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Old 02-02-2013, 08:41 AM   #1
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Best time for surgery?

I am new here. Just found out my daughter (12) needs: Evans calcaneal osteotomy, cotton osteotomy, and a procedure to lengthen her Achilles' tendon. On both feet. Her left is worse than her right. Dr will do one foot at a time. My daughter wants to have it done ASAP so she can just get on with her life. She also is very anxious about it, so the sooner it is done...the better for her mental health. So the dr said most patients will do the first door when school gets out and then the 2nd during Christmas break (at the beginning so that she would have 2 weeks to recover).

She wants to do it now. If she does, how long would she have to stay home from school? I was thinking 2 weeks? Is that reasonable? Obviously we would discuss this with the surgeon... But thought I would ask those of you who have gone through it. Would she be able to get around on crutches at school or would a knee scooter be better? Or a wheel chair? I know her friends would gladly help her out.

We were really hoping the orthotics and PT would be enough.

 
Old 02-02-2013, 01:15 PM   #2
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Re: Best time for surgery?

I am sorry your daughter needs such extensive surgery. Be sure to get more than one opinion.

I think you should count on 12 weeks out of school with each surgery, so one surgery phased over the summer months makes sense in order to minimize the amount of school she misses. If she has surgery in Feb/March, and then again in 6 months (Sept), she could end up missing 6 months of school spanning two school years. Even if you can work out the academics, the social aspect of missing so much school is something to consider.

Best wishes to you both.
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Old 02-02-2013, 01:40 PM   #3
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Re: Best time for surgery?

Hi, I've had Achilles' tendon reconstruction but of course much older than your daughter, she will probably heal faster and deal with pain better, I was about 52 then.

I was non weight bearing for 6 weeks. Then started partial weight bearing with a walker, couldn't do crutches. I had pt for 12 weeks the first time, had to go back two more times but I also have fibromyalgia so don't count those two .

I couldn't do steps the normal way for about a year, had to take them one at a time.

I did use sort of a knee walker. They are expensive so I just used a walker with wheels and seat and put my knee on that with a pillow.

Be sure to get an ice machine, it's like a small cooler with a hose and has a thing to wrap around the ankle. They sent me one home when I left the hospital. Lots of trips to the store for ice though ice maker can't keep up !

I think I'd wait and get the first one done in summer just to see how it goes. You don't know how she's gonna react to the pain and the isolation does get to you.

Cathy

 
Old 02-02-2013, 03:00 PM   #4
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Re: Best time for surgery?

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Originally Posted by PesCav View Post
I am sorry your daughter needs such extensive surgery. Be sure to get more than one opinion.

I think you should count on 12 weeks out of school with each surgery, so one surgery phased over the summer months makes sense in order to minimize the amount of school she misses. If she has surgery in Feb/March, and then again in 6 months (Sept), she could end up missing 6 months of school spanning two school years. Even if you can work out the academics, the social aspect of missing so much school is something to consider.

Best wishes to you both.
I am calling Monday to get an appt for a 2nd opinion. Really this will be a 3rd opinion. She was seeing a podiatrist who was trying every conservative way to help her. He recommended surgery but did not do enough surgeries on flat feet so he sent us to the dr who told us what procedures she needs. I would rather not put her through surgery, but I also do not want my child in pain for the rest of her life.

12 weeks out of school? You do not think it is possible to be in a wheel chair or knee scooter after the first 2 weeks? I do not remember how long the dr said she would be non weight bearing but she would have a cast on, then go to a boot. Wish it were an easy surgery..

 
Old 02-02-2013, 03:11 PM   #5
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Re: Best time for surgery?

Have you talked to the school yet? I know some if them will do home schooling type of scenario where they send an instructor to the house. Check in to that as well keeping into mind sols, exams, etc. cathy

 
Old 02-02-2013, 03:17 PM   #6
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Re: Best time for surgery?

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Have you talked to the school yet? I know some if them will do home schooling type of scenario where they send an instructor to the house. Check in to that as well keeping into mind sols, exams, etc. cathy
I had planned to ask the school about it on Monday. But didn't know they could send an instructor out. I will have to look into that. Financially, it would be best to do both in one year, but we will not push for that but what is best for our daughter. Thank you for the suggestion!

 
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Old 02-02-2013, 03:58 PM   #7
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Re: Best time for surgery?

I would shoot for the first surgery when school gets out....do one fun thing first, so the whole summer isn't a bummer. This would give her the most time to heal before she has the 2nd surgery during school. She's going to need that first foot healed well before they do the other...it takes a lot of time. She should heal quicker than most of us older gals.. A knee scooter will work well at school provided she doesn't have to deal with stairs. Ask to get her out of classes early to avoid the crowds in the hallways if she has to switch rooms. Also with todays technology she could have another student skype her classes, while she is homebound, using a tablet or laptop. I missed 3 months one winter (30 plus years ago) my school set up an intercom system that a student carried to all of my classes.
It would be much easier now. A wheelchair she can elevate her leg would be less cumbersome in some ways but hard to navigate. The first 3 weeks are miserable. It maybe hard to even concentrate with pain meds on board. You could probably get both surgeries in this year. My Dr includes post op checks in the cost of surgery....this saved me lots of $$$ since I had 3 surgeries in one year & post op care falling in the new year. Winter on crutches sucks if you live with snow! Good luck....
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Old 02-02-2013, 04:58 PM   #8
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Re: Best time for surgery?

I'm sorry your dtr has to go thru these surgeries. Very painful and long recoveries. definitely get another opinion. I agree with the other posts,,,first one in the summer,agree you do something fun. But,,,,,if first surgery in the summer, I'm not sure she'd be up to another surgery by Christmas. That's hard on a young one.
As far as school goes, in our area, the school will do home schooling, at no cost to the family. You have to schedule this as far in advance as possible, but it's doable. At her age, the social aspect of school is very important. If home school is agreeable, I'd schedule visits from her friends as soon as she's up to it. A wheelchair would prob be a safer bet for her at school. The knee scooter works really well, and is convenient, but if she has probs with both feet, the non-surgical foot might not be ale to carry all the weight during her recovery. I think, at the very minimum, she would be out of school at least 3 weeks,,,more like 4 weeks, before she could be comfortable enough to concentrate all day. Best wishes to you,,,,keep us posted.

 
Old 02-02-2013, 07:42 PM   #9
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Re: Best time for surgery?

I am not familiar with all the procedures your daughter needs. My son was born with club feet and had to do the heel lengthening when he was 6 months.

I am writing though about the home schooling. When my daughter was in high school was had to request home schooling because she became very ill her senior year. With a doctors note stating the reason they will assign someone to come to the home. In my daughters case she would talk to the teacher several times a week over the phone in reference to the assignments and things and then the teacher would come out twice a week to help with any questions she had, collect work and assign more.

 
Old 02-02-2013, 09:13 PM   #10
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Re: Best time for surgery?

I have not had this particular surgery. But I did have knee surgery when I was a sophomore in high school, so I'll give my story. They thought I could make it back in 2 weeks, and couldn't. I did manage to go back after a month though. I had set up with my teachers to email back and fourth so I could get the work and made up tests when I got back. I was non weight bearing for 7 weeks and then school was 3 stories but I managed with a "5 minute pass" and help from another student. It wasn't super easy, but it was definitely doable and I liked getting back to school as soon as possible. Being young definitely has advantages! Now with my most recent ankle surgery, I'm over 7 weeks post op and I can't return to work yet.
I hope everything works out for your daughter!
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Old 02-03-2013, 07:01 AM   #11
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Re: Best time for surgery?

I am sorry to hear that your 12 year old needs surgery on both feet. I think that my perspective may help you since I am probably the closest in age to your daughter on here. I am 25 years old and 19 days post-op today.

-------
I posted this on the unrealistic expectations thread a few days ago:

"I am just over 2 weeks post-op (16 days post) from flat foot reconstruction surgery (PTT debridement and repair, FDL tendon transfer, lateral column lengthening, calcaneal osteotomy, gastrocnemius recession) and I returned to "work" exactly two weeks post-op. I am a grad student, but I also teach a college course and work in the lab.

My first day back, just bathing, dressing, eating breakfast, and packing up my stuff completely zapped all of my energy before even getting out of the door. I was only motivated to continue because I knew that my students hadn't even met me yet because my surgery was on the second day of the semester. Teaching went well and surprisingly I was able to do more stuff for myself than I expected. I was even able to write on the board with careful balancing between my crutches and wheelchair. I only stayed for 4 hours the first day. When I got home, my foot was visibly swollen (looking at my toes peeking out of my hard cast) and throbbing in pain from not being elevated. Once I iced and elevated it and took some acetaminophen, it was better about an hour later.

The next day, I was at school for another 4 hrs. This day, I was sitting in a computer lab for a 3 hr statistics class. I again was unable to elevate my foot while sitting there. My foot did not scream as much as it did the first day, but being away from the comforts of home is still tough at this stage.

It is definitely possible to return to work a few weeks after the surgery, but as everyone is saying, it is not going to be comfortable, you won't want to do it, and you have to ease into it. Start out with a few hours a day. It will take me quite a while to get back to my 12-16 hr school routine.

I would also recommend getting a wheelchair so that you can save as much strength as possible getting to and from places (to your car, from the parking lot to your office, around the office) and use the crutches for only short trips."

---------

When I went to my first post-op appointment (13 days post), it was clear that I was healing much faster than those older than me that have the surgery. My 5 incisions were mostly healed and my bones also show really good signs of repair. The first 10 days were really tough for me because none of the pain meds really did anything to lessen my pain. Your daughter may be in a similar boat because I assume that she won't be able to take as strong narcotics as us adults. At the same appointment, I got my surgical cast switched out for a traditional hard cast. My life has been exponentially easier since then and relatively pain free. I will only be non-weight bearing for 6 weeks (2 weeks surgical cast, 4 weeks hard cast). As soon as I finish the 3 remaining weeks I have in the hard cast, I will be working towards full weight bearing in a boot.

I had my surgery on the second day of the semester, and went back to school 15 days after my surgery. As I say above, it was tough but definitely doable. Your daughter will have it a little easier sitting in middle school classes. I think that her returning after 3 weeks is more realistic than after 2. That will give her a little more time for her pain level to come down and for her to get her energy back. At this point, I just feel like I am being held hostage by the cast on my leg. I haven't had any pain for days and will be returning to my full school schedule this week.

I would recommend that if your daughter has a week long spring break that she should get it close to then. That way, she will have a free recovery week without worrying about school. I would get the surgery sooner than later (only if she is mentally ready), because putting her through another several months of struggling with her feet waiting for surgery is unnecessary. Having the surgery around spring break will also give her much more time to recover before having her second surgery at Christmas. The remaining support foot needs to be strong to make it through the non-weight bearing.

By the way, my doctor has done a lot of these surgeries on young people and he has had them return to their activities with no problems. He even had someone return to soccer, which involves cutting and running! I am a runner and triathlete and he is confident that I will be able to return once I heal.

I hope this helps you and let me know if you have any more questions.
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Old 02-03-2013, 07:18 AM   #12
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Re: Best time for surgery?

She's lucky to have you. Sounds like you are really trying to plan what is best for her. I had very similar procedures and was in 4 casts over 10+ weeks. Crutches take a toll when you are out and about. The biggest impact on me was having to bear all my weight on my good leg and if her good leg has problems, it could be hard on her. I did use a wheelchair when I was out, it gives the body a rest. At home I actually wheeled around on an office chair on my hardwood floors. Keep in mind that crutches also means you really cant carry anything unless in a backpack. A wheelchair with crutches with her would likely work best at school. She could crutch into the bathroom, across the room etc without having to manouver the chair in small spaces.
Keep in mind the weather in your area. (I dont know where you live) Winter with ice and snow can be very challenging for crutches and wheelchairs and downright dangerous. It can lead to cabin fever whereas nice weather makes it easy to even sit outside and fresh air and sunshine can greatly improve the mental health aspect of recovery. She's young and that will be a bonus for her. Amazing how kids can be resilient and heal faster than us. The first 2-3 weeks was the hardest for me-pain, meds, low energy, shock to the body, needing to elevate all the time. A transition into school might be good, half days to start but kids constabtly surprise us wiht how quickly they can rebound from things! Best of luck to her, and you!

 
Old 02-03-2013, 08:27 AM   #13
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Re: Best time for surgery?

I really appreciate all of the advice. I sent an email off to the principal to ask about what can be done if she is out for 3 weeks. Even if we wait until the summer to do the first one, she will probably miss a little school with the second one. She is also auditioning for a performing arts school, so she doesn't want the surgery to interfere with the new school. We will know by the end if march is she is going to the new school.

We have a vacation planned and paid for on her spring break, so that isn't an option and she wouldn't want to give that up. Both of my kids are really looking forward to it (Disneyland).

We are in north Texas, so I do not think winter weather is a a factor but you just never know what Mother Nature will do!

So a wheel chair with crutches would be better than a knee scooter? She uses a backpack at school, so that isn't an issue. The school is mostly one level but is set up to accommodate wheel chairs (there are a few kids who are in one permanently). Though the classrooms would be a snug fit for a wheel chair.

I am not sure about the dosage of pain meds she could use but she is almost fully grown at 5'4+" and 110lbs. We will move her down to the first floor guest bedroom. Luckily we have no carpet on most of the first floor (only a living room) and besides the bathroom a wheelchair would work. I can get a shower seat for the shower. (Love the sticky with all the tips). Glad that I decided not to go back to work yet so I can take care of her post surgery).

I know she is very worried about the pain. She saw me suffer through an extensive shoulder surgery (two actually on the same shoulder) and the pain post surgery is making her anxious. I was told my surgery was one of the most painful of all joint (hip, knee, ankle,etc)... So I am using that to reassure her but I have no idea how she will handle pain. She has never had surgery. She did break her wrist when she was 7, and she remembers how much that hurt but that it felt better after it was in a cast. I wish I could just take this all away. It stinks to see your child in daily pain and know the pain will only get worse before it gets better.

 
Old 02-03-2013, 08:42 AM   #14
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Re: Best time for surgery?

Quote:
Originally Posted by Happy2try View Post
I am new here. Just found out my daughter (12) needs: Evans calcaneal osteotomy, cotton osteotomy, and a procedure to lengthen her Achilles' tendon. On both feet. Her left is worse than her right. Dr will do one foot at a time. My daughter wants to have it done ASAP so she can just get on with her life. She also is very anxious about it, so the sooner it is done...the better for her mental health. So the dr said most patients will do the first door when school gets out and then the 2nd during Christmas break (at the beginning so that she would have 2 weeks to recover).

She wants to do it now. If she does, how long would she have to stay home from school? I was thinking 2 weeks? Is that reasonable? Obviously we would discuss this with the surgeon... But thought I would ask those of you who have gone through it. Would she be able to get around on crutches at school or would a knee scooter be better? Or a wheel chair? I know her friends would gladly help her out.

We were really hoping the orthotics and PT would be enough.
Ok here is my opinion. I am not familiar with your daughter's surgery but you said the Dr. indicated 6 weeks non weight bearing. I had a triple arthodesis and ahcilles lengthening and was 10 weeks non weight bearing. I was usining my skooter/knee walker while in the hospital and right away at home so please seriously consider buying one. I got my second hand on Craigslist for $140 and was the best investment. I am 66 and your daughter is 12. At 66 I was out and about on my skooter one week after surgery. I would think she should be able to go back to school in one week provided she progresses on schedule after surgery. You will need to have the knee walker and get one with a basket ( I didn't need a basket) to put her books in. All you need to do is have her dropped off and picked up provided that have handicap access (no stairs) and she won't even need to have her crutches with her. As for getting up and down stairs, PT while in the hospital will want to see her using the crutches to go up and down stairs but I found using them to be a total waste of energy and risk of falling. Going up just crawl like a child would and going down use your bum to lower yourself one step at a time. After a few weeks I was able to carry my knee walker down the step since it folds down some and held on with my free arm to move down the steps. I rarely used crutches in the house but did need them after I got the knee walker into my car and had to maneuver to the drivers side to drive and yes I drove with my left foot. So that being said I see no reason why a nimble 12 yr old can't get back to school in a week. Just make sure she doesn't flip over on the knee walker but taking sharp turns ( did that in the kitchen and used my casted ankle to break my fall but luckily the heavy cast prevented any damage). Your daughter probably will work the crutches effortlessly too - I didn't and relied on my knee walker. You can rent them but the cost is not worth it. Best to find and second hand one that she is really going to need since she has to have both feet done. YOu can always resell it afterwards. Good luck and I am sure she will be fine once this is all behind her
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Old 02-03-2013, 08:52 AM   #15
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Re: Best time for surgery?

Ok, no sping break surgery. I am glad she will have a fun trip to look forward to before being out of commission for a long time. She may be able to work ahead towards the end of the semester so that she can have the surgery a few weeks before school let's out for summer vacation. Again, I would say sooner than later to give her as much time to recover before the second surgery.

Wheelchair plus crutches for school definitely. I originally was going to get a knee roller, but after I realized how much stress the crutches put on your support foot and hands, I reconsidered. The knee roller will not provide any relief for either of those. The wheelchair will allow your daughter to put her backpack on the back, carry something on her lap if she wants, and transport her crutches. It will also allow her friends to help her out by pushing her around. She can use the crutches for short trips around the classroom.

Also, make sure she has a rolling desk/computer chair to get around your house. That has helped me the most.

I can't sugar coat the pain. I have an exceptionally high pain tolerance (no wonder why I was able to become a marathon runner), and this surgery nearly broke my spirit. It hurt more than I could have imagined in the first 10 days, but like I said before, I have been relatively pain free since then. It will be tough but I know she can do it if she focuses on what she will gain by having two healthy feet.
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1/15/13: LEFT PTT debridement, FDL transfer, calcaneal osteotomy, lateral column lengthening, gastroc recession
6/04/13: RIGHT calcaneal osteotomy, lateral column lengthening, gastroc recession

 
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