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JoeGuinn

Ankle Fusion for Drop Foot.

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Next week I go in for my first foot, right, ankle fusion. I was told they will release my A. Tendon at my foot and raise my foot then fuse my ankle in position. Two weeks later I go in for my left foot. The Dr does it in two as it is 6 hrs. per foot. Has anyone else had this done? How's the pain/recovery? How long before you could bear weight for transfers? I have some anxiety going in.

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Hi  Joe, This sounds like a pretty drastic procedure that will leave you with both feet at a fixed angle, and unable ever to walk again. I assume you are no longer walking at all and will be permanently in a wheelchair after this.  I personally would not agree to this (especially given by your profile you are only 40 years old) but I don't know your full history, prognosis, life situation, etc.  If you are anxious I'd be asking the doctors for more information before making such a commitment. Life altering surgery is not something to go into if you are feeling at all unsure about it.

 

I did have muscle release surgery last year to give me a better range of movement and after it I was in a walking cast for 6 weeks.  It was very painful for the first 3 weeks in the cast extremely painful for a few days after they took the cast off and over 3 months after the cast was off before the calf had healed to the point where I could walk without a pulling sensation in the calf. This was also what my surgeon told me to expect.

 

Whatever you decide to do listen to your surgeon and if they are not making you feel comfortable about what you are doing and how you will manage after then it's time to get a second opinion.

 

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Joe, I've never even heard of that. It sounds kind of drastic to me. But, also, if a doc told me I needed 12 hrs. of surgery, I'd flip rt out. So, my reaction needs to be considered along with that. Seriously, why both feet? Do you have drop-foot in both? Have you tried any other methods of correction? An AFO? A Bioness leg brace? Exercises for foot and ankle? Again, I could be wrong, but that does sound drastic to me. Have you gotten a second opinion? Maybe you should, just to be on the safe side. There has been several on here who have had to cope with drop-foot, but I don't recall any who have had their foot and ankle fused. Good luck with whatever you do. 

 

  Joe, I wrote the above response late last night, and thought that I had posted it, but, it was still waiting to be posted this AM, so,I didn't post it as I thought I had. Meanwhile, Heather responded. I didn't read her response before I wrote mine, yet, we used the same word, "drastic", to describe your surgery. To me, it sounds alot like a "knee-jerk" response. By that, I mean that it sounds like you went in to see the doc, told him you had drop-foot, and he responded with the fusion answer without suggesting any other options for you to try. I just had a custom brace made because my affected foot wants to roll over. I had 3 AFOs before this which either didn't work, and/or restricted my ankle movement so much that it was painful to wear them after having them on awhile. So far, this one doesn't hurt, and it keeps my foot from rolling over. So, I know that sometimes, there are non-surgical options. I'm wondering if any have been discussed with you, or you've tried any?  If  it were me, I'd want a second opinion before I consented to something so drastic. Becky

 

 

 

 

 

 

 

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I have tried AFO Braces to no avail. I have researched the surgery online and on YouTube. There are many joints in your feet other than the ankle that help the foot move. Range of motion is still pretty decent from what I have seen. It actually pretty common procedure. Mainly for arthritis. Foot drop also. My feet are really bad from having been in bed for so long. I can't walk right now because my drop is so bad. I do have a therapist that recommended the procedure to me. In the beginning, when I had my stroke, I nearly died and my feet were the least of my drs worries. Now I'm not so medically frail, we are finally getting to it. I had a major brain stem stroke in my Pons area. I was wondering if anyone has dealt with the pain associated with the surgery, recovering. It looks like it's a painful deal. Thank you for your response, it is no doubt "drastic."

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Joe, Please forgive me if I sound overly persistent, but I am not comfortable with a few things. 1- I still do not understand why you have to have surgery on both feet. Are both affected? 2- Do you  have your doc's assurance that this surgery will not keep you from learning to walk? By that I mean: Will having your ankle totally immobilized prohibit you from ever walking again?

Let me tell you why I'm concerned. I,too, had a major stroke in the pons, 10 years ago. And, I'm just now learning to walk. Actually, I've been  working on it for the last 3 yrs. I, too, have had 3 prior  AFO's which didn't work, but I think that the full-leg brace will help a lot, but it's taken me 10 yrs to find it. You're only 40, and 3 yrs out. You have a lot of good  recovery yet to come. I'm not a dr, and every stroke, and every survivor is different. If you want to see what I mean by "other options, you might check out the Bioness website. I think that it was originally designed to help with drop-foot issues, and you might be able to pick up some useful info there. Good luck, Becky

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Hi Joe, I had bad foot drop in the beginning too.  But as well as foot drop I had severe foot eversion. This meant I was unable to cope with the pain of an AFO (we tried 3 or 4 different styles). Anything that held my ankle in a fixed position would set off my foot eversion and cause cramps.  I ended up using a Bioness  which was able to lift the foot and as it was active not static did not create the tone reaction. What I'm saying is have you looked at what/why the AFO or brace does not work for you?  I'm also concerned that the surgery can't be undone once done it's not like an AFO that you can adjust or take off.

 

My eversion and calf tone eventually lead to shortened muscles (even with the bioness stretching the muscles in active range daily) that I had corrected surgically and now I walk without any AFO/brace or other aid.

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Becky, no worries. I too was like that when my Dr recommended the surgery. I think I might be on the extreme side of foot drop. Both feet are affected. I have tried and have outer leg braces. No go. I have spent months in therapy learning to walk. We have now determined that I'll never walk without this procedure. It does not hender walking at all. Please look up ankle fusion range of motion on YouTube. It will give you a better understanding. It did me. My feet are literally almost as straight as they can be and stuck. I think I have tried pretty much everything which brings me here. If they can get my feet straight I will have a much better chance of learning to walk again. Right now I'm on the balls of my feet with weak hip flexors causeing me to fall forward. So right now I have no chance to walk again. I have been reassured by my therapist and foot doctor that I'll have a much better chance of walking after the surgery. I am having anxiety about the recovery and the pain associated with the surgery though.

My Achilles has shortened to the point my feet are locked. AFO Boots do not work because my feet are stuck down and they are very painfull to wear. You can imagine. 

He says this is much better than lengthening on my Achilles because the feet can not roll over.

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Hi Joe, That last reply reassures me a lot . thanks. you've got classic spasctic "tippytoe" walk, but without the strength to control it.  I don't have to imagine that pain I lived through a version of it, with my left foot eversion.

 

My surgeon will also not do Archilles lengthening as he feels it's too hard to get exactly the right length, and if they are too long that's worse than being too short, he prefers to work on the calf muscles as he finds that gives a better controlled outcome.  The recovery time is quite long but I was surprised at how quickly I was up and about again although it's only now 12 months after surgery that I'm getting any strength in the muscles he operated on.  I was on Vallium for 2 weeks post surgery, both for pain and to relax the muscles and promote healing. They put me on a morphine pump for post op pain while I was in the hospital but I found I didn't need it and they removed it after 48 hours.  The main annoyance is the cast.  Although because it's designed to be walked on its in the way more than painful.  Hardest part for me was first getting up with the walker when the ward physio was not neuro trained and tried to make me use my useless left hand/arm to stabilise and take some weight off the leg.  She would not understand that I would be more stable and safer with my crutch than the walker.

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Hi, Joe. Thanks for your clarification. I feel much better now, too!

 

One of the things about having a stroke in the pons is that you can have bilateral ( on both sides of your body) damage. Sounds like both of your feet took a hit. Both of my eyes and both ears were affected, even though it's mostly my left side that was affected. I've been wheelchair-bound since my stroke 10 yrs ago, have been working intensively on walking for the last 3 yrs., so I completely understand your wanting to walk. I'm not sure I'd be brave enough to undergo surgery for 12 hrs total in order to do so though, even with my determination.

 

Thank-you for not getting upset with all of my questions. I was concerned that the surgery would crush your ability to ever walk again, instead of helping it. Good luck,and Godspeed, Becky 

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Hi ladies. Just a quick update. The surgery is done on my right foot. By looking at it I would say it's a huge improvement. Especially having my left foot to compare. It's a true 90 degrees of my leg and I can wiggle it a bit. It's in a half cast splint so near as I can tell anyway. There is no chance of ankle roll as the two are now fused together. I'm really excited to have them both done and healed.

i will say this, the pain, oh the pain. Let me tell you. I'm a 40 year old male. The pain has brought me to tears on several occasions. It's one of those things where the long term benefits outweigh the short term struggle. If anyone else is going to get this done. It's an amazing transformation, but it hurts bad, real bad. 

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Hi Joe, Thanks for letting us know.  Fingers crossed the pain settles down quickly. I've never had a broken bone so I can only guess what it's like. But as you say sometimes you take a step back so you can move forward. Hang in there and do your physio as prescribed.

 

:cheers:

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At least it's done, and you don't have to worry about it anymore. Hope it does everything that you want it to, and more. And, let's hope and pray that the pain disappears quickly. Thanks for the update, and please update as you can.   Becky

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