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Old 08-28-2011, 10:52 PM   #1
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Outpatient flat foot surgery question!

Hello! I'm a 46 yom, and a brand new member, with upcoming surgery scheduled at an outpatient surgical site. I feel confident in the Podiatrist, but I have had major surgery before and I'm a little skeptical about the idea of being discharged 12 hours after this invasive procedure.
I Haven't gotten all the technical names for each procedure yet, but I'm sure you're all as familiar with these as I was with my prior surgical details so you'll know what I'm referencing...I think they're called Subtalar Fusion, Calcaneal Osteotomy, along with lengthening the 5th Metatarsal (sp.?) with a wedge, and moving the big toe down and inward to recreate the arch. Don't believe I'm slated for the Achilles lengthening, but I'm scheduled for a fact finding appointment with the Doctor soon.
Anyway, I'm wondering if anyone has any thoughts on whether or not there are advantages to hospitals vs. surgical centers (the center in question has a full 'crash cart" and a staff trained to use it) other than peace of mind? Thanks for any thoughts/advice you can offer!

 
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Old 08-29-2011, 06:22 AM   #2
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Re: Outpatient flat foot surgery question!

Good Morning,

I had outpatient surgery on June 6. Initially I had the same reservations as you but it worked out fine.

I chose to have a block. My leg was numb from the knee down for several hours. I had twilight sleep & therefore didn't remember the surgery at all. I had been advised by many (& the surgeon) to have the block.

You mentioned "podiatrist." Is it not an orthopedic surgeon who is doing the surgery? One who specializes in foot/ankle surgery & has performed several of those.

You need to know exactly what is being done. I had a post tibial tendon repair and a subtalar fusion. I continue to go to physical therapy, 3 times a week & am wearing an aircast.

This healthboard had given me so much information. Do read the article that tells you how to prepare. Renting a kneewalker was a lifesaver for me.

Good luck to you. Zoeys Grammy

 
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Old 08-29-2011, 07:21 AM   #3
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Re: Outpatient flat foot surgery question!

I had flat foot reconstruction in an outpatient facility and I was fine. I had surgery around 3:00 in the afternoon. I was in surgery about 2 hours and at 7 or 7:30 I was discharged. They gave me a nerve block that ran the entire length of my leg so I didn't feel anything. With the nerve block, I had no problems being discharged that early.

 
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Old 08-29-2011, 07:33 AM   #4
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Re: Outpatient flat foot surgery question!

I am 13 months post op ptt/spring ligament repair, tendon transfer, cotton and calcaneal osteotomy and gastroc recession. My surgery took four hours. My surgeon always does the surgery in patient, keeping the patient in the hospital approximately three nights. I am so happy that I was not sent home the same day as pain control could be done much more effectively inpatient. Despite being on an IV pain pump and receiving oral meds as needed, one evening I started to have horrible spasms. The pain management doctor was in my room within ten minutes. They were able to help control the spasms. When I woke up from the surgery, I had a cathetar. I quickly realized how wonderful it was not to have to deal with going to the bathroom right after the surgery. By the time I was released to go home, I was in much better condition to deal with the post op stuff.

There are other people on this site who have had the surgery outpatient and did ok; however it seems that more people have the surgery inpatient.
Many doctors have partial ownership in same day surgical centers. I often wonder if they may push the surgical center (as long as safety is not compromised) due to financial incentives.

I would reccomend that your discuss your concerns about having the surgery performed on an outpatient basis. You should absolutely have more than one opinion. I went for four opinions and narrowed my choice of surgeons to two. One surgeon was fifteen minutes from my home and did four or five flat foot surgeries a year. The other was at a major orthopedic hospital in NYC and did three to four flat foot surgeries a week. I ended up doing a three hour round trip to use the doctor in NYC who does this involved and complicated surgery on a regular basis.

Good luck with your decision and surgical outcome

Last edited by roxygirl1; 08-29-2011 at 07:34 AM.

 
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Old 08-29-2011, 08:19 AM   #5
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Re: Outpatient flat foot surgery question!

I've had various surgeries over the years and most are outpatient now except for things like heart and very complicated ones. You'll probably be fine. But I also question the use of a podiatrist for this particular procedure. i would rather a foot and ankle board certified ortho.

 
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Old 08-29-2011, 08:29 AM   #6
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Re: Outpatient flat foot surgery question!

I too went the in-patient route and stayed two nights. I am very glad I did too mainly for the pain management issue. Interestingly my surgeon and anesthesiologist both recommended against doing a block. Both said they are good while they last but when they wear off the pain can potentially get bad; especially if you do an out-patient procedure and are at home. I'm sure as with any medical procedure the block may work well on some and not on others. I had the worst pain for two days in the hospital and glad I was there because I could not have received the same pain meds at home. Luckily my pain went away about two to three days after surgery and hasn't been back since. I also started running a fever the second day in the hospital which was easily resolved with a breathing apparatus that you suck in to expand your lungs. The point of that is that I could not imagine having 103 degree fever and having to go sit in an ER two days out of surgery. I'm not sure I could have done that.

You would be having a surgery almost identical to what I had done. My surgeon lengthened my achilles but did not make that decision until he had basically "re-built" my foot in surgery and determined at that time that it needed to be done. Having gone through the surgery and doing research I've learned a lot about some of the procedures but by no means am I an "expert." Having said that I too would be cautious with a podiatrist vs. an orthopedic surgeon. I went to both as well and ended up with an orthopedic surgeon that specializes in foot and ankle surgeries. I did a lot of research on the surgeons as well. Good luck!

Last edited by amainc; 08-29-2011 at 08:31 AM.

 
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Old 08-29-2011, 01:40 PM   #7
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Re: Outpatient flat foot surgery question!

I had my surgery (calcaneal osteotomy, kidner procedure, fdl tendon transfer, achielles tendon lengthening, fractured bone excised and bone shaved down) one year ago. My operation was done in patient. I was originally supposed to only be there one night for pain management. The fractured bone did not show up on x-ray or MRI. Due to my doctor putting in a drain, I needed to stay an extra night. At the time of surgery, my doctor decided to do the achielles tendon lengthening. My doctor is a board certified ankle & foot surgeon/podiatrist. I had a seventeen hour popliteal nerve block, and for me it was wonderful. Even after it wore off, I never did have bad pain. I know many of the surgeries are done out-patient. The personnel there are well trained in the event that anything should go wrong. I am sure it will all go well. Good luck.

 
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Old 08-29-2011, 09:32 PM   #8
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Re: Outpatient flat foot surgery question!

Dear Titchou,
Thanks for the help! On the subject of Ortho vs Podiatrist, I asked the questions I learned lessons from my spinal fusion such as ''how much time is spent on this particular surgery in Med school for Orthos and Neurosurgeons" (I was originally supposed to have an ortho do my fusion) where I found that Orthopedic surgeons spend roughly 30% of their 5 yrs (after med school) on the spine and Neurosurgeons spend 50% of their 7 yrs on the spine. I met with a board certified ortho first who has completed a 'fellowship' on this surgery (minimum 150 surgeries of this type) and was seemingly bright and capable but unfortunately (for me) completely disinterested in my pre-surgical questions and concerns. I've now met with a Podiatrist (over 500 such surgeries before opening his practice 9 yrs ago and I'm confident in every way except the site. I guess I just want every possible detail to be right and in this case I don't know whether I'm being cautious or over cautious. Thanks again for your time and response!

 
Old 08-30-2011, 06:45 AM   #9
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Re: Outpatient flat foot surgery question!

I had FDL transfer, calcaneal slide, and first metatarsal-tarsal fusion on June 1st at HSS in NY. The surgery was actually done at their outpatient surgical center onsite at the hospital, but a 2 day stay was planned. I actually wound up spending a third day due to pain issues and the fact that I live alone. From there I went to subacute rehab facility for a week. One important thing to consider in your recovery, is how much help is available from family and friends afterwards. I'd also check to see if doc has financial interest in surgicenter. Last, how are you usually in dealing with pain since that seems to be one of the biggest issues after this surgery. Good luck.

 
Old 01-29-2012, 08:36 PM   #10
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Re: Outpatient flat foot surgery question!

Can you please tell me who you used in NYC. Also, how long were you off your feet totally? Thanks

 
Old 01-30-2012, 05:49 PM   #11
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Re: Outpatient flat foot surgery question!

I used Dr. Deland at HSS. I was NWB for 8 weeks followed by several weeks in a boot. I have a job that requires me to be mobile so I was out of work for 4 months. I am now 18 moths post op and am happy with the results of the surgery

 
Old 02-19-2012, 01:32 PM   #12
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Re: Outpatient flat foot surgery question!

I have been to 2 doctors at that hospital. They will take my coverage for the hospital but not the doctor. Can you just give me an idea on how much they charge for this type of surgery? I have a follow up appt with Dr. Roberts. Thank you.

Last edited by hb-mod; 02-19-2012 at 01:47 PM.

 
Old 02-19-2012, 02:35 PM   #13
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Re: Outpatient flat foot surgery question!

Quote:
Originally Posted by diane719 View Post
Can you please tell me who you used in NYC. Also, how long were you off your feet totally? Thanks
I used Martin O'Malley and am very pleased with result, 8 months later. I was nwb for 6-7 weeks. Partial weight bearing for 7 more.

 
Old 02-19-2012, 02:40 PM   #14
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Re: Outpatient flat foot surgery question!

Quote:
Originally Posted by diane719 View Post
I have been to 2 doctors at that hospital. They will take my coverage for the hospital but not the doctor. Can you just give me an idea on how much they charge for this type of surgery? I have a follow up appt with Dr. Roberts. Thank you.
Surgery alone was over 30,000. I have Horizon blue cross. They covered the surgery but I had to pay for office visits and xrays, then got reimbursed afterwards.

 
Old 02-19-2012, 04:14 PM   #15
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Re: Outpatient flat foot surgery question!

The Dr. billed a bit of 30,000. They waited for insurance to pay. I got a bill for about $2,000 which was much less then the difference between the Drs. bill and what insurance actually paid. It was so worth it. I am now 19 months post op and went to a wedding today. I wore dress shoes with a low heel but a heel never the less. I even danced and am absolutely pain free.

 
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