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So the leg cast is off


heathber

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Hi folks,

Surgery was done on May 5th, and they took the lower leg cast off this morning, How I'll get through this again but longer if they do the tendon transfer I don't know. 4 weeks nearly sent me demented.

 

The surgery was planned to be calf lengethen, rec-fem lengthen and tib ant split tendon transfer. But once they started they found that the calf was too tight and while they lengthened as much as they could in the calf, if they do the tendon tranafer on a too tight calf it either won't heal (would tear off under pressure) or it will stretch and be useless in 6 months time. So they did the rec-fem (quad) and the calf and I lived in the lower leg cast for 4 weeks so that the calf had to heal in the extended position.

 

So the rec fem healed very quickly and nicely, and I once again have full range knee flexion. Still have to keep at my stretches to make sure it stays at this length as the tendon regrows. The really nice thing about this bit is that its taken the pressure off my hamstring and pelvis, so I can use my hamstrings much more easily as they've been fighting the too short fec rem so have always been partially on, and as my pelvis now sits were it should be and my hamstring isn't fighting my knee seems to have stopped hyper extending as well ( I hope I'm not imagining that we'll see for sure as I start to use the lower leg again.

 

Now with the cast off I'm back on the crutch as the calf is very weak. we have got at least 5 degrees dorsi flexion now too, needed pressure to get to 0 before surgery. But at the moment when I put any load on it at more than 0 it really hurts, that calf muscle has a lot more healing to do before I can start to load it up properly. I can now lift my toes easily when seated, although I'm now going to have to work on controlling direction of foot placement.

 

The surgeon is still talking about an AFO as when I was first started to move around his office I was walking very flat footed although not quite at foot drop level. Since then I'm being very careful when walking with the crutch to make sure I lift the toes and get the heel strike to happen. It tires very quickly though so I'm only get about 10 steps with heel strike before the toes don't want to lift, and I have to stop and reset. But I am getting heel strike so hopefully It's just a matter of training and I'll be able to stay without an AFO.

 

I see him again in 3 weeks for next assesment, and it'll be a 6 month wait with lots of training to see if I can loosen the calf enough for him to try the split tendon transfer, although right now the thought of 7-8 weeks in a cast is much harder now I know what this has been like.

 

So all up I think it was worth it, although now thw hard work starts again to get the most from it.

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Don't you love it when they fix something and you go back to start PT over with all the pain and hard work. But then one day you say, hey, this isn't so bad. Remember that we're all there in spirit cheering you on.

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I had an operation on my right knee where they put the tendons back with muscles and man I was down for a couple months sitting in a recliner day and night with that leg raised, ice packs and finally a support brace.... 

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How times have changed Fred, These days they want you up and about as soon as you can tolerate the pain, even after knee and hip replacement surgery they get you walking within the first few days,even if it is with a frame.  I have been told not to overdo it but I've also been told keep walking.

Scott I can handle going back to PT, especially when I can see the improvements.  No formal PT done yet but I've already been able to abandon the crutch and I walked to the end of the block and back at lunch as I had to get some cash from the machine for the weekend.  It took a long time and I'm a bit stuffed now, but I was able to maintain heel strike most of the way and when I lost it a 30 second standing rest was enough to get it back.

 

I'm still not stepping past the left foot with the right when I walk, but I think the stride is slowly lengthening, there's so little strength in the calf at the moment I've got no push off power, and I'm going to have to go back to the old "sit to stand" daily practice I think.

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Found this site after I got the email.  Sorry. Still not used to the maneuvering the forum. So glad all is well.  That swelling takes of long to go down.  Just the anesthetics affect our system.  Can you put it above your heart when sleeping.  I did that per their suggestion but it still did not go down.  When I did not it did not improve at all.  Hope the side effects decrease rapidly for you.  What a trooper you are!!

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yep definitely getting the fat foot/ankle problem it's not too bad when I get up in the morning, and the shoe is certainly limiting it to some degree but it's pretty bad by the time I go to bed.  Lymphatic drainage on that side hasn't been very good since the stroke so surgery is just putting more strain on a system that's already compromised.

 

Cursing myself at the moment.  Saturday evening I had a brain fart and tried to walk down some steps "normally", completely forgot that I can't step past yet, let alone step past and down  I felt the muscle strain (I suspect it tore a little) and I certainly set myself back at least 2 days worth of healing.  was walking very flat footed for about an hour but I did manage to get the toe lift back before bed that night.

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You are braver than you believe, stronger than you seem,and you are a survivor! This will take endurance but it will pass as well. Hopefully a new you will emerge in time and you will feel proud. In the meantime to pass the time spent waiting for pain to pass, may I suggest colored pencils and this coloring book that has been translated in 56 languages...Secret Garden by Johanna Basford. Creativity is a healing force.

 

Rootin Tootin for You!!

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Sorry for you set back.  It is so easy to do when recovering and have the optimistic spirit you have.

 

BTW.  Do you have one of those bouncy balls you sit on to exercise?  If you do, found that I use that when ankle swells drastically. Just put it on the bed with foot on top or in a lounging chair.  I used to use pillows per their suggestion, especially when recovering from the broken tibia a  fibula.  They were such a nuisance and did not discover the ball trick until recently.

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