well as the medial slide calcaneal osteotomy and achilles lengthening.Found HSS to be a wonderful facility in implementing needs.My pain management sounded a bit different.I elected to be in a study group,not sure if this had anything to do with why I required so much pain med.I had 2 nerve blocks,Dilaudid drip(which I knew is quite potent,used for cancer patients,and had percocet every 3to4 hours).Presently,I am 5.5 weeks post op.My surgeon is having me return at the 7th week for the cam walker.Did the walking boot hurt more than the cast?Was it uncomfortable initally to sleep without protection on the foot?
My surgeon too specialized in posterior tibial tendon dysfunction.Maybe we had the same surgeon.Did you have to go to PT or did the surgeon rely more on the exercises he gave to you to implement.In all honesty,Im a little leary of some of the skills of the medical practice being away from a big city.I was a critical care nurse working next door to HSS and I can see the difference.
Thanks Roxy,you have been very kind in answering questions to so many different people.The plus side of living here in upstate is not missing New Jersey traffic.

 
Old 04-14-2011, 02:08 PM   #4
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Re: Questions Concerning Post-Surgery

I also had similar surgery at HSS on 3/2. I had about five things done-evans calcaneal osteotomy with bone graft from my hip, gastroc procedure, the tendon transfer and something with a metatarsal fusion. (I'm not good with all the names.) I went for my almost six week xrays and post-op on Monday. Everything looks great- the foot on xray looks amazing (except for staring at all the screws!) I am going back on May 2nd to hopefully start PWB. It takes eight weeks for the graft to fully take so on this xray it hadn't fully grafted-I guess that is how you say it. I start PT that week and the rx had me going 3x a week for six weeks. I didn't ask about how long I wear the boot for, but I would imagine for at least another couple of weeks once I start weight bearing. I feel like I am nearing the end...not quite there yet...but getting there!

 
Old 04-14-2011, 02:13 PM   #5
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Re: Questions Concerning Post-Surgery

immobile girl, were you a CCU nurse at Cornell? My husband is an MD there. Also, read about your inquiry regarding high heels. I too, hope I can get in them soon. At this point, I just want to get a sandal on for the summer. Are you in a cast? I've been in the boot for the past two weeks. My foot continues to look better. All the scabs have fallen off and the scars aren't too bad. I am constantly flexing and rotating my foot in the hopes that once PT starts, the rehab goes quicker.

 
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Old 04-14-2011, 03:25 PM   #6
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Re: Questions Concerning Post-Surgery

Hi Foxy,
We had our surgery within 5 days of one another.I had mine on March 7.I was in the hospital for 5 days which seems a bit more than the usual.I didnt have a bone fusion.Im happy for you that you were able to get into a boot so soon.I'm scheduled to get mine off the day after Easter,March 25.Were you allowed to sleep with the boot off initally?Did it feel strange?Noone ever mentioned PT to me yet.Im a little concerned like I said since Im now in upstate NY and feel they are a little antiquated when it comes to how to handle certain surgeries.Please keep me posted if you dont mind about youre PT.I dont want to ruin this surgery by improper PT.Are you receiving PT in NJ or the city?
I was told not to wear flat shoes(sandals)after everything heals.Is this true?
My husband is also a physician.I worked at Cornell in the MICU for 10 years.Do you work?I stopped working when we moved upstate.Are you still taking any pain meds?In all honesty prior to surgery I had severe insomnia so I only take 5 mg Percocet to help sleep with being in a flat position and foot elevated.How was youre stay at HSS?Glad to find someone out there with similar circumstances.

 
Old 04-14-2011, 03:55 PM   #7
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Re: Questions Concerning Post-Surgery

Hi Immobilegirl,

I would love to compare experiences. I found a local PT practice that was recommended by a friend who is a foot and ankle surgeon in Englewood Hospital. He only refers to this specific practice. I set up the appt for 3 weeks from now because sometimes I have heard there is a back-up at these PT practices. My md gave me the rx so I see exactly what I'll be doing. I can't wait to reach this next stage!

When did your md say you can start PWB?

I'm going again one week after you for another set of xrays and I hope on that day to get the green light. This seems like an eternity!

Regarding the shoes, it didn't even come up yet. I guess I just am avoiding it. I hope I don't have to wear sneakers all summer! I live for sandals.

Last edited by moderator2; 04-14-2011 at 04:54 PM.

 
Old 04-14-2011, 04:37 PM   #8
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Re: Questions Concerning Post-Surgery

Which doctor did you use? I used Dr. Deland. I was in the hospital for three nights. I was very pleased with the hospital facilities and staff. I am almost 9 months post op and so far I am thrilled with the outcome of the surgery. When I first started to sleep without anything on my foot, I wore the aso brace that I had used prior to the surgery....more for my own peace of mind. When I went for my 8 week check, I had almost no movement in the toes so Dr. Deland sent me for pt. I used the outpatient facility affiliated with a local hospital. I had used on of the therapists before and he is excellent. His first job was working for a foot and ankle ortho in MD. When he first moved to NJ, he was going to go for an interview as supervisor of pt at HSS but he decided that he didn't want to deal with daily travel into the city. I agree with you that you have to be selective with your choice of Physical Therapists. You mentioned that your husband is a physician. Does he work near your house? If so, could he find out which pt's are good?

 
Old 04-14-2011, 04:49 PM   #9
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Re: Questions Concerning Post-Surgery

Hi Foxy,
Whats your views on the caustitive agents of why this happened to us?Personally I think its genetic.I recall my grandma walking with her ankle bone almost touching the floor.Although you are younger than me,statistics show this commonly happens over 60,overweight or diabetic.Im none of these,luck of the drawer?
Very difficult initally,since you understand husbands long hours,we have no family up here so had to rely on friends.Although they are great you hate to ask for help.Did you have help in NJ?Sorry if any of these questions are redundant and you have answered them before.
When I go back it will be the beginning of the 7th week.Its hard trying to schedule an appointment because my husband has to reschedule his patients initally and we have to drive 5 hours each way.I think PWB begins at the 8th week margin.Is that when you have to begin PT or later.I guess what meager means I have up here I have to look into this soon.What did you put on youre foot when you first got the cast off for the dry skin
Had over 40 to 50 stitches.How many screws do you have?I have 4.Will not have them taken out unless they bother me.My husband was in a head on car crash several years ago broke his ankle and had 6 screws placed.He never had them taken out.Im assuming its different for us based on anatomy.We are stepping down with our heel,much easier to feel the screws than your ankle.Youre back at work?Thats amazingHopefully theres sandals and high heels in our future..

 
Old 04-14-2011, 04:59 PM   #10
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Re: Questions Concerning Post-Surgery

Hi Roxygirl,
I too used Dr.Deland.Can i askyou how many screws you had placed in your feet?I recall the NP telling me Dr.Deland is very strict about his PT and gives his own specific exercises.Is this true?Like Ive told Foxygirl its hard to find good PT in rural area.
I too found HSS too be an amazing facility as I worked at hospital next door for 10 years.Hospital staff was courteous and kept up with pain management.After the surgery I didnt see Dr.Deland for 2 days although the PA stopped by.I guess he'S a busy guy.Very long wait on the 5th floor to see him especially the drive takes 5 hours and I have my little girl with me.Glad to hear he did and amazing job on youre foot.Enjoy the summer with youre new found foot.

 
Old 04-14-2011, 05:26 PM   #11
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Re: Questions Concerning Post-Surgery

I had two very long screws for the calcaneal osteotomy and a pin for the cotton osteotomy. He was clear that he wanted pt to consist of rom activities but NWB and no stretching the ptt area. Dr. Deland is cautious which is fine with me. He had me in the boot 6-8 weeks post op. He is big on not putting any stress on the ptt until it has had ample time to heal. I was out of work for 4 months because I have to be pretty mobile at work. I can't believe that the podiatrist said that he saw two amputations as a result of flat foot surgery. I wonder if it was due to severe infection

I can't believe how good I feel now. Prior to the surgery, I was barely able to walk from room to room in my house due to pain. I am cleared for pretty much all activities except high impact and activities that involve lots of twisting or pivoting. Last weekend, my husband and I went to New Hope with another couple. We walked about 1 to 1 1/2 miles. I was able to do the walk without any problem!!!!!!!!!!!!!!!!! I was working all day today and then did some errands after work. We plan to walk our three dogs tonight.
I am so happy that I took the time to research the different doctors and use one that has done so many of these proceedures. We had a two hour drive into the city. Even though the drive is a pain, it is so worth it. I figure that a bit of inconvenience is no big deal if it could make the difference between a good outcome and a life of pain and disability. Keep us posted

 
Old 04-14-2011, 06:05 PM   #12
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Re: Questions Concerning Post-Surgery

Agreed that these are bad genes. I am the only one in my entire family that inherited these nasty feet from my grandfather. I am young and not overweight at all but my feet have been flat since I can remember-I was in orthotics when I was 10 years old. I had my excess naviculars excised in high school and my feet have just gotten worse thru my 20's. I started exercising a lot more and have had three kids which I believe led to the final straw-the rupture of the tendon! The doctor said that it is rare to see a woman my age with my feet-what can I say, I'm unique!
I saw the xrays and I counted at least six screws-two at the heal and four + around the rest. But, my foot looks great. He showed me the before and after and I almost cried looking at it.
I will be NWB for over 8 weeks. The bone graft has to fuse completely. I am already moving my ankle around in ROM exercises as well as flexing it up and down. I still cannot drive because it was my right foot. That is the hardest part. I am completely dependent on everyone. My husband works crazy hours and my parents live out of town. My friends have been amazing. They drive me to and from work every day. I had meals for my family for over a month. I can now bear to stand long enough on the knee scooter to get dinner ready for the kids. But I have reached the point in this process of frustration. It's so hard to rely on others. Luckily, I live just outside the city so I don't have to travel. Every time I have an appt, I have to figure out how to get to the city and how to get home. I hate asking my friends for huge favors like taking me into the city. I've already gone to a couple of the appts by myself but after being married to my husband for so many years, I am totally used to it!
The PT is hugely important so I wanted to make sure to go to someone that I know is trustworthy and knows how to work with this kind of surgical procedure. I trust my friend so I am comfortable with this practice.I'll be going 3x a wk for six weeks-and the first week I can't drive.
I hope I can get this boot off soon. As the weather changes, I dread the heat of this boot.

 
Old 04-14-2011, 07:06 PM   #13
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Re: Questions Concerning Post-Surgery

It's funny I also think it skips a generation since my mother and father had no problem at all and my mom is still going strong at 75.I too was born with flat feet and had to wear orthopedic shoes.Youre right we are lucky ducks.
Although my ptt repair was on my left foot I found myself attempting to drive a little too early.I tried after the fourth week.Although I drove safely and only for 10 minutes your primary focus is the leg.Not sure how safe that is similar to people talking on the cell?Would not try alone just yet.Can you recommend anything to put on your feet that works well after I get the boot?God Bless you have three little ones.I feel bad because although my daughter is 11 I feel somewhat guilty for its as though we have switched roles.She's a blessing.Before she leaves for school she has brought my pillows,computer, toiletries downstairs.There's 12 steps to get down to my first floor.She also brings the walker.I didnt feel steady enough to use crutches and I use the walker.Most malls have wheelchairs to borrow.Not sure if the trials and tribulations of having this surgery is more physical or psychological.What form of exercise did you do prior to surgery?My surgeon has a more conservative approach so although he tells me its probably better not to run the elliptical,walking,swimming are all options.
Understand the frustration.While I was in the HSS I had 2 roomates.Although they were both there for knee replacement surgery they were both mobile very quickly.My surgeon told me that the most painful surgery are foot and ankle and spinal.Like Roxy once explained there is a very poor blood supply that goes to the tendon and we place a large percentage of our weight on this tendon.Bones do heal nicely in several months,tendons tend to be a little slower.Stay focused .

 
Old 04-14-2011, 07:25 PM   #14
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Re: Questions Concerning Post-Surgery

My kids have been great under the circumstances. They get me everything I need. My husband was on call last night and today was garbage day. It was quite the scene seeing my two big ones lugging the garbage cans to the corner! I have primarily been wearing either a sneaker on my left foot or a suede Cole Haan Nike Air boot that is very comfortable. On one of the warm days I tried a fit flop but it was too dangerous and I changed it immediately.
I had gotten in to weight training and body conditioning at the gym. I was training privately once a week and going to classes whenever possible. Since the summer I had pretty much stopped using the treadmill for more than a few minutes. It was hurting my feet too much. I love the ellipitical so I hope to be back on that soon. I know swimming is the best exercise but I hate swimming. Hopefully the pt will give me some strengthening exercises to do on my own at home and I'll be back at the gym soon.
You are correct about these types of surgeries. Everyone I asked said foot and ankle are the worst. THe first two weeks post-op I thought I was going to die every time I had to get up to go to the bathroom. Now I am so much more mobile.
I know all of the surgeons there are pretty much under the same overall philosophy but they all have varying protocols. I have been thrilled with my experience. I had to go to the office two extra times and it was not a problem at all to get with him and see him. When I've had to call, he calls me back right away. As hard as it has been, my experience has been only positive.

 
Old 04-14-2011, 08:15 PM   #15
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Re: Questions Concerning Post-Surgery

Foxy, where did you have your surgery? Who did you use?

 
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