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Old 01-24-2013, 09:47 PM   #1
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Triple Athrodesis for a young athlete

I had a triple athrodesis and FHL to achilles transfer and I had my heel shaved down yesterday at the Balboa Naval Hospital.

I am a 27 year old Marine and I had a triple A yesterday. This is my back story.

PAST

I injured my foot training. I am a machine gunner in the Marine Corps. I didn't realize it was as bad as it was and trained on it for three more months before being unable to walk on it any longer. When I got an MRI I had a broken first and third metatarsal, my talor neck bone was split in half and filling with liquid, and my calcaneus was fractured. I was on an electronic bone stimulator for three hours a day and the fracture of my talor neck heeled. I spend some time in a hard cast, and ended up needing a surgical repair of my achilles tendon. The road to recovery took a little while. A lot of people told me my career was done, but I found a physical therapist who believed in me. I wore an AFO (Ankle foot Orthotic) which held my foot at a 90 degree angle and wouldn't allow me to pronate at all. My achilles tore again, and I was getting ready to get my triple athrodesis and achilles surgery when I found out my battalion was going to Afghanistan in 6 weeks. I passed a physical fitness test and combat fitness test to go. I ended up at a small patrol base in Afghanistan where we were partnered with the ANCOP. I carried a machine gun and 600 rounds on over 50 patrols and my ankle held up. I got back to meet my newborn son.

PRESENT

My surgeon told me I will probably never run again. She said if my kid was in danger I would be able to get him. She told me swimming and biking would be no problem but running is not going to happen.

I talked to my physical therapist who got me up and running on the Afghan deployment. I can run an 800 meter sprint (half mile) in 3 minutes and 2 seconds thanks to her! She told me "You are far too stubborn to not run again." And not only will I run but that I will at least be able to play a "janky" game of basketball.

It was very, VERY, VEEEEERRRRRY difficult for me to decide whether or not to get the surgery because of the fact that I was getting around so well. BUT that being said, I was in A LOT of pain. Not consistently. I would have times that were better than others and then nights where I couldn't even sleep because I could not get my foot comfortable. At night standing barefoot in the kitchen or the shower was rough. The AFO would offer temporarily relief but if I wore it too long it was terrible.

SURGERY

I had my surgery yesterday. I got in at 5am and didn't leave the hospital till about 6:30pm. The surgery itself took about 7 hours. They set me up with a nerve block and attached a catheter to my thigh, which I still have on now. It releases some pain block consistently for the next two to three days. I got another shot in my thigh which was a bit painful. And then they put something in my IV which would make it feel like I had a "Margarita".

I woke up from the surgery and looked at the clock and asked "When am I getting the surgery?" They told me I had just gotten out. It was 3:30pm and the surgery had taken 7 hours. They were going to keep me overnight but I did not want to stay. I had to pee, keep some food down, and use crutches. It took me about two hours to get up and going. I was very dizzy and because I could not feel my foot so I didn't notice if it was on the ground. I ate the crackers, and my wife grabbed me a six inch meatball and some chips. They explained everything to me. My wife and father in law picked up the pain meds, and they gave me two percocet and monitored me for an hour before I got to go. I was hoping to get a scooter like everyone suggests for a triple so I could get around. But my doc said maybe in two weeks because she doesn't want me "getting around" she wants me to rest. I had no idea just how little I would feel like getting around.

They loaded me up in a wheelchair and into the backseat of the car and I put my foot on a foam elevation support thinga ma bopper. We drove my father in law (a little bit too quickly) into the parking structure to the third level. When we got up there and I said to my wife "can you take it a bit slower on the way down? I'm not feeling too good. I'm gonna barf." I opened the door and got rid of the six inch meatball and my cheesy doritos.

We drove home, it was kind of a rough drive and in hind sight, I am not too sure I would have done it again. The drive took over an hour and I felt every bump. We drove with a couple windows down even though my wife was probably freezing cold.

I laid down on my couch, elevated my foot. We hung out for a bit and I was feeling great! Then I got up to go pee and paid for it for the next hour or so. My wife head up to bed to go take care of our baby (who my mother in law watched all day) and I stayed up watching sports shows, and played some video games. I thought FOR SURE I would go right upstairs with no problems. I am telling you, it is rough. Even with the catheter in my thigh, the two percocets every two hours, and two hydrocodone every 12 hours.

I got into a rhythm last night and felt super good. I slept well, waking up every hour or two and watching some TV or played some games. My wife set me up with some water bottles, pills, remotes, xbox controller, my ipod and a laptop. I'll be honest, I peed in the water bottles... That's embarrassing, but I want to be honest.

My wife came down with my boy in the morning, I used some hand sanitizer and said hi to my beautiful baby boy. I felt great for a few hours. Took a nap. My wife brought me some baby wipes, a toothbrush, and whatnot. I got cleaned up and changed. My body has been killing me. And honestly, I'm not sure right now that my catheter is dripping and called to see what the deal is. Today has been rough. My doctor told me at my pre-op "your foot will feel like it got hit with a sledgehammer." and "will swell up like a grape." It does. Man oh man it does!

I had an intern install my catheter and I am looking at it now, it looks like it is not any smaller. I am in pain. Just being honest.

Let me know if you have any questions. Sorry this is really long, but I wanted to be in depth so you can know where I am coming from.

 
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Old 01-25-2013, 12:02 PM   #2
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Re: Triple Athrodesis for a young athlete

It is hard, Dave, and it hurts like nothing I have ever felt before. But on top of that, it sounds like your nerve block is absolutely not working, which makes the two oxycodones every 12 hours woefully inadequate. I was taking a 5mg pill every hour at the peak of my post surgery misery. You need to call your doc...

Ps -- wish I could've just peed in a water bottle, haha.
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1/18/13: PTT transfer, peroneal longus to brevis tendon transfer, calcaneal osteotomy with medial slide, plantar fascia release
9/11/13: 4 toe fusions

Last edited by PesCav; 01-25-2013 at 12:07 PM.

 
Old 01-26-2013, 03:25 PM   #3
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Re: Triple Athrodesis for a young athlete

hi dave,

welcome to the world of triple arthro. i had my surgery 2 weeks ago. i had a whole mess of things done. first off, for the pain-tell em u need something stronger. i got long-lasting morphine and delauded. worked wonders. im about 2 weeks out now and got my first cast on thursday. the pain will get better. i have over 40 staples in my foot. i hope to get them out in 2 weeks. seriously, get the heavy drugs. they help. keep in touch.
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Triple Arthrodesis Achilles lengthening and tendon transfer 1/11/13.

External fixator and achilles lengthening around 12/14/10.

Last edited by Administrator; 01-26-2013 at 04:08 PM.

 
Old 01-26-2013, 03:29 PM   #4
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How are you doing today? Did you get someone to look at your catheter? It does not sound like it's working at all. I am so sorry. We are here for you so vent when you need to.
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Peroneal brevis debridement; peroneal longus transfer to brevis: tenosynovectomy, 11/20/12

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Last edited by Snowrunner; 01-26-2013 at 10:18 PM.

 
Old 01-26-2013, 09:47 PM   #5
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Re: Triple Athrodesis for a young athlete

Hello Everyone!

The Catheter was not working at all. And unfortunately my options were limited with being active duty military. We spent a good chunk of the day trying to get it working. We call the number the anesthetist gave us if there were any problems. They kept telling us "Sounds like it is on to me! But if you want to drive down here we can take it out." Now, "down here" is an hour and a half away, and I am already dealing with a nerve block that doesn't work! So, needless to say, no thank you.

I finally called and said "look, this thing isn't working, you guys have been giving me the run around all day. I'm not driving down there. Can someone please just trouble shoot this with me over the phone?" And he said "Dave, we are having an emergency down here. Can you call me back in 15 minutes?" I hung up the phone and called the company that manufactures the product, they set me up with a very nice nurse who did what she could. I ended up just turning it WAY up to 14 mLs. And it shot on, I briefly felt like my foot was going to explode because I was supposed to keep it at 8! So I turned it back down and waited for it to explode.

I felt like I had been hit by a truck. My wife called up the hospital and they told me I could go to the ER. My wife convinced me to go. The drive over was TERRIBLE and I felt like I was going to barf AGAIN! We pulled up and the long and short of it is they gave me two shots into my bum and those shots made me feel significantly better. On the way home we stopped at Starbucks and that too made me feel significantly better. I didn't even get a moderately healthy drink or something manly like a black coffee. I got a mocha frappaccino with whip cream because my inner fat girl felt like she'd been good. It was delicious.

I got home, the rest of the day was very easy because the shots made me feel significantly better. I turned off the catheter that was already not working and waited the six hours I had to wait to pull it out of my sciatica. I untaped the machine from my belly, and untaped and unglued it from my thigh and then had the very unpleasant job of pulling four to five inches of tubing out of my sciatica. Which he had told me "it's pretty much just going to fall out when you untape it." He also told me when I asked "how long have you been doing this?" That he is "technically still an intern." Which explains so much! Having the second nerve block administered was one of the most painful moments of my life while the senior tech just gave minor pointers here and there!

I went to bed, stayed up waaaaay too late playing Madden and watching different specials I had taped on the NFL Network (Top 10 Records that will never be beaten, Best 10 rushing quarterbacks etc.) I am glad my team is going to the Super Bowl so I have something to distract me.

I woke up this morning (Saturday) feeling pretty damn good. I had the surgery Wednesday. So that makes this day three... And it has been a pretty good day three. I feel more lucid, my head is much clearer, and I noticed that my pain pills will run out Monday. The Naval Hospital told us we have to go down to Balboa to get a refill. You would think, knowing I do not have my post op till February 5th they would set me up for success or AT LEAST let me go to a local pharmacy if I am willing to pay the co-pay. So my wife may be making the trip Monday morning to go down. I am sure she is excited to get out of the house a bit. Get away from her husband who is writhing in pain, playing video games, and peeing in water bottles all the while asking for "more ice cream'! Not exactly what she pictured five years ago when we got married! But she has been amazing. Truly amazing. And of course I am kidding. I am sure she pictured exactly this.

I decided to make my first trip upstairs today to take a bath. My wife has been bringing down baby wipes, a toothbrush, and a fresh change of clothes every day to make me feel like a real human being. But today I decided I was feeling good and went upstairs and bathed. I am glad I did. I feel much better. I did pay for it, even on the way up the stairs I felt all the blood rush to my foot and by the time I got back down my foot was pulsing and I am not sure I will do that again tomorrow. Though I am glad I did today.

Now I am just unwinding. My battalion did the Marine Corps ball last night because we were in Afghanistan when we normally have it in November. So it was kind of a bummer seeing everyone post pictures in their blues with their girlfriends and wives. But my wife and I cuddled up and had a really romantic evening cuddled up watching Hoarders.

I am doing fine. It's nice to log on and see other people responding! Makes me feel a little less isolated.

 
Old 01-26-2013, 09:49 PM   #6
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Re: Triple Athrodesis for a young athlete

Pes,

I have a feeling the water bottle may not have worked out quite as well for you! The Catheter did not work out at all. But we ended up running to the ER and got a shot that felt great!

 
Old 01-26-2013, 10:01 PM   #7
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Re: Triple Athrodesis for a young athlete

Thanks New and Snow,

I am new to this whole posting thing so I apologize in advance if I do anything wrong.

It's good to hear there is a light at the end of the tunnel! 50 staples?!?! Good God man! I think we probable had a similar achilles procedure done too.

They told me they were not able to fuse it perfectly straight because my talor neck healed small because of how long it was broken before getting treated. And my achilles surgery was not perfect. Apparently the FHL tendon did not have as much muscle as she had hoped and she had to cut out more scar tissue out of my achilles than she thought BUT the she is very happy with the fusion, so GOOD ENOUGH! I am just ready for the next step already!

 
Old 01-26-2013, 10:10 PM   #8
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Re: Triple Athrodesis for a young athlete

Wow Dave that sux that the surgery wasn't perfect. Let's hope its gud enuf though. Get lots of rest if u can. Glad the pain is better!
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Triple Arthrodesis Achilles lengthening and tendon transfer 1/11/13.

External fixator and achilles lengthening around 12/14/10.

 
Old 01-26-2013, 10:54 PM   #9
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Re: Triple Athrodesis for a young athlete

Dave, first of all, thank you for your service! Hope you're finally able to get some pain relief. The surgery you (and so many others here) have had is so very painful. Pain is to be expected, but there are pain meds available that should keep you comfortable. Listen to your dr and just take it easy for the next few weeks and let your body heal. Patience is the hardest thing for all of us! Keep posting and best wishes.

 
Old 01-27-2013, 05:09 AM   #10
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Re: Triple Athrodesis for a young athlete

Going to the ER was a smart move. Happy healing, love your positive attitude!!
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9/11/13: 4 toe fusions

 
Old 01-27-2013, 01:30 PM   #11
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Re: Triple Athrodesis for a young athlete

Well the nerve block works differently for some people. I was told as short as 8 hrs after surgery or as long as 36b hrs. Sounds like you should have stayed overnight and would have avoided some of the complications but that is now behind you. You should be fine but do elevate your foot as much as possible. Try to get that knee walker. If you weren't 3000 miles away I woud loan you mine but the cost of shipping wouldn't be worthwhile sending it to you. Try looking on Craigslist.
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Triple Arthrodesis and Achilles lengthening 9/28/12

 
Old 01-27-2013, 08:37 PM   #12
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Re: Triple Athrodesis for a young athlete

btrfli,

Thank you. I appreciate your gratitude.

Patience is extraordinarily tough. I want to be able to help with the baby, or at least with myself but I am very limited. I read a lot of what people posted about getting somewhat depressed. I definitely get that, being at the beginning of a long road of recovery and not being able to help with my kid can make me feel like a burden. My wife has been very careful to not make me feel like that. I love being able to hang out with my boy whenever I can. Today for about an hour I held the little guy and tickled him and he laughed and Tracy was able to have some down time. That felt good.

I did rush it a little bit and stood up on my sofa with my good foot to close the blinds and slipped up and put my foot down. I definitely feel like I have a certain amount of time to have my foot down when I am crutching around before I can really feel it start to swell up.

Today was good though. Nice and easy.

 
Old 01-27-2013, 08:45 PM   #13
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Re: Triple Athrodesis for a young athlete

Powerplay,

Hindsight being 20/20 I definitely should have stayed overnight. The nerve block didn't work at all because the medicine ball was supposed to release medicine and decrease in size and it didn't. At my post op they are going to get me a knee scooter so I can get around. My surgeon actually told me they are not going to give me it until my post op because they don't want me getting around just yet, they want me (like you said) to just keep it elevated in bed rest all day, every day.

 
Old 01-28-2013, 06:17 AM   #14
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Re: Triple Athrodesis for a young athlete

Dave

Glad to hear u had u gud day. I know how frustrating it is to not be able to take care of itself let alone not to be able to help ur partner. I've been disabled the past couple of years so my fiances ben great in dealing w it but she has more on her plate now that I'm completely limited. Those of us that are doers find it difficult to just sit around and let others work. Its easy enuf to slip n have an accident w the leg. Do ur best to try n relax and get better pain meds. I got a muscle relaxer too which helps a lot. Ull get thru this in no time. Hang in there!
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Triple Arthrodesis Achilles lengthening and tendon transfer 1/11/13.

External fixator and achilles lengthening around 12/14/10.

 
Old 01-28-2013, 06:18 AM   #15
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Re: Triple Athrodesis for a young athlete

Dave

Glad to hear u had u gud day. I know how frustrating it is to not be able to take care of itself let alone not to be able to help ur partner. I've been disabled the past couple of years so my fiances ben great in dealing w it but she has more on her plate now that I'm completely limited. Those of us that are doers find it difficult to just sit around and let others work. Its easy enuf to slip n have an accident w the leg. Do ur best to try n relax and get better pain meds. I got a muscle relaxer too which helps a lot. Ull get thru this in no time. Hang in there!
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Triple Arthrodesis Achilles lengthening and tendon transfer 1/11/13.

External fixator and achilles lengthening around 12/14/10.

 
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achilles tendon surgery, bone fusion, running, triple arthodesis



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