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Foot & Ankle Problems Message Board

Foot & Ankle Problems Board Index

I will be 19 weeks out from these procedures tomorrow. My surgeon was very conservative and my recovery time was very different than Damac, although I'm getting the same good results. My situation was complicated by a 5 year delay from a severe sprain where at minimum my CFTL, AFTL and achilles were torn; my peroneals probably were also but that wasn't caught until much later. I had many sprains for many years after fracturing my ankle in high school and not knowing about it; it's hard to know what was torn when although the peroneals definitely were torn this spring when I rolled my foot completely under. I just know they had been injured multiple times because of the amount of scarring the surgeon found when he went in there. I had been in a substantial brace for 4 years but after that I was hurting it several times a week and had numerous falls from it giving out. I wound up in a stirrup brace for 2 months while waiting for surgery. I even had to wear it on the beach while on vacation and then remove it on the hard sand but I couldn't go in the ocean without it being hurt. It was a hard wait.

In my case I had the surgery on a Friday with an extended popliteral nerve block placed. Because of a medical complication unrelated to surgery I was in the hospital for about 24 hours and then was drugged up well, the nerve block was given a huge boost and I was sent off on my 2.5 hour trip home. The nerve block was great through Sunday and the infusion person wanted me to try to stop it on Tuesday but on Monday I dropped the pump which apparently moved the catheter and it made me completely numb again. So I stopped in on Monday and had no problem with that. In fact by 5 days I was already backing off the pain pills a little. I had to stop that though when I found out my surgeon doesn't want people to use anti-inflammatories until much later to increase the scar tissue. Even so I came out of the hospital on Norco (vicodin) and while I was given a script for Percocet they didn't tell me it was for anything different and so I never filled it until much later and only took about 2 of them. Pain really wasn't much of an issue after the first week. I was still on pain pills for some time regularly but it was easily controlled. The only time the pain was truly bad was when my nerve block failed in the hospital and had to be replaced. It took a while to get the people together to do that and I wasn't on sufficient oral meds to cover the pain because the nerve block should have been taking care of it. So that was a rough couple of hours. Aside from rare occasions I've been fine on prescription strength naproxen for a long time and I don't take it daily. I try to take it before PT but I don't always and I'm ok then. It's always stiff in the morning and it is uncomfortable in some way daily but never painful, just tight and sometimes sore. After the hardest PT session I've had my pain was a 3 and it went back to a 1 or 2 within an hour or so of resting it. It was uncomfortable early on to put it down and feel the blood pooling in it but I learned that if I sat still and let that happen before I tried to get up it wasn't as bad. That only lasted maybe a week or two and then was only something I was sort of aware of but not something awful.

I was in the surgical cast/dressing for 5 days and then went into a cast. My hospital does casts differently so the cast went over my toes and was shaped to give arch support and increased support around the ankle. The covered toes made my stairs into the house very difficult so I had home health PT for a few weeks to help me learn safe ways to do that.I had that one 2 weeks and then it was removed and my sutures were taken out and another cast applied. It was not done correctly (my toes were pointing down) and so we had to make an emergency trip back to the hospital to be re-casted the next day. I had been saying the cast did not feel right and learned the hard way to not leave if you don't think something is right. I had a lot of pain from that because it caused muscle spasms as well as pain from not being positioned correctly.

I was on bedrest with toes above nose for 6 weeks. That was hard. I honestly barely remember most of it because of pain meds but I spent nearly all of it in bed because the couch wasn't very comfortable. I ate in a semi-reclined position, I slept in a semi-reclined position and I did everything else in a semi-reclined or flat position. I had a big support pillow Amazon calls a "bedrest pillow" and that I used to call a "reading pillow" and one of those around the neck travel pillows. Those kept me supported at the top and my leg was supported by varying combinations of pillows, couch pillows from an old couch, and rolled blankets and towels. The first few weeks it hurt to have my ankle turned in or out so I kept it from doing that; after that I slept with it turned in just because I hate sleeping on my back and that was a little more comfortable.

At 6 weeks I got a walking cast and was PWB with crutches. Life got a lot easier then; I could finally do some things for myself, was able to take a shower without someone in calling distance, could drive and was allowed out of bed. I still elevated daily but I also took a walk daily.

At 10 weeks I got a walking boot and orders to start PT. This was a tough adjustment at first as my heel was badly bruised (I had some minor pressure sores from the surgical cast and then for whatever reason my heel just was angry for a while) and putting weight on it felt really weird. i also had a night splint that kept me on crutches during the night and NWB while it was on. I gradually weaned down to one crutch and then none and then had a minor fall and had to go back to crutches and wean off again (but nothing was hurt which was good). I was walking well in the boot at 14 weeks and doing strengthening and ROM in PT with the boot off and balance with the boot on. We actually reached a point in PT where I was doing so well that we were just waiting out my last week or two in the boot.

At 16 weeks I got a brace (which I hate because it rubs on my incision; my incision has stayed sore where the peroneals go into the bony groove and they are too swollen to fit in there so they rub and are so close to the surface that it irritates the scar tissue) and permission to start weaning out of the boot. I only wear the boot now if I am doing something obviously dangerous which is almost never. PT has gotten more intense and I'm doing something new and difficult at every session now. Last week I fell in PT when I was standing on one leg throwing a ball into a return net. I just kind of slowly slid down to the floor when my ankle got tired and gave out. It was fine and that was good for me to know since for the last 5 years every fall has made things worse. I also know that I may hate my brace but it does work. PT is focused right now on balance and improving my knowledge of where my foot is in space. That's really hard because I've looked down at my feet while walking for some many years that I am having to learn that for both feet. I have at least 5 more weeks of PT then we'll decide about more. I imagine it will be 10 weeks because I want to be walking normally before I'm done or close to it and right now I am not. I have to focus to walk heel to toe and I'm still limping so my walking is exaggerated looking and off-balance. I also want to have some PT after I'm out of the brace just because I haven't been out of a hard brace since 2010 and I want to be sure I am safe without it. I do not intend to repeat this surgery.

It is a process to heal from this and it requires patience. The reward is great though; no more ankle problems. I was told in the cast room when I got the first one that if I complied with the instructions I'd do great and the people who don't comply don't do as well. It's important to have things to do set up and to plan that entertainment in the first few weeks be easy since you will be groggy; I read some children's books my niece has been enjoying and watched stupid reality TV shows and laughed my head off at awkwardfamilyphotos . You need to be ready with equipment: a shower seat, cast cover for showers, a walker or kneelie walker, crutches, a reacher, and whatever you need/want to position yourself in bed are all important. If you have things organized before surgery it really helps. Practice getting into the car and getting that leg elevated to toes above nose; you'll be glad when you are coming home. Also make sure your driver knows what works beforehand so you aren't explaining while groggy. I recommend using old sheets as I found that my casts tore every sheet they came near except one. You need very loose shorts to come home in; I thought I had loose enough ones and then had to send my mom to get bigger ones before I came home. The post-op cast/dressing is enormous.

I'm very glad I did this although it certainly is a big deal. I honestly did not expect healing to take so long but I wasn't given a lot of information about that part. My doctor's nurse tends to not answer questions and she was the one I had contact with for that sort of question. My doctor does do things slowly so you probably will be faster than I've been.

Feel free to ask questions. This is a good place to get good answers.

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