Ankle Dingo dad in recovery from TAR

[Newhip_Pol]

@dingo dad So sorry to hear this - the lack of consideration from the drs practice is awful. I do hope you can find some resolution soon. I don't know enough about US health system but wonder if you can get help elsewhere?

 

[dingo dad]

hey pol, thank you. With my paid-for insurance company I have exceeded my deductible and normal out-pocket costs. which is 9k$. I can go to another surgeon,doctor whomever. I located one close to home, on this site. honestly, I wish I had consulted with someone else on the post - op care. like so many things in life. as soon as you're about to figure things out a bit, you're just about done. My surgeon trained with the best guy in the area, yrs back. I imagine that he was the only doc that did anle surgeries. 2005-... but since Austin has grown so much. there may be others.

 

[dingo dad]

Another Saturday night! woo hoo
It's hard to imagine just being able to be out in public having fun.
My pain (focal neuropathy or whatever) has not subsided. Not able to use crutches for more than 5' without my ankle and foot swelling and turn colors.
The nerve pain (right now) makes ya hold your breath or holler. Couldn't say if the gabapentin regiment is very effective for me. I don't not mean to complain. my intent is to document it for others. Texted the Dr about the continuous high pain, all he had to say was "we'll see how you are at your next office visit". 26 September. They reduced the pain treatment dosage from 10mg oxycodone to 5mg.
There is a Pain Management document somewhere on the homepage of this org that was just brilliant. can't seem to find it. Take care, jery

 

[Newhip_Pol]

Hi All,
Does anyone US based have advice for @dingo dad prior to his appt. 26 Sept with ankle surgeon - about possible second opinion, pain control, presumed nerve pain post TAR (although there seems to be colour change and swelling too) ?

@djklaugh @benne68 @Jamie

 

[djklaugh]

@dingo dad Here is a lengthy article about pain management - while it refers to hip and knee replacement it is applicable to other joint replacement surgeries as well. Is this the one you remember? https://bonesmart.org/forum/threads/pain-management-and-the-pain-chart.5349/

Also here is a different kind of 1-10 pain scale - intended to be humorous but it does accurately reflect how awful things can be: https://bonesmart.org/forum/threads/new-kind-of-pain-scale.52544/

It is a very sad reality these days that because of some physicians over prescribing narcotics and the unfortunate crisis with addictions, that narcotic pain medications are now under prescribed for those who truly need them. And it is actually very rare that people taking narcotics for genuine pain relief become addicted to them.

Make notes about when your pain is at the worst, what triggers that, what (other than medications) you are doing to try to ease the pain, and what effect medication(s) are having for you. Take the notes with you to the appointment and hand them to your surgeon. Insist on help with this problem and if surgeons is unable to provide any reasonable plan, insist on a referral to some one who will.

While you are still early in the recuperation period you should not be having this level of pain AND your foot should not be swelling so much and changing colors! Be sure to demonstrate that aspect to the surgeon!

Hopefully one of my colleagues will have more specific information for you about TAR.

 

[benne68]

@dingo dad Sorry to read that you are in so much with pain, but please know that it is normal during the early stages of recovery. I had an ORIF for a trimalleolar break - - not have a TAR -- and I struggled with pain and was on a walker for two months. I'm sure a TAR is even harder.

Are you icing and elevating throughout the day? You might find these articles helpful:
Elevation is the key
Ice to control pain and swelling

Also keep in mind that recovery from a joint replacement can take a year or more -- so you are barely 1/12 of the way through.

We don't have many members who have TARs who are still active on the forum, which is probably why you aren't getting many replies. However, you can look for others who've been through a TAR by using the SEARCH button on the far right of the blue toolbar above.

 

[Jamie]

We do have an entire section on pain management options that can be accessed from a tab at the top of the page in the blue toolbar called POST OP CARE. You may have to click on one of the arrows to move your tool bar to see it….it’s on the far left. Hope this helps you. Also, you might ask your surgeon or GP if you could try Lyrica in conjunction with the OxyCodone for pain. Sometimes it works a bit better than the Gabapentin. You would stop the Gabapentin completely if you made the switch.

 

[Iski]

Dingo Dad: sorry to hear about your pain and swelling issues. I had TAR July 7. The initial pain was notable, but I got off Oxycodone after 2 weeks, off Acetaminophen 3 weeks post surgery. What you're dealing with does NOT sound normal from all the research I've done and my experience. I hope you get some type of diagnosis at your appointment tomorrow - fingers crossed they can figure this out and get you squared away.

That said, I'm coming up on my week 12 appointment this week and still am battling a wound that opened up and can't spend too much time walking or without foot elevated without a reasonable amount of pain. I envision this is going to take a while to get to feeling like a reasonably normal ankle: many have said it's a year or so until swelling and pain goes away. Hang in there!

 

[dingo dad]

Saw the surgeon assistant 23 September. 3 xrays done. was directed to begin weight on my ankle. And physical therapy 4 weeks later. The xrays showed bone growth on surgery site. 1st attempt with crutches or a walker putting light weight on my leg caused a lot of pain the whole next day. I did not use it at all. Still taking gabapentin, oxy and acetaminophen. Surgeon told me what @Iski did. My surgery/recovery was not typical. They had to do a lot of extra bone removal on the fibula in order to make the joint fit correctly. That's why the surgery was 5hrs instead of typical 2hr procedure. Lucky me! Bottom of my foot from toes to heel are completely numb. Swelling is going to be around for a long time. Tried compression socks, they cause a lot of pain. I can only tolerate it for about an hour. Don't have shooting nerve pain though. I think that nerve repair and pain is going to be around for a while though. jery

 

[Newhip_Pol]

Sounds as if your surgery was pretty rough. Take it steady, one day at a time and I'm sure things will slowly improve. Best wishes.

 

[Iski]

Yes, it sounds like you had a very complex surgery and it would be logical you'd have a slower recovery. For me, recovery from the "typical" TAR is a slowwww process. I do see improvement every few days though, so keep at it: hopefully, the pain backs off soon for you and you can start gradually getting back to walking and activities!

 

[dingo dad]

As the unending summer in Texas moves to a cooler beautiful cooler October I have found things finally starting to improve. As of September 28, I found a gentle compression sock, (that may have been the key) that I could wear. That helped a lot with swelling and gradually eased up on the pain. Started some non-weight bearing leg excersizes and light stretching. Then was able to tolerate some weight bearing steps in the house using mobility aids(crutches/back handles of wheelchair/ kitchen counter top. In just a few more days I have been able to stand and "hobble" a minute or so at a time. PT starts in 2 weeks. Can now sleep thru the night. All of that feels very positive. Very grateful... Worry is letting up. Confidence improving. More smiles (cautious) happening. A definite beginning point to recovery. I am going to end this thread on a more positive note. Prejudice, lack of knowledge, or possibly fear, caused a new "general healthcare" Dr. to accuse me of "drug shopping" and "look like a Marijuana user" "you should be farther along and not be in pain". Mind you, I was only establishing new "general health care". Not asking for a single thing, nothing". I'll be shopping elsewhere for a general doctor. (I'm pretty upset right now) thanks everyone for your support!

 

[Newhip_Pol]

Prejudice, lack of knowledge, or possibly fear, caused a new "general healthcare" Dr. to accuse me of "drug shopping" and "look like a Marijuana user" "you should be farther along and not be in pain".

Kind of you to be so generous in your opinion of this doctor who, presumably, has not personally experienced broken bones or joint replacement!
Good to hear your positive news and hopefully you will find an understand general doctor very soon. Slowly does it!

 

[Jaycey]

@dingo dad Sounds like you are on track with this recovery. Well done on persistence!

That GP was out of line with those comments. Not someone you need to deal with. Hope you can find someone more supportive quickly.

 

[Iski]

Unfortunately, every profession has its losers. Drag you had to go through that, but awesome you're getting better! Just remember to be patient. It's been really hard for me with good days and bad days, but every week I'm improving: hope you do the same.

 

[dingo dad]

Unfortunately, every profession has its losers. Drag you had to go through that, but awesome you're getting better! Just remember to be patient. It's been really hard for me with good days and bad days, but every week I'm improving: hope you do the same.

@Iski can you briefly describe how your much you were able to do when you got the "weight bearing" ok from you Dr? Was pain your "feedback" when you first began the excersize your new ankle? Or what would you recommend that helped you?
Today I did too much maybe. Pain and swelling increased a bit. It's a fine line between painful and sore. thanks for sharing your experience.

 

[Iski]

Dingo Dad: I started progressive weight bearing 4 weeks post surgery in boot: starting at 25 lbs, increasing by 25 lb every 2 days until full weight bearing: 10 min walks 3x daily. Started PT week 5. Managed some tendon pain and was going good until wound opened up at end of sutures on "toe side" of incision in week 5/6. That slowed me down a lot as I had to back off PT and walking to let wound heal.

Week 8 I was cleared to walk in shoe and made wound worse or no better b/c I was doing too much. At week 12 followup, surgeon said wound almost healed (maybe 3 weeks more). Movement (dorsi/plantar and inversion/eversion) was behind normal but "within bell curve". OK'd to do mild weight-bearing PT and after wound is healed, he recommended I hit PT hard for 8 weeks or so and I should get my movement back to more normal.

When you say "Today I did too much maybe. Pain and swelling increased a bit." Welcome to the club you never wanted to belong to! That's exactly how it's been for me. I was cleared to e-bike and have been doing as much "mild weight bearing PT" as I can to keep wound healing. Did e-bike rides last 2 days in a row and now ankle is pretty sore. It seems like it's always - push, then rest, push then rest and let pain be your guide (other than wounds, which is a different issue). Good luck!

 

[Jaycey]

Recovery is all about progressing and finding your limits. Then trying again another day. Unfortunately it doesn't happen in a straight line. More like this:

Hang in there @dingo dad !

 

[dingo dad]

@Iski @Jaycey I just grabbed a screenshot of that, just before I saw your post. These things are $$$. expectations vs reality. what a difference this group makes to my awareness, quality of life. yall have been so great. "welcome to the club that you never wanted to be a member of". Believe it or not, that has been so major for me, as I have have felt in total despair, scared, alone, frustrated with all the things. will I ever walk again? "omg, why is my leg/ankle hot and swollen today"? well, cuz you worked you ankle yesterday, dork! haha. Oh, that's to be expected? I learn every day when I pay attention to this group. I have a looong way to go. y'all lead the way. that's really cool. jery

 

[dingo dad]

hi everyone. I've been meaning to update. going for 1st pt visit tomorrow. I'll repot after that. Has anyone found that the "surgeon locator" tab on our site is working/not working? I just tried it and it is taking me to a bonesmart app (google).