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Author Topic: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12  (Read 24551 times)

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drmark

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #15 on: June 10, 2012, 03:27:25 PM »
Since they are non narcotic, and pretty much without serious negative effects, you can take them as long as you feel you need to.  Two more weeks is reasonable.  After that it may be unnecessary. 

Offline natenix

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #16 on: June 10, 2012, 09:54:14 PM »
Post op day 11

Just a few things.  Dr got back to me and said I can begin walking in a chlorinated pool, I'm anxious to do this though my wife is wanting me to hold off till the staples are removed (I can understand why, we haven't gotten to enjoy activities outside together in like 4 years and she doesn't want anything bad to happen).  I don't know if I can find someone around here that I know that has a chlorinated pool anyways, everyone seems to be going to saline pools.  I need to ask if it'd be bad to swim in one of those.  Dr. gave me permission to up biking time to an hour and a half and I am going to start doing that at 45 minute intervals.  I did have an incident where going to sit down on the toilet and my good foot seemed to slip (i'm not sure what happened exactly) I probably fell 3-5 inches but my femor thankfully and not my tibia struck the toilet and lower leg never hit anything.  It scared me to death and was a good reminder of how easily I could ruin all the forward progress by a fall.  Thankfully no pain in any part of my leg just a scare.  I was trying to post some pics but it keeps telling me my file sizes are too large, oh well.
Nate

Offline crankerchick

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #17 on: June 10, 2012, 11:58:24 PM »
Hey Nate, sorry to hear about the "fall" but glad to hear you are none the worse for wear. I think everyone has a few of those "oh crap" moments that scare us far more than they are actually in danger of undoing the good doc's handiwork, but best to be cautious nonetheless. Like Doc said, when you come off the dope is really on you. If you need pills you need pills and there's really no particular time that you should have to stop based on others. Each person is different. I took the pills regularly in the hospital, then started weaning off with 1 Vicodin and 1 Tylenol at the hotel for 2 more days and then straight Tylenol after that. I didn't take regularly take anything after 7 days post op when I got to ATL as I pretty much felt like Tylenol wasn't really doing anything for me anyway. I took 1 or 2 vicodin here or there after that as needed, like before a long car ride, home, before my first PT session in ATL, etc as a precaution or if I was feeling really bad and nothing else was helping.

Enjoy your bike time. I tended to ride more than the prescribed hour too, just because it really helped things hurt less by keeping them moving. If I found myself feeling more pain than usual while sitting around, instead of going for pills, I went for exercises and/or the bike and surprisingly that did the trick more often than not. Moving really did feel good to me, even if did it hurt at the start.

It sounds like you are doing wonderful. That's awesome!
« Last Edit: June 11, 2012, 12:00:36 AM by crankerchick »
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline natenix

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #18 on: June 12, 2012, 03:55:53 AM »
Post op day 12 (getting bored)

Found out from doctor that it's fine to get in a saline pool.  Good news, now it's just pursuading my wife to let me do it.  She is wary and I can understand we haven't played sports together for a long time, and she doesn't want me to do too much too fast.  I really really want to get in that pool and walk though.  2 reasons, one is cause I want to see how my leg feels in some ways now that things are in different places.  I hear everyone say that when they start walking again after a derotational osteotomy it is really strange and they limp for a long time.  I figure if I've been pool walking for 3-4 weeks before I am cleared to be off crutches it may help that some.  The other thing is I'm starting to get bored, 12 days mostly laying down will start to get to yah.  I think the fact that I'm in this basement room that doesn't get lots of daylight through the windows may be some of it.  I'm going to have to get out a little even if it's just a quick crutch outside, walking in a pool for 30 minutes would sure be better though.  Anyways feeling ok today.  I do notice I've got a little more work to do to get full range of motion on this ankle.  I almost have full range dorsiflexed and plantar-flexed but when I go in circles I can tell I am a little short of my good ankle.  The ankle is still swollen up like a badly sprained ankle. It's somewhat uncomfortable .  I am starting to wean off these pain meds.  The standard protocol for Dr. Sanders patients must have changed as they prescribed me much more than crankerchick.  Tylenol, Tramadol, Neurontin/Gabrapenten, Meloxicam, Asprin for preventing blood clots.  Anyways I am cutting the Tylenol today, may cut something else out tomorrow.  Speaking of blood clot prevention today is the first time I've felt tired of these compressions stockings, they prevent bloodclots and haven't bothered me much till now, but I will be glad when they come off.  I am only suppost to wear them for 10-14 days, but seeing as to how my legs still looks pretty bruised (though improving) I figured I would go the full 14 days.  better safe than sorry and I don't want to fool with a blood clot..  Anyways that's all for now, don't want to be a complainer any frustration I've experienced I would gladly take for a leg that works.   

Nate

Offline crankerchick

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #19 on: June 12, 2012, 05:18:40 AM »
Yes things have changed since my surgery. You guys and your epidural with multimodal analgesia cocktails crap. Pfft! I got a poke in the back and some pills when I woke up. ;D

I got a nausea med which I didn't take, some ambien, which I should have took, and some pain pills. I did have lovenox injection since I had some more risk factors for blood clot, but i think he has moved away from that in favor of aspirin. I had the aspirin regime after my hardware removal instead of the lovenox.

The pool sounds like a great idea. I didn't even think of that for me, but is definitely something I will do if/when I do my other leg.

Definitely try to get out. Some days i sat on the porch or just took a ride with my father-in-law. Not leaving the house is a blower enough, so being in a basement room with no windows is even worse. I work in such an environment and it definitely makes for long days.

No worries, you arent complaining and even if you we're, that's allowed from time to time. Surgery sucks. :-)
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline natenix

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #20 on: June 14, 2012, 05:35:29 AM »
2 weeks post op   Also a question below for anyone, (I'm trying to put it in red font but it seems to be doing something funny when I try this)

First, Crankerchick I remember somewhere before that you wanted to be asleep for that needle going in your back, what I'm wondering is did they actually put you to sleep before that epidural or do you just not remember it.  Cause I was scared to death of that epidural too and I know they didn't put me to sleep but I for the life of me can't remember it.   Last thing I remember is being wheeled into the operating room people walking around in what looked like spacesuits or something.  It felt like they were about to perform some sort of Alien autopsy on me or something, crazy.  Anyways today is 2 weeks post op, sleeps been bad I think some of it may have been due to tramadol but maybe just discomfort at night, but that doesn't explain why I'm so wide awake and can't go back to sleep or maybe it does.  Anyways sort of feeling depressed when I woke up this morning.  I think it's due to lack of sleep, boredom and I had a sort of depressing private message the other night from an osteotomy patient who hadn't faired so well (they weren't trying to get me down).  I feel like keeping good moral is going to be part of good recovery.  I want to get in that pool but my wife ain't going for it at least till these two places on my leg that drain a little close up.  One is the scope hole from my ankle and the other is wierd little spot an 1/8 of an inch to the left of my knee incision.  Not sure what caused this spot (seemed like just really dry skin sort of flaked off and left it.  It's not infected but when I pull the gauze back sometimes it bleeds.  I think the compression stockings were pulling on it so much that it wasn't healing, as it's day 14 I'm losing those, so hope it heals up.  The pool would be positive.  I am also backing off the cryocuff some.  I am going to just try and use it after any exercise, I have been 24/7 with it for 2 weeks.  Here's what I want to know, does ice/cold therapy ever become counterproductive.  I mean you use it to decrease swelling by decreasing bloodflow correct?  But ultimately if you keep a place cold that no longer is swelling aren't you decreasing bloodflow thereby slowing healing?  (I welcome any opinions here).  For me my ankle is swollen still but not swelling more (i don't think) my knee isn't even swollen now.  Last thing, I am getting these wierd shooting feelings of pain in my heel they come on like a cramp or like a jolt of electricity and then may be gone almost immediately or last for 5-10 seconds like a cramp.  I got no idea what this is (nerves?), I hope I can sleep through it, first day I've really felt it, started feeling it more after I lost the hose and pulled back on cryocuff today.  Anyone know what it might be?   Alright, it's late going to bed. 

Nate

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #21 on: June 18, 2012, 05:12:36 AM »
Day 18

Incision sight and leg are starting to look pretty good now.  I'm going to call tommorrow morning about getting the staples out either Monday or Tuesday.  Bruising is almost completely gone, I've cut the medicine's in half and am continuing to cut back.  Still biking 45 min two times a day.  Feeling my ankle a little more on these last couple of days, not sure why.  In fact in general ankle's been bothering me a little more for the past 5 days or so.  It still swells up pretty good and is usually bothering me the worst by nightime, I'm not really on my feel much at all during the day.  It's sort of a throbbing in the general area where the bone was cut, though not sure if it's bone pain or ligaments that were moved during surgery.  I also still have those shooting feeling sometimes at night that run down into my heel.  Anyways hope to post again after staples are out and I've walked in the pool.

Nate

drmark

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #22 on: June 18, 2012, 02:27:49 PM »
When a large corrrection derotational osteotomy of the distal tibial and fibula is performed, the tendons on the lateral aspect of the distal leg and foot are lengthened against their will.   It wouldn't be reasonable to expect that they would take is lying down.  They will be kicking and screaming for some time.

Offline crankerchick

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #23 on: June 18, 2012, 04:32:10 PM »
Nate,

I don't remember the epidural. I think they gave me the twilight meds before? I remember being wheeled up to the OR doors and I was a bit emotional and scared (wuss, yeah I know) and the anesthesiologist was joking with me and then asked me if I wanted the drugs and I said sure. She put something in my IV, we went through the doors, I saw the big room, felt how cold it is in there, and saw a bunch of people walking around. That's the last thing I remember until I woke up to a nurse giving me ice chips and then Doc coming in sometime after that.

Doc told me I would be asleep for the needle, and that was all I needed to hear to give it the ok to have the spinal. I wasn't scared at the idea of chopping my leg up 8 ways from sunday, but the idea of being awake for a needle in my back made me very uncomfortable.

I hope you have been able to rest more since your June 14 post. You are right around the time where it seems depression starts to set in, so rest assured this is all rather normal, at least in my opinion. These are big surgeries and of course take a long time to feel better, and somewhere around the 7-14 mark, as you begin to turn the next corner, it seems like we all get a bit depressed and frustrated. I remember thinking I just wish I could either keep sleeping all the time like I did the first week, or just hurry up and better. I so remember being annoyed at not being able to find a comfortable way to just sit and have some relief--some way to exist that just "normal" or something. I was pretty irritable during this time.

It is important to keep good morale and the way I did that was to do things each day that I could do that did make me happy. Sometimes it was a splurge (I was and still am working on living a healthier lifestyle) and having my father-in-law take me to have ice cream or my favorite lunch, other times it was simple just saying to myself and everyone else that it was my day to be in a funk and to just leave me alone. Sometimes I would hit the PT extra hard (and pay for it later but oh well) in frustration but it was at least a mental release even if I did physically pay for it later.

I personally found the cryocuff uber-helpful and while I didn't use it 24/7 after I guess about 10-14 days, i still used it quite a bit, kind of like a safety blanket so to speak. I always used it at night and after exercise and anytime I was in bed or napping. When I was up and around the house, I usually didn't use it. I never found it counter-productive, but that is just me. I did have swelling still though.

I wonder if the shooting pains in your heel are anything like the "zingers" I was getting. They weren't in my heel of course, but what I would get were these like, "twitches" where my whole body would kind of twitch. It would happen really fast, but I could tell the twitches were coming from my leg at first, and then my whole body would jerk quickly, which would of course hurt my leg! It all happened very quickly, but it was definitely a pain that started in my leg that then caused a body-wide twitch. I got them a few times a day and sometimes even in my sleep. I have read other people describe these occurrences too, and some have said it's just nerves. As I healed, they stopped.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline natenix

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #24 on: June 19, 2012, 05:51:56 AM »
Day 19

Crankerchick, Man I had some of the same feelings about that needle.  I was like, well if I die in this surgery well I will go to heaven, if it's botched and I lose my leg, well maybe a prosthetic will feel better, but the though of that needle going in my back that was scary for some reason.  Anyways for those of you out there that will be doing surgery with Dr. Mark you don't have to worry bout that one.  Anyways not much news today except I basically have a normal looking leg except for a sort of fat ankle and about 2 feet worth of staples.  Bruising's gone color looks good, foot swelling is even down.  Excited about getting staples out tomorrow and walking in that pool on Wednesday. 

Nate

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #25 on: June 19, 2012, 06:00:09 PM »
Hi Nate, I actually had my osteotomy in Gainesville only a few days after you did and I definitely do remember the needle in spine. They had me sit up on the edge of the side of the table, lean over, and rest my head on a nurse's shoulder, while the anaesthesiologist was directly behind me with the needle. It felt fiery and it hurt, but I admit it didn't quite hurt as much as I feared (they did give me painkillers earlier that day). Then they had me lie down and I fell asleep not long after that.
Zills are a type of finger cymbal. They are one of the few aspects of dance I can do while sitting in a chair. I'm tired of them and look forward to being able to dance with my legs again.

drmark

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #26 on: June 19, 2012, 06:20:05 PM »
Life is full of trade offs.  Spinal anesthesia will lower the amout of post op pain, decrease the occurrence of venus thromboembolism, and also decrease the infection rate.  The epidural drip allows everyone to have nearly full motion of the knee from the get go. 

I would be the last person to discount the fear and discomfort of a needle in the back, but it is alot safer than a tube in the throat.

Offline natenix

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #27 on: June 20, 2012, 06:50:07 AM »
Zilldancer,

Well I am sure all those events happened the same way for me, but I can't for the life of me remember them.  I was telling the anesthesiologist (or his assistant) before hand that i wasn't crazy about that needle in the back before I went in there.  They kept saying we will give you plenty of "I don't care medicine".  I don't know if they gave me a little more because I had mentioned that or what.  Anyways for me it's not the pain of that needle I fear but a paranoia of something being that close to my spinal cord so glad I don't remember it.  I will certainly take all the benefits.  By the way Zilldancer, how you doing with your recovery?  I don't see many post surgery posts, you progressing well?

Nate

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #28 on: June 20, 2012, 08:21:26 PM »
The main reason I wanted sedation instead of general anaesthesia is that I very much wanted to breathe on my own instead of having a tube in my throat. So I'm not really complaining (much) about the spinal. Like I said, it was bad but not that bad. I'm glad I went to North Texas for the surgery.

Nate, I too was told that at some point before surgery will be a time where I will have no memory of what happened. I don't know for sure, but it's my guess that this "start to forget/not care" time happens at slightly different times for each of us and it happened to be a bit later for me. Either way I think we both were lucky to get good care at a good place.

I think I'm progressing well. With the exercises I think I do a bit better every few days, e.g. bending my knee a little farther, activating my quadriceps a little stronger. But the pain is very bad sometimes. True, I don't have a diary of my own as I wasn't sure I'd have much time to devote to it. But I don't want to hijack your thread and it's cool to find someone who had one of the same surgeries in the same place and nearly the same time I did. :) You were earlier so you're a bit ahead of me, so I'm quite curious about how you're doing too. Keep us updated!
« Last Edit: June 20, 2012, 08:25:14 PM by Zilldancer »
Zills are a type of finger cymbal. They are one of the few aspects of dance I can do while sitting in a chair. I'm tired of them and look forward to being able to dance with my legs again.

Offline crankerchick

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Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #29 on: June 20, 2012, 09:37:25 PM »
General anesthesia is the suck. I had it for my hardware removal (stupid mixup by the anesthesiologist) and let's just say waking up wasn't too pleasant, not even compared to the original surgery, which you think would hurt more.

For the original, Doc gave me the choice of either anesthesia after explaining the benefits of the spinal. After the hardware removal, I can say without a doubt, from my own experience, that he is right that the spinal is less pain. Nothing like waking up with a scratchy throat and a crap ton of pain to prove a point.

Watching Michelle ream out the anesthesiologist, however, was *almost* worth that initial pain.

Glad to see both of you recovering well. We all have the best doc out there to thank for that.
« Last Edit: June 20, 2012, 09:39:51 PM by crankerchick »
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor















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