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  • VERY STRESSED... PTTD Surgery next week - Please help

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    Old 08-10-2013, 11:07 PM   #1
    RespectTheFoot
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    Unhappy VERY STRESSED... PTTD Surgery next week - Please help

    Hi Everybody,

    I'm a newbie here, but have lurked quietly for months. I am a 47 yr old female, average weight for height, who has suffered from flat feet all my life. Have been an orthotic user for over 23 years. Most of my life I lived relatively pain free until about 14 months ago when my PTT started to swell and cause pain. After exhausting all conservative options, I am scheduled for PTTD surgery on Thursday, August 15th.

    It has been a LONG journey to the decision of going through with this surgery. I have to be honest, initially when I was told that I needed the surgery back in March, I went to the internet and came across this board and read A LOT about it. I should mention that I suffer from panic disorder and GAD (gen. anxiety disorder) ONLY when faced with stressful events (i.e.. surgery, father passing last year, moving family to new state), I don't suffer from GAD daily, just situationally.

    When I read about this surgery, I remember telling my husband that I will have to be crawling on the floor before I go through with it. A lot of "bad outcome and painful stories" came through in the posts. Of course, that being said...the truth does have to be told and supported! (even though I am too much of a wimp to read about them). I understand this is a board of SUPPORT, it's just that with my anxious personality, this board was doing more damage than good. I fell into a mini- depression and it took getting OFF this board to recover from it. Which I did. I realize the stories told on this board are of the good outcomes as well as the bad(and they HAVE TO BE TOLD TOO). I have revisited the boards occasionally, only to the point of what I can handle. My family, friends and orthopedic Dr. said...GET OFF THE INTERNET!...I sorta did.

    Now to the point of my post (other than for encouragement). I have noticed that a lot of the posts on this board re: PTTD reconstruction have stated that the patients have stayed in the hospital overnight. Almost forgot to mention my surgery: Post. Tib Tend Transfer(FDL), Calcaneal Osteotomy, Lapidus Bunionectomy with plates/Screws, 2nd (lesser) toe shortening(Weil proc) and Gastroc. Rec. My 2, 3 and 4th opinions here in Denver have said that the "norm" for this proc. is as an outpatient. I asked due to my fear/anxiety and very low low tolerance to pain (pass out very easily when experiencing pain = WIMP!) I wanted to stay the first night in the hospital. My Dr. (whom I love) said fine and she would submit to insurance for that.

    I received the denial letter from my insurance a few hours ago. It stated they would NOT allow for a overnight stay for this type of surgery and that it didn't warrant it. Only a outpatient stay was approved. My anxiety level was a 10 on a scale of 1-10 before I read this news. Now it's a 15.

    Could any one speak to the experience of coming home as an outpatient? Is this routine for most people on this board who have this surgery? I will be receiving a nerve block (not sure when. before or after surgery). I will be given pain meds, don't know what kind yet. I can't take any NSAIDS or relatives of NSAIDS.

    I am worried about not being able to get to the bathroom with my foot down...have read about horrific pain when trying to crutch or scoot yourself to "pee"(have read about people buying female urinals and bedpans to pee/sorry TMI)....... oh my...the question the questions -sorry. I could go on and on about imagining how bad this could be. (there's that catastrophic thinking getting the best of me).

    I do have my husband(will be home for two(2) weeks before he starts traveling again,) he travels a lot for his job. I have no family in town or out to help. I do have 3 wonderful daughters to help they are 9,11 and 12 yr. They are so very supportive(at least for now, well see how things go as time moves on).

    If anyone could weigh in on any "manageable" experiences they've had, in respect to pain and mobility the first week, to encourage me, I would be forever be indebted. With all due respect, I have already read ALOT of the worst senarios and horrific stories about coming home without an overnight stay and would rather not be exposed again to those experiences at this time. I already feel, I am risking alot posting at this crucial time(so close to surgery)but felt the possible benefit outweighed the risk by rewarding me with some renewed hope in light of now having to cope at home the day of surgery.

    Thanks so much for listening. I LOVE this board and HATE it at the same time. Once I get through "my" personal experience with this surgery, then I'm sure I'll be on it all the time, posting progress and/or looking for support as well as GIVING it to as many stressed souls as I can! The unknown is always the scariest part. Thanks to ALL OF YOU, very strong men and women!
    Fondly, RespectTheFoot

     
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    Old 08-10-2013, 11:26 PM   #2
    Eeoj
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    Hi, I am nearly 7 months postop. I had a FDL transfer, calceneal osteotomy, Achilles lengthening and some other general tidying. I don't regret it getting it done. The best way to cope is preparation. The first 3 days will be the worse and then, at least for me, the pain declined dramatically. Stay ahead of the pain, take the meds around the clock, set an alarm clock if need be. Elevate! All the time! The less swelling, the less pain. I promise. Use rails on the toilet, helps with getting up and down, and a stool to rest your leg on when showering and toileting. Get 2- one to sit on, one for the leg. Stool softeners! Make some premade casseroles for the freezer. Use a cooler for lunches and drinks. Read the presurgery checklist on these boards. Plan to spend a lot of time in bed. If people offer help, give them a specific task. It is not easy surgery, you will be tired, there is pain, you can't poop, and bathing is a challenge, BUT... It is worth it. The pain will be gone, you will be able walk again. I see huge gains monthly and you will too. Best of luck, breathe, and enjoy having the little ones wait on you for a change. Big hug!

     
    Old 08-10-2013, 11:49 PM   #3
    RespectTheFoot
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    Eeoj- Oh thank you for the encouragement!! You are right....I can do this, I can! I can buck up and handle the pain..I'm digging for my big girl panties now. I have practiced with a lot of my devices, crutches, scooter...even trying to pee, with leg propped up. That is difficult, it's so weird to do that in that position ....haven't even begun to think about pooing....(sorry tmi) now that's an image. I do have everything you mentioned on hand. Feel like I could make my home into a small assisted living /adult daycare. Someone referenced getting a small stool with a pillow propped on top or a "pouf" for putting my leg on when I have to pee. I think I had better do that. There are too many posts about NOT having your foot down at all for the first week or two. Throbbing must be intense. (yikes) Hoping pain meds work. If not...there's always the ER. I finally made my deductible and I'm at 100% coverage. Think I'll take advantage if need be. Thank you for your support and belief in me...I can't wait to post that "I survived". Hugs !

     
    Old 08-11-2013, 12:05 AM   #4
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    You are more than welcome. Some additional little suggestions- bath in a bag- large thick wipes for bathing. You should be able to obtain from your local surgical supply store. Wet ones for general cleansing. Night gowns. I bought sweat pants from lands end. Look nice, go over the cast easily, and are super comfy. Cast sock - I knit a long baby hat to go over the toes, they get cold due to circulation. Lots of pillows! Subscription to Netflix.lap tray for meals- I got a great one for $20 from ******. like childbirth, this will all be a dream in a few months.

     
    Old 08-11-2013, 12:29 AM   #5
    RespectTheFoot
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    great tips! I don't have the "bath in a bag". Interesting. I'll check out a few medical supply shops for that. Would you know when it would be a reasonable amount of time to expect to take a shower, sitting on my shower chair? I just was wondering if it would be a long time? I have a cast/boot cover . Although I will be in a surgical splint for the first 10 days then right into a boot. non weight bearing of course for at least 8 weeks depending on bone healing. I had low vit d levels but just increased those to 52. My nunber went from 26 - 52 over the past 4 months. I was given the ok for surgery, but no promises on bone healing time. I have netflix and have been giving some music purchasing gift cards I have lap desk and all the power outlet strips and light dimmers on extendable cords to try to do everything from bed. I moved to my first floor guest room. Kids tell me it looks "homey". Ill check into bath in a bag(thank you) I only have washcloths and bought some absorbent pads to sit on in bed while I washed laying down. Have some dry shampoo also. I'll force myself to use the potty no matter what, especially since I'll be on a blood thinner for possible clotting. Dr. said, move to that bathroom at least 4-6 time a day, just to get out of bed for moments at a time. My mom had double Pulmonary Embolisms in both lungs 8 years ago(almost didn't make it), so that is yet another worry to add to my long list of things that "could" happen to me. Ok..I'll stop with that kind of talk...Positive, stay positive, stay positive! I'll let you get some shut-eye (you east coaster)....it's late where you are, in fact, I suppose it's late here in the rockies too. night night and thank you again! ZZZZzzzzzzz( yawn)

    Last edited by RespectTheFoot; 08-11-2013 at 10:35 PM.

     
    Old 08-11-2013, 01:55 AM   #6
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    The worst pain is in the first few days, so make sure you're keeping up with the pain meds. Keeping your leg elevated and iced is always absolutely essential, not just when you're swollen and hurting. Elevation and ice will help prevent these things.

    I had really freaked about how I was going to pee, too. Nightgowns are a godsend (and no panties if you're really adventurous/in a hurry). I don't prop my leg up when I use the restroom, but it would definitely be a very good idea. My boyfriend actually held my leg up to make sure it didn't touch the ground for the first few days. Make sure you're getting up even if you don't think you have to bathroom. You probably do, and the last thing anyone wants is to pee themselves while crutching along..

    Also, be careful while standing/walking. You might feel a bit lightheaded from the blood thinners.

    Last thing: Coming home for me was an experience. I didn't get home until midnight, and I was still vomiting and half-asleep from the anesthetics. Just stay positive and focus on getting to bed; bed = good, bed = sleep. Just stay positive!
    __________________
    August 2, 2013: Achilles tendon lengthening, Evans anterior calcaneal osteotomy, medial calcaneal displacement osteotomy, PTT repair.

    Last edited by dactyl; 08-11-2013 at 01:58 AM.

     
    Old 08-11-2013, 04:34 AM   #7
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    Respect the Foot,
    First, there are several instances where a procedure is scheduled to be outpatient, but after post surgery observation (pain level etc) the Dr. can order a stay overnight so that is still possible. So just b/c things are denied prior to procedure, doesn't mean your doc can't make the case afterwards.

    Second, in my opinion a knee scooter is a MUST. If insurance won't pay for it, you can probably check eBay or craigslist for one being sold.

    Not sure why the procedure recovery is different in different parts of the country. Here in NY I was given 3 day hospital stay which became 4, due to problems of pain control. That said , the rest of my recovery went very well and I'm now 2 years post op and doing very well.
    Best of luck and God Bless.

    Last edited by Administrator; 08-11-2013 at 06:54 AM.

     
    Old 08-11-2013, 07:18 AM   #8
    Eeoj
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    Just a correction. Blood thinners do not cause lightheadness. But certainly, the anesthesia and pain meds will.

    Last edited by Administrator; 08-11-2013 at 04:25 PM.

     
    Old 08-11-2013, 07:32 AM   #9
    Eeoj
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    Smile Re: VERY STRESSED..PTTD Surg. next week-Please help

    Quote:
    Originally Posted by RespectTheFoot View Post
    great tips! I don't have the "bath in a bag". Interesting. I'll check out a few medical supply shops for that. Would you know when it would be a reasonable amount of time to expect to take a shower, sitting on my shower chair? I just was wondering if it would be a long time? I have a cast/boot cover . Although I will be in a surgical splint for the first 10 days then right into a boot. non weight bearing of course for at least 8 weeks depending on bone healing. I had low vit d levels but just increased those to 52. My nunber went from 26 - 52 over the past 4 months. I was given the ok for surgery, but no promises on bone healing time. I have netflix and have been giving some itunes cards. I have lap desk and all the power outlet strips and light dimmers on extendable cords to try to do everything from bed. I moved to my first floor guest room. Kids tell me it looks "homey". Ill check into bath in a bag(thank you) I only have washcloths and bought some absorbent pads to sit on in bed while I washed laying down. Have some dry shampoo also. I'll force myself to use the potty no matter what, especially since I'll be on a blood thinner for possible clotting. Dr. said, move to that bathroom at least 4-6 time a day, just to get out of bed for moments at a time. My mom had double Pulmonary Embolisms in both lungs 8 years ago(almost didn't make it), so that is yet another worry to add to my long list of things that "could" happen to me. Ok..I'll stop with that kind of talk...Positive, stay positive, stay positive! I'll let you get some shut-eye (you east coaster)....it's late where you are, in fact, I suppose it's late here in the rockies too. night night and thank you again! ZZZZzzzzzzz( yawn)
    I didn't shower for the first 3 days, didn't care what I looked like, lol. My husband subtlety (well, not so subtlety ) suggested that I shower on the third day. The bath in a bag did a great job for those first couple of weeks. It really depends on how you feel. Remember when you use the cast cover to pull it up and push it down slightly so the rubber gasket is upward, better water seal. Moving around is a must as changing position in bed, tightening your thigh muscles and butt muscle (tightened, relax, repeat) ask your MD if you can wiggle toes postop. Repeat the mantra, "I am getting better, this too shall pass"

     
    Old 08-11-2013, 09:08 AM   #10
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    Respect the Foot - I can relate. I am also a 47 year old female who had flat feet her entire life. The left foot always the problem foot with the PTT "acting up" over the past 2 years. It wasn't an easy decision for me - esp since I wasn't in horrific pain prior to surgery but 2 top surgeons told me that surgery was in my future - no denying it and if I waited too long - it would be a fusion rather than building me an arch. I did a lot of research, a lot of crying, and finally came to terms with it. I had surgery done the end of June (see list of procedures below). I have written about my exploits in various posts but at present - I am 6 weeks out and in a walking boot. I just started partial weight bearing (PWB) on Thursday. Although I won't know my "true" outcome for several more months - so far it's been healing well and I have no regrets.

    Best of Luck to you.
    __________________
    Flat Foot Reconstruction Surgery on June 26, 2013:
    Lateral Column Lengthening
    Medial Translation Osteotomy
    Cuneiform Osteotomy
    2 bone grafts
    Gastroc Recession
    FDL Tendon Transfer to PTT

     
    Old 08-11-2013, 09:27 AM   #11
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    [QUOTE=Eeoj;5210071]Just a correction. Blood thinners do not cause lightheadness. But certainly, the anesthesia and pain meds will.
    Thanks!
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    August 2, 2013: Achilles tendon lengthening, Evans anterior calcaneal osteotomy, medial calcaneal displacement osteotomy, PTT repair.

    Last edited by Administrator; 08-11-2013 at 04:26 PM.

     
    Old 08-11-2013, 09:44 AM   #12
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    i129-I loved reading your post! You survived!!! I'm at that point were you can't even think beyond the unknown of the moments and few days after the surgery.

    I also took months to come to the decision of having this surgery. I can't tell you how many months I would say "yes" I'm getting the surgery because the swelling and slight discomfort were such a bother. Then there were the good days and I would say "no way in he__l am I getting that surgery. Then there was the eternal hope of PT, or maybe bracing, or maybe Arizona Boot, or even ***. I even called into Sirius/Satellite Dr. Radio Show Orthopedic Show out of NYU (I know...I was flippin' desperate) and told them of my possible PTTD surgery. All 3 Dr's agreed, if I didn't do it now, it would have to be done eventually.

    I cried after that call in March. I cried and cried so often when I first read about this surgery. I panicked, then cried, then tried to explain to friends how impacting this surgery was, and many didn't quite understand the full context of the procedure. I was desperate for someone to make the decision for me (since I didn't have a torn tendon or in huge pain). Some friends just assumed it was like bunion surgery and that was that. So here I am approx. 96 hours out from showing up in that pre-op area where their going to ask all those questions and I'm sure I'll have the "flight or fright" kick in.

    There are many other challenges to this surgery to come. I am only on the first part...getting through the first couple weeks of the surgery - that's all consuming at this point. I can't even begin to think about the recovery and lack of mobility part. Thats depressing too, but my mind is only willing to focus on one bad idea at a time. Somewhere in there (I sometimes have to dig a little deeper than my surface thoughts) there is a "me" that knows I am stronger than I think I am. I know I will do this, come good recovery or bad, and I will take it in stride and with a positive view (with the exception of a pitty party now and then). I know that my FUTURE mobility of hiking and walking and going to do fun things with my family is why I am going through this (and to where a nice pair of comfort shoes for a dinner date with my husband..that tennis shoe...I want to BURN it!) I will keep my eye on the goal and will keep looking towards and thinking about the great future ahead.

    Thank you so much for being a resource. I will follow your recovery and learn a way to post to you if I have any questions. In just the few hours I've gone online here at the boards, I feel the way many must feel...you are here to "give back" and HELP those who are so anxious about the unknown. I feel so lucky to have made the decision to post for help. God bless you and thank you.

     
    Old 08-11-2013, 09:58 AM   #13
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    pterodactylpoke- Thanks so much for the comments on "peeing" (sounds ridiculous), but it is one of my main worries. I have nightgowns and I think it will be easier to just "punt" the underwear the first few days. When I practiced how to do this(getting to the bathroom and trying to pee) on crutches...the underwear always tripped me up. I wish I could take my knee scooter right to the potty, but it won't fit in my small guest bathroom, it's just the potty and the shower and a small area outside of that room for a sink. I may be able to put a little stool or a "pouf" (small softer ottoman in the corner to put my foot on, but it will be tight.

    I've spent just a brief amount of time thinking about how I am going to get into the back of my cross -over vehicle when it's time to come home. My car is sorta like a station wagon/mini van. I'll sit in the back seat and prop my foot up across the entire row. My husband will hopefully remember the pillows. Then it's the crutches up the 2 stairs from my garage into the house. That should be fun. I'll practice that as well. Thank you for your input. I am a person that preparation helps me feel more in control...or at least as much as I can be. I'll remember...Bed=rest, Bed=recovery Thank you so much.

     
    Old 08-11-2013, 10:15 AM   #14
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    Eeoj- Thanks for the tips on showering and especially ways to keep the blood flowing to my foot. I am afraid (shocker) of blood thinners. I remember my mom getting spontaneous bruises from hers (think it was lovanox ??), anyway, not sure if I'll get injectable type or pill type. Just hoping I'll know if blood is too thin. I'm sure they'll share with me what I need to watch for when taking that drug. I would rather bruise than clot....I think. ;/

    I will use the tightening exercises to help with blood flow. I will be in a special toe/bunion splint as well as the surgical splint for the foot/leg. The bunion splint will be underneath, i think. So I don't think I'll be able to move my toes to help blood flow.

    Thank you again for all tips to help make this experience as best as it can be. I will repeat the mantra "I am getting better, this to shall pass"...in fact, I'm starting relaxation guided techniques for stress management. My Dr. and (other studies for that matter) have stated that stress which causes increased cortisol levels in the body will delay healing in the body and can amplified pain receptors in the brain. There are many studies out there on this subject. I felt the studies were compelling enough that I am giving them a try pre and post op. Hope they help. Have a great Day!

    Last edited by Administrator; 08-11-2013 at 04:29 PM.

     
    Old 08-11-2013, 10:23 AM   #15
    RespectTheFoot
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    Re: VERY STRESSED..PTTD Surg. next week-Please help

    Swimbunnie- Thank so much for renewing hope on the possibility of staying the night. I will expect the worse, but hope for the best. To be honest, I really hope that I look back on these posts in a few weeks and say...what was all that fuss about. I worried myself to death, caused many more wrinkles and raised all that cortisol in my body for nothing. I know I can do this, with a hospital stay or not (wow...what a good night of sleep does for one's perspective) I am taking everything in stride. I will handle things as best as I can when I get home that evening (8/15). If things go bad...there's always the ER.

    One thing worrying me (other than peeing ;0) , what if the surgical splint gets too tight due to swelling(say, over the weekend)? I've read and heard from a friend that that happened to, that it is unbearable. Would I go to the ER? I don't know what to do if that happens. It probably won't, but just to be prepared...have you heard of what people do to get that loosened? I tried to google image what a surgical splint would look like after PTTD surgery and I couldn't find one image. I am assuming it may be a wood piece with a lot of gauze and padding and it is taped? Any input would be appreciated. Thanks!

     
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