New – Foot/Ankle Surgery & Recovery

Prior to writing this new saga on my ankle, I read my last notation on May 13, 2013 about the left knee surgery. In that post, I was having grave difficulties with my right knee buckling and causing great pain during a shotgun shooting round.

I also need to note that in July, while on vacation, I fell down some steps and landed on the side of my left knee. From that day till my ankle surgery, I had swelling on the front of the knee. The swelling had previously been on the left side of the knee. The swelling was moved over from the force of the fall.

I set up the surgery for the other knee. Unfortunately, between that day and the day of the surgery, my ankle and foot collapsed and became a far more painful problem than the knee. Later yet, in November, I was hunting in West Virginia. While walking, something moved inside my foot and I was instantly in serious pain. I could hardly walk. I was satisfied that the choice of ankle surgery over knee surgery was the right thing to do.

On January 14th, the ankle surgery was done by Dr. Daniel Cuttica of the Orthopaedic Foot and Ankle Center. This newest surgery is according to the surgeon, minor surgery on the left ankle and foot. The surgery was to repair several issues on my foot and ankle on the left side. These issues were: repair of the left tibia tendon, stretch the Achilles tendon, reshape the foot with an arch. The methods of this repairing were to break the heel on the left foot, cut the Achilles tendon, incise the foot in two location on the top, pull the tendons on the bottom of the foot, drill holes in the back of the foot’s bone and push the tendons in separate holes. The point of all of this was to make the foot into a normal foot by pulling the Achilles tendon down and reattaching it to the heel with a screw. This fix, alone, will pull the foot into having an arch. The tendons in the holes in the bottom of the foot were to relieve tension on these tendons from the flat foot problem. The breaking of the heel is to realign the foot so it is shaped correct like a normal foot. After all this is done, considerable time in a splint, then a cast is required before a walking boot is issued and physical therapy begins. The recovery time prior to the walking boots could be as long as two months. Here are some graphics showing some parts of this surgery.

. My thanks to Certified Medical Illustrations for their permission to use their illustration on this article. See their website here. medical illustrations If the hyperlink isn’t working for you, just copy/paste the site shown here: http://www.certifiedmedicalillustrations.com/

I thought readers might like to see the medical explanations for the surgery. The Orthopaedic Foot & Ankle Center of Washington D. C.,2922 Telestar Ct Falls Church, VA. was where I was diagnosed. They were nice enough to allow me the use of a part of their web site to medically describe what problem my foot had.ankle surgery Click to read about it. If your hyperlink doesn’t work, copy and paste their site as shown here: http://www.footankledc.com/medical-library/posterior-tibial-tendon-dysfunction/

In 2006, I had this same surgery on my right foot. Following the surgery, I had a considerable reaction to the post-surgery medication and had to go to the emergency room two separate times. This caused great consternation to me upon finding out I was having this same surgery to my left ankle. Generally speaking, I used relaxation techniques and meditation to relieve this stress for the upcoming surgery. I had learned and used these techniques through the years for other stressful times. Knowing relaxation techniques are very helpful in calming oneself prior to any upcoming stress.

I also used prayer. I have used prayer to calm myself, or to get thru various life situations since I was a little boy. My mother and grandmothers were my early life teachers. A lot of their teaching was on religion and how much prayer helped them in circumstances beyond their control, or helped them make correct decisions on situations within their control. I could go on and describe many times where I relied on prayer. Perhaps in another posting I’ll describe those times. Suffice to say that prayer assisted me with calming before the surgery, at the surgery, nearly at the moment of anesthesia, and following the surgery. Relying on God, a power above all known human power to assist one into calmness is a far more reaching relaxation than relying on one’s own small brain to do it.

In the first surgery, to my right foot/ankle, the recovery time was nearly exactly two months. Recovery time means the foot is encased in a cast to the knee, but not over the knee. No weight is allowed on the problem foot. Mobility is with crutches, or a special little cart made for foot and ankle recoveries.

Anyone who has ridden or driven in their childhood’s little red wagon is immediately familiar with how to operate this cart. Those unfamiliar with the cart might take a couple minutes to be a competent driver. The hardest part of using the cart is getting on and off of it. But it is still far better than crutches and far safer as well. With the cart, the operator’s weight is over 4 level wheels with a brake. Crutches depend on the adeptness of the user to stay on balance. If the user is off balance there is nothing that will prevent a fall, which could cause further injury. About the only bad thing with the cart is it is awkward to carry in a car.

On the first ankle surgery and after recovery time, I received a walking boot and began therapy. I believe therapy was about 3 months at 3 days a week. There was a very large problem when the cast was removed, and the walking boot attached: my calf muscle had atrophied so bad it look like a leg from a POW. I had zero muscle left. Not only would I have therapy, I also had to rebuild my entire calf muscle! This muscle rebuilding took far longer than the therapy took. What this meant was that when the therapy was complete, I still didn’t have a good calf muscle. How is calf muscle evaluated? According to the surgeon, when the rehabilitation is complete, the patient should be able to lift his body by pushing up on the toes of the affected foot. It’s the calf muscle accompanying the foot that does the lifting. It took me about 3 years to be able to do this. It’s been 7 years since my first ankle surgery. I still cannot do this on demand. Meaning, I cannot show this lift without preparing to do it by first stretching my ankle and pushing several times.

So what to do about this calf muscle issue? I asked my physical therapist that did my knee replacement therapy about exercises to make sure this didn’t happen again. A handy thing about physical therapists is that they are knowledgeable about every part of the body and can give exercises to help a patient on any exercise subject. My therapist, Jorge, advised me to do leg lifts in all directions. That is: standard leg lifts while lying on the back, leg lifts while lying on the unaffected side and raising the affected foot up and lying on my stomach and raising the leg backward. The point of this was to build up the muscle around my knee and have my calf muscle stay the same, or even build a little more. I understood building the muscle around the knee. I did that during knee replacement surgery. According to my therapists I recovered from that quicker than normal. I figured that was because I do a lot of leg weight lifting at the gym and had a lot of muscle prior to the knee surgery. Whatever the reason, I determined to do these leg lift exercises during my recovery time.

The first day after this newest ankle surgery was a complete fog. Even though, when I awakened following the surgery, I was only kept in the recovery room for about another hour or two. On returning home, I had assistance from my wife and daughter, and her boyfriend to get back into my home. I had rented a wheelchair which was a great assistance. My last surgery found my two sons having to lift me up the 5 steps into our house and place me in a recliner chair. Even though they ate their Wheaties every day, that was an overpowering lift test for them. This time I got into the wheelchair by sliding out of the vehicle I was in, and settled in. My help pulled me into the house on the wheelchair and I got myself into a bed/chair that my wife & I had purchased prior to the surgery. This bed on the first floor was so I could stay on the first floor of our house. After the first surgery, I wanted nothing to do with climbing stairs in a fog. Nothing like pre-planning after knowledge of a previous disaster. The reentry into the house and into the bed was easy. The day ended in success and calmness rather than the last chaos.

This is the first post of more posts on the recovery from this surgery.