Banner - Hide this banner





Author Topic: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12  (Read 24552 times)

0 Members and 1 Guest are viewing this topic.

Offline natenix

  • MINIgeek (20-50 posts)
  • **
  • Posts: 39
  • Liked: 0
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #30 on: June 21, 2012, 05:27:39 AM »
3 Weeks post op, first day walking in the pool.

A few milestones have been reached in the past couple of days.  1st of all I had my staples removed yesterday.  My primary care physician said that everything looked good and staples came out really easy.  The line on my upper leg is almost unnoticable.  I do have one place around my ankle that I took a photo of and am going to email to doc.  That was the only place my pcp was at all concerned with, she said it's not infected but that it doesn't look like healthy tissue and to keep an eye on it.  It's about as long as my pinky finger nail but pretty thin and is sometimes a grey looking sometimes a purple looking color, weird.  Today I got to get in the pool for the first time (though doc would have let me at post op day 10 my wife wanted me to wait till my staples were removed).  I put a waterproof bandage and steristrip over that one weird looking area I described above and hopped on in.  I just walked back and forth for about 25 minutes.  I fluctuated in depth from right at my chin to the tops of my shoulders and really felt little discomfort though i was apprehensive some.  I try to stay conscious of heel to toe walking though I get little push with my toe (i'm sort of scared to).  All in all it was a good experience, only thing that hurt was my heel a little where I am swollen (nothing bad though).  Knee pain was zero, very little pain in ankle.  Overall I was pleased and it was so good to get outside.  After getting out of the pool I sat in the sun for 10 minutes, this was glorious.  Sunshine on my shoulders makes me happy!  I was a little concerned tonight looking down at my ankle I realized I couldn't plantar flex as far as my unoperated ankle can, I thought I was doing well with this but seem to have perhaps lost some in the past 3 days (don't think it's related to pool walking but perhaps).  I want to ask Dr. about that tonight, I want to get it equal the other ankle but don't want to damage bone repair by forcing too hard.  Anyways looking forward to continued pool walking.  Hopefully by the time I'm able to walk no crutches, walking on my surgical leg will feel almost normal due to walking in the pool everyday.  Oh yeah and the 3rd milestone si this is my 20th post so I can actually respond to the private messages I've recieved now.

Nate

Offline natenix

  • MINIgeek (20-50 posts)
  • **
  • Posts: 39
  • Liked: 0
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #31 on: June 22, 2012, 05:02:52 AM »
22 days

Zilldancer, I am really glad I chose to go to Texas and have this done and very glad for the epidural.  Sorry to hear some days are worse than others, but hopefully the short term loss will be outweighed by the longterm gain.

Crankerchick, is the epidural for leg surgery a very common practice, I'd never heard of it except for labor deliveries but I haven't researched it at all.  Hope all is well with yah.

Doc emailed me about my questions and said the skin spot that looked funny to me looked fine to him, just to use hibiclens and antiseptic for a few more days.  He said not to worry right now about the lack of range of motion in ankle (again it's not way off).  I actually have a Physical therapist friend who is going to measure my ROM in that ankle tomorrow.  Pool walking went well again today.  Probably won't post for a little while unless some stuff changes in the next week as I see things being mostly the same till I'm cleared for more weightbearing.

Nate

Offline natenix

  • MINIgeek (20-50 posts)
  • **
  • Posts: 39
  • Liked: 0
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #32 on: June 22, 2012, 09:42:43 PM »
Post op day 23

Wasn't going to post today, but my wife has a friend who's a physical therapist and she measured a few things for us today which was interesting, at least for me.  First she was amazed at the Range of Motion with my knee, it's as good as my other knee (don't know the numbers).  For the ankle:

                      non operated leg             operated leg
Plantar flexion        56                              45
Dorsi flexion          22                              15
inversion               50                              22
eversion                25                              16

That PT wasn't worried about the numbers, and even showed me some stretches my wife could do to help the inversion and eversion.  I will ask doc and see if he's cool with it.  I also had the PT watch me walk with crutches.  She said the heel toe motion looks great but that I probably could put a little more weight on it, she said it almost looks as if I'm just hovering the operated leg.  Anyways, I'm out.  Hope yall enjoy your weekend.

Nate     

drmark

  • Guest
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #33 on: June 23, 2012, 03:29:44 AM »
You  can do any gentle stretching you want. Make sure you are not weight bearing
While u are stretching

Offline natenix

  • MINIgeek (20-50 posts)
  • **
  • Posts: 39
  • Liked: 0
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #34 on: July 13, 2012, 02:06:05 AM »
6 Weeks out.

Wednesday was 6 weeks for me.  Dr. saw my xrays on tuesday and said everything looks good and that I may begin "putting as much weight as (i'm) comfortable with".  That was a relief to know my bones are healing.  It was psychologically good and today was the best day I've had in the pool yet.  I have full range of motion in my knee still and little pain (like almost unbelievably little).  My ankle is probably close to the ROM that i posted above.  It's a functional ROM but I suppose I will need a little more in the lateral eventually walking on hills etc.  I never have real bad pain in ankle but I do have some, when I do have pain I wish I knew if it was bone, ligament or tendon.  I'd probally push through more if I could be sure it was the latter two it's probably best as it is though because it keeps me from overdoing things.  Currently on a scale standing I've gotten up to about 60 lbs on the operated leg and felt no pain I plan on increasing a little each day.  I'd love to be walking somewhere between weeks 8 and 10 we'll see if that's possible.

Nate

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #35 on: July 13, 2012, 01:54:27 PM »
Great post Nate. Thanks for the update.

Glad to hear both osteotomy sites are healed.

I'm not sure if this helps, but I *think* I could tell bone pain from muscle and soft tissue irritation because the bone pain was more of a deep, stabbing pain while the soft tissue irritation was more of a surface pain that I felt when I moved certain ways or did certain things. My biggest obstacle with walking at the stage of rehab you are at now was my femoral osteotomy site, as I would get that deep bone pain in my upper thigh and into my hip if I did too much. Walking just didn't bother the tibia site much at all and I had very little pain in that area save for a few isolated incidents.

My local PT had a rule that pain that didn't go away within 1-2 hours of was indicative of over doing it. I'm not sure if Doc's therapists would agree, but I do know that the one I worked with in Houston said something similar, in that I should most certainly feel fatigued after training, and some pain is ok, but pain that remains for hours and doesn't ease up with rest meant I was doing too much.

That said, weight on the bones is also good for healing. It's a balance that you just have to push yourself to find. The mind can be stubborn. I know for me, after not walking for 7 weeks, it was tough to get my mind to let me take steps without the crutches. I just reminded myself that Doc knows what he's doing and if he says it's ok to put weight down then that's what it is.

I guess the key is to push yourself but listen to your body also.

Are you planning seeing a trainer or physical therapist for this part of the rehab?
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

  • MINIgeek (20-50 posts)
  • **
  • Posts: 39
  • Liked: 0
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #36 on: July 18, 2012, 04:26:30 AM »
6 weeks 6 days

Hit a milestone today, I was able to put my full body weight on my operated leg.  I hit 110 lbs Sunday, 135 on Monday and Today hit 174.5 (well I actually weigh 180 but I think my two index fingers that are balancing me are keeping it from going all the way up, my left leg isn't even on the floor!).  Over this next week I want to work towards balancing comfortably on that leg, walking in shallower and shallower water with the hope that I could walk no crutches by 8 weeks post op (at least take some steps no crutches!).  I am upping the resistance on the bke and it feels great no issues there.  I am also sleeping good at night and enjoy being able to sleep on my sides finally.  I also enjoy just standing with both feet planted and my right foot pointed straight ahead.  I can tell a huge difference and from everything I've read at this stage it's good to keep putting weight on those bones  I do swell still but at the ankle sight and extends down into my foot but not as bad as it once was and the cryocuff takes care of it pretty quickly. 
Crankerchick that's some helpful stuff you posted.  I appreciate it and all the help you've been.  It seems that the pain I do have is gone within an hour so hopefully not doing any damage.  Dr. told me when I asked about a  therapist "you are doing fine as your own therapist right now."  I do plan on getting one eventually as there is a great one in my home town but I guess I'd like to be walking first (they cost me 50 bucks a pop!)  Crankerchick were you walking without crutches at this point?  Anyways thankful for the good results of late and I will keep posting with more milestones etc..

Offline Zilldancer

  • MINIgeek (20-50 posts)
  • **
  • Posts: 26
  • Liked: 2
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #37 on: July 18, 2012, 03:55:03 PM »
You're making me look bad.
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 natenix

  • MINIgeek (20-50 posts)
  • **
  • Posts: 39
  • Liked: 0
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #38 on: July 21, 2012, 06:07:19 AM »
7 weeks 2 days

Good day today.  Poolwalking with about half of my torso out of the water.  That's the shallowest water I've walked in yet.  It's got to keep getting shallower if I'm to walk by the 8 week mark.  I've been trying is balancing on the operated leg when in the water, still scared to try this when I'm out of the water.  Also when I'm poolwalking now I'm really intentionally trying to push off with the toes on my operated leg.  In the early stages in the pool I was walking but more going through the motion.  Not the case now.  I can tell I'm a little leary when I get in the shallower water to "not think about things and walk" but am getting better. 

I have backed off a little on the full body weight standing on one leg.  At about 130-140 lbs I start to feel presssure/pain in the knee.  A few days ago I would go to 140 lbs hold till pain stopped (about 5 secs) then increase 10 lbs up to about 175.  At after a few seconds I didn't feel any pain and stayed there.  I did notice when I finished my leg sort of making popping sounds but it wasn't painful.  Didn't know how to take it.  Since then I have noticed pain at knee on occasions when I get up to the 130 lbs or so, and for the last few days I sort of just stop when I begin to feel that.  I am going to try and get 155 or so tommorrow and back up to 170 or so by monday.  About the only other thing is my fibula where they broke it does get pretty sore sometimes.  All in all I aint complaining.  I do sure hope I can walk by next wednesday but if not oh well I will just keep on trucking.

Zilldancer, has doc seen your x-rays?  What's he told yah?  Where are you at in your own therapy?

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #39 on: July 23, 2012, 04:43:34 AM »
It sounds like you are doing great! Just keep with it.

At 8 weeks post op I was not walking without crutches. I was hobbling around so I stayed with one crutch to avoid developing a habit of limping. I stayed with one crutch for a while when going longer distances, and then a cane for longer distances too, just to keep from limping. I already limped for who knows how long before surgery and the local PT and even Doc both were rather adamant about not limping. Since I didn't even feel like I knew how to walk without limping, I obliged with the crutch then the cane. It's actually kind of sad because even now, I still have a limp sometimes even though I feel like I'm walking properly.

My quad muscles and the soft tissue in the area of the femoral osteotomy are really what did me in for walking. I just had pain putting weight on and taking weight off. It wasn't bone pain I dont think, just like an ache and a sharp pains too like muscle spasms. I only had what I consider was bone pain if I kept going and going beyond the initial pain.

Everyone goes at their own pace and the important thing is just to keep pushing yourself and get there in your own time. One thing I did pretty soon after getting the ok to weight bear was walking on the treadmill. My local PT wasn't in love with the idea and actually didn't have me doing it there, but I did it on my own in the gym everyday starting around 8 weeks I guess and that helped a lot I think. It helped with confidence, strength, and cadence.
« Last Edit: July 23, 2012, 04:46:04 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

  • MINIgeek (20-50 posts)
  • **
  • Posts: 39
  • Liked: 0
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #40 on: July 24, 2012, 02:44:04 AM »
7 Weeks 5 days

Well the day after that good report I had posted I had setback Saturday.  Not sure why other than I must have overdone it the day before but Saturday when I got in the pool even in the deep water I was feeling pain walking.  I walked about 10 minutes and then decided not to push it anymore.  My pain was at neither of the osteotomy sites but rather where they broke my fibula.  It hurt some that day when I got on the bike at higher resistance so I backed off.  I did very little on Sunday other than a 20 min bike ride in the morning.  I could feel a sharp pain around the fibula area even when I would do stuff like a side leg raise so I just backed off and rode the bike under light resistance.  Today it has felt a little better.  I have biked under heavier resistance and just stood a couple of times so about half my body weight is on the leg.  It's wierd because when I am not walking on crutches bearing as much body weight on my leg, my leg sort of goes off color.  I guess the blood is pooling a little bit.  It has been it's best colorwise when I am able to put the most weight on it crutch walking.  I guess I will slowly work my way to more and more weight bearing, sadly it doesn't look like I am going to be walking at 8 weeks.  Depending on how tomorrow and wednesday go I will reasses and set a new goal.  I am starting to wonder after this setback if I should get a PT, but really don't want to pay for one till I can walk and am at a place where I can do more exercises.

drmark

  • Guest
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #41 on: July 24, 2012, 01:35:28 PM »
Everyone takes two to three steps forward, and then one step back.  Thats' normal.

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #42 on: July 25, 2012, 07:50:06 PM »
Nate I had a few setbacks in my journey too. It was a tough hill to climb mentally as well as physically. Some days I would be so disappointed in myself at not being able to just put the crutches down and walk. I was worried that my progress wasn't good. This is the point where I found it easiest to get frustrated and depressed. Try not to get too down on yourself and just allow yourself to go at the pace your body wants to go. It's not a race to a finish line, it's just a finish line you want to cross.

It's hard to know what is too much until you do too much and find out so just use this time as your guide and keep pushing.

I got my ok to weight bear like 2 weeks before Christmas, and set a goal to walk by Christmas which was like the 8 or 9 week mark. I was pretty irritated when I didn't hit that goal. Just remember to congratulate yourself for the small victories too, and not just focus on the big goal. My small victory at Christmas was that I had overcome the mental hurdle by that point and could get myself to take steps. I was hobbling around just fine for short distances and pissing off everyone at Christmas because I would take my one crutch to walk while they were looking, and then leave it when they weren't. While I wasn't walking at that point, I was "walking" if that makes sense and I wasn't too disappointed or pissed off when I remembered to focus on the little things and not just the big thing.
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

  • MINIgeek (20-50 posts)
  • **
  • Posts: 39
  • Liked: 0
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #43 on: August 01, 2012, 03:04:32 AM »
9 weeks tomorrow

I feel like I'm going backwards.  It's not either of the osteotomy sites just my dadgum fibula.  I just got off the exercise bike and I had to stop peddling.  It wasn't killing me just irritating and I don't want to keep going backwards.  At this point it's just hard to not get frustrated.  I haven't been weight bearing other than 20-30 pounds when I'm walking places (I was doing that week 1 post op).  I haven't been pool walking in a week as that flares up the fibula.  It's just frustrating.  My mind starts snowballing down hill.  To me my fibula on xrays looks rough, there is a piece sort of splintering off to the side so when I feel pain at the break site  I worry about non-union/delayed union.  There are times when it feels like the bone is popping/shifting at that site (not that painful so maybe that's not the case but definite popping). Then I start thinking, "well how long might it be before I walk?"  I know weight bearing in some ways helps leg bones heal after 6 weeks but I just don't have confidence that I'm not doing damage to that fibula site.  May ask doc if he'd let me get 9 week xrays, I feel like I need something to reassure me about the fibula.  Crankerchick, that's good advice you have there, it really encouraged me the other day.  I am probably just venting after just getting off the bike with a frustrating experience, but it's good to have this stuff in the diary I suppose as I will look back on this stuff with the other leg.


Nate

Offline crankerchick

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1863
  • Liked: 26
  • How 'bout them Cowboys!
    • Derotation osteotomy & TTT Post-op diary
Re: Nate's Derotational Tibial Osteotomy (Proximal and Distal) 05-30-12
« Reply #44 on: August 02, 2012, 05:33:17 AM »
Nate, talk to Doc about the fibula pain. I'm pretty sure at this stage, pain is the biggest guide. If it is an irritation and the mental struggle of worrying if you are damaging the fibula that is the problem, then you just have to trust that Doc wouldn't have you doing something he didn't think your bones can support. But if the pain is bad, he should know. He can reassure or recommend the next step either way. Pain that is bad enough to make a tough guy like you not ride the bike is definitely pain that Doc should know about.

That said, you are still early in recovery. Don't get too ahead of yourself worrying about delayed union. Your X-rays showed sufficient signs of healing to get the ok to weigh bear, and there is still plenty of healing left to happen still, so definitely try to relax and just take it one day at a time, one step at a time.

At one point, I was like 6 months post op and fresh out of Texas after working out at the clinic with the best trainer ever and I had a huge setback in that my leg hurt so bad I couldn't even walk on it at all. Come to think of it, it was right around the tibiofibular (is that a word???) joint. I had had pain in that location a few times before but not since the early weeks before I was allowed to fully weight bear. I called Doc and Ed doing my version of freaking out, which is something I like to pride myself on not doing. They both told me to chill out and not train beyond riding the bike if i could do it with no pain. It lasted for over a week and then was gone as sudden as it came on.

My point is: it takes time. At 6 months post-op i was devastated to be sitting with my leg up and unable to walk without severe pain, and for some unknown reason at that. Even that far in the game, setbacks might occur. Just have to roll with them. As doc told me many times, "Rome wasn't built in a day."

It seems the recovery has lots of bumps along the way. It is important to just ride it out and don't let it bring you too far down. Fortunately you have an excellent surgeon that is also very easily accessible for you to consult and find out exactly what he thinks you should do.
« Last Edit: August 02, 2012, 05:37:37 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