Triple ankle fusion - 12 weeks on.

[Lynda Moore]

Hello fellow ankle sufferers. I thought it might help some of you to hear about my journey. I am 64 and was a Nurse for 40 years, retired early because long shifts were getting a struggle with the ankle problems.

I have always had very high arched feet and had enormous problems with shoes as a result. Gradually had more instances of spraining my ankle, and knee and back problems. Impossible to balance on the right leg. In 2003 I stepped off a mini step ladder and suffered a lateral ligament tear, eventually having an operation to repair it, with micro fractures performed across the mid foot to strengthen the bones and try and increase stability. Since 2007 I have been to hospital 2-3 times a year for steroid injections into the joints of the mid foot to control the pain. There has been severe arthritis in the talonavicular,  navicular cuneiform, and sub talar joints and last year it was proving more difficult for the surgeon to inject. I was at the point when it was felt further steroid injections could affect the bone strength if I had a fusion. I had tried to put up with the increasing inability to mobilise far, and the flare ups of back ,knee and neck pain. This was not only because of the potential length of recuperation needed post operation, but because there were conflicting opinions from surgeon, chiropractor and podiatrist. I read many medical articles but a chance meeting with a retired orthopaedic surgeon who was really positive about the benefit it would bring me, actually convinced me the time had come! I prepared for the operation extensively - I bought a good knee trolley with pneumatic tyres and a gel cushion for it. I  bought a wheelchair with a right leg extension as it was cheaper to buy than rent. I found a shower chair in a charity shop. Bought a Limbo waterproof plaster cover, a toilet frame, a V pillow, suction grab handles and a half step for outside. I practised getting in and out of the door on crutches. I've rented a stair lift for six months from Acorn stairlifts which has been brilliant, meant I could go up and down stairs without effort safely. Having been non weight bearing in the past I was concerned about the impact of crutches on my back and shoulders at this age. Having a long career in rehabilitation meant I was ahead of the game - I hoped! I even installed Echo Dots up and downstairs in order to summon my husband!

The triple arthrodesis and lengthening of the gastrocnemius muscle was performed on 14th February 2020, Valentines Day! It was a quite a long complex operation and I woke in recovery 5 hours after leaving the ward. The anaesthetist gave me a nerve block in recovery and I can honestly say I had zero pain following that. I had a plaster back slab on. Up on crutches non weight bearing the next morning and home at lunch time. Kept foot elevated at all times, used knee trolley to and from toilet. Showered the next day with the Limbo cover protecting the cast. Fairly sick that day - due to the codeine phosphate- so stopped it and just took paracetamol. I've only taken about 10 doses in total in 3 months - no pain!  Back to the hospital at 10 days for dressing change - three wounds, one on top, one on the outside and one back of leg. Plaster cast replaced by an airicast boot which was worn night and day. Soon got used to it, bit cumbersome in bed but helped by a bed frame to lift the duvet off, and a leg lifter strap . Two of the wounds healed fairly quickly but the top wound seemed to have pressure from the air-cast boot and became quite sloughy. Needed a course of antibiotics and regular dressings. At last healed - at 11 weeks. I bought a second knee trolley off Amazon, a cheaper model for upstairs so it didn't have to be carried up and down by my husband, and that gave me total independence. I have taken daily Vitamin C 1000mg to aid wound healing and Vitamin D supplements.

I found it initially difficult getting in and out the front door due to our step, but a tall stool on Amazon which fits on the step meant I could swivel out safely. Two weeks post operatively I was going outside on the knee scooter for exercise( be cautious, I did the downward dog yoga position over the handlebars once!! -) went round the shops and visited the cinema. Then Covid 19 struck and we went into lockdown! I was suddenly on my own with the rehab, doing my own dressings. No follow-up appointments and no prospect of physiotherapy. It has probably meant I've rested more, so in some ways it has been beneficial. It's been quite scary though, with increasing the mobilisation on my own. I had a telephone consultation at 8 weeks when the consultant said I could gradually increase to partial weight bearing, and then to full weight bearing, over the following month if I felt comfortable.. I got tired using the crutches more and my ankle swelled up if it was down for long. Initially post operatively the circulation wasn't as good in that foot and it went quite dusky in colour if down. I have a  'Revitive' circulation booster and have used it twice daily and things have really improved. I'm also wearing Doctor Organic compression socks ( about £14 on Amazon - they are so comfortable) to keep the swelling down. Not painful pulling them on.I got fed up with the aircast boot at 9 weeks and have gone into walking boots and good supportive trainers. Even my Hotter shoes are ok - they were so uncomfortable pre -op. I was quite nervous at first putting more pressure on the ankle, and felt I needed a rocker insole. I have excellent up and down movement but no side to side  movement to speak of - no different from what I have coped with for some years. I have had a private podiatrist for a lot of years and an enquiry to him meant he opened up especially during lockdown and made me new orthotics as socially distanced as we could manage! He said I limped in and walked out normally! That has been the turning point for me, mobilising much more easily with the orthotics in.

I managed to go in for Xray last week at 11 weeks, and the Consultant phoned to say he is delighted with the amount of fusion already happening. It remains pain free - bit of an ache if I overdo it but I am even doing short walks without the crutches now. I am now cycling every day - did 7 miles yesterday without a problem. I haven't been able to do that for years because of foot and back pain! I would be swimming if it wasn't for the Virus.I can do the stairs easily. I've even driven the car up the road and back to check out ankle movement and I am fine.

So so far so good and no regrets so far at 12 weeks. I will update you on my progress! Keep positive everyone, good luck best wishes to you all, whatever chapter of the ankle horror story you are at.

[Deborah Bilafer]

Amazing!   

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On May 10, 2020, at 10:47 AM, Lynda Moore <lyn_v...@hotmail.com> wrote:



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[brian gregan]

Congratulations and we'll  Lynda 

I suppose that you wish you had it done years ago

Kind regards 

Brian

[Anthony Matthews]

Hello Lynda, I am about to make a decision to have exactly the same operation as you, and your extreemely well written blog of how you have been managing over the past 3 months is very encouraging.  It is now August and I was wondering how you are getting on, especially with the cycling as this is a passion of mine.

Look forward to hearing from you.

Best Wishes

[Lynda Moore]

Hello Anthony, 

I’m 6 months now. It was easy in the first three months compared to now! It’s hard work as my body gets used to the change in gait and I’ve got pretty tight muscles in calf, lower back and shoulders and my left knee gets a bit unhappy at times! I’ve been back for a change of orthotic and got trainers with a slight rocker. I’m keeping the swelling down with ankle compression socks. 

Every day is different, can be difficult mobilising in the night to the loo as it stiffens up, and walking barefoot isn’t easy. I need crutches then and often need them outdoors for stability and confidence. I’m driving well. I potter around the house and garden without aids, but if I stop I often need crutches to get going again. It gets very tired if I do too much- I occasionally get to 5000 steps but usually about 4000. The day I walked 0.6 mile I was wrecked for two days afterwards!! I’ve just been granted a Blue Badge for a year which will help with parking. Still having a wheelchair for any significant distance, which I hate. I’ve still got the stairlift until workmen have finished and they stop using the downstairs loo! - though I can do stairs ok. The scars have been SO itchy-even with bio oil. Worse than the op!! Skin on top wound still a bit vulnerable, though circulation is much better and it’s a normal colour and temperature. 

I continue to cycle pretty well- still occasionally feel a bit precarious starting and stopping but ok when I’ve got going, I’m not an avid cyclist but it’s been the only exercise I can do with the Covid shutting the pools. I’ll try swimming when the schools go back but they were saying Nothing could be left at poolside, and I need a crutch and jelly shoes for stability. 

No physio or Surgeon followup yet though I’ve insisted I see the surgeon next week! It’s been a long lonely road but mainly due to lockdown and no professional support. I’ve no pain, just tightness and swelling. I don’t regret it at the moment. Watch out for weight gain! Do message me if I can help again. Good luck.

Lynda

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On 20 Aug 2020, at 12:31, Anthony Matthews <cavend...@gmail.com> wrote:

Hello Lynda, I am about to make a decision to have exactly the same operation as you, and your extreemely well written blog of how you have been managing over the past 3 months is very encouraging.  It is now August and I was wondering how you are getting on, especially with the cycling as this is a passion of mine.

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[Anthony Matthews]

Hi Lynda,

Thank you for being so up front with what you are going through.  I must say it does not sound like a walk in the park ( excuse the pun).  However ater erading up about this procedure it does seem to be a long haul, but hopefully worth it in the end.

thank you once again for letting me know what to look forard to!!

Best Wishes

[Lynda Moore]

I sat next to a retired orthopaedic surgeon at a dinner last September and he was the person who persuaded me it would be ok!

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On 20 Aug 2020, at 18:21, Anthony Matthews <cavend...@gmail.com> wrote:

Hi Lynda,

To view this discussion on the web visit https://groups.google.com/d/msgid/ankle-fusion-support/06bdc381-a6bb-4468-be7f-86a163fd5f65n%40googlegroups.com.