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Old 08-08-2011, 07:08 AM   #1
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OCD lesion surgery in two days, please help!

Hello everyone,
I'm new to these boards so please excuse me if I'm in the wrong place! Any info would be helpful.
My story:
I'm a 53 year old runner/woman (hah, former runner I guess) who has been limping around on a bad right ankle for about a year. I did the right thing,went to an area ortho who specializes in sports medicine. He said it was Achilles Tendonitis, advil, ice, reduce running, stretch.
I did all that and kept running. Gradually, walking became more and more painful. Went back to ortho who said it was def tendonitis, (no xrays) and shot it up with cortisone.
That didn't help at all.
I was still hobbling around, forcing painful runs, stretching, trying to increase my over-all fitness, when a friend/nurse suggested I see an ankle specialist.

I went, he did the MRI and I'm having OCD surgery on Wed.
I went to the appointment alone and was so stunned by the results that I was off my game. Iv'e been calling the nurse for further info on the surgery, injury.
They are going in with a scope and drilling the area. She just left me a message that the lesion is 553 mm. I called her back to ask if that is considered big/small/medium.... meanwhile, registered here and figured I could get answers.
Questions: how bad is the post op pain? They said I have to keep foot above heart for 2 weeks. That blows my mind. I'm extremely active, have had to cancel everything in my life it seems and the recovery sounds horrible.
Any tips??? Should I try to rent better crutches? I picked up a shower seat and stocked the fridge with food. My husband is great but I'm worried this is going to be a lot to handle.
I'm also pretty freaked out about all of it.
Any help is greatly appreciated! Oh, and this is petty but should I call the first doc and let him know that he was wrong?

Last edited by runnerwriter; 08-08-2011 at 07:36 AM. Reason: Oops,,okay, just heard back from nurse and the lesion is 5 by 3, some edema, some cinivitis, small rent, p

 
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Old 08-08-2011, 07:38 AM   #2
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Re: OCD lesion surgery in two days, please help!

Although I had a different foot surgery than you, the "sticky" post above in dealing with non-weight bearing following surgery is a must read. I am now in my 7th post-op week from surgery for Hallux Limitus Rigidus.

I too was 2 weeks with my foot elevated 23 out of 24 hours - it is tedious and your body will not like you for it, but it is completely doable. I used my one hour of hobbling on my heel (which I was permitted to do) in small increments - sometimes I would get down on my yoga mat and do some stretches & twists to help my body - I also used some "meditation" & guided imagery tapes for relaxation (one was my 25-year old lamaze tape!) - also yoga "legs up the wall" pose is great - takes a lot of stress off the hips - I also did this one with laying on the floor with my legs up and my calf supported by the sofa or a chair - a great break from laying on a soft surface like a sofa or a bed with your legs propped by pillows.

Just so I wouldn't feel like I was a prisoner in my bedroom, I moved myself to the downstairs and slept on the sofa for a few weeks - I felt it was safer to be on the ground level in case of an emergency and I wouldn't be able to navigate the stairs safely. Also, the sofa (which is big and comfy!) gave me more support for my foot and leg - the more confined area kept my foot in the elevated position much more easily - and I didn't have to worry that my husband would roll over or kick my foot during his sleep!

I'm sure you will get more advice regarding your specific surgery, but there is a wealth of info on these boards for just the coping with the aftermath that all of us are going through.

I'm sending my positive thoughts to you!
Grace

 
Old 08-08-2011, 07:45 AM   #3
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Re: OCD lesion surgery in two days, please help!

Grace, thank you so much!!! I am getting out my meditation tapes too. I'm so not a TV person but I borrowed the entire LOST episodes.. Would you mind explaining about sticky notes? I would love a link to a good thread on this!

 
Old 08-08-2011, 08:21 AM   #4
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Re: OCD lesion surgery in two days, please help!

hello, see the thread overview of ankle OCD procedures that should be under this one.. With a 3 x 5 you should not be rushed into anything unless the pain is unbearable. Read up on this first plus research your doc.. You may want to postpone it for now.. Make sure doc is qualified

 
Old 08-08-2011, 08:27 AM   #5
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Re: OCD lesion surgery in two days, please help!

It is quite painful to walk for any period of time. I've been limping around for months. Sometimes the foot "locks" and that's almost unbearable. But then,,there will be days when I don't feel any pain.
THe doc is supposed to be one of the top ankle guys and checks out. I was told, or at least what I heard was that these tend to get worse. I've felt better in a boot but as soon as I walk around w/o it, it starts up again.

 
Old 08-08-2011, 08:55 AM   #6
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Re: OCD lesion surgery in two days, please help!

Hi Runnerwriter -

The "sticky" post is in the area of this Foot Problems board right above where the new posts are displayed

Here is the direct link - have fun reading!

http://www.healthboards.com/boards/showthread.php?t=737812

Grace

 
Old 08-08-2011, 09:53 AM   #7
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Re: OCD lesion surgery in two days, please help!

I have had OCDs in both ankles. The locking is not fun thats for sure. Your pain level sounds like you need action. There have been others who do not have alot of pain so they can wait and reserch techniques and doctors. My first 2 surgeries I went into fairly quick. The third was after a failed drilling and the doc wanted to do it in 2 days. I chose to wait a week cause of work and my kids, I needed time to tie up ends before an OATS. The one I am almost recovered from I waited over 2 years to have. Best wishes for the surgery and recovery.

 
Old 08-08-2011, 02:07 PM   #8
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Re: OCD lesion surgery in two days, please help!

My personal opinion is you should not have surgery so quickly. Yes you probably need surgery and what the doctor suggested is probably the right surgery, but my suggestion is take some more time to think about it and get ready for the surgery, unless your insurance coverage is about to expire. If you are wearing the boot and not running or jumping, it's unlikely to grow if you wait a few weeks. Have to run to a PT appointment, will post more detailed thoughts later.

 
Old 08-08-2011, 07:45 PM   #9
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Re: OCD lesion surgery in two days, please help!

ok more thoughts on this.
  • 5x3mm is not so big for talus OCD. If you're lucky, it will turn out to be smaller in real life than it was on the MRI.
  • Yes, they usually grow over time, especially with running or jumping. But I doubt it's going to grow in any significant way if you walk around in the boot for an extra week.
  • Ask your doc how many times he/she has scoped the ankle and how many times microfractured an OCD. IMHO, good answer is >50 times. Better answer is >100 times. Compromise answer for an ankle specialist could be >100 ankle scopes and >20 OCD microfractures.
  • Scoping cleanup and MF is probably your best bet, but it's not the only treatment option. Most of the other options (OATS, DeNovo, Carticel, etc.) probably have a higher success rate but usually require osteotemy and cost more, and might not be covered by your insurance. At least discuss options with your doctor first. Consider getting a 2nd opinion.
  • You will want to elevate as much as possible for the first week. My personal experience was having it down for more than 20 minutes caused swelling and discomfort so I elevated 23/24 hours. By the 2nd week, I could have it down 30 minutes. By the 3rd week I could have it down for an hour. Now (5th week) I can have it down for 3 hours with no pain and almost no swelling. But your mileage may vary. Depends on how many blood vessels get nicked in the operation (which can be inversely related to the skill and experience of the surgeon) and how your body responds.

Whatever you decide, best wishes for a fast recovery and good outcome.

Edit: I was a little too optimistic on the swelling part. I noticed this morning that with the foot down for 20 minutes, I still get dime-sized swelling bumps around the portal incisions. It doesn't hurt, but looks funny. I'm still happier putting my leg up when sitting for long periods, but I liked putting my legs up even before the surgery.

Last edited by LivesNearStore; 08-09-2011 at 10:18 AM. Reason: shorten post; then revising my swelling story

 
Old 08-12-2011, 08:18 AM   #10
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Re: OCD lesion surgery in two days, please help!

thank you! He said the lesion was deeper than the MRI showed, 1mm? And was more on the side than the middle like he thought.
I hope it was necessary to do this! I was afraid of further damage considering I've been running/walking with pain for a year. He made it sound like it was the only option. What do you think?

 
Old 08-12-2011, 09:31 AM   #11
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Re: OCD lesion surgery in two days, please help!

Well no point in stressing yourself out or beating yourself up about the options at this point. Just concentrate on your recovery. Don't over do it. Nothing crazy like trying runing or jumping too soon. It seems to me (my opinion) that OCDs do not heal on thier own, so no matter what or when, I think, you would have to take some action. I think your pain made it feasable to take action. So take it easy. Ice, Elevate, do yoga, puzzles whatever. just don't beat yourself up mentally. This recoop is hard enough without all that too.

 
Old 08-12-2011, 10:11 AM   #12
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Re: OCD lesion surgery in two days, please help!

I don't know much about OCD lesion depth. Read somewhere that for the average adult female, talus articular cartilage is 1.0-1.2mm thick and for average adult male it's about 1.5mm thick. Did your doctor mean it was 1mm deep, or 1mm deeper than it appeared on the MRI? Mine looked to be a lot deeper on the MRI, but that was OCD+edema. At surgery mine was somewhere between 4-6mm deep (based on the photos--the doc did not give me his estimate).

Some OCD lesions affect only the cartilage; maybe you had one of those? Mine unfortunately had cystic bone underneath. One doctor said that meant MFx would not work and my only option was OATS, but I'm hoping he was wrong.

Was yours medial (inside) or lateral (outside)? I know on the medial side, lesions to the side on the "shoulder" of the talus are harder to treat with grafts, because of the unusual shape. I don't know anything about the location of lateral talar OCDs.

 
Old 08-12-2011, 01:58 PM   #13
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Re: OCD lesion surgery in two days, please help!

ithink he meant deeper, and there was a lot of fragments and such. I hate it that I didn't get to talk to him after surgery but I will go to the 2 week check up very prepared with questions. Upon my first visit to him, I was hobbling and in pain. The boot really helped and I felt like a few more weeks in the boot and I would be okay.
Anyway, like you said, it wasn't going to resolve and would probably have gotten worse.
Still, I'm so worried that he might have jumped the gun.

 
Old 08-13-2011, 06:25 AM   #14
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Re: OCD lesion surgery in two days, please help!

thank you! I am trying to keep a positive attitude. It's rough having to be so dependent on someone to fetch for me! I wish I had found these boards a few weeks ago. Anyway,, I'm going to keep on reading.
Did you have bad headaches after the surgery? I've never had headaches before and this is a crushing scary headache pain. I'm wondering if it's the lortab?

 
Old 08-15-2011, 09:38 AM   #15
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Re: OCD lesion surgery in two days, please help!

Lortab, appears to be similar to Vicodin, which is what I took. It didn't gave me headaches but gave give me GI problems. The ***** link on narcotic painkillers (including Lortab) says they can cause lightheadedness.
http://www.*****.com/pain-management/narcotic-painkillers

Make sure you're drinking enough water. I think something like 1/3rd of headaches are related to dehydration.

I don't think you jumped the gun having surgery. My earlier advice to delay was more around checking out all the options and feeling comfortable that you were making the right choice. Personally, I like to overthink things and analyze them to death before taking major action. After waiting a year, researching on the web, and consulting 3 additional doctors, I ended up having the same surgery the first doctor recommended, though I had doc #2 perform the surgery because he'd done it many more times than doc #1. (Too early to know if mine was successful or not.)

 
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