Ankle TAR doing it alone

CassieH

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I will be having a TAR soon (date not set yet) and I live alone. My adult daughter, who happens to be an orthopedic nurse (yay me!) will stay with me in the beginning. I don't want her to have to stay any longer than necessary, although she will still come by to check on me and do the bigger stuff. I know everyone's different but I'm wondering about how long will I really need someone to stay with me. Also, what items do you suggest I get to make it easier to be home alone? I'm planning to get a knee scooter, shower chair, and toilet riser.
Thanks for the help and I appreciate reading everyone's journey.
 
@CassieH Welcome to BoneSmart! As you have probably seen, the ankle group on our site is growing. I'll tag a couple of our members who are in the later stages of recovery to come and chat with you @Larryr @NickB . They are both living life again post TAR. They are better placed to recommend items that you might need during recovery.

I think you will find that you can get around on your own from day 1 post op. It's more about confidence and gaining mobility slowly. Having your daughter with you in the early days is probably a good idea. But as you say - everyone reacts differently to surgery. I would see how you feel when you are first home and go from there.
 
Hi Cassie,
Good luck with your upcoming TAR. The equipment you mentioned is very good, especially the knee scooter. I bought mine on Amazon. Two more items to consider is a cast cover that comes all the way up to your thigh and an extension to your shower hose. I got one that was 8 feet long in place of the standard 5 foot. It helped to reach me at the other end of our shower. Also ordered them on Amazon, although CVS has them.
I used crutches to get over the step to get into the shower, it’s a little tricky but would be good if you had help. Maybe the shower chair will make it easier, I sat on the permanent seat within our shower.
i had to be in my hard cast for four weeks prior to getting into a walking boot(also bought on Amazon), followed by two weeks in the walking boot, then into soft sneakers.
Learn to be patient because it’s a long recovery but well worth it.
Best of luck.
 
Thank you both for your replies. I'm also wondering if anyone has tried the iWalk2? My dr recommended it but the reviews seem to be pretty mixed. Since ins won't cover it I'm trying to decide if I should spend the money.
 
I've seen it advertised and it looks like it could work for a lot of people. Why don't you go to the store now to test drive it. Sometime these devices can be comfortable for one person, and somewhat awkward for another. Let us know if you decide to get it as we'd like to know how it helps. you.
 
Hi Cassie,
Sorry to be slow responding, and maybe you are already "in the process" or done!
Anyway, Larry has pretty well covered all the points, I was lucky having an extremely caring and competent partner. Also i didn't have a plaster cast, just straight to boot, this made showering easier (boot-less); but sleeping (+boot) less so!
How long you'll need help is a tricky one. I would think a couple of weeks would be a minimum, the non-weight-bearing period is critical and fraught with potential accidents! You just don't want to have any set backs during the early days. Even if you had someone who could pop in at critical times (showering etc) would be good.

I tried out a knee scooter; but it felt a little unstable and in confined spaces I imagined my ankle sticking out and colliding with doorways etc.....just a mind over matter thing I'm sure! I hired a wheelchair for a couple of weeks and that allowed me to be reasonably independent, stable and move on relatively uneven ground. Crutches were the mainstay though for quite a while.

I am now nearing 8 months and am quietly happy about progress. I need to keep reminding myself how far I've come movement and pain-wise......as we keep saying, the speed of recovery is glacial and often it's easy to forget how much improvement there has been.

Good luck with you TAR and let us know how it goes.

cheers, Nick
 
Also i didn't have a plaster cast, just straight to boot
Hi NickB - how terrifying that you didn't have a cast! I was just told I might not have one for the 1st week and I'm so afraid I'll be bumping it and accidentally flex it.
Right now I'm waiting for pre-approval from ins, then will get the date set.
I found someone I could borrow an iWalk from and it's not gonna work for me. I just don't feel that I would be safe using it and I haven't even had the surgery yet. It was also hard on my hip on the good side. That joint is getting worn because of my change of gait from the ankle anyway. Really glad I had a chance to try it first without spending the money.
I'll update after the surgery.
 
Thank you, LarryR and Nick B for this advice. I'm preparing for a TAR in the fall and appreciate your comments. I don't understand what you mean by a cast cover extension. Can you give me a few key words or brand name to search?
 
This is what I used and it worked well.

 
@FCBayern .... that's a great product! Thanks for the reference.
 
I had my surgery on Sept 9, 2020. Everything went well and I have the Salto Talaris joint. My nerve block lasted about 18 hrs then it was Oxy every 6hrs. Honestly the pain wasn't terrible (and that's coming from someone with a low tolerance to pain). I thought it would be awful when due for the next pill but it wasn't. So I cut back the amount of rx.
I had a follow-up at 5 days. They took off the splint and everything looked good. Then I got my cast. He only gave me 7 days of oxy which I didn't think was anywhere near enough, but I didn't really need them. I've heard some people have terrible pain, but mine really isn't.
At about 10 days I started having some nerve pain that was tolerable during the day but keeping me up at night. It feels like intense pins and needles with some burning. He prescribed Gabapentin which has helped.
I am now 18 days out and mostly just frustrated with how difficult it is to get around. And having to sit a lot keeping my foot raised.
I didn't feel safe with the iwalk so I went with the knee scooter and I love it! It makes getting around so much easier than crutches. I borrowed a transfer seat for the shower from the Knights of Columbus (they lend medical equipment) and it made getting into the tub as simple as sitting down and scooting over. I also got the cast cover to keep the cast dry and it's wonderful.
I go in tomorrow to have this cast removed, the stitches taken out, x-rayed, then a new cast put on for another 3 weeks or so. So far it hasn't been anywhere near as bad as I expected it to be. Living alone has been a bit hard, but I have some great family and friends that come by almost every day to make sure nothing needs to be done.
I hope it continues to be this easy.
 
@CassieH What a great update! So glad your recovery is going well. Sounds like you have all the equipment you need plus a good support network. Well done!

Please keep us updated!
 
Way to go Cassie,
your report sounds very familiar to me. I did exactly what you describe, knee scooter, cast cover , etc. one difference maybe, before I left the hospital I was put into a hard cast; two weeks later it was removed, then X-ray and put back into another hard cast without removing the stitches. While putting me in the second cast they forced my leg and foot to as close to a 90 degree angle then applied the cast. This was to begin the treatment to get the ankle towards its natural position while healing.
The next step was two weeks later to remove the cast and stitches, and put me into a walking boot for two more weeks; then I was able to go into sneakers and start walking around tenderly.
From there is was PT, and more PT.
I did have tingling and nerve pain and I too was put on Gabapentin 300 mg, but that was too much and I switched to 100 mg. Nerve pain disappeared.
I hope you are a patient person(I am not), because it’s a long journey and you will need to take it easy during your recovery. I am very glad I chose a TAR vs fusion, because I have total flexibility. Good luck and I will be interested in your recovery story. Don’t hesit to contact me if you need to kick around thoughts regarding your recovery.
 
Thank you Larryr. It's interesting the difference in when people get casts, etc. I got my first cast on day 5 and now on day 18 I just got my stitches out, x-rayed and new cast, which I will wear for 3 weeks. Everything is really good so far. I had to do the 90 degree angle with my first cast at 5 days. It wasn't as bad as I thought it would be.
I'm not terribly patient but I knew going into this that it is a long recovery.
They gave me 300mg Gaba today. I will take less if I can. It turns out my first cast was too loose and may have been causing my pain at night.
Larry, how long did it take for the nerve pain to stop? Just wondering.
 
The nerve pain, mostly in my toes , and a little on the side of my foot went on for about nine months and only got better when I started to take Gabapentin. That was my fault because I resisted taking it earlier, so you are doing the right thing. I will be interested in how much 300 mg affects you. I had to reduce mine to 100 mg because I was so drowsy in the morning. I like 100 mg because I can double up on it when need be, but for the most part 100 is doing great.
 
I realized I never posted pics so I've attached some. The first 2 are 5 days after, the next is 6wks after and the last is 7 wks, one week after cast off and finally able to wash it.
I am now in a walking boot, which is so much better than the cast! I am using a shoe leveler to even out my stance. I understand the pain I have in my hip and lower back from the boot but I am also having pain in the knee of my leg with the boot. I am walking with my foot facing straight ahead and not taking large steps. Anyone know why my knee might be hurting?
I only use the boot for walking and try to take it off as much as possible when sitting. I've been told to stretch it and do some light exercises. It's getting a little easier but still tough to do them. I was also told to put oil (Vit E, Coconut or Shea butter (and I've added essential oils)) on my foot and leg and to rub the incisions to break up scar tissue. I'm finding it really hard to do that. I can't rub it that hard or that long. Anyone have any tips for breaking up the scar tissue?
Walking in the boot isn't as painful as I expected. My ankle joint doesn't really hurt at all. The pain comes from stretching it and the nerve pain on top of my foot. It's very nice standing on 2 feet again! I won't take that for granted again.
 

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Hi Cassie,
Well done with your progress. I'm not sure why your hip should be hurting, only that wearing the boot will (even with levelers) will throw your gait out somewhat, which may well put extra pressure on your knee.....probably time will sort that one. With nerve pain I have been pretty lucky, I am almost 11 months in and I still have what I can only describe as a feeling as though my foot was partially wrapped in some sort of material. I have partial numbness from my big toe through to the middle of the side of my foot, and perhaps most irritating is the constant feeling on the sole of my foot that i am wearing a crumpled sock, you know when you haven't straightened it properly !!BUT no pain, so I am not grumbling at all. My scar however is pretty ugly, despite oils and massage it never seemed to subside and makes wearing boots almost impossible, but hey my boot scooting days were probably over before they started :)
Good luck and hang in there.
Nick
 
Anyone have any tips for breaking up the scar tissue?
I really would not worry about scar tissue. It's the soft tissues around your incision that are aggravated. Let them heal.
 
My dr told me to rub the incision to break up the scar tissue so the skin can move around a bit and not be stuck down. I just can't rub it hard enough to do that so was wondering if anyone had any tips. Now I'm wondering if that's not something others have done without issue.
 

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