Ankle Dingo dad in recovery from TAR

[dingo dad]

I had subtalar fusion in prep for total ankle replacement. I'm at 5 weeks post TAR surgery. Ankle surgeries are not frequent. so it's hard for us to gather other folks experience to better inform ourselves. my experience is that surgeons are necessarily "on to the next patient". for me. the subtalar fusion pain got better after 4 weeks. was light weight bearing at 6 weeks. my journey started June 1. surgeon initial quoted me 120 days for subtler fusion to TAR recovery. That didn't happen, obviously. I'm in consistent moderate pain until I drop my leg. Then the pain goes way up for a couple hrs. I hope I get some improvement in mobility soon. A 30 minute car ride, crushed my soul cuz it hurt so bad afterwards. discouraging... hope you are well today.

 

[Jaycey]

@dingo dad Welcome to BoneSmart! I moved your post to a thread of your own so that you will get more input from our members.

Was your TAR surgery date June 1st? Which ankle? We will put the information in your signature for you.

surgeon initial quoted me 120 days for subtler fusion to TAR recovery.

We see this far too often. It's so frustrating when realistic expectations are not discussed. In truth joint replacement recovery time can take one year or longer. There are longer and shorter recoveries. But recovery is never measured in days.

Spend some time in the Ankle Recovery forum. There are many success stories. In most cases the slow and steady approach works very well!

 

[benne68]

120 days for subtler fusion to TAR recovery. That didn't happen, obviously. I'm in consistent moderate pain

I'm sorry you were so misled by your surgeon. I think you'll find by reading through others' stories that pain at 5 weeks post is quite normal. While I didn't have a replacement, it took me 3 months just to begin to feel as though I could walk without pain and stiffness after my ankle surgery -- and the better part of a year to feel "normal" again.

Wishing you a speedy recovery.

 

[dingo dad]

I had subtalar fusion on June 1. then TAR on Aug 16 in Austin TX by Dr Stockton. TxOrtho is a huge ortho group here. It "feels" like it is darn near impossible to reach anyone. They provide a patient "portal" where messages left are routed to staff. I have only had success at getting pain prescription refilled. Typical response is 24 hrs. not sure if it is appropriate to share medication types here. But I was prescribed a 10mg dose 3x daily. My surgery was complicated, took 5 hrs to complete. Fitment and alignment trouble I was told. So after the first "splint" was removed, I was shocked by the amount of "other" incisions that were made to correct the alignment. My ankle was a hot mess. A lot of work had to be done in a small space, so the ankle/foot site was very traumatized. I had no way of knowing that it was going to be this painful. I've had 6 other bone fractures at different times, but I was not self informed or prepared for this one. I appreciate everyone's responses.

 

[dingo dad]

reading a post made by another member... he was using a knee scooter a week or so after his TAR surgery! Astonishing progress. I'm 3.5 weeks surgery. I can't have my foot down for more than a few minutes before my toes turn reddish blue! Pain has been very high throughout. Can't compare cases. because everyone's is different I guess. it's really nice to be connected to others instead of isolated.

 

[dingo dad]

As a new member I'm not sure if I'm posting comments in the right place. Trying to keep them all on this thread....
one thing that has puzzled me in my left TAR post op recovery. At 3 weeks post op, I experienced a change in ankle/ foot. Previously I could do minor activity from my wheelchair-clothes washing, light chores etc... for about 10 minutes or so, then back to an elevated spot. 4 days ago, something changed. Within one minute i would experience a increase in swelling, pain and red/blue color in my toes (2 weeks in a hard cast). The discoloration hadn't imeadiately occured before. Sharpness in pain increased to the point where I will only allow my foot down when absolutely necessary. swelling pressure is typical. But did not occur as drastic and rapid as before. Just...fyi.

 

[djklaugh]

@dingo dad I am so sorry you are having such trouble with your TAR! Have you contacted your surgeon about the episodes of increased pain and swelling? That does sound worrisome to me though I'm not very educated about ankle problems.

 

[Jaycey]

@dingo dad Sounds like your activity level increased resulting in this swell and pain. Listen to that ankle! Recovery will not happen in a straight line. It's more a roller coaster. Cut back on all activity. Ice and elevate. And if the pain is not decreasing please get in touch with your surgeon.

 

[dingo dad]

@djklaugh thank you! Yes, I have contacted the surgeon several times. But he has not responded to calls or messages. only for refill authorization. So at least for my experience, I only am able to talk with them during scheduled visits. With TAR, it is 2 to 4 weeks.

 

[dingo dad]

@Jaycey I appreciate your reply. During postoperative TAR my activity level hardly anything. Pain wouldn't allow it. I will definitely listen when I begin to have increased mobility. When I had a preliminary surgery (sub-talur fusion) I was partial weight bearing at 6 weeks. But because of this group, I think my TAR procedure was more complicated than most. Sub-talar fusion was minor in comparison to the TAR. Only 3 screws, prepped the site, added a bone graft then out the door, same day. Had good recovery progress. But... I haven't been able to communicate with the surgeon to discuss what's been happening.

 

[Newhip_Pol]

Hi @dingo dad - sounds as if you're having a tough time. I'm following your thread because I am on the waiting list for TAR. Not being able to contact your surgeon is not good when you have concerns - is there no-one on his team who can help?

 

[dingo dad]

Hi @Newhip_Pol .
4 weeks post TAR surgery. (I need to learn how to use the "qoute" fun.) Staying on topic...
Communication frustrations. Surgeon group user portal- unresponsive to e-messages (2) and 2 voice-mails.
I requested pain med refill.. gave then a heads up request on Friday and another on Sunday.
i used my insurance co.. patient care team to see if they could get through. They couldn't either.
Lesson: remember to be diligent about maintaining a handy contact list and how to use them. From all your surgeons, case mgr, billing manager, insurance etc.. (I didnt do so good) It will reduce stress when need to contact them). Because in time of trouble (pain, problems etc...) you may not be at your best to remember how to contact them. I wish I would have documented every detail. Later you may not need to remember the date of your first visit. But it might be helpful to have it notes of what the doc said.
My 1st visit was on Feb 17 and here it is mid-september. That's a long time to remember something, especially during recovery.
This site is incredible has been the most helpful resource. And I just found it last week. It will take a while to learn how to use it.

.

 

[Jaycey]

@dingo dad Here's a link to a tutorial on How to use the quote feature. And you will find lots of information and how to do threads in the How To Use This Forum area.

 

[Newhip_Pol]

Surgeon group user portal- unresponsive to e-messages (2) and 2 voice-mails.

I'm not surprised you feel frustrated
I'm in UK so cannot offer any suggestions other than to keep going. Perhaps others will have some ideas

 

[Jaycey]

@dingo dad Can you call your family doctor for a refill on your medication? Sounds like your surgeon's office has handed you over to your primary care. Unfortunately this is often the case.

 

[dingo dad]

Saw surgeon Sept 12. removed cast and stitches. Am now in airsoft cast. Discussed pain level. He described much of my pain to be nerve related. Started gabapentin 100mg once daily at bedtime.
He did not mention titration schedule. still in steady pain, breakthrough pain and interrupted sleep 5x last night. (not fun). follow up in 2 weeks. And in the meantime? I did message in my "patient portal" what titration schedule to use. it's been so long that I haven't had pain pretty much all the time. my activity level is.. none. guess I'm just frustrated to be prescribed something to help with healing or pain to go for 2 weeks before reviewing it efficacy.

 

[Newhip_Pol]

Ouch - that doesn't sound like a lot of fun. Grit your teeth and let's hope the Gabapentin effect kicks in soon - apparently it can take one to two weeks

 

[dingo dad]

no weight bearing for 2-4 more weeks. I'm at 4.5 weeks post op, still having extra pain and swelling as soon my ankle goes less that horizontal. Every surgery is different, I sure thought I could be farther along in my recovery journey.

 

[dingo dad]

Sooo much pain. I'm careful and calm not aggravated or overuse any part of my leg/ankle. I still have incredible stabbing pain and needles. they make you want to scream. I can't call it breakthrough pain because it's been happening everyday post surgery. I keep my leg ellivated, no weight bearing. pain starts now at about 3pm and grows stronger every hour til I sleep. I've messaged Dr's about it and they do not seem to care that one of their patients is in extreme pain, constantly every day. I'm beyond frustrated with their practice. They're very professional and all...but they seemingly are not concerned with the three conditions of concern and treatment that we all should be aware of.
Constant pain, breakthrough pain and sleep deprived pain. These are the "red flags". Dr's have acronyms for these, but
whatever. Nerve pain, short and long-term were never discussed. Last week was the first mention of it.
He prescribed gaba 100 MG once daily 20 tab.
after I learned of it's application, I asked about titration, he changed his instruction via text, to me. 300mg 3x daily. So that ate up the quantity prescribed (20) in a matter of 2 days. Pharmacy would not refill based at on 20 tabs 1x daily. Insurance would not pay.
So... my gabapentin is locked out til tomorrow. told surgeon. he said he sent refill at the original instructions. If that is true. I will be refilling this every 2 days.
what...this seems like it would be important to resolve. Sorry for the rant, but pain does that.
learn what titration is! Check how medications are usually prescribed!
I'm out of options, I've called the case mgr and nothing gets cleared up and question are unanswered. I can describe the phantom nerve pain like "stepping on a nail" like all the way...
it is debilitating.

 

[dingo dad]

Nerve pain- I forgot to mention. my pharmacist told me that traditional pain meds. oxy, nsaids, do not treat nerve pai well. (he said. " not at all",)
I am 5 weeks post op Aug 16.