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mary2 04-01-2009 07:15 PM

PTTD surgery 5-1-09 --many ?s
Greetings Folks,

I am scheduled for PTTD surgery on 5-1. It will be a tendon transfer, sliding calcaneal osteotomy, and achilles tendon lengthening. I have recently joined this site and would appreciate information about how to prepare.

Some questions that come to mind:
*Are certain crutches better than others?
*Has anyone used a knee chair (?)
* What about a seat for the tub?
* Are pillows good enough for elevation?
* Is a cast more comfortable when a leg is not shaved ?
* What clothing problems come up with the cast?
* How much assistance is needed for a shower?
* What type of help should I arrange for?
* Has anyone tried accupuncture to assist the recovery?
*Has anyone tried Arnica during recovery?
*Anything that others have found useful?

Thanks for your sharing.:)

Tracie1204 04-01-2009 10:55 PM

Re: PTTD surgery 5-1-09 --many ?s
HI Mary 2!!!!! :wave:

Welcome to the boards-----I hope you find as much info as you need! There are lots of people here who can give you the best advice---or at least help you through this process!!

As far as your questions----I know there is another kind of crutch out there, that you use more with your forearms---however I have the regular aluminum crutches---and have gotten fairly used to them (except on steps).

I am not sure what you mean by knee chair---however, if you mean knee walker, they are the BEST!! I actually am 3.5 weeks post op from a tendon transfer, kidner procedure, left heel osteotomy---and right now I am using crutches and a wheelchair-------I never thought a wheelchair would be as mich of a godsend as this has turned out to be----but if you want to get out of the house, and have some freedom, even while in the house, a wheelchair is great for the first 6-8 weeks. I will have the DME company deliver my knee walker when i am about 6 weeks post op.....

Yes---you will need a shower stool----and possibly a waterproof cast cover, if you can find one---you can do the plastice bag thing, or whatever other suggestions you may get---but I have a waterproof cast cover and it is so great.

Pillows will probably be fine---I think thats what most use on here----I have a wedge type pillow that is very large, but allows me, for my recovery, the most elevation and comfort. But I am sure regular pillows will be okay.----remember to ice behind your knee if you are having alot of swelling---

As far as shaving the leg----I of course shaved it on surgery day, and I shave what part is exposed, but I have not taken a razor with me at cast changes, b/c yes, I think now that the hair is "grown out" so to say, I have much les itching, than if I shaved it each time my cast was changed.

Clothes---loose sweatpants and shorts are probably best. I can get my jeans on and things like that---but you are going to want comfort---so keep that in mind.

I do not take a shower without help---however its b/c of the way my bathroom is set up----you may find after the first couple of weeks that you can manage on your own. That will just have to depend on your need.

As far as help---my boyfriend stayed home with me the first week of both surgeries---and that was a blessing! You will need help with alot of stuff to begin with---food, bathroom, showers, etc----I have a mini fridge set up in my bedroom, so my boyfriend makes my lunch and puts in there each day. I have drinks and snacks. Lots of books and videoes, and TV if you like to watch it.

Don't know anything about accupuncture or Arnica----not sure what that is...

I am sure there are others with other ideas-----B/c i am so unsteady on my good foot (it has tendon issues too----but not nearly like the other foot)--I have a potty chair over the toilet b/c it has handles to help me up and down.

take your pain pills faithfully the first couple of weeks, even if you think you dont need them----you do not want that pain to get ahead of you!!!

If you have other questions please ask!! I am on here alot b/c I am at home recovering, and like I said, I know there are many others who will give you great advice!!!! Good luck!!!!!:wave:

SoCalGal09 04-02-2009 10:59 AM

Re: PTTD surgery 5-1-09 --many ?s
Hi Mary 2,

You ask some great questions! I wish I had found this website before my surgery, it would have made life much easier!

Tracie1204 answered most of your questions with what I'd say, so I second her!
As for the arnica - I don't know about that. I gave a detailed list of all the medicines and supplements that I take to not only my doctor, but the anethesiologist before surgery. Everything was fine, but since arnica is classified as an anti-inflammotory, they might say no. Ask your doctor and explain what arnica is used for if he/she doesn't know. They put me on Celebrex (a hard core anti-inflammatory) after surgery with strict instructions to take NOTHING that is an anti-inflammatory - no advil or tylenol, or herbal supplement, etc. That's why I caution you.

I just got a knee walker this week (I'm 4 weeks post op) and it's great for scooting around for groceries, etc. I don't use it inside because it is in the car and I find getting it in and out is too much trouble. Crutches are fine for indoors for me.

Showers. Ugh. Something that takes 10 minutes normally takes half an hour at least! I can do it all on my own, but my husband is nervous and is always there to help me out of the shower. We put towels on all the tile just as a precaution. Crutches and water don't mix. A shower seat is a must.

As is a toilet seat or rails. I have the rails and I don't know how anyone can use the toilet without them!

I also suggest some exlax for when you get home from the hospital. All the pain meds really stop you up and do a number on your digestion. I also took a flaxseed fiber twice a day for the first two weeks.

Oh, probiotics! Definitely take them starting now.

I also worked out with a trainer for several months before my surgery and the month before we concentrated on upper body. I'm so glad we did! It takes an amazing amount of strength to haul your body up and down and around on crutches. If you can get some upper body strength training in before the surgery, you'll be ahead of the game. I've even started doing some light weights while seated so I don't lose all my muscle tone. Really, I think most of it is gone by now, but it makes me feel stronger.

I have a recliner that I camp out in, so I put up the foot thing and put pillows on it and that works for me as far as elevation goes. At night in bed, I just put a pillow under my cast foot and I haven't had any problems.

If you don't have someone who lives with you, then arrange for friends to come over for lunch and to maybe help prepare dinner for you as well. My husband did 100% of everything around the house for the first two weeks. After that, I felt strong enough to put a load of clothes in the washer and pick up a little around the house. I'm just starting to help make dinner and it's hard. Most days, I only have energy to type messages on this board!

Finally, the most important thing you need for this surgery is patience! I was a fairly active mom before the surgery and just sitting around makes me nuts. But, I've embraced the solitude and am finding comfort in just being. If I can get up and move around during the day, great. If not, I don't beat myself up. I do what I physically and mentally can and that's good enough. For now. I've had a few down days and threw myself a five minute pity party. Then I took a deep breath and reminded myself that this too shall pass.

Good luck and let us know how your surgery goes!

WorldWalker 04-02-2009 10:07 PM

Re: PTTD surgery 5-1-09 --many ?s
I have forearm crutches, I feel they're easier to manage. Try them both out and make the choice that best suits your needs.
I think I've got an arsenal of like 8 pillows, usually 3 under my leg and the rest I use to prop myself up.
I can't answer the shower thing. I managed to recover in a house that had a handle in the shower to help when my grandparents used to own the house. I did use a chair and a cast shield.
PJ pants became the new it thing for me and boot cut jeans worked well.
Ugh, its late and I can't remember anything else, but I'm so sure I've already posted it? I hate to cop out and tell you to sort through my posts but if I think of anything else I'll post again. Until then! :wave:

labec 04-03-2009 10:26 AM

Re: PTTD surgery 5-1-09 --many ?s
Hi Mary 2!

My surgery date was 11-25-08 (got me out of any cooking and working during both holidays-great!) I had the same 3 procedures you are having plus an implant with 2 short screws on the top outside of my foot. I have been reading this board since last summer when I realized what I was facing. This board is a godsend. I have yet to see anything that is way off target or less than helpful. The shared experiences and encouraging words will carry you through.

As for advice, my most difficult problem after surgery was getting out of my recliner. I'm 5'8" (a little over 5'7" before surg-really), overweight and 58 years old. Also, the knee on my "good" leg is arthritic with ligament problems so I was not very stable. Only weeks later did I realize that when I'm sitting up, ready to stand, in that chair my knees were much higher than my hips. I almost tipped the chair over several times struggling to get out, even when someone was there to pull me up. The light bulb went off and my husband used a 2x4 to add height to the front of a chair & a half recliner we had. He drilled 2 holes just deep enough to hold the 2 front legs. This is very stable for me and enables me to slide off and stand much easier, just didn't figure it out for awhile. I still have it in place and will probably keep it that way.

The other things, I have my mother's transport wheelchair which is a bit narrower and more managable in the house. I used it exclusively the first few weeks. I got a Weil knee walker/scooter before surg and tried it a few days after surg and could'nt handle it, thought I had really wasted my money. However, I could not balance on my crutches (issued at the hospital) while I was totally NWB. It didn't take too long though before the knee walker was my best friend. We have a van and I was able to get to it and put the walker behind the driver's seat and go out of the house by myself and even take my 90 yr old Mother to the grocery store (kinda funny to see, she uses a cane & walker). It also enabled me to cook, do dishes, wash clothes, stand in front of the mirror (very short times in the beginning). It has a removable basket in the front which frees you to carry many different things. I also attached w/velcro one of those "grabber arms". You do drop things more than you might think and also it just extends your reach many times so you don't have to get up or call for help.

In my bathroom, my commode is separate in a small alcove. We had replaced our toilet 2 yrs ago with the higher, handicapped model. The facing wall is close enough we installed a white handicap grab bar. I also added the side rails that attach to the back of the toilet under the lid. I could not have managed without them, still use both. My tub is the larger oval kind and had a step in front of it. We took out the step and replaced it with tile and were able to place the larger transfer seat which has two legs outside the tub and also added the hand-held shower. The tub surround is only 2' high with painted wall above. I added a spring-loaded shower rod with 2 full curtains on the window wall and then another one with 2 more full curtains on the outside. I put a leg cast sleeve (pharmacy) on, left my leg on the outside of the tub and used heavy duty clips to hold the curtains, worked great. We have a small shower stall and installed another white heavy grab bar on the inside wall. I didn't start using that until I was fully weight bearing and walking, the 10 min shower is back!

Like others, shaved before surg and then not til hard cast was off. I still tend to have ingrown hair on that leg even though I'm wearing my compression hose less all the time. All things that improve with time and you really won't be as concerned with that as you think now.

For clothes, I'm lucky and not working (employed i should say!). I got 3 pair of knit comfy crop pants a size too big and never had a problem. For me, the biggest cast was the original surgical splint. Your hard cast will be smaller and then your walking boot comes off.

For pain, I had Lortab and Meperghan(?). I took everything on schedule in the beginning (1st week) and feel I could have gotten by with less, but I'll never know. Pain was controlled and I was very out of it. After that, I think I could have been OK with aspirin but they don't want you on that at all so I just used half a Lortab, mostly in afternoon and evening when swelling is worse. I used the freezer gel pacs for swelling and had different pillow combos depending on where I was. Almost forgot, I used PVC pipes to make a square/rectangle about a foot & a half higher than my mattress, with 2 pieces that slid between the mattess and box springs. This made it much easier to accommodate all the pillows and then when finally sleeping "bare" foot again, to keep the weight of the covers off. I'm 4 and a half mos out of surg now and I took that off the bed about a month ago.

All these transitions; from wheelchair to scooter to crutches to boot to orthotic insole inserts to SHOPPING FOR SHOES AGAIN! I didn't realize that I would really even be thinking about shoes at this point. I saw my surgeon 2 days ago, x-rays showed one of the small screws holding the implant is snapped/broken. He thinks I'll be OK, wait and see. I can't remember any point where it may have happened. Anyway, another transition is 5 steps forward and only a half step back. (Pain is almost gone, walking is better every day and then you have a day of pain/swelling and hardly able to walk, just happens less and less)

Good luck with your surgery. If you are like me, you like to have it all figured out before surgery, you're in control (somewhat!) There will be something unique for you, that you might not have read about, but, you'll figure it out. Prepare and then just relax, you'll do great.

Thank's to all on this board for all the help and support, I really haven't been alone.

Becky in Louisiana!

SoCalGal09 04-03-2009 12:45 PM

Re: PTTD surgery 5-1-09 --many ?s
Something I just thought about - I tried the cast cover and I'm claustrophobic so I couldn't use it. First, it didn't fit over the soft cast I was sent home with and then when I had the hard cast, it felt like it was squeezing my calf and I couldn't handle it.

Now I just use a trash bag and tape it around the top. It works great and no claustrophobia! Yay!

Oh, yeah, and pajamas are my new best friends. When I go out, I have a great pair of stretchy crop pants that look like a skirt, so I wear them a lot. Stretchy waistbands are a godsend. Comfy, and easy to remove when in a hurry. ;)

ggola 04-03-2009 08:43 PM

Pending PTTD surgery
I injured my PTT on 12/28/08 while working out. I had my left knee replaced on 6/12/08 and my right knee replaced on 7/23/08. I went to my orthopedic surgeon the first of Feb. when my PTT pain began to be annoying. He ordered an MRI and at that time it showed moderate damage to my left PTT. I was then placed in a boot for four weeks and told that if the pain returned once I was back in my regular shoes that he would recommend me to a podiatrist. The pain returned and I went to the podiatrist. The podiatrist ordered xrays and he watched me walk. I was then told that my ankle and heel was collapsing inward. He read the MRI report and then did an ultra sound. The ultra sound showed a portion of my PTT thickening and then a nice size section that was inflamed with a loose bone fragment in the middle of the inflammation. He told me that my PTT was dysfunctional. He suggested that I be casted for a Richie brace. My insurance will not pay for the brace which is about 1,000.00. Yesterday, I was in the office to pay for 1/2 of the cost of the brace and was asking the nurse several questions when the doctor walked in the office. I then asked him my questions. He took me to one of the rooms to review my xrays and then did another ultra sound. My PTT is now showing a small tear and he is recommending surgery.

1. Did anyone else have their surgery with a podiatrist?
2. How long was the hospital stay after surgery?
3. I live alone, did anyone stay in a rehab hospital?
4. Since I had my knees replaced last summer, the knee roller is probably out for me if the weight is placed on the knee on the knee roller?

I'm a teacher and my principal feels like I'm in pain, I should have the surgery sooner than later especially since I would not want to miss the start of the new school year on August 31st. I'm looking at scheduling surgery April 30 or May 7th. I'm very scared because my orthopedic surgeon told me to avoid surgery if possible (which I feel like I have) and that this is a surgery he wouldn't want and that has me terrified. Please help me clear my mind.

SoCalGal09 04-04-2009 11:33 AM

Re: PTTD surgery 5-1-09 --many ?s
Whoa, that's a crazy foot you've got! I'm NOT a doctor, just someone who had the surgery and I would definitely recommend getting it. The pain never goes away and it isn't something your body can fix on it's own, so surgery is really the only way to get back to normal.

I just started using the knee roller thing and at first I kinda hated it, but today I scooted everywhere on it and I am very smitten. But it does put pressure on your knee, I don't know if it would be too much for you - probably. You'll want a wheelchair for sure. Some of the posters on here have said crutches with not so good knees is not so fun.

If you live alone, you'll need someone to help for a good three weeks. I didn't know there are rehab places you can stay - that sounds like a viable option. The first two weeks I was as sedentary as you can imagine. I got up to use the restroom and shower and that was it.

Everyone's surgery is different. I only stayed in the hospital one night. They said I could stay one more, but I wanted to go home. My surgeon is an orthopedic surgeon, but plenty of people here had their surgeries done with a podiatrist.

If you're really nervous, get a second opinion. The surgeon who doesn't want you to do this, is he an orthopedic surgeon? If not, his opinion doesn't count. Well, for me it wouldn't, but you know him and I don't.

Whatever you decide, keep us posted.

ggola 04-04-2009 11:37 AM

Re: PTTD surgery 5-1-09 --many ?s
Yes, the doctor who said that even he wouldn't want that surgery is the orthopedic surgeon who replaced both of my knees. I'm going to call his office Monday. I totally trust him and his staff 100%.

I think I would feel better if he was doing the surgery because I know how he operates but if he is uncomfortable with the surgery, I just don't know.

I'll keep you informed when I find something else out.:confused:

emmie54 04-06-2009 07:13 PM

Re: PTTD surgery 5-1-09 --many ?s
Hi Becky. Nice to see a fellow Louisianian on here! I had PTTD surgery 3 years ago, in Baton Rouge. Cool idea about the device to keep the covers elevated. I'll eventually have to have my other foot done so I'll remember that!

welcome to the board. :wave:

mary2 04-11-2009 05:10 PM

Re: PTTD surgery 5-1-09 --many ?s
Hi Tracie 1204,
Thanks for all of your ideas. Another question came up. Do you take anything to prevent clots while you are recovering? A friend suggested it but the Drs nurse said he doesn't usually prescribe anything. Thanks!

Tracie1204 04-11-2009 11:44 PM

Re: PTTD surgery 5-1-09 --many ?s
Hi Mary--

Glad I could be of some help. Yes, I am on Lovenox shots----I am taking them for a total of 60 days----Doctor said I would be more prone to clots due to my age, the fact that I am on birth control, and b/c I was SO active prior to surgery, and the fact that I now do not do anything except sit in bed--He wanted to take extra care, and so he has me on them for such a long period of time.

I think they are a good idea----I give myself a shot each morning, in the belly. I think each doctor is different----my last surgeon did not do this, and I know several members on here have said it was not dont for them.

Good luck---let me know if you have anything else you are wondering about!!

mary2 04-12-2009 02:41 PM

Re: PTTD surgery 5-1-09 --many ?s
Thanks for all of the ideas. I find that many folks like the knee walker! I appreciate the advice of patience...I believe I will need it. I have found all of the posts very helpful. Thanks!

bgsu 04-21-2009 09:18 PM

Re: PTTD surgery 5-1-09 --many ?s
Mary...I've had the surgery twice and was able to get around my house (3 story townhouse) with a bit of practice and patience. Since I live alone, I stocked up on most of what I needed in advance so I wouldn't have to bug friends and family too much. If you can get your crutches in advance, practice walking on them and learn how to go up and down stairs ("up with the bad and down with the good") I kept a chair in the sink to rest my knee on it when I was preparing food, washing dishes, etc. Remember to crutch on a dry surface. A crutch on a wet floor is dangerous so I always made sure to dry the crutch tip off on a rug when I entered my office on a rainy day. I also got some of those crutch cozies to pad the top of the crutches and they were a big help.
I recommend a transfer seat for the shower as well as a cast protector.
Dr. sent me home on percoset (sp) and oxycontin but I stopped taking both after three days and just used 800 mg of advil 4 times a day. I didn't find the pain to be bad at all.
I also have a couple of ice gel packs that are a godsend to put on the foot to help with the swelling. Always keep your foot will start to throb if you don't and that was always my signal to prop it back up!
Good is a long healing process so don't get discouraged. Tendons take longer to heal than bones. Don't try to rush it!

mary2 04-25-2009 05:52 AM

Re: PTTD surgery 5-1-09 --many ?s
Hi Tracy,

I am curious about the lovanex shots. I am still discussing things with my doc and I am wondering what it is like to give yourself shots. Do you have a medical background? Is the needle short? I guess you can tell that I am uncomfortable thinking about it. Only experience I have was giving my dog allergy shots years ago. Thanks for any info you can share.

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