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Worried about upcoming foot surgery


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Old 12-31-2010, 09:45 PM   #1
91cavgt
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Worried about upcoming foot surgery

Hi everyone. I hope I have finally found a place that I can chat with other people who have gone through or are going through what I am about to have done.

First a little background. I'm 34 years old and have had bad knee pain on and off for the last 3 years. Bad knees run in my family (my grandfather had one of his knees replaced last year, my dad had one of his knees replaced last year too, and my dad is having his other knee replaced this coming spring) so I have been trying to find out what is causing my knee pain and get it fixed. Well, after going to 5 different doctors, trying Ideal Feet orthodics, and getting very little relief I finally went to my dad's doctor. He was the first doctor after seeing me that tried to see what was causing my knee pain instead of just treating my knee pain. On my first visit he asked to see my feet and legs without the crutches or shoes while standing. Immediately he found the problem, and then proceeded to get mad at all the other doctors who never even looked at my feet.

What he found was that my left heel is not directly under my ankle the way it should be. I am suffering from a bad case of pronation, but my left heel is far enough out that he said if I don't get surgery to correct it, I will always have knee pain and it will end up causing damage to my knees and possibly my ankle too.

Now I am amazed that for the last 15 years I have had zero ankle pain! But, when I was a teen I got SEVERAL sprained ankles, and after a trip to the doctor with one really bad sprained ankle I found out that I had previously cracked my ankle without knowing it (I guess I just thought I sprained it bad again). In 1995 I got discharged from the Army due to weak ankles (I had 2 sprained ankles, a case of achilies tendonitis, and a pinched nerve all in my left foot during basic training). However, ever since I got out of the military I never had any more problems with my ankles.


So, I have been put into an ankle brace to try to support my heel/ankle. The doctor says that the surgery is going to entail moving my heel to where it is under my ankle, he's gonna take a wedge out of it to align it better (I think), and then secure everything in place. I don't remember what he called this procedure, but he did say that the recovery time will be about 3-4 months. I will be in a hard cast for 4-6 weeks, a walking cast for another 4-6 weeks, and then some pretty hard core physical therapy so I can relearn how to walk right.

Does anyone know what this procedure is called? I am calling the doctor on Monday to try to schedule the surgery as soon as possible. I will be out of work for at least 3 months and since I am a mechanic, the summer time is the busiest time for me so I need to be back at work before the summer hits.

I am usually a very laid back kind of person that doesn't get worked up over much, but this is really getting to me. I'm worried about not being able to get around later, or about possibly damaging something in there when I go back to work. This is also the first major surgery I have ever had (I have broken several bones and have had 3 hernia surgeries in the past but those are quick recovery times compared to this). Is anyone here going through this right now? I guess I just need some support from people who know what I am going through right now. I am over joyed at the fact that a doctor has finally discovered the source of my pain but I am scared at what needs to be done to fix it.

Last edited by moderator2; 01-01-2011 at 09:02 AM.

 
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Old 01-01-2011, 05:04 AM   #2
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Re: Worried about upcoming foot surgery

I'm going through something similar although the procedures I've had are a bit more extensive than yours.

I have a severely flat right foot and I had surgery on 21 December to move the heel bone (the calcaneal) and do some work on a tendon. I'm not sure what the technical term is for your heel surgery. Mine was a medial sliding calcaneal osteotomy. Essentially this means cutting the heel bone, moving it a short distance and screwing it into its correct place. This normally also involves shaving the bone slightly to remove any jagged edge. You mention removing a wedge and that sounds different to what I had done. Others with far more knowledge than me should be along to confirm what your doctor is proposing.

I too had to make a quick decision as to whether to have my surgery and I would advise you to research extensively before going ahead. I found this forum invaluable both in terms of people who are currently going through this and an archive of people who done so in the past.

I think the two most important things you need to do are

1) Make sure that you need the procedure and that you have the right surgeon. This type of surgery is a big deal (and it's an even bigger deal if he's doing more than adjusting the heel) and it will, as you mention, have a big effect on your life for a while. Making sure that you actually need the surgery is critical although it sounds as if you do. Getting the right surgeon is critical. Make sure that he's done this before lots of times, again particularly if he's doing more than the heel.

2) Think through how being immobile for a period will affect you and how you will live during this period. There's a really useful thread on here dealing with tactics whilst non-weight bearing. I printed it off and went through it line by line with my wife and we made lots of changes to how the house is arranged to make it as easy as possible. The healing times you mention are similar to what I was told and this is because the heel takes a long time to heal so to speak.

Good luck with your procedure.

 
Old 01-01-2011, 07:16 AM   #3
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Re: Worried about upcoming foot surgery

I am 21 weeks post op flat foot reconstruction surgery. I had 5 different proceedures, one of them was the calcaneal sliding osteotomy.

I absolutely agree with london chap. Get a second and possibly third opinion before having this surgery. It is a MAJOR surgery. I was NWB for 8 weeks followed by about 8 weeks in an air cast. I was out from work for about four months. I have only recently transitioned back into shoes. When at work, I wear an ASO brace and when at home, good shoes with modifications by a CPED to ensure appropriate support for my new foot. My knees are also a mess. I have grade 3-4 arthritis in both knees and they constantly catch, crackle and chronically sublux.

I am not saying that you should not have this surgery. It may well be the best thing you do for yourself. DO NOT rush into it. Do your research first. Find out exactly what the doctor proposes to do. Find out how many of these proceedures he does each year and any possible complications. I went to four different doctors. In the end, it was a choice between two doctors. One does two or three of these a year while the other is at a top orthopedic hospital and does 3-4 of these a week. The doctor I chose "wrote the book" about flat foot reconstruction and is currently involved in clinical trials. When dealing with flat foot reconstruction, the surgery is a balancing act. Practice does make perfect. You want a doctor who has done enough succesful proceedures to know exactly how to balance everything in the foot.

It is worth waiting a few extra weeks to be sure that you have the correct proceedures done and even more important by the right doctor!!!!!!!!!

Are you using a general orthopedist or a foot and ankle ortho? Did he also check to make sure that your achillese tendon is not tight? It is entirely possible that the posterior tibial tendon and maybe spring ligament are also damaged from years of stress on these structures!!!!!

Just do your homework!!!!! Find a major well regarded orthopedic hospital that has a dedicated foot and ankle department. Find a doctor in that department who has a special interest in flat foot reconstruction and see him/her for a second opinion. I am pretty sure that there are other people from Texas who have had flat foot surgey done. You can post asking for the names of doctors who specialize in Flat foot surgery in Texas. The doctor yous saw may well be a good choice but just don't jump into this without the propper research!!!!!!! wave:

Last edited by roxygirl1; 01-01-2011 at 07:23 AM.

 
Old 01-01-2011, 09:17 AM   #4
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Re: Worried about upcoming foot surgery

What the others have said, but also,you mentioned you had tried Ideal Feet orthotics. I don't know if this is an off the shelf type or custom. If off the shelf, you definitlely need to go custom. It is possible to have very flat feet that cause knee pain and still not need the foot surgery. My older son has the flattest feet I have ever seen-pronated pancakes basically. He had knee pain and got custom orthotics and has had no further problem (he is 30). I would not rush into anything and like the others said, get at least 2 opinions.

 
Old 01-01-2011, 10:02 AM   #5
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Re: Worried about upcoming foot surgery

Quote:
Originally Posted by indaslot View Post
What the others have said, but also,you mentioned you had tried Ideal Feet orthotics. I don't know if this is an off the shelf type or custom. If off the shelf, you definitlely need to go custom. It is possible to have very flat feet that cause knee pain and still not need the foot surgery. My older son has the flattest feet I have ever seen-pronated pancakes basically. He had knee pain and got custom orthotics and has had no further problem (he is 30). I would not rush into anything and like the others said, get at least 2 opinions.


I had the custom orthotics and had relief for a couple of months before the pain came back.


I wish I could post the video I made of my ankle. To put it into perspective, I have seen videos on You Tube of "Extreme Pronation" and there is no comparison to how my left ankle is. My heel is quit literally at a 45 degree angle to my ankle in relation to my leg. Everyone who has seen the video is in utter amazement that I can still walk and that I am not in excrutiating pain.


One of the reasons for trying to get this done as soon as possible is that my current insurance expires on January 23rd.


Now about the doctor. He has done several of these procedures (sorry, I don't know exactly how many he has done), and he did say that yes, this is a delicate procedure. He also said that the only time he has seen someone with as severe of a case as what I have is when they have some major muscular/skeletal problems. He told me that he has never seen anyone with this severe of a problem in an otherwise healthy person. He did look at my achilies tendon and said that it felt fine, not too tight and not too loose. Now, he did replace one of my dad's knees and he is going to replace my dad's other knee this spring. My dad has been seeing this doctor for 5 years now and so my whole family REALLY trusts this doctor. I have searched on the web to see if there have been any problems with this doctor and the ONLY bad things I can find have to do with billing. Here is his credentials;

Undergraduate Degree:
Case Western Reserve University
Cleveland, Ohio


Medical Degree:
Stanford University School of Medicine
Stanford, California

Orthopedic Surgery Residency:
University of Rochester
Rochester, New York

Hospital Affiliations:
Texas Regional Medical Center at Sunnyvale
Dallas Regional Medical Center
Lake Pointe Medical Center
Presbyterian Hospital of Rockwall


Professional Affiliations:
American Academy of Orthopedic Surgeons
Dallas County Medical Society




I too have printed off the "Tactics for coping while non-weight bearing after foot surgery". I had already started a list of things that I need to get done before I am laid up for a couple of months, but this list was VERY helpful! I too went over it with my wife and we made some changes here and there to better suit our situation.



Thank y'all for your responses! I appreciate it!

 
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Old 01-01-2011, 10:13 AM   #6
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Re: Worried about upcoming foot surgery

Good luck and keep us posted. Do you have someone who can help you for the first few weeks when you will be pretty incapacitated?

 
Old 01-01-2011, 10:16 AM   #7
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Re: Worried about upcoming foot surgery

Quote:
Originally Posted by roxygirl1 View Post
Good luck and keep us posted. Do you have someone who can help you for the first few weeks when you will be pretty incapacitated?


Luckily and not so much at the same time I do. My wife got laid off along with 20 other people back in October and she has not been able to find a job yet so she will be home to help. My dad has also offered to take a week of vacation to help with me the first week since my wife might have some trouble trying to help me get around at first. Thank you!

 
Old 01-01-2011, 10:24 AM   #8
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Re: Worried about upcoming foot surgery

My husband was also a vicitim of the economy and unemployed when I had my surgery. In a way if he had to be unemployed, the timing was right. It was amazing how much help I needed for the simplist tasks. I was out on disability so the timing was not great from a financial situation. I went back to work to my full time job three weeks ago. In four or five weeks, I plan to start seeing some of my private clients again once my foot is ready for the additional stress. Do you have a date set for the surgery? How long will you be in the hospital post op? In my case, I was in the hospital for three nights

 
Old 01-01-2011, 11:45 AM   #9
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Re: Worried about upcoming foot surgery

Quote:
Originally Posted by roxygirl1 View Post
My husband was also a vicitim of the economy and unemployed when I had my surgery. In a way if he had to be unemployed, the timing was right. It was amazing how much help I needed for the simplist tasks. I was out on disability so the timing was not great from a financial situation. I went back to work to my full time job three weeks ago. In four or five weeks, I plan to start seeing some of my private clients again once my foot is ready for the additional stress. Do you have a date set for the surgery? How long will you be in the hospital post op? In my case, I was in the hospital for three nights

I am calling on Monday to schedule a time for the surgery. On my next doctor's visit I will find out how long I will be in the hospital for post op.

 
Old 01-01-2011, 01:37 PM   #10
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Re: Worried about upcoming foot surgery

Take a look at the post on this cite that's called "Tactics for Coping while non-weight bearing after foot surgery." It has a lot of helpful hints. Definitely look into getting a commode that fits over the toilet or some type of raised toilet seat, knee walker or knee scooter and some type of shower chair. The knee walker is a great substitute for crutches -- no hopping! Good luck.

 
Old 01-01-2011, 07:12 PM   #11
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Re: Worried about upcoming foot surgery

Quote:
Originally Posted by FlatfootDiva View Post
Take a look at the post on this cite that's called "Tactics for Coping while non-weight bearing after foot surgery." It has a lot of helpful hints. Definitely look into getting a commode that fits over the toilet or some type of raised toilet seat, knee walker or knee scooter and some type of shower chair. The knee walker is a great substitute for crutches -- no hopping! Good luck.


I have seen that post and have printed it out! LOTS of good information there!! My dad has a commode that he used when he got his knee replaced that he is letting me use so we can keep it next to my bed, my wife is looking into local places that rent wheel chairs and such to see about renting a knee scooter, but the shower chair I hadn't thought of yet. I'll look into that. Thanks!

 
Old 01-01-2011, 07:25 PM   #12
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Re: Worried about upcoming foot surgery

I got a shower chair without a back at a local surgical supply pharmacy for about $40-$50. It is a must have. I was NWB 8 weeks and then in a camwalker but NWB when the camwalker was not on my foot for another 8 weeks. I just had the hardware removed and have the keep the incision dry for 2 weeks. I figure that I needed the shower chair for 18 weeks. I will store the shower chair in the basement once my sutures are removed. Never know when it will be needed again!!!!!

 
Old 01-04-2011, 05:30 PM   #13
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Re: Worried about upcoming foot surgery

Had another doctor appointment today. I got to talk to my doctor some more and started the process on getting the surgery done.

First off, the doctor said I will be having a calcaneal osteotomy done. He is VERY optimistic on my outcome due to me having full range of motion in my ankle, he said all of the major tendons feel good when manually moving my foot around, and besides needing this surgery I have no other problems or pain in my foot or ankle.

My doctor has done a very large number of these surgeries. He told me exactly what was going to be done in order to repair it. My heel bone was going to be cut off, a wedge of synthetic bone graft was going to be made to help position my heel in the correct location, and then two 6.6mm screws were going to be used to hold everything in place. However, before the screws are put in, he is going to use a portable X ray machine to make sure the bones are in proper alignment before they are set in place.

So the surgery is going to be done on Monday or Wednesday of next week. I will know exactly when tomorrow afternoon after the insurance company tells my doctor what information they need and what all they will approve.


Since my dad recently had one of his knees replaced, I am going over to his house to pick up a few things on Sunday for me to use while I am down. A portable toilet, shower seat, an ice pack that is connected to a cooler and a pump to constantly keep my ankle iced, and rig that goes around our toilet in our master bathroom that will help me be able to get on and off the toilet once I can move around on my own.

 
Old 01-18-2011, 12:09 PM   #14
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Re: Worried about upcoming foot surgery

I had ankle surgery in Aug I a tendon graft from a donor put in my ankle with screws and plates. This surgery was done after 10 spaines and 2 other surgerys. Having surg. on your ankle and leg was THE WORST expecicne of my life and the pain was like death. Dont do any surg unless several doctors agree on the diagosis and its the last chance to walk !!!

 
Old 01-18-2011, 02:27 PM   #15
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Re: Worried about upcoming foot surgery

Well, last Monday (January 10th) I went under the knife. I have to say now that I am glad I did even though it is still too early to see if it has helped. My doctor told me that my heel was the worst that he has seen. He started off with a 6mm wedge insert but it was immeditately too small. So he went up in size to an 8 mm, still too small so up to a 10 mm, still too small, so he went to a 12 mm wedge which ended up being the right size! I just didn't know my ankle was that bad! Because he had to use such a large wedge, he also had to lengthen my achilias tendon slightly and he also added a plate as reinforcement to the 2 screws.


It took a few days of really bad pain to get my pain meds down right, that was the worst of it. The morphine pump in the hospital didn't really do enough IMO.

I go back in this Thursday so they can assess my progress and to see about putting me into a hard cast if the swelling as gone down.

 
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