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Old 10-19-2012, 04:26 PM   #1
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HSS Ankle Distraction with osteotomy

Met with Dr. Fragomen at HSS today. Uneven Osteoarthritis with varus, the plan is to fix the varus (supramalleor osteotomy) and do the distraction at the same time. That means they break both bones in my leg too, resulting in a longer time in the frame for healing (more like 4 months). Anyone else have this done? Have it done in winter (how do you keep foot/leg warm)? Anyone else excited and scared to a level of mild nausea? How was getting around? Anyone swim? Drive? Work?
Please share...
thx

 
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Old 12-18-2012, 10:11 AM   #2
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Re: HSS Ankle Distraction with osteotomy

Quote:
Originally Posted by puppetlady View Post
Met with Dr. Fragomen at HSS today. Uneven Osteoarthritis with varus, the plan is to fix the varus (supramalleor osteotomy) and do the distraction at the same time. That means they break both bones in my leg too, resulting in a longer time in the frame for healing (more like 4 months). Anyone else have this done? Have it done in winter (how do you keep foot/leg warm)? Anyone else excited and scared to a level of mild nausea? How was getting around? Anyone swim? Drive? Work?
Please share...
thx
Puppet,

You and I are the only folks on this health board who posted about having these two surgeries combined. As I told Hilde, with part of my fixator gone I can walk easier. The lower frame that was removed was for ankle distraction and the doctor decided that 10 weeks was enough distraction for my ankle. The remaining two frame halos are fixating my lower leg since I had a second surgery (like you) to cut my lower leg bones in order to adjust the alignment of my foot. This surgery in my case was necessary to ensure my foot would sit flat on the ground instead of the outer foot angling down lower. It was a deformity the surgeon needed to fix so that my ankle distraction would have the best results. My hope is that all of this hi-tech advanced approach to fixing my ankle pain actually works and I will return to a new normal. I hope the same for you.

How are you doing into your second week? Don't get discouraged because the logistics of doing everything is much harder now that you are with frame, your leg muscles have probably atrophied, you need help with everything, and your pain requires medication. I've been there and I tell you for sure - IT GETS BETTER. Good luck making it through each day and I hope for your sake, that time doesn't drag on like it did for me. Try to stay upbeat and remember this year-long investment you are making into your ankle joint health will be worth it in the long run.

Take care,
DJS

 
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Old 12-18-2012, 10:51 AM   #3
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Re: HSS Ankle Distraction with osteotomy

Hi DJS,
Oh man, the second week sucks. I joined the antibiotic study (whether or not prophylactic antibiotics should be given automatically) and ended up not getting the antibiotics, and of course day 8 got my first pin infection. Also ran out of painkillers on the weekend - bah, Sunday was a bad night.
I'm not weight bearing at all yet, as part of the repair in the joint I received cadaver cartilage along with marrow cells from my hip - and Dr. Drakos wanted me off it (not that I can imagine having done much walking on it anyway) for at least 2 weeks.
I am so lucky, my husband is an angel, and fortunately had a lot of vacation time he needs to use before end of year. I am actually flexible enough to be able to reach all my pinsites, so if I have to, I can and have, cleaned and dressed them all by myself. He doesn't mind, though. He's kind of geeking out about the whole contraption, and has put himself in charge of adjusting the struts when he's here. For my surgery, they did the distraction completely in the OR, but set up the re-alignment to be done over 12 days at home with 6 struts and a wrench. Did you have the same?
I've got 3 posts and 8 wires. So far the sheets are intact, though I did make some fleece bags to wear over the whole thing and that helps. I have destroyed underwear, chopped up countless sweatpants, took a chunk out of the bedframe when my foot slipped off the cushions (pretty amazing how little hurt I felt, the bed frame fared not so well).
You are absolutely right that this is not a solution for wimps. I'm still determined and fairly positive about the whole thing. It is good to be working towards something, but holy cow there are times it really hurts. The rush of circulation when I put it down is sometimes excruciating (particularly first thing in the morning, prior to pain killers kicking in). I find that some of the strut adjustments renew the base pain.
They've sent a 'visiting nurse' and pt to make sure all is well at home, but the first nurse I had did not impress - she actually, can you believe, Asked Me to Take the Frame Off so that she could measure the swelling of my foot.
I see Drakos tomorrow, and Fragomen next week. I find the doctors very responsive, and their staffs as well, no complaints there.
Thanks so much for responding - I guess you're right there aren't many out there who had quite this much done in one shot.
My *** is actually tired from having to spend a lot of time fairly sprawled with the leg above heart, I'm looking forward to doing more.

Puppet

 
Old 12-18-2012, 06:13 PM   #4
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Re: HSS Ankle Distraction with osteotomy

Puppet,

I'm in week 13 and I still get the pooling of circulation as I move my elevated foot from atop the pillows to the floor. My wife stares at me as I sit on the side of the bed to endure the moment before making my way to the bathroom. The mornings are the worst for this sensation, I totally concur.

I feel sorry for you that you had a pin site infection. I was lucky enough not to get one although there were times I thought an infection was beginning because the sites were oozing orange/amber colored juice. But this I was told by Dr. Fragomen's nurse was normal. My wife cleans my pin and rod sites (4 rods & 7 pins, originally) almost daily and they are totally healed now. I was able to return to work on week 3 by going in to the office on M-W-F but telecommuting on T-Th. My situation at work is a total blessing! I have pillows propped up on a secondary chair and I work from my desk in an awkward position reclined with the keyboard extended to my lap. Everyone who passes my desk stops to observe and inquire about the apparatus on my ankle. Everyone wants to help with everything - making coffee, opening doors, getting lunch for me, etc. I truly appreciate the help and accept their generosity, although they are probably sick of me.

As far as your sweat pants, you should consider buying some breakaway pants with the snaps on the side.

The great warm-up pants that I wear daily are called Augusta Sportswear Brushed Tricot Tearaway Pant. I bought four for everyday use (2 black and 2 blue). I wear button-up shirts and sweaters with it and it looks decent. You can snap the pant leg around your fixator if you want to protect it from the elements outdoors.

I had to adjust my screws on my fixator on week two over a seven day period. Those screws look like hydraulic struts. Are you wearing a bone stimulator? I have worn one for the last two months. I believe the bone stimulator helped for sure with the bone union healing process. My wife cranked the screws according to the schedule and the pressure from that was definitely something to get used to.

My last follow-up appointment with Dr. Fragomen is next week. I am counting down the days until my fixator is removed in January.

Hopefully, some of this information helps you. I learned from those who preceded me. It is interesting to hear about your experiences because they mimic what I was going through at the beginning. Good luck with recovering from your infection and thank God for your husband. I appreciate my wife as well.

Take care,
DJS

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Old 12-22-2012, 12:03 PM   #5
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Re: HSS Ankle Distraction with osteotomy

Ho ho ho DJS,

Tell me about the bone stimulator. It has been mentioned, but at this point I still have the stitches in from the bone break and the clean out - and we're on the last 2 of 12 days of strut adjustments. Not even weight bearing yet, not on purpose anyway.

Wiped out on a strewn hand towel this morning, life is full of unexpected hazards. I'm very impressed with the protective qualities of the frame, this is my second full out fall and I'm amazed at how little damage I did. Perhaps it's luck, too. Getting used to the extra 3 or 4 inch radius of leg frame around corners takes practice as well. I find that bumping into something from the front where the rods are is the eye watering worst.

Did you have many falls or crashes?

I'm glad that work has been flexible for you, and accommodating. I have a workshop and can overlap into the house so when I'm ready it should not be too difficult to keep up. I used a wheelchair this week for a three hour meeting I felt compelled to physically go to. I'm not driving yet though. I promised my husband I'd wait until January.

You are a distance from HSS and Fragomen's office, are you flying, training or driving up for the checkups?

I'm jealous that you had no pin infections. It's gross. On top of the lovely weeping of the plasma, it's like an endless cleanup job. Did you swim? I can't wait for clearance to go back to the pool.

What have you done to cover your foot/frame? I'm not using "the shoe" yet, just a series of elasticized fleece bags. Not sure how to weather proof it, although I'm not planning on shoveling the driveway or anything, there will be times when splash and snow are unavoidable. Does a plastic bag work?

On the positive side, over two weeks down, only 3.5 months left! HA. The cats are really enjoying my captivity, and vying for the pillows.

Are you planning to keep the frame after they remove the rest of it, or would you rather forget you had it?

Best,

Puppet

 
Old 12-22-2012, 02:15 PM   #6
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Re: HSS Ankle Distraction with osteotomy

Puppet,

I really get a kick out of your experiences and questions because it takes me back down memory lane (even if it was just a few months or weeks ago)! I laugh out loud reading your posts.

It does take a little getting used to having that frame around your ankle. I hit mine on cabinets, door frames, table legs, bed frames, chair legs, car doors, etc. I too would pause when I hit it with that grimace on my face until the eye watering pain left my foot/ankle. And yes, I have also fallen hard. I fell at work while I was on crutches. I was leaving the restroom and was rushing to get out of the way of the closing door when my left crutch slid right from under me. Either water on the floor or moisture on the bottom of my crutch foot was the culprit. Either way, I was down in an instant. I first hit the vending machine on the way down which I displaced from it's bolted down position and then instinctively to protect my foot/ankle and its contraption, I kicked my foot out to lessen the damage. Before I could blink, six coworkers were around me horrified and spring-loaded to call 911. I reassured them I was okay and that I just needed help getting up after I assessed the damage. Once I was lifted from the floor I noticed two of my pin sites on my heel were bleeding. It was just a superficial injury and it was my opinion, nothing to be worried about. This was confirmed when I called a couple of days later to Dr. Fragomen's office (at my wife's urging) and the nurse Cathy told me that many fixator patients of theirs report falls and it's no big deal. She told me it would take a lot to damage the frame or my surgical repair from a simple fall. It would have to be a severe tumble (i.e., down the stairs or something similar) to do any real damage. The blood was normal because the pins were jostled a little. I was relieved. The fall at work was scary and embarrassing more than anything else. From that point on I used my walker at work and left the crutches in the car. I've also slipped on towels placed on the floor but I haven't fallen onto the floor again.

The bone stimulator is awesome. It is manufactured by a company called Biomet and the model is called the OrthoPak. It supposedly speeds up and ensures a bone union 40% faster for healing time. I recommend using it for your own sake. You cannot feel the electrical pulses which penetrate your leg and bone, so it is essentially transparent. It is easy to apply too. I clip the transmitter/monitoring device directly to my frame. People are always asking me why my cell phone is clipped to my apparatus on my leg, and I just laugh.

As far as getting to Dr. Fragomen's office (HSS) for appointments, my wife drives me up to NY once a month. I tried to help out with the driving one time and I lasted about 30 minutes before my swelling became a problem. So I sit in the back of our SUV in the 3rd row with my foot up on pillows for the whole trip there and back. My wife gets a raw deal and the lion's share of the burden when it comes to being a caretaker for me. I think she is more excited about my upcoming fixator removal surgery in January than I am.

I use "the shoe" all the time. Sometimes with a sock but most of the time without. The weather here in Virginia Beach allows for that. Since the swelling naturally makes my exposed ankle and foot hot, I welcome the cool outside air hitting it when I venture outdoors. You really should consider those tearaway pants I suggested because you can snap the pant leg around the fixator and it hides most of it with the exception of the bottom halo.

I had my bottom halo removed on week 10 and when the nurse (Vera) dropped it in the trash, I told her I wanted to keep it for sentimental reasons. So she cleaned all the blood off of it and gave it to me with all of the hardware. I plan to put it all back together and display it somewhere when it's all said and done as a reminder of the whole ordeal.

I visited my neighbor last night and they have a cat which was enthused with my fixator. He sniffed my wounds and rubbed himself on my frame. He is an affectionate cat so I let him have his fun (smile).

Be careful not to fall too much. You don't want to hurt something else. How is your pin infection doing? I hope you get that cleared up so that you can get back on track and on your way to a full recovery. I visit Dr. Fragomen next week and I hope after the standard X-rays that he has good news again for me. During our Nov session he reduced the time I had to wear the fixator by one month (4 vice 5 months) and he discontinued the distraction by taking off the bottom halo. I am hoping that I am in that 75% success rate statistic that he told me about in the beginning. I just want to walk without a limp again, ride a bike, get back to swimming laps, and playing golf. I have decided to give up competitive tennis and racquetball for the sports which are more gentle on my ankle joints. I never swam with the fixator on since I didn't want to clean the pin sites in the pool locker room and bandage them back up with gauze before making my way back home. Dr. Fragomen did, however, encourage me to swim with the fixator. I bet it would have been nice to maneuver in the pool with the fixator since weight bearing would have been more tolerable. Try it if you get the opportunity and let me know.

I hope you have a Merry Christmas and a Happy New Year. Keep posting.

Take care,
DJS

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Old 12-27-2012, 08:32 AM   #7
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Re: HSS Ankle Distraction with osteotomy

Good Morning, DJS,
Happy day after day after christmas.
Saw Dr. Fragomen yesterday, who showed me how to unlock the frame and this morning I stare at it, recalling only 68, the mm that I need to reset it to. I can't remember how to do it, and fear loosing the wrong nut and watching the erector set just explode or something. Actually the fear comes from that first stretch extension of my foot yesterday - there's a a pin going through that does not want my foot to go up and down and it is very painfully loud about it. I know Dr. F will get back to me soon, and my husband says he's pretty sure he remembers, (it's the 'pretty sure' that makes me hesitate and wait for Dr. F). All will be well.
Another 5 days of strut adjustments, the initial pull apart of break was a bit over zealous, the angle is fine, but you could stick your pinky in the inside of the big bone space. Pain is better. Begin to weight bear, but find it difficult to imagine ever putting full weight on this thing. It feels alien, like something attached but not part of me - aside from the pain, that is. How often do we think of our legs, our feet unless they are failing us?
Ok, ok, back to humor. I tried the snap pants. Really, I did. Because the last thing in the morning when everything is an ordeal, from getting out of bed wrong and wrestling with the shower chair and not having the right scissors to clip off the dressings, and you don't want to get into the shower and don't want to get out of the shower once in, and cleaning and redressing the holes, honestly, the last thing I need is a fight with my pants.
I am a costumer, set designer, prop maker, - I want to appreciate other people's designs and ideas even if they are intended for basketball wear only... I cannot wear that much polyester next to my skin. I checked out the apparel websites for people with disabilities as well and was mortified at the designs and fabrics and funereal feel of what is commercially available. I ended up in the workshop, leg up on the sewing table, wearing a bathrobe only, swearing, and have made several pairs of billowy skirt like pants that I'm afraid would not look quite right on you, but suit me fine.
We met a guy, waiting in radiology yesterday, who's having three inches added to his upper leg. His frame is way up there, I can't imagine ever getting comfortable with that thing on. The nicest guy - totally positive, in his 30's, 6 months with this thing on while the space is made - I mean you and I had pain, and limitation, and damage, but most of our lives the thing has functioned in a somewhat normal fashion. I'm looking to get older more gracefully and with less pain, with mostly original parts. This guy's life is going to change radically. He has trouble finding pants too, but he wasn't complaining about it. If I run into him again, I'm going to offer to make something flashy for him.
Looking forward to driving again. Control issues.
Have you been to your last checkup yet? Waiting for removal date?
The weather up here is AWFUL. It can't decide whether to rain or snow so it does both in fits and starts. I don't like the confinement of the walker, but I also don't like a crutch going out from under on the ice, I may have to go back. Where does it fit in the car?
It must be much easier to walk now with the footplate gone.
Are you noticing differences from before? I can actually see the left leg is straighter than the right. It's wild.
Hope you are enjoying the holiday lull -

Puppet

 
Old 12-31-2012, 09:44 AM   #8
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Re: HSS Ankle Distraction with osteotomy

Happy New Year Puppetlady,

If you read this before New Years, then happy New Year's eve (smile). I want to first answer some of the questions you brought up before I go off on my tangents.

1) Where does it [walker] fit in the car?
The walker I have is a retractable rollator which folds down enough to put in a trunk. I used my crutches to get out of the car and to make my way to the the back of the car. Now granted, I have an SUV so my trunk is really a lift gate with the third row of seats laid down flat. But it fit in my wife's car so I know they can go in a trunk. My rollator has a seat which hinges down once it is expanded. I found the rollator much more stable than my crutches once I was told by Dr. Fragomen that I needed to push through the pain and put more weight on my involved leg/foot. A rollator walker has brakes on the handles and I did a sort of "wedding walk" by stepping forward and bringing the other foot even while the brakes were applied for stability. Step forward, apply brake, step together, step forward, apply brake, step together, and so on.

2) Is it easier to walk now with the footplate gone?
Much easier! The four pins which were removed along with the footplate were restricting my ankle/foot's motion. I had two pins that criss-crossed through my heel bone which hurt any time I moved my foot for dorsiflexion. When I slipped and fell at work, it was these two pin points which bled after being jostled. With the footplate gone, I can put 100% of my weight on that foot and can have the necessary range of motion to walk with a cane. I still have a ways to go to get a normal gait.

3) Are you noticing differences from before (regarding leg alignment/straightness)?
I just saw Dr. Fragomen on Dec 27th and he showed me the before and after x-rays from now and prior to the surgery. WHAT A REMARKABLE DIFFERENCE!!! Not only was my leg and foot alignment absolutely straight but the distraction worked like a champ. Looking at a weight bearing x-ray, there was an ideal spacing in my ankle joint which prompted Dr. Fragomen to say "You could be a poster child for this type of procedure. You really have had ideal results from this." Prior to surgery I had bone on bone almost throughout the ankle joint especially on the outer portion of my ankle. Also, he said I went from a 102 degree alignment to 81 degrees. This was the angle my vertical tibia made with my horizontal ankle joint as he used the mouse pointer to construct thin lines on the x-ray displayed on the computer screen. Dr. Fragomen was extremely satisfied with the results and his enthusiasm was contagious because it made me feel great.

Now, some additional comments...

My wife told me that no woman would want to wear breakaway pants with the snaps (smile). You are right, they are made for basketball. So, I totally understand why you went a different route. I laughed at how you said, "I cannot wear that much polyester next to my skin." Ha ha ha. I hope you were able to sew something that suits you and your frame.

You will definitely be able to weight bear as time goes by. I experienced a lot of pain in the early goings, but eventually I pushed through the pain to gain strength and tolerance enough to consistently weight bear. By the way, how is your final screw adjustment days going? I only had seven days of adjustments and I remember the pressure I felt on the bone as each minor screw adjustment was made. I have six adjustable screws between the halo plates flanking my bone break. So I feel your pain.

I hope you have a great New Year and that your recovery goes as planned and is successful.

Take care,
DJS

 
Old 01-13-2013, 01:11 PM   #9
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Re: HSS Ankle Distraction with osteotomy

Hi Puppetlady,

I haven't seen any posts from you lately and I wondered if you were doing well. Last I heard you were recovering from a pin infection and finishing up some frame adjustments. Have you started driving yet (I know you were looking forward to regaining your control)? I hope things are progressing well for you and that you and your husband are coping well with life revolving around an external fixator existence.

I had my external fixator removed on Thursday last week and I must say it feels weird not to have anything attached down there. Dr. Fragomen decided my bone union was healed enough to go straight into a boot for a couple of weeks while my rod holes healed up. I expected to wake up with a cast on but I was pleasantly surprised. I had to wear the boot two days non-stop before removing it and the surgical bandages. When I took all the bandages and wraps off the tiny rod holes were covered with steri-strips and my leg/ankle/foot was skinny. Although I was told to keep my ankle elevated during the two days of wearing the boot, I was not the greatest patient and I sat around for many hours with my foot on the floor (playing scrabble, eating meals, and just sitting around conversing with my family). It has been convenient that during this whole ordeal I was able to rest a few days following both surgeries at my mom and dad's house in Long Island. For 4 hours out of the 7 hour drive back to Virginia Beach, I was able to sit up front in the passenger seat or drive myself instead of spending the entire trip back in the third row seat with my foot up on pillows over the second row seat backs laid down flat. My wife was sick of communicating with "the man in the mirror," as she called me (smile) and having me up front was a nice change.

Now that I have a naked ankle/leg, I have noticed that my range of motion will require lots of work. I am not allowed to do any physical therapy until my bone has fully healed (six weeks). I am also limited to 50% weight-bearing within my boot for two weeks. Although I am disappointed that my leg muscles will AGAIN atrophy until I can resume physical therapy, I am unwilling to take any steps backward at this point so I will follow the doctor's orders. I long for the days when I will be able to walk normal, ride a bike, swim, and play golf with no pain. I am so ready for low impact cardio exercise. I look forward to returning to work tomorrow for the first time in dress pants instead of warm-up pants that snap up the sides. I might even wear a tie to celebrate the change. Wearing two shoes at the same time may be weeks away but it's another goal I look forward to meeting.

Pain in my leg is minimal to non-existent without the fixator. But this I expected because right now I am not taxing my ankle or leg with anything since I am on crutches. When the PT starts I hope there is little internal pain to deal with other than muscular soreness. My objective will be to stretch my tendons and improve my ROM in an effort to regain a normal gait.

So there's your update of what to expect upon removal of the fixator. Just ask if you want to know what awaits over the horizon during your weeks with your external fixator attached. I hope things are going well for you and look forward to reading your posts describing your experiences.

Take care,
DJS

 
Old 01-13-2013, 04:44 PM   #10
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Re: HSS Ankle Distraction with osteotomy

Hi DJS!
Still fighting with pants, but winning more than I'm losing these days. CONGRATULATIONS on the REMOVAL of the fixator... I'm thinking that we should design a t shirt "I survived the FRAME".
I saw Dr. F. last wednesday, and he measured and measured and measured again, and the correction to my leg bones is now finalized (no more strut adjustments) at a whopping 13 degrees. Ankle is distracted at 8mm, but 13 degrees of correction is a lot.. no wonder the leg/foot feels different (aside from the hardware). When I attempt to weight bear, I feel like I'm walking on the inside of the foot for the first time ever. He determined that it is not overcorrected, so I'm cool with it.
We had a few scruffy sad weeks with a dying cat... she was diagnosed with oral cancer the week after the surgery. There was nothing they could do, just pallative as it worsened until we determined she was suffering. We have a couple of cats, but this was MY quirky brilliant cat, and it was difficult to watch her sicken and die, particularly curled up next to me as I was around a lot.
I had to get back to swimming to keep from getting depressed.
My first day at the pool I thought of you. I was stupid enough to take crutches to a pool. Crutches to a pool. The tiles were dry at opening time... but an hour later they were not. An eager chatty lifeguard handed me my crutches, two steps later I was flat on the tiles, apologizing for bleeding, and wondering what damage I had done. I thought of your vending machine incident as the lifeguards appeared from everywhere...
I was mostly afraid that they would not let me back in the pool for liability reasons.
I did not panic at the bleeding pins, as I remembered you had bled too. I bounced it around good, one in particular at the inside ankle looked nasty. Dr. F. put me back on antibiotics three days later when he saw them - I feel like a failure - one month out and twice on antibiotics...
Anyway, with a note and a standard walker they let me back in the pool.
I also rented a knee walker/roller. I tried one out at a medical supply place and had enough leg clear to weight balance on it. I'm pretty fast on the crutches, but the pounding on my arthritic right ankle is taking a toll. I do not want to destroy the right one... and the knee walker is a great relief all around. When I can get it away from the kids that is. It is wicked fast.
Can't walk the dog with it, can't do stairs with it, but I can get around the kitchen, the workshop and quick light trips to the store. I have a van, so I can toss it in and pull it out with not much fuss.
I hate the regular walker. We've graffiti-d it so that I don't feel so old with it. I resisted, resisted, and then kissed the pool tiles, so thank goodness I have a van for all the medical appliances I haul.
Yes, I'm driving, quite fine with it. Apparently in New York State it is illegal to drive with a cast or medical device on your leg, but fortunately not in Connecticut. My husband has so far chauffeured me to the doctors' (I find it much easier to see Dr. F. in the Queens office, and the other surgeon who did the repair work in the joint (we respectively call them the Cage man and the Cadaver man) out in his Long Island office.
Did you have donor cartilage too? And the stem cells from the hip?
I was doing very well, very little swelling as I managed to keep it up most of the first two -three weeks. The pain wasn't much, started unlocking the frame and THEN started the dreaded PT. Just when you thought it was safe to get up, BAM all kinds of new and unusual pain. There have been a few post PT nights and mornings where I was quite sure that barbed wire had been tightly wrapped around the joint in a big ball. Instead of the pale fleshed pierced limb at the end of my leg, I had a bloated eggplant in the cage.
I hate PT.
I do like going to the pool and leaving the frame unlocked while I swim. I strap on a child's floaty to the frame to balance the 6 or 7 pounds.
I'm lucky with local driving that my daughter is 16 and scheduled to take her driving test in February. We've taught her on the stick Passat and Mazda (we insist she take test on stick) and she easily handles my van which is automatic - so I can ride in passenger seat with leg up.
I don't like being the 'man in the mirror' - I get queasy in the back. My husband cites the cause as my control issues.
WEARING TWO SHOES that match.. who would think it would be such a treat (I do!).
I wonder about those holes, the post holes are significant, and right over the bone. They've healed so cleanly open, what signal do they get to close up?
I'm sure there's been atrophy, and more to come.
How was your ROM in the frame unlocked? Did you have much?
Thanks for getting back to me.
Be well, tell me more stories of life without an erector set on your leg...

Puppet

 
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Old 01-16-2013, 02:02 PM   #11
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Re: HSS Ankle Distraction with osteotomy

Hey Puppet,

My rod holes from the removed fixator are all closed up in less than a week. It is amazing how our body heals itself so quickly. When I read of your fall on the poolside wet tiles, I relived the horror of my own tumble (smile). The bleeding immediately gets your attention, huh? I'm glad you recalled my incident and realized it takes a lot to damage anything when you fall wearing an external fixator. I hope your pin and rod sites heal back quickly and you are spared any infections.

I'm glad the knee scooter is working out for you. I (like you) was concerned about my good leg being overworked (in my case due to my bum right knee) since I depend on it compensating while my left ankle/leg heals. So you have an arthritic right ankle too, huh? I too have problems on my right side considering my right knee has been surgically repaired twice due to a lack of meniscus. Believe it or not my right knee was my only concern before the rapid decline of my left ankle a year and a half ago. My right knee pain now seems so insignificant comparatively speaking.

As the holes on my leg and ankle heal, they itch pretty good. I've been patching them with bandaids until the scabs form without oozing anything. I have maybe one more day of wearing bandaids. I sent Erica Lenihan (Dr. F's nurse) an email asking her to clarify my instructions post removal of the fixator since my wife and I heard different guidance (smile). I have six more weeks of being in a boot with crutches and 50% weight bearing. I guess this gives my leg bone riddled with bullet holes time enough to heal before returning to unaided walking around. I was told to continue using the bone stimulator for faster healing. Going back to crutches instead of the quad cane I was using seemed to be a huge step backward since my hands are not free to fetch my own coffee and hold things while I walk. With less pain in my ankle/lower leg, I have to rely on others to get me things again. There is less patience for me at the office now that the contraption has been removed and since I look better with the boot on. Even my wife believes I should be more self sufficient now because she was used to me getting around better in the final days of wearing the erector set.

I am scheduled for a follow-up with Dr. Fragomen in 5 more weeks before I am on my own. I may try to get an appointment at the Queens office since the parking in Manhattan is ridiculous ($50 +) and the traffic is insane. Being from NYC, I somehow forgot how hectic it is. My biggest concern in the weeks before seeing Dr. Fragomen is my apparent "stiffness" in my ankle and lack of ROM. I am gently rotating and flexing my foot up and down when I take the boot off at night but it sure seems to be an inevitable permanence to this inflexible condition. I am hoping that follow-on PT will drastically improve my flexibility but I am preparing myself for a new normal so that I don't set my expectations to an unachievable level. Well, I am in the home stretch now so I guess I shouldn't complain.

Good luck with your ankle/leg healing progress and I am sorry for your loss regarding your brilliant and quirky cat. I can relate since we lost our cocker spaniel a few years ago and he was indeed a family member.

Take care,
DJS

 
Old 01-31-2013, 05:53 PM   #12
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Re: HSS Ankle Distraction with osteotomy

Hey Puppet,

Any interesting stories or adventures to share about your daily life wearing the contraption? I am doing remarkably better every week. I still have a scary lack of ROM and stiffness but the pain in my ankle and leg is very minimal. I am almost to the point that I don't rely on my cane when I wear my boot. I waddle when I walk since I have a hard time getting the right amount of inserts in my "good foot" shoe to balance the height compared to the leg with the boot.

Dr. F told me to only use crutches two weeks so I have been going without while I have the boot on. I only use the crutches to make my way to the restroom if need be throughout the night. In a few more weeks I head to NY (Queens office) to get assessed at my next follow-up appointment. I haven't been keeping my leg elevated during the workday, but I keep it propped up on pillows when I get into bed each evening. The boot probably helps reduce the swelling but I believe my swelling has subsided significantly ever since the fixator was removed.

I hope things are going well with you.

Take care,
DJS

 
Old 02-12-2013, 03:11 PM   #13
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HildeW HB User
Re: HSS Ankle Distraction with osteotomy

He djs,
Hope you are still doing better and better. I too am curieus about how puppet is doing.
Today I went to the 'ilizarov doctor' for the first time and he thinks I am a good candidate for distraction. My frame will be a bit different than yours, because it will not be hinged. In 2 weeks we will discuss the ct scan and the exact procedure. My subtalar will probably need distraction as well as the tibiotalar.
Because the waiting list is very long it may take up to 6 months before I will be operated.

Take care,
Hilde

 
Old 02-12-2013, 07:27 PM   #14
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Re: HSS Ankle Distraction with osteotomy

Hey DJS,
My computer crashed, I got a new one but lost all my cookies and passwords and a chunk of data, work exploded, so it's taken me a while to log back into lots of things.
Sorry, I've been all over the place. I wonder if you've had your 5 week check and are now on your own...
That bloody footplate, drives me nuts. I've twice caught it on the gear shift of my van while sliding from driver seat to passenger seat ending up body wedged in the footwell - figuring out how to extract myself taught me a lesson in patience and contortion. I've ruined the upstairs tub finish and some tiles, ripped a bit of leather couch, dented a door...
I see Dr. F tomorrow, a day short of 10 weeks and I'm hoping against hope he decides "I've had enough distraction", takes out the pliers and wire cutters and away goes the footplate. You got yours off a little early... didn't you?
I've not had a lot of luck with weight bearing. The wire at the far back of the heel (I have four through the foot, assuming yours was the same) rips the holes, and the one most front pushes unbearably hard on a bone when I put more than half weight on it. I'm wondering if the leg angle change has thrown off the initial balance of the frame... who knows how they figure this all out. I swim three times a week, my ROM is very good, circulation good, I've had three infections, one from the spectacular fall at the pool (it wasn't really an infection, the pins that bled were inflamed and Dr. F. just said 'take the keflex) two of them at the same pin site that's been irritated and inflamed since the surgery.
It's amazing how fast this really has gone so far. The cat died, the snow fell, the days get longer, and I no longer wrap the leg up in scarves and covers when I go out - people tend to get out of your way when they see the frame. It's visually very impressive.
How are you doing? Is it nice to sleep on your face? I so hate sleeping on my back.

Puppet

 
Old 02-12-2013, 08:02 PM   #15
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Re: HSS Ankle Distraction with osteotomy

Hi Hilde!
Congratulations on finally getting in to see the doctor - I'm glad that he believes that he can help. Late summer into fall sounds like a good time to have the surgery... you can go OUT! We have two feet of snow from the past weekend outside, and plenty of ice. I long to sit in the back yard, and oh my poor dog. I have people to walk him and he can go out in the yard by himself but I miss walking him, and he misses it too... I have had luck with the knee scooter, but it isn't much good in snow, and even on rough ground it is not a long distance option. Tipping it over is embarassing, not to mention painful. You will need extended help with the dog(s)!
After the first few weeks, finding ways to DO things, to go places, independently, becomes important. Healing can be boring. As much as I get to swim a few times a week and my shoulders and arms are very strong from crutching around, my legs feel strange and weak. Some imagination, some medical fact - you spend a lot of time sitting around with your leg up in the air.
There is now something positive to look forward to when your leg hurts! A good chance that it will be better...

Hooray!

puppet


Quote:
Originally Posted by HildeW View Post
He djs,
Hope you are still doing better and better. I too am curieus about how puppet is doing.
Today I went to the 'ilizarov doctor' for the first time and he thinks I am a good candidate for distraction. My frame will be a bit different than yours, because it will not be hinged. In 2 weeks we will discuss the ct scan and the exact procedure. My subtalar will probably need distraction as well as the tibiotalar.
Because the waiting list is very long it may take up to 6 months before I will be operated.

Take care,
Hilde

 
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ankle problem, ankle surgery, osteoarthiritis, osteotomy



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