Pre-op apt Mon Triple Arthrodesis - Foot Problems Message Board

Pegret · 05-09-2009, 09:17 AM

I am so greatful for fining this site! I see the doc Monday (11th) surgery is the 27th. Here is my list - what am I missing? If I am going to be out of commission for months, I really would like to be as prepared as possible. I am hyper-mobile and have had failed bunion and hammertoe surgery in the past.

• What kind of a cast will I be in post-op? For how long? When will it get changed?
• What is/are the name(s) of the procedures being done?
• Will my bunion be re-done? Toes straightened?
• Will I have bone grafts? Synthetic? Cadaver?
• How many screws will be put in? How many external pins? Where will the pins be (on the top or side of the foot)? Are they permanent?
• How long do I have to be down (limiting my "crutching/walker" to only when going to the bathroom)?
• Spinal/local/block please? Do they do an ankle block after my surgery to numb my foot for several hours?
• How long until I can wash my foot (can I get the external pins wet, as I will have them for 6 wks)?
• What about a knee walker? A wrist brace? A brace for the other foot?
• How long will I be in Physical Therapy and when do I start?
• When can I get back in the pool? Water walking…water arthritis…water aerobics
• When can I drive?
• Demerol please. No Tylenol or morphine products.
• When can I get the left foot done?

Suggestions/comments by others:
1. ice definately does help, and does go through cast. i had a machine with a cuff and pump, it pumped cold water thru cuff for about 10-12 hours. so nice. would sleep with it. def made it feel better.
2. Use ice behind the knee
3. Knee walker is a great thing. Just don't get Invacare brand, I found it dangerously unstable. Rolleraid or Turning Leg Caddy is better.
4. Be careful of P/T : “…my PT I had after PTTD surgery was very experienced with a great reputation....BUT, I didn't know, and should have asked, if he had ever treated someone with my surgery. He hadn't, and I didn't find out until he was way too vigorous in pulling and turning my foot trying to force my inversion to come back (which it never will completely and that's okay) and he tore my peroneal tendons - both of them. Although my surgeon wouldn't and couldn't say for sure as they are "at risk" following surgery (due to bad pronation causing them to shorten, then re-alignment stretching them back out)… as it turns out, I had torn peroneals and had to have a second surgery.”

lynnyl · 05-09-2009, 11:40 AM

Sounds like you've got it covered! I hope all goes well. You'll be mentally okay and able to ask questions and make changes to the plan afterward, too.

If I had to add anything it would be to "source" your appliances before hand -- to figure out how and when you will get them. i.e.My hospital would have allowed me to bring my extra-tall walker in with me, and I would have if I'd known that. I'd have also bought more "slippery" pajamas to make it easier to move in bed at home.

Let us know about the bone grafts. I had a hip graft--it scared me, but was no big deal.
Don't blame you for wanting things to go without a hitch this time! -- Lynny

shelleybutn · 05-09-2009, 02:49 PM

pegret, first things i noticed on your list....what foot is it on? that will determine driving, etc. if right foot can't drive until you are full weight bearing. why no tylenol? you will not be able to take nsaids because of bone healing but tylenol products good (and narcotics i thought needed the first 2 weeks). my bone graft was out of my tibia (by knee). i was in a half cast with lots of gauze padding for the first 2 weeks then went into hard cast for 4 weeks then into boot. i have 5 screws (2 in talonavicular which i am getting removed in a week, a big one thru heel and 2 little ones in the other bones). no external pins usually. you can shower when you feel up to it, buy a cast cover at walgreens---very helpful. no swim until out of cast and incisions are amazing and you can actually get in and out of pool...my doc said NO for first 4 months. i just crutched the whole time, but i am only 31, some of the other TA's online here used walkers/knee walkers. PT begins after casts are completely off and works on range of motion and strengthening of calf, leg, etc.

you won't be able to hurt your peroneals...since that motion (inversion/eversion) will be non-exsistant after this surgery. you will only have up and down (dorsi and plantar flexion).

they kept me one night in hospital. surgery friday, then went home saturday afternoon and was down that day and some of sunday but then moved out to the recliner and did ok. you gotta keep your foot propped up all the time, the first few weeks you won't feel like doing anything but hanging out.

i wouldn't count on doing the other foot until you feel awesome on this one...it took me 10-12 months to feel like i could do the other one. it's alot of stress and a LONG recovery. i didn't get out of boot until october and had surgery in may.

keep your questions coming, let us know how your appt goes. sorry i was long winded
shelley

Pegret · 05-10-2009, 07:19 AM

Thanks Shelly. It is my right foot and I am concerned about the driving issue because I hate burdening my friends. I'm 60, I own a business, and I have no family other than my adult single sons - one is 1200 miles east of here and one 1200 miles west... you just get them raised to where they can be useful and off they go! Sheesh.

For me, I have very limited pain meds that work. As for Tylenol, I might as well eat M&Ms for all the good the product does. And that includes the 'script only varieties. Just don't do anything for me. Normally Demoral is my pain drug of choice when the Ibuprofen does not give relief. And the morphine makes me throw up! I had not heard that the Nsaids slow healing. Sure don't need that.

I had a total meltdown yesterday. I have too much on my plate. I'm hosting a 4 day conference here for 40 folks from around the country starting the 18th. It finished the 21st and surgery is the 27th. The first day activities for the conference are at my house. Arrgh. I have no where near enough time to get everything done for both events while setting up my office so it can run without me. And I am scared. I have had hips and knees replaced (at 50 & 58 - I am the poster child, all went really well), but they certainly don't have a 9-12 month recovery time. After surgery (University of Iowa - which is 2 hours west of here) I am going to a friends home for about 2 weeks, and she is another 1.5 hours north of the university. I have to have everything packed (except for what I forget) tomorrow. She is coming to the pre-op appointment with me and taking my suitcase and stuff home with her. It is coming back to I am scared!

lovelyladi · 05-10-2009, 09:15 AM

HI Pegret

I had my triple Jan 15...so I do understand. I am 60 years old. I had a cadaver bone graft and not an allograft. I used a knee walker mostly...I was not able to get the hang of crutches (falling) or hoping on my arthritic knee with a walker for more than short distnaces.

I suggest (if you can afford it) that you get some help in every day for a few hours (prepare meals...light cleaning etc..help you bath drive you to any doctor visits) It made a huge difference for me.

good luck

Hugs, Shelly (there are 2 of us one with an e and one with out)