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  • Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

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    Old 06-20-2004, 09:57 PM   #1
    Mpls21
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    Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    Hello. I just found this site and I am so glad I did. I am looking at the possibility of having arthroscopic surgery on my ankle which has just been diagnosed as "Chronic Ankle Sprain/Instability."

    I have been having foot and ankle problems for many years, but they were tolerable until about 3 months ago. It started with some pain across the top of my foot and into my arch, and a catching/stabbing pain right at the base of the leg where the foot forms an angle, when I was walking down stairs. That all got worse and I began having a lot of pain in my ankle, on both sides.

    I am in sales and this has greatly effected my ability to work because I need to be on my feet and moving all day. I have been to the doctor, had xrays, cortisone injections, and been in a walking boot. Nothing helped. Thursday I had an MRI and Friday I saw the doctor. That is when he told me there was "nothing really specific on the MRI, but there were indications of Chronic Ankle Sprain and signs of scarring from an old, severe ankle sprain."

    When I was in highschool, I tore up my ankle pretty severly playing basketball. I have had problems ever since with electric shock like pain shooting across the top of my foot and with my ankle folding under me for no reason.

    Anyway... sorry this is getting so long... the doctor thought that I should have my ankle scoped, and one of the ligaments (that is in very bad shape apparently,) repaired, and some bone chips removed.

    I am absolutely terrified.

    1.) It will mean 6 weeks of no weight bearing which means 6 weeks of no work.
    2.) I have heard horror stories of nerve damage and all kinds of bad things with any ankle/foot surgery.
    3.) I am seeing a podiatrist and I don't know much about them. He works in the same office as my Orthopedic Surgeon whom I just love. He has done fantastic work in the past on my shoulder and my knee... both are like new after severe injuries... but his secretary referred me to the Podiatrist in the office when I told her I needed to make an appointment for my ankle and foot.

    You know, I don't even really know what I am asking for here. Hope? Words of encouragement? I don't know. I have spent the last 2 days (and most of those nights since I can't sleep with the worry) searching the web for any info I can find about this and have not found much.

    I have to do something because I can't continue as I am, but I am really uncomfortable with the thought of surgery on my foot.

    Any input would be so massivley appreciated. Thank you.

    Last edited by Mpls21; 06-20-2004 at 10:01 PM.

     
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    Old 06-21-2004, 02:35 AM   #2
    squirrelmom
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    Well, you are right to approach any foot surgery with caution. I think you need not be too afraid of the surgery if it's determined to be absolutely necessary, but it would be good to consult with several people about this first. So get a few "second opinions" from people your trusted orthopedic surgeon recommends. Get his opinion, too, even if he doesn't do foot surgery. If all agree there is no non-surgical way to help you, and this particular type of surgery is right for you, then you can work on deciding which of the surgeons you have consulted is best. As always, pick someone who is very experienced in doing that type of surgery, and who does it on a regular basis. Look up their medical background and history of any complaints lodged against them. Everything else being equal, pick the one who seems the most communicative, generates the most trust, has the best bedside manner, etc. Finally, educate yourself about the condition and other people's experiences with it (and with the surgery) by browsing the net for information, but take all you read with a grain of salt, too!

    This is all just general advice for any kind of surgery. I do not know anything about your particular condition or proposed surgery, but i think the above advice applies in all cases. A couple of times now I've had to have surgeries that I was really afraid of, but in both cases I came to be very sure about the necessity of the surgery and comfortable with the person who would be doing it. In both cases (well, so far--I'm still recovering from the second one) my results were very good. So just do your homework first, is my recommendation.

    Good Luck!

     
    Old 06-21-2004, 04:41 AM   #3
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    Mpls21, Hi! Last August I had an open Brostrom Repair on my ankle for instability. I am curious as to where you live, because the podiatrist who did my surgery also shares an office with a bunch of orthepedic surgeons who they defer their ankle and foot stuff to. My ankle has healed well, although I have just started PT nine months after the fact due to other issues.

    Regarding the six weeks of NWB, may or may not be the situation. Depends on what is really found during surgery. I was initially told six to eight weeks NWB,but after three weeks I was in a CAM walker with crutches (slowly bearing weight). I had the CAM walker for five weeks and then moved into an ankle brace. The podiatrist I had always set me up for the worse and I can out better.

    Don't hesitate to ask lot of questions. When scheduling your appt. let them know you have questions, they will alot time for it and write down your questions so you remember them all. Ankle surgery for me was scary, I am not at 100% yet but expect to be soon. If you have any questions, I'll see if I can help. Take care - eko
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    Old 06-21-2004, 09:32 AM   #4
    Mpls21
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    Thank you for the replies. I did call the office today and will be talking with the Podiatrist sometime today with my list of questions. It doesn't look like I will be able to see my Orthopedist because his first available appointment is around July 20th. He's just that busy.

    I went ahead and scheduled my pre-op physical for tomorrow, but I am not committed to the surgery 100%. I need to get more information on podiatrists doing surgery etc. In my quest for info on the internet I have come across both good and bad info on podiatrists and of course in my current state of mind I am only remembering the bad!

    After spending all day yesterday off my feet, recovering from a week of being on it and walking in that boot thing, I know I need to do something, but I am quite frightened.

    I know when I had my shoulder, knee and groin repair surgery (I tore my groin muscle playing hockey, tore the bicep tendon and ligaments, rotator cuff and muscles in my shoulder also playing hockey, and partially tore 3 ligaments in my knee playing softball.) I wasn't this afraid. Probably because I knew the doctor, he was an Orthopedic Surgeon, (I had no idea that Podiatrists did surgery.) and I knew what was wrong going in and that there was no other option.

    This "well, it could be this so let's do a scope" is scary. I don't know if the ligament will actually require repair. I know the bone fragments will have to come out, but it's so unclear what all will happen when they get in there.

    Thank you again for the responses. If anyone has any information on podiatry and podiatrists doing surgery, or can direct me where to find it or find the information mentioned in the first post (if there are any disciplinary complaints against this doctor etc.) I'd appreciate that too.

     
    Old 06-21-2004, 11:50 AM   #5
    Mpls21
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    Thumbs up Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    OK, I spoke with the doctor and I feel a lot better, just having more information is calming.

    What the plan is for surgery is to repair the damaged and scarred ligament. He said their are a lot of different ways to do this and what it might involve is using the tendon and bringing that through which would involve drilling into the ankle.

    He was very honest and said that "surgery is surgery, it's going to hurt a lot and it's not a 100% guarantee, but in your situation it really is the best option."

    I know I don't have any other options since we have tried everything else and that has not worked.

    He also said that with my ankle and the number of injuries it has suffered, this may not solve all of them, but without fixing this problem, we can't address any of the others. It may be that because of all the limping and adjusting that I have done to my gait, many of them may go away after repairing this. I know I have been favoring this leg for many years so that made sense.

    Looks like I'll be having surgery by the end of this week or early next week.

    I'll let you know how it goes..... wish me luck.

    Thanks,

    Mary (Mpls21)

     
    Old 06-21-2004, 11:50 AM   #6
    StephanieVD
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    I would be cautious too. No matter how much surgery you have had it's always hard. I have had my thumb fixed for chronic dislocation and my knee scoped a few times for multiple problems.. Also have had 4 surgeries for chronic instability of the ankle, and then 2 debridements and hardware removal for infection. Make sure you know what the surgery is, especially with the ligament repair. I have never heard of a way to tighten the ligament through an arthroscope unless its a thermal shrinkage (like they do in shoulders a lot) and from all the people I have talked to its not very effective. But the bone chips need to get out obviously cuz they can tear stuff up. If they don't do the ligament repair I would imagine you could walk sooner... Good luck. I know the ankle stuff sucks pretty bad. Have you seen the podiatrist at all?? Just wondering.

     
    Old 06-21-2004, 11:51 AM   #7
    eko
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    As I said in my previous response, a podiatrist did my ankle repair. Podiatrist are trained to work with the foot and ankle. Your podiatrist should have served a residency for foot surgery and should be a member of the American College of Foot and Ankle Surgeons (they have a website). It should give you some confidence that the Orthopedica office has referred you to him. I know my podiatrist is often referred to by the ortho guys because his speciality is the foot and ankle and theirs is not. When I sought a 2nd opinion, an ortho doc suggestion ankle fusion, obviously that is not the way I decided to go and had my tendon repaired.

    Just curious, what state are you in?
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    Old 06-21-2004, 12:11 PM   #8
    squirrelmom
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    Well good luck, Mary, and I'm glad to hear the talk with the podiatrist was reassuring. I wanted to add that my surgery (bunionectomy) was done by a podiatrist, but she is a highly experienced podiatric surgeon with every kind of certification there is. There are podiatrists, and then there are podiatrists, if you know what I mean. Anyway, be sure whoever does it is board certified in that type of surgery, and does lots of those types of surgeries, since experience is the best indicator of the quality of the surgical care you get. You can get information about your doctor, and any other doctor, by contacting the state board of health and telling them the information you're looking for...also bear in mind that podiatrists are often not registered in the same databases as MD's, so make it clear you're looking for the background on a podiatrist. Also call the hospital where your surgery will be done and ask if your doctor is on their "active" list, meaning that they do a lot of surgeries. If they are not "active" that is a warning sign.

    But it sounds like your doc is good if you're feeling reassured. Your gut feeling about a person is also something to take into consideration.

    Best wishes!

    Squirrelmom

     
    Old 06-21-2004, 02:45 PM   #9
    Mpls21
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    I have seen the Podiatrist, 3 times now. He is certified and is a member of the ACFA and did do a surgical residency at St. Paul Regions Hospital.

    I am aware of the seriousness of the undertaking, that's why I posted here and have been doing all the research that I have done. It is definately scary and hearing of people who have had multiple surgeries for this is frightening.

    The scariest thing right now is that it appears as though, due to this ankle and foot, that I am going to have to look at a career change. I don't know if I will be able to continue in a field that requires as much on your feet time as my current sales career requires.

    I'll cross that bridge when I come to it, but the whole situation is just really frightening and rather overwhelming.

    Last edited by Mpls21; 06-21-2004 at 02:45 PM.

     
    Old 06-21-2004, 03:11 PM   #10
    eko
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    Mary,

    Your Dr. is correct, this is going to hurt and it will take time to recover. Don't panic about a career change yet, one thing at a time. Having had ankle surgery, the first week will be the worse for swelling and pain. Keep the ankle elevated and ice religiously. You may not feel the coldness through the cast, but I was told it helps. Some others put ice behind the knee or up on the toes to reduce swelling. Take your pain medication, don't let the pain get ahead of you (I took my pain meds for 5 days, then moved to Motrin). If you will be in a cast and are on birth control, ask about exercises you might be able to do to avoid DVT.

    The good news is that I had only one surgery for my instablity and it seems to have done the job. So there are success stories out there.

    Just a few other things... For anesthesia are you having a general or local w/ sedation? For getting around, if possible practice with crutches now or use an office chair with wheels to help get around the house. For bathing, you cannot get a cast wet, so be prepared with garbage bags or you can find cast covers that will keep your cast dry. Depending on your bathroom facilities, you will want something to sit on in the shower and have a hand shower available. Do you live alone or do you have help? Have some entertainment ready, books, movies, etc. because you will get bored.

    I wish you well with your surgery! -eko
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    Old 06-21-2004, 03:38 PM   #11
    Mpls21
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    It will be General Anesthisia, and I have used crutches many times in my life. I hate em with a passion, but I unfortunately know how to use them.

    I live with my sister and her son, and have a shower with a shower head massage feature so I should be able to muddle through with that.

    I am looking into the possibility of renting one of those 3 wheeled scooters so that I am not entirely house bound, but that may prove too expensive when living on disability insurance.

    As for entertainment.... You mean there is more than surfing the web???

     
    Old 06-21-2004, 10:03 PM   #12
    kehorner
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    Welcome to the wonderful world of ankle surgery! I had ligament reconstruction done in March this year. I had the ligaments put back together (the Brostrom procedure) and also the tendon graft (mine was the Evans procedure, and there is a similar one called Chrisman-Snook). My procedure was scheduled to be open, with a scope just for fun, since they were going to be in there anyway. I was in a cast on crutches for six weeks, then in a boot for some time (maybe 4 weeks?). I started physical therapy near the middle of May, still in the boot. Now I am walking around in regular shoes, pain free.

    The pain right after surgery was definitely not fun. I decided to go home from the hospital while under the influence of heavy drugs, then went back after being home for an hour and stayed overnight. The main problem for me was the swelling. Every time I put my foot down for any amount of time my toes turned purple. I am in grad school and I did the surgery over spring break, and for the next month I sat in classes with my leg up on the desk. I was able to get around on the crutches though. Most stores have wheelchairs or scooters that you can use in the store, and if you get your doctor to fill out the DMV paperwork you can get a temporary handicap sticker for your car. Between the handicap parking and the scooters in the stores I was out shopping within a week.

    I guess my advice would be to just go ahead and get it over with if you need to do it. It was a frustrating recovery, but I am feeling good now and my ankle doesn't go out on me anymore. I feel like I will actually be able to do things without falling over it now. I am still taking it easy and not doing terribly strenuous things, but the doctor says that everything is completely healed now so it's just up to my comfort level.

    I found that for bathing what worked well for me was to just sit in the bottom of the tub with the shower on to do everything but my hair. That way I could leave my leg outside of the shower curtain. I used the good old garbage bag and wide masking tape, but I practically didn't need it for that part. To wash my hair, I turned around so my head was under the faucet and got a little foam bath pillow. I tried to find a stool that would fit in the shower, but my tub is in a new, energy efficient house, and the tub is tapered so it doesn't hold as much water. It also doesn't hold any standard sized stool.

    Just take it easy and let the pain be your guide. You will probably only be stuck inside on the couch for a week. But remember to keep it elevated as much as possible. I rode around the grocery store in the electric cart with my leg up in the basket! Sure, it got in the way of steering, but it's always fun to knock over grocery store displays, right? Best of luck to you!

     
    Old 06-22-2004, 09:04 AM   #13
    Mpls21
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    Well, after about 8 gazillion phone calls yesterday and bad news regarding this from work... I have decided to wait at least one week and get another opinion. I am able to see my Orthopedic Surgeon, the one I like, next Tuesday, so I decided I should at least do that.

    As for the bad news from my job, I was informed yesterday that since I have not been there for a year, I am not "protected" by The American Family Leave Act and that if I am going to miss up to 10 weeks with ankle surgery I would be asked to resign. I can't believe it. I understand their business decision, if I am gone that long and they can't hire a new sales rep to replace me, they are short one sales consultant during the busiest time of the year. At the same time, I was very hurt and dissapointed, not to mention what this might entail for the future. I can't exactly go job hunting while on crutches so I'd have to wait until it heals to start looking.

    Now I just don't know what to do. I can put it off for a while, but I can't work at full strength right now and I can't really tolerate the constant pain much longer.

    I dunno........

     
    Old 06-22-2004, 10:27 AM   #14
    StephanieVD
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    Oh my, sorry about the job problems. I never had to worry about all that since I was in school. I'm glad you got in to see your ortho, I have gotten second opinions on a few occasions, it's nicer to think that 2 doctors think you should have it done. My tendon transfer went great and my ankle is super tight now and finally works after a long haul. Good luck and keep us updated.

     
    Old 06-22-2004, 08:36 PM   #15
    knurb
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    Re: Please help, I am new here & have a bunch of questions (impending ankle surgery) EEK!

    I am sorry to hear about all your difficulties with your ankle and work. I didn't realize that you had to be employed for 1 whole year for the family act to be valid. It wasn't with me. On another subject, yall were talking about seeking second opinion. I am really thinking of seeking a second opinion. I had my first procedure a year ago a brostrum, athroscopy and a peroneal repair, where they deepen the groove and screw ad suture the tendon in place. Had complications from the site not being cleaned up and had to go for a second surgery to debrid the tendons because the bone chips tore them. My question is now i am 5 mos postop and having increased pain and new bruising along the peroneal tendon site and went to see my OS, she seems to think it is the desolvable suture popping causing severe inflammation in the tendon and the achilles tendon. I am just worried and think i need to seek a second opinion. Sometimes i feel she withholds certain details from me. Just curious how to go about seeking a second opinion and can you get one and continue seeing the original OS?

     
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