Ankle Overhaul - anyone had this much work done at once?
After 2 years of ankle fun/he!!, Doc #5 has recommended a combination that he assured me would be the "worst experience of your life" (thanks doc) : Brostrum's procedure, peroneal tendon repair, sinus tarsi synovectomy and ankle debridement. Based on what I've heard from the 5 different docs, this combination unfortunately sounds about right.
How's the recovery from this, aside from the first 3 days, when he says I'll just be swearing at him, even with the drugs after the block wears off (he really sugar coated this didn't he)? I had debridement done last year and had a pretty easy go of it. I have the luxury of being able to work at home, and even at work I can keep it elevated. Heck, by now my coworkers are pretty used seeing my foot on my desk or even occaisonally on a conference table.
I'm not really fretting over this, just curious. I've probalby had more cortisone than the average NFL player and been in & out of a boot for the last 6 months. I've spent so much time in PT, I almost consider the guy a friend. The last time I got out of the boot, 4 days later my ankle dropped over; so it's definitely time to do SOMETHING.
Re: Ankle Overhaul - anyone had this much work done at once?
Wow! If the doc puts it like that it must be rough. My surgeon doesn't play up or play down pain. He doesn't say a whole lot about it but doesn't hesitate to treat it when it does hurt.
Re: Ankle Overhaul - anyone had this much work done at once?
Hey! I'm so sorry you had all this done! I've had most of this done just in 2 different operations (and my synovectomy was different), but in my 2nd surgery, I had about the equivalent of it: Brostrom (2 ligaments), retinaculum repair, peroneal tendon repair, debridement of scar tissue (from injury and first surgery), and fibular osteotomy for groove deepening so my peroneal tendons couldn't sublux anymore. My doctor also said pain would be bad (especially when he added the osteotomy). He was VERY good at treating it. As far as my recovery, it went well. 6 wks NWB in a cast on crutches, followed by 4 weeks in a boot and 3 months of PT. I was on 2 7.5/325 percocets every 4 hours around the clock for the first 3-4 days and then I gradually increased the time in between doses until I was taking 2-3/day total by week 2. I did well with recovery and the week after I finished PT, I went to Europe for 2 wks (scheduled before surgery with my doctor's okay). A month later I went to Alaska and hiked and ziplined. I didn't do any of this without pain and swelling (and my brace), but it was normal post-op pain and swelling. It wasn't till Sept when I had a freak accident walking on an uneven brick sidewalk (without my brace because I wasn't doing anything athletic) that I resprained it and am currently back in PT, but I also walked a 1/2 marathon after the injury too (LONG story and not the smartest thing I've done, but I already had signed up with my doctor's okay). So all that to say....I think you will be okay! Is it fun? Nope! Painful? Yep! Doable? Absolutely! Hang in there!! When are you scheduling surgery?
Re: Ankle Overhaul - anyone had this much work done at once?
Thanks, I'm a bit worried but I'm not. I have no problem whatsoever taking painkillers! They've gotten me through a lot (boot camp) in the past. Definitely not one of those "I don't like putting things in my body" types, more like "Better living through Chemistry"
Hollywood, I was wondering how your 1/2 marathon went.
I've got to call later today to schedule, but it looks like the end of February for the deed. Between now & then, I get to spend a week running around a Navy ship. The ship part doesn't worry me; my steel toes are pretty darn supportive. The inevitable walks through Old Town Sand Diego for dinner do - I have a knack for finding any unevenness in a sidewalk. Like most everybody else here, it sounds like.
The fun conversation comes next week when I ask my green-as-grass local OS (#4) if I can do the post-op stuff with him after having Dr.#5 do the surgery, 2 hours away. I'd really rather not spend 4 hours in a car just to go up and get stitches out. #4 isn't a bad doc, but he just finished his fellowship last spring & isn't board certified yet. I'm not even sure that he's done all of this stuff before.
Re: Ankle Overhaul - anyone had this much work done at once?
Wilki, my first surgery was almost identical to what your dr is proposing except I didn't have the sinus tarsi synovectomey. With pain meds, I was able to manage post op pain fairly well. My surgeon prescribed strong enough meds to handle the pain level. After the first few days, I was off the prescription meds, except at night. Of course, I don't know how the sinus tarsi surgery would have affected my outcome. I just had an ankle reconstruction (chrisman-snook with an allograft tendon) and recovery has been a lot more painful than the first).
I didn't have a block for the first surgery, but did with this one, and I would definitely recommend having a block. Wishing you all the best with your upcoming surgery. With all you've been through with your foot, it sounds like you'll definitely get relief from the surgery, once you're fully recovered.
Re: Ankle Overhaul - anyone had this much work done at once?
I had my surgery done 7 hrs from home and they didn't have any problem with my local doc taking out the stitches and doing the follow up.
Didn't you see a doc at Mercy? If you are going there, I had Dr. Myerson. He was wonderful. Good luck!
Ginger
The Following User Says Thank You to ginger62 For This Useful Post: wilkinak (01-11-2013)
Re: Ankle Overhaul - anyone had this much work done at once?
Yes, I saw Dr. Jeng at Mercy. I like him, seems to know what he's doing. Thanks for the recommendation to go there. I've been pretty impressed by the parts of the place I've seen, and the people working there have been great. They set up a quick pre-op visit so I don't have to drive back up there.
If it were 7 hours from home, it wouldn't feel awkward to me; at 2 hours, it feels like I'm borderline local. I went up there the day from work, so it just around an hour. The reality is that I just don't trust the local guy enough to do the work, and that is a bit awkward, even for someone as tactless as myself.
Re: Ankle Overhaul - anyone had this much work done at once?
The way the expected pain was described was almost funny for another reason. My 87 year old aunt is having a TKR next week and her hack surgeon hasn't prepared her at all for what's coming. She expects to be up and out of the nursing home in two weeks; none of us will be surprised if she never leaves there. She's not one of those exceptional old people who is freakishly active and still running marathons; she's a normal old person who has balance problems and just has trouble getting around. And takes the occaisonal Tylenol for pain. So in that context, having the docs tell you, at less than half that age, it'll be 9 months to get back to normal, and the first few weeks will be pretty rough, is kind of entertaining, in dark sort of way.
Re: Ankle Overhaul - anyone had this much work done at once?
I wouldn't think the local guy wouldn't have a problem with doing the post-op stuff. If he were to ask why you didn't have it done with him, then I'd really pro up your surgeon at Mercy vs telling him he's green, hasn't done this before and isn't board certified. Make sense? I'd just say he came recommended to you, has,done this several times, great success/rep, whatever. He'll understand! How does your post-op pkg work though? After my surgery, for 3 months, every visit was covered under the surgery blanket. Will the local doctor charge you and if so, will your surgeon pay it/him?
The 1/2 marathon went! Ugh...SO.MUCH.PAIN. Never again when my ankle is injured. Wouldn't have done this one if I wasn't already signed up. I'm PT now with it and my poor PT has his work cut out for him! Thanks for asking!!
Re: Ankle Overhaul - anyone had this much work done at once?
TKR's have changed in the past few years. I had one 3 years ago and they get you up and walking the first day. Auntie is going to need some stronger drugs though (apparently a lot of older folks have trouble with that but it really is necessary for recovery and PT, cuz that hurts a lot too). Do please tell her though, because I didn't know and wish I had, the first 48 hrs are absolute hell. The pain from this PTTD surgery doesn't even compare. However (very important) the bad stuff does not last long. Just get through that and it is smooth sailing.
Good luck at Mercy. I had such a good experience there, I hope you do too. If you just need stitch and splint removal I agree with Hollywood, talk up your OS, or go to an Urgent Care if you really don't like the guy. He shouldn't be offended...no one in my town wanted to touch my surgery with a 10 foot pole.
Ginger
Re: Ankle Overhaul - anyone had this much work done at once?
I don't think Doogie Houser is going to say no, I just feel a bit like a tool asking. I have good reasons, but I still feel a bit like a tool. Catholic - I can feel guilty about anything.
Hollywood - be glad you don't have my PT, if I went there after walking a 1/2 marathon, he'd probably rip me a new one. when I went back this summer to rehab the sprain, I was greeted with "WTH did you do now?" and a smile (sort of)
The aunt is whole 'nother frustrating disaster. That surgeon really is a hack; he's advised her that conservative measures and pain managment are a waste of time and TKR is her only option. HUH? I'd love to know what his Medicare reimbursement is. Multiple drs, other than the OS, have advised against it. Old girl isn't quite all there any more, but not bad enough to be incompetant. I know a couple people her age who have had this done. It didn't end well for them.
Re: Ankle Overhaul - anyone had this much work done at once?
Northern VA isnt that far from Baltimore -- what, 50 miles or so? I think you need to suck it up and drive for the relatively few post op appointments you will have. Schedule appts non-peak hours.
Re: Ankle Overhaul - anyone had this much work done at once?
Hahaha, I forgot you had a Doogie Houser!
If your aunt doesn't need a TKR why on earth is she getting one? Is she "well" enough that perhaps she could talk to some others that have had one? Sometimes info from your peers can carry more weight and may help her make a better decision. Maybe tell her it would just make you feel better if she got another opinion. The thing is, once you start that stuff, so many other things can happen, especially falls...not good at her age. Good luck!
Ginger
Re: Ankle Overhaul - anyone had this much work done at once?
My aunt's getting a TKR because she's an idiot and a stupid old woman. Forty years ago, she was a stupid young woman. Everyone has talked to her until their blue in the face. This is a woman who didn't think her granddaughter was retarded since she had a "diploma"; it was a certificate of completion. She is the embodiment of "you can't fix stupid".
Pes - I'm not sure how you get this being a 50 mile drive. It's 30 miles for me to get to work in SE DC. From my office it's 58 miles. I've done the drive in non-peak hours. It's about 2 hours, best case 1.5 hrs, I've been up there 3X. I also have to find someone to drive me back up there.
Re: Ankle Overhaul - anyone had this much work done at once?
wilkinak
This is a complete change of subject - I am seeing Dr. Jeng this Tuesday. How is Dr. Jeng? I've heard good things about him. I am also about 2 hours away from him, but a friend that lives in Laurel is going with me, so I will be leaving from Laurel instead of Southern MD...
Re: Ankle Overhaul - anyone had this much work done at once?
I like him. He's very personable and seems to have a sense of humor. Obviously smart, but not a hot shot. He has some minions, not sure if they are interns, residents or just junior to him, who took a look at me first. They are very thorough - by the time the 2 of them (Jeng and other guy) got done with my foot, it was throbbing. Seemed like an eye exam "hurt more here or here?" I was ready to smack him if he prodded me more time by the time he was done! He came up with some answers that my previous docs didn't. When he gave me the diagnosis of sinus tarsi syndrome, he kind of laughed and told me to look it up on the internet, since they all know that's what we do when we get home anyway.
As others have said, the staff there is great and the front office folks are some of the best I've come across. They actually seem to want to help, as opposed to most doctor's offices I've been in where they appear to think patients are a (somewhat) necessary evil or just a bother. The last thing they worry at Mercy about is your copay. All of my appts have been mid-day, so it hasn't been busy and they are pretty quick getting people in.
Re: Ankle Overhaul - anyone had this much work done at once?
Oh my PT was NOT in favor of it I assure you! When I went back to rehab my sprain in Nov, he was like "this wasn't what I had in mind when I said bring me some business. I meant referrals, not repeats!" LOL! He actually thinks we are getting some movement in the joint that is just now ready to move post surgery. Since its moving more, the soft tissue should follow suit and I should gain more mobility. Strength is a different story. Says its still weak and it still hurts too!
I essentially had what you are having done my first surgery but I didn't have the synovectomy... and it was unpleasant but doable. I like it when docs give it to straight about pain. It helps you prepare...
My second was actually worse and only involved the peroneal tendon transfer... I think it will depend on how he's repairing yours. Suturing hurt but merging two tendons was worse.
And the only reason I'd make the two hour would be for maybe your 6 week appointment and the one after. Just getting your stitches out is no big. Have your surgeon communicate protocol with Doogie though...
__________________ Peroneal brevis debridement; peroneal longus transfer to brevis: tenosynovectomy, 11/20/12
Re: Ankle Overhaul - anyone had this much work done at once?
Quote:
Originally Posted by wilkinak
I like him. He's very personable and seems to have a sense of humor. Obviously smart, but not a hot shot. He has some minions, not sure if they are interns, residents or just junior to him, who took a look at me first. They are very thorough - by the time the 2 of them (Jeng and other guy) got done with my foot, it was throbbing. Seemed like an eye exam "hurt more here or here?" I was ready to smack him if he prodded me more time by the time he was done! He came up with some answers that my previous docs didn't. When he gave me the diagnosis of sinus tarsi syndrome, he kind of laughed and told me to look it up on the internet, since they all know that's what we do when we get home anyway.
As others have said, the staff there is great and the front office folks are some of the best I've come across. They actually seem to want to help, as opposed to most doctor's offices I've been in where they appear to think patients are a (somewhat) necessary evil or just a bother. The last thing they worry at Mercy about is your copay. All of my appts have been mid-day, so it hasn't been busy and they are pretty quick getting people in.
Oh this gives me hope! Thanks for the information, it has actually helped me to not be so nervous, etc on Tuesday. Thanks again!
Re: Ankle Overhaul - anyone had this much work done at once?
Quote:
Originally Posted by Snowrunner
I essentially had what you are having done my first surgery but I didn't have the synovectomy... and it was unpleasant but doable. I like it when docs give it to straight about pain. It helps you prepare...
My second was actually worse and only involved the peroneal tendon transfer... I think it will depend on how he's repairing yours. Suturing hurt but merging two tendons was worse.
And the only reason I'd make the two hour would be for maybe your 6 week appointment and the one after. Just getting your stitches out is no big. Have your surgeon communicate protocol with Doogie though...
Great, he talked about splitting and suturing stuff back together, can't remember if it was ligaments or tendons. The difference in protocols is a concern, Doogie said 6 & 6 for the less involved approach, where Jeng said 4 & 4 for the whole shebang. They definitely need to talk for this to work.
So in that context, having the docs tell you, at less than half that age, it'll be 9 months to get back to normal, and the first few weeks will be pretty rough, is kind of entertaining, in dark sort of way.
when I went back this summer to rehab the sprain, I was greeted with "WTH did you do now?" and a smile (sort of)
When I went back to rehab my sprain in Nov, he was like "this wasn't what I had in mind when I said bring me some business. I meant referrals, not repeats!" LOL! He actually thinks we are getting some movement in the joint that is just now ready to move post surgery. Since its moving more, the soft tissue should follow suit and I should gain more mobility. Strength is a different story. Says its still weak and it still hurts too!
