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Bunion Surgery And Cp

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  • panther
    panther Community member Posts: 251 Courageous
    Well it has now been a week since my surgery and what can I say I'm shattered. I was saying to a friend the other day I wonder when the consultant said I could weight bear to transfer if he realised just how many times I would be transfering seeing as social services didn't put in any help. I said it's a bit like someone asking you how many times you go up and down the stairs. You think you don't do it often until you start counting.

    I've got district nurses coming in twice a week to change dressings but so far all they've done is moan that it's a wasted visit as they don't see why they are doing it every supposedly 3 days. They all keep telling me that usually dressings are left for 2 weeks until stitiches come out. Considering I was sent home in the dressings that were put on straight after surgery I'm glad they are being changed. Shouldn't infection control come into play somewhere here rather than district nurses telling me there is no point?
    The consultant has also requested that soft dressings are used after the stitches are removed to prevent the surgical shoes from rubbing even though I'm not walking yet. The district nurse today said what's he on about usually once the stiches are out that's us finished we don't put any extra dressings on. If he wanted that he should of specified what exactly he wanted. I think he just said the first thing that came into his head!!

    The gp has stopped some of my tablets as she was not happy to hear I'd been put on a 6 week course of aspirin. She said there's no need as long as you do your exercises. Sorry what exercises I was only given one to do that would keep my hamstrings loose I wasn't given any guidance on exercises to do to prevent dvt.

    Also the hospital were unable to advise me when I could go back on my contraceptive pill they looked at me blankly and said they had no idea even the pharmacist didn't know. Can't believe I'm the first woman to of asked that question or is it because I was in my wheelchair they didn't want to consider the possibility that I could have a sex life?

    I must say so far all of this is making me wonder just how much physio I will get when I go back. If last time what should of been 6 weeks ended up being 1 hour. As the physio told me the consultant may ask for 6 weeks but we will decide when we do our assessments what we feel you need.
    What happend to what the consultant asked for the consultant got? And also nurses/district nurses actually doing their job even if it is only changing dressings since when did just changing dressings become a waste of time? The district nurse said it was because my stitches aren't bleeding any more but they are there was blood on the padded dressing she removed under the bandages.

    Oh well will keep you posted of what delights happen next week.
  • Belle
    Belle Community member Posts: 5 Courageous

    Hello and welcome home

    perhaps its them that don't have a sex life.

    I have always had a big issue with hospital and comunity care staff who grumble to patients about their lot. its bad enough having to be in need of their attentiion without being made to feel guilty about being a waste of time or whatever - they choose to moan about.

    Anyway hope things improve and that Christmas is merry and 2008 is kinder to you.
    Cheers
    belle
  • panther
    panther Community member Posts: 251 Courageous
    Hi Belle

    Well I've got up this morning and I've got one bandage nearly falling off I haven't bothered to ring the nurses back to come and re do it I've asked my friend to call in and re do it for me at least then I know it will be done properly!!

    As you said let's hope 2008 is better and kinder to all of us have a happy christmas.

    Helen
  • Hymerkar
    Hymerkar Community member Posts: 63 Courageous
    Hi Helen,

    Glad to hear you are home, and the surgery is well behind you. Lets hope the recovery is speedy and its all a success.

    I am still suffering with the trapped nerve, my community physio has stopped coming while I am attending the hydro pool each week. The Physio in the hydro has told me it can take 8 to 9 months for this to be back to normal, and he then added 'if ever'!

    However, on the bright side, I am up and walking again, but only with the walker and not for very long, but at least I can get around the house now.

    Keep us all informed with your progress, have a great Christmas and Happy New Year when it arrives.

    Bye for now

    Karen
  • panther
    panther Community member Posts: 251 Courageous
    Hi Karen

    Hope you had a good Christmas and happy new year to you. There's not much to say about my recovery at the moment other than it's long, boring and frustrating.

    I've got probably another 4 or 6 weeks before I can try to walk again it depends what date I get for my first outpatient appointment. Some days I feel like I could walk and all those days I have to remind myself that I'm not allowed to yet. But then there are other days when it will feel really painful when I put any weight through my feet while I'm transferring etc.

    I'll get there in the end and I guess when I do my out patient appointment that will be when the hard work and physio starts etc.

    Take care talk to you again soon

    Helen
  • sammystar
    sammystar Community member Posts: 3 Listener
    [quote name='panther' date='Jan 2 2008, 09:14 PM' post='15208']
    Hi Karen

    Hope you had a good Christmas and happy new year to you. There's not much to say about my recovery at the moment other than it's long, boring and frustrating.

    I've got probably another 4 or 6 weeks before I can try to walk again it depends what date I get for my first outpatient appointment. Some days I feel like I could walk and all those days I have to remind myself that I'm not allowed to yet. But then there are other days when it will feel really painful when I put any weight through my feet while I'm transferring etc.

    I'll get there in the end and I guess when I do my out patient appointment that will be when the hard work and physio starts etc.

    Take care talk to you again soon

    Helen
    [/quote]
    Hi Helen.

    Happy new year to you. I hope it's a better one for you.

    I hope your recovery goes well.
  • stewarttate
    stewarttate Community member Posts: 3 Listener
    Helen

    I'll pray for you. I hope you are doing better and soon you will be back on your feet pain free.
    In early Nov 2007, I had surgery on my left foot attempting to relieve pain while walking.

    Two toes were broken and re-aligned.
    In the big toe, the doctor placed screws. In the toe next to the big toe, the #2 toe, I guess; the doctor placed a six inch pin that was later removed in early Dec 2007.

    After reading your blog, part of me wishes I'd found your words of experience a few months sooner
    and part of me is glad I didn't. I had everyone of your fears and no answers.

    I was told by the doctor that my recovery would take six weeks.
    I repeatedly questioned this statement and stressed my concerns given my CP.
    At first, I believe the doctor didn't believe the CP would cause a major recovery issue.
    Now, I'm sure he understands the impact and this hopefully will help the next person with CP and this problem.

    Nine weeks has now passed and I'm only able to walk a few steps with pain.
    At the moment, swelling in my left foot (after a few steps) is the biggest problem.
    I've read a few websites that state "the swelling can take six months to go away" -
    http://orthoinfo.aaos.org/topic.cfm?topic=A00140

    Did your swelling go away?
    If yes, how long did it take?

    As you pointed out, as the nerves grow back; the pain also returns.
    I would say the pain is less then before surgery (right now) but still more then I expected.

    I've been very careful to step slowly using a heal to toe motion. Not, toe first - toe in (my normal gait).
    Of course, I'm using a walker or holding onto something around the house.
    I've been mainly using a chair to get around, which I don't like.

    So far, I've received two main statements from my doctor -
    1) when the swelling goes down, the pain should reduce allowing you to walk more.
    2) when we re-aligned the two toes, this places the toes into a correct position that is new for your foot. Many nerve endings are now receiving walking presure that did not received presure in the past. This will causes pain when you first begin walking on your newly aligned toes. In most cases, the nerves claim down after walking a few weeks. Sometimes, the nerves do not adjust to the changes. When the nerves do not adjust, they can be removed.

    Has your doctor said anything to you about this?

    After reading this blog and others, it apppears that toe alignment problems is a common, serious issue for people with CP. As we age, the problem appears to reach a point where the misalignment must be corrected if walking is to continue without pain.

    What concerns me most, is the doctors in the USA & UK don't seem to have any case studies to guide them.
    This is very serious given how common this problem appears to be in person with CP.

    I know that I toe in when I walk. This is the gait that many people with CP live with.
    I'm not a doctor but it seems logical this gait over many years of walking would cause toe alignment issues.

    In people without CP, toe misalignment is caused by poor shoe selection not gait!
    As a male :-), I've never selected shoes that would cause this issue. It was caused by my gait!
    I've talked to my doctor about this and he agrees although no studies have been done in the USA (I've asked!).

    In his large practice, my doctor is booked solid with woman (over 90%) that love poorly fitting shoes.

    Given my slow recovery, my doctor has asked me to take it very slowly not wanting to much toe-in presure put on my newly aligned toes before they have a chance to heal totally.

    I fear my CP induced "toe-in" gait is a great way to cause problems with toe screws.
    Perhaps, a safer surgery method is needed for persons with CP?
    I've resently read about different misalignment procedures that can be used that avoid screws or pins such as Exostectomy or Resection Arthroplasty. While screws and pins maybe better for most people,
    someone with CP may do better using other methods. Where are the studies?

    My plan at the moment is to slowly increase walking using a walker in the house.
    I expect pain when walking given the statements from the doctor about nerves.
    Hopefully, the pain will decrease as I walk alttle more each day.
    Has your doctor said anything to you about this?

    Takecare,
    Stewart
  • panther
    panther Community member Posts: 251 Courageous
    Hi Stewart

    You raise a number of things in your email the question is where to start. Yes first time round when they just operated on my left foot yes the swelling went away but I'm not sure that I could tell you how long it took probably a couple of months. I think at the time swelling was the least of my concerns as I was to concerned about moving screws etc. I think if I remember rightly I was back in normal shoes in about 12 weeks certainly by my second outpatient appointment.

    At the moment the right foot is still slightly swollen and I can still see some bruising but it has only been just over 3 weeks 4 this Thursday.
    Going back the consultant has always been honest with me he told me that if I didn't have the bunion surgery done I'd end up in a wheelchair full time because I couldn't put shoes on. That seemed a silly reason to me to become a full time wheelchair user. But the consultant was also very clear on the fact that he didn't know what complications the cp may cause and believe me I threw every possible thing at him!

    Medically so far as I know all 3 lots of surgery have gone as they wanted them to go. Always the unknown in the equation has been how the cp would react to the surgery that was done. I guess they just don't know what to expect with someone with cp when they do surgery. My expierence so far have taught me that they don't seem to be able to cope with an adult with cp that is still walking. As they seem to expect by the time you reach your early 20s you should be in a wheelchair full time.
    I think the other problem is very few physio actually work with adults with cp many of them have said to me we work with you up to 16 or 18 then you are on your own. Because they don't work with us during adulthood they really are stumped as to what to do with us.

    So far I've had to fight to get physio input after each one of my surgeries and the level and understanding of physio received has been useless. I was given no physio first time round and 1 hour second time round who knows what I will get third time round!!

    Until adults with cp are actually recognised as having needs and not just pushed to the background I don't think medical professionals are really going to understand the issues. And the other probelm is that everyone with cp is different so we'd probably react in different ways.

    Will keep you posted on how things are going and what they say long term. You sound like you are doing well hang on in there.

    Helen
  • stewarttate
    stewarttate Community member Posts: 3 Listener
    Helen

    Thank you for the reply.
    I agree with your comments, I've had to insist to get the GP to send me to PT.
    Like many of us, I've worked hard to keep walking.

    It hasn't been easy - my back, hips and knees now give me a fair amount of pain by the end of the day (that I just deal with). Of course, some days are better then others.

    Right now, I'm hoping the swelling goes down and I can walk more then a few steps without pain.

    I've been searching for studies on this topic.
    My doctor is a good guy. I know he would review anything I find.
    In the latest Lovell and Winter's Pediatric Orthopaedics, it talks about the best methods of correction based on the type of CP and amount of spasticity. Two paragraphs on the topic, amazing. I guess it's better then zero. As you pointed out, I found no information covering adults.

    I was also very concerned about pins and screws not holding up.
    The doctor and I talked about this prior to surgery. Sometimes, I have uncontrolled movement.
    He put me on Flexeril to help control muscle spasms right after surgery to four weeks.
    This REALLY helped but makes you very tired.

    Takecare,
    Stewart

  • panther
    panther Community member Posts: 251 Courageous
    Hi Everyone

    Well I'm 4 weeks into my recovery now and all I can say is I am exhausted I'm so tired there are days that I just don't know what to do with myself.

    Things are not going too good either I rang the gp yesterday as I was concerned that my right foot was still so swollen. I also mentioned if she was coming out could I have a repeat prescription of my contraceptive pill. Her response was have you gone back on it? I said you know I've gone back on it I spoke to you 3 weeks ago and asked your advice as the hospital had not been able to advise me when I asked them before I left hospital when I could go back on it.
    She said oh it's just that 2 weeks ago I got confirmation from the hospital and they have made it very clear that you are not to go back onto your contraceptive pill until you have been up and walking for at least 2 weeks, and as he doesn't want you walking until after your first outpatient appointment you will have to come back off it and wait. Interesting how nobody either the hospital or the gp thought to pass this information on to me 2 weeks ago. But then maybe that's because I'm only the patient and not that important?

    Anyway the gp came out today to look at my foot and she thinks I may have a skin infection she also wants to rule out a bone infection but wants the hospital to bring my outpatient appointment forward rather than have me go backwards and forwards between hospitals for x rays.

    Tried to ring the consultants secretary today as he normally does a clinic on Fridays so I thought she would be there, But she wasn't there and her voicemail box was full so was unable to leave a message. Will have to try on Monday.
    So now on top of all the painkillers I also have antibiotics to take as well.

    Helen

  • Belle
    Belle Community member Posts: 5 Courageous
    Hi Helen
    Glad to hear that the threat of infection is passed - that sounded potentially quite a problem,also that you are slowly getting mobile again.

    nothing to report from here except yet another fitting for new boots and another few physio sessions booked.
    i must say they're taking endless trouble over the boots and they almost look fashionable!

    All the best

    belle
  • panther
    panther Community member Posts: 251 Courageous
    Hi Belle

    Glad things going ok for you. Have just heard this afternoon that I've got a physio appointment on the 4th Feb this is about an hour assessment so they can then decide if they want to five me any further sessions to help me get more mobile after my surgery.
    Am not expecting much though as am managing better than I thought I would be. I can carry a cup of tea across the room so don't expect they will think I need much input.

    Take care

    Helen
  • sammystar
    sammystar Community member Posts: 3 Listener

    Hi Helen,

    Hope you are ok.

    Just wanted to wish you well. Hang on in there!


    Sam
  • panther
    panther Community member Posts: 251 Courageous
    Hi Sam

    Thanks for that it's nice to know people are thinking of me and care. I'm doing ok went to hospital on Friday luckily no infection it's all starting to heal as they want it I'm not fully healed yet but they have said I can start to do some gentle walking.

    So am slowly getting back on my feet am doing better than I thought I would be after 5 weeks of no walking. So don't think when they finally sort out physio the physio will do very much. The only problems are that my right foot is still very swollen but the consultant said that's to be expected with the amount of surgery they did on that foot and also my achillies tendons have gone really tight due to not walking for so long. The gp wants me to try baclofen again I had it before about 7 or 8 years ago and couldn't get on with it as it relaxed my muscles too much and I couldn't stand. But the gp is still saying try it again. I'm very reluctant to but I guess I'm going to have to as she has given me a prescription. She's suggesting I take it short term to see if it just gets me through this bit where everything is so tight.

    Hope all is well with you take care

    Helen
  • Hymerkar
    Hymerkar Community member Posts: 63 Courageous


    Hi Helen, Glad to hear things are going in the right direction at last. Not much to report from me, other than that I seem to be improving, at a very slow rate! Its frustration and is made worse by the physios thinking that I am doing well. The seem to think I should have given up by now and im expecting too much. My tendons are also very tight through lack of use and i have been given stretching excersises which is painful, I cant do it on my own, so I have to rely on my partner being around 3 times aday. I am on Baclofen. I was a bit concerned when my GP gave it to me, but between us I agreed to take one 10mg in morn and another at tea time and increase it slowly. The recomended dose was 60mg a day but the gp and physio didnt want me to go that far in case I went too weak. The 10mg am and pm has definately helped and so i havent increased it. I have been on it for about 8 weeks now and its helping. So give it a go in small doses???

    All the very best Karen
  • panther
    panther Community member Posts: 251 Courageous
    Hi Karen

    I've tried the baclofen but couldn't get on with it the gp has stopped it today. I lasted 4 days today would of been the 5th.
    I was taking 5mg three times a day so 15mg but it was making really fuzzy headed, tired, causing more pain in other places other than my achillies tendons and I also felt like I was living in my own little world and found it really hard to concentrate.

    I cried so much over the weekend because I was in so much pain and so down with it all.
    Glad baclofen seems to be working for you though. I've decided to try a herbal supplement now and see if that works. If not I will go back to the tried and tested grit my teeth and grin and bear it method!!

    Take care

    Helen
  • Hymerkar
    Hymerkar Community member Posts: 63 Courageous


    Hi Helen,

    You poor thing, I can really sympathise. I know how hard its been for me with this tapped nerve, you just dont know what to do with yourself and cant see an end to it all. I can honestly say that I have NEVER had pain like I have had with this. I too was in tears. I couldnt even get myself to the toilet, it was awful.

    Sorry the Baclofen havent worked out for you. They make me light headed for about an hour and i am tired all the time, but at least they have stoped the spasms which was making it all worse.

    How are you feeling today? Have you got some strong pain killers? I am also on CoCodamol 30/500mg which I can have up to 8 in a day but I have managed to reduce that to one in morning one before bed and usually one at about 5am. Night time is worse for me at the moment because I just cant get comfy in bed, my hip is very painful. It just seems like when I get on top of one problem that causes another. I am really fed up of it all.

    Its good to know there is someone out there who understands what I am going through. Hope its helping you too.

    Well, I hope that you are feeling better. Keep in touch, and take care.

    Karen
  • panther
    panther Community member Posts: 251 Courageous
    Hi Karen

    I am feeling better today having stopped the baclofen I'm now trying a herbal supplement called Tang Kuei and Chamomile. I got it from a friend of mine who sells the herbalife products. Although it's early days it does seem to be helping.

    I start to get spasms going up the lower front of my leg the baclofen started these spasms off but taking these supplements does at the moment appear to stop them. And the achillies tendons don't seem as tight. They are definately not painfully tight which is what they were and why the gp put me on to the baclofen in the first place.

    Will keep you posted on how things go. I'm always here to chat just glad my rambalings are helping someone else and it's good to talk and know you're not going through all this on your own.

    Hang on in there take care

    Helen
  • panther
    panther Community member Posts: 251 Courageous
    Well what can I say about today's physio appointment apart from I'm more confused than ever and in more pain.

    It started and I really got the impression that she was just going to say oh but you're walking so we'll leave you to get on with it. Then my friend mentioned that since I've started walking again I'm throwing my left leg out to the side, and I made clear that during the 5 weeks of not walking I didn't walk at all she said oh I'd better have a look at you then.

    She has then proceeded to give me exercises that I can't do easily she has said I've got to start moving my feet to the sides both inwards and outwards can't really remember why now. My feet don't/can't do that on their own they need help. When I use my hand to do it she complained that my hand was doing more of the work than my foot.

    She's also shown me an exercise to do on a gym ball, I don't own a gym ball and haven't got the space for one but she's still suggesting I buy one. She's suggested I go swimming and walk in the water. At the moment I'd need help walking on the wet poolside etc I have no one that can go with me so can't do that either even though she wants me to report back to her in a fortnight how I got on.

    I was also told if my foot is swollen I should rest it as much as possible and put ice on it and elevate it otherwise if I continue to walk on it with all the metal in my foot I could cause infection. She said but you know that when I said no I didn't no one has told me that her reply was oh they should of done.
    Why am I confused because half the exercises I can't do and she said let your foot be the guide if it's swollen and warm don't walk very much but don't stop walking!! But it's warm and swollen all the time at the moment!!
    I go back in 2 weeks time so will see what happens then.

    Take care

    Helen


  • panther
    panther Community member Posts: 251 Courageous
    Hi Karen

    Thanks for the support. The physio was rather baffled I think as she was trying to get me to do some stretches to stretch my achillies tendons but on one leg I could feel they were doing something and on the other I couldn't feel a thing no matter what she did.

    She has now suggested that I try acupuncture as apparently that is really good for relaxing tight muscles. I am a bit aprehensive as I don't like needles but a friend has promised I can hold their hand through the whole thing. So I am booked in for a session next Friday after my outpatient appointment.
    The physio said if the acupuncture doesn't help there's nothing else she can offer other than talking to the consultant again to see if they would do tendon lengthing surgery or if there is something else he can suggest.
    I don't think he will agree to surgery as about 9 or 10 years ago he said no to that type of surgery because I'm an adult. I have been taking a herbal supplement called Tang Kuei and Chamomile which I've found has really helped a lot of time I have either no pain from my achillies tendons or I can just feel that they are not as tight as usual.

    Hope you are well take care

    Helen

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