Ankle surgery this week--what I am forgetting?

[KSO]

I managed to tear my achilles tendon in half and am having surgery on Friday (the 13th :eek:). I live alone and will be on crutches for at least 4 weeks. So, I'm trying to prepare for this by stocking up on things like toilet paper, kitty litter, and cat food. I do have family in the area and they'll be able to help me out with laundry and grocery shopping after the surgery so I won't be completely on my own but I will have to manage myself on a day-to-day basis.

What are some things I should be thinking about and preparing for now? For example, I think I will be much happier if I bring my lunch to work every day instead of having to deal with leaving my building on crutches, etc. Also, I doubt I'll be able to do much cooking so easy to prepare meal suggestions would be welcome also.

Any other thoughts, suggestions, horror stories?

[hotflungwok]

I had an ankle anthrodesis several years ago, and spent many months in a cast on crutches.

Your new favorite word is 'convenience'. If it's going to be anything like mine, standing up will cause more blood to flow down to the foot, which will hurt. You want to have food ready that can be prepared easily. If you don't like frozen dinners, then I suggest cooking up a big pot of stew or chili and pouring it into individual bowls & freezing them before you go in. You're going to need a way to get beverages around. Either individual bottles, or some kind of sealable cup.

Get a few extra small pillows, for placing under your foot when you're somewhere you can't put it up, like in the bathroom. You're doctor will tell you this, but elevation is good, so having a pillow on your bed you can put your foot on at night will help.

Make sure your normal paths of travel are clean. Practice walking on crutches through your house to get the hang of it.

Have things to keep you occupied ready. Books, video games, movies, whatever. Having something that completely occupies your attention is the best way to beat pain.

Having friends is good, I paid mine to get groceries for me each week.

[rocking chair]

get bags that can hang from the crutches. it takes a bit before you can carry things and crutch along at the same time.

small plastic bags can hang from the hand grips, with out getting in the way much.

[KnitWit]

Buy anything "embarrassing" you might need now. You know, before you have to say, "Sis, would you mind picking me up a box of laxatives and some condoms?"

[Etherman]

I went through exactly this situation a few years ago. How bad is yours? The ends of the tear in mine were separated by 10-12 cm, normal is 3-4 according to my doc.

The first few days you aren't going to want to move. You'll want packaged foods that don't need heated or refrigerated, and bottled drinks. Make one area you will stay to minimize walking, especially while drugged up. Put a table or something right there to keep everything, meds, food & drinks, books, etc. As said, have every pillow and blanket you have right there. I crashed on the couch for several days straight, day and night, moving around is a pain. Have something to put your foot on when sitting up, you'll need to keep it up, but lying on your back constantly sucks.

Sounds strange, but get a portable urinal from the drugstore. Getting up to pee will be a pain in the butt(heh). Also, bag-baths and baby wipes so you can wash yourself off easily without getting up to go to the bathroom, and a few rolls of paper towels, you never know where they will be handy.

The one that killed me? The batteries died in my remote. All I could do is lay there and watch tv and surf on my laptop, and suddenly I couldn't change the channel. Trivial, but annoying. Get batteries for everything.

Later on, yes, take your lunch to work. If you don't have one, get a backpack or some other hands-free way to carry things.

Get those re-usable cold packs. I had a wrap that had inserts you could freeze or microwave, so I could do the heat/cold thing during rehab.

Speaking of rehab, it won't be fun, but in the end its important to do everything they tell you.

[Chanteuse]

From what I'm reading about how you're not going to want to move around a lot and should get a lot of convenience foods, I would suggest that you also get disposable flatware to eat it with.

I think I'd also have a big trash can near wherever you're going to be laid up, with a fresh bag placed in it just before you leave for the hospital. Piled up junk around your recovery area would be pretty stressful, I'd think.

If part of your entertainment includes doing puzzles and such, don't forget to have plenty of pencils and erasers on hand, and a sharpener as well!

[kunilou]

Before you go into the hospital, be sure and mark which ankle you want them to cut, and which you don't. Seriously.

[KSO]

Great suggestions, everyone. Definitely some things I haven't thought of.

I'm not sure how bad the tear is but it when it happened (during a volleyball game), the ref and one of my teammates heard the pop, plus it only took my ortho about 2 minutes to diagnose it.

My surgery is Friday and I was planning on going to work on Monday. Is that too ambitious?

[Eva Luna]

My surgery is Friday and I was planning on going to work on Monday. Is that too ambitious?

Most likely, yes. (I've had Achilles surgery twice, and spent large chunks of a 3-year or so period on crutches. Long story.)

If you can, see if you can scrounge up a wheelchair or walker, maybe from a thrift store. My worst problem was feeling isolated - I couldn't drive my car (hard to drive a stick shift with one leg), and my doctor had told me to avoid public transportation, which would have been a nightmare anyway. So unless someone came to get me, I basically couldn't leave the house. I was completely stir-crazy. On New Year's one year, a friend got me a wheelchair at a thrift shop for like $5, but it meant I could go out for the evening, even in snow and ice, without being totally exhausted or worrying about slipping on crutches. People could take me for walks in the park. It made a HUGE difference.

Of course, if you're only going to need the crutches for 4 weeks, it might not be a big deal for you.

Oh, and if you hands sweat on the crutch grips, get some cotton bicycle handlebar tape.

[cormac262]

Been there, done that. Good lists/advice so far, but here are some things that come to mind:

- if you take showers, you can get these small, narrow chairs to sit on in the shower (they are narrow enough to fit in a bathtub). Extremely helpful. Taking a shower balancing on one foot is doable, but dangerous and gets old really fast. (You'll master the plastic bag over the cast routine easily enough, though). I was lucky enough to borrow one from an aunt. But even if you can't borrow one, I'd highly recommend getting one.

- if you will be able to drive, make sure your doctor gives you a note to get a disabled parking tag (in CA they are plastic cards you hang from your rearview mirror). A definite must. As I sidenote, I happened to need to get my license renewed at the DMV while I was on crutches. And at least here in CA, crutches are a "go to the front of the special line" pass. Not only did I avoid the normal line, but got to sit while I waited at the special "disabled" desk. In and out in less than 20 minutes ! So if you have any DMV stuff you need to take care of, do it while on crutches !

- it has been recommended to get small bags to carry (on your wrists). I tend to disagree. For one thing, the unbalanced weight will mess up your crutch work. Instead I opted for a (soft) shoulder bag that I could carry stuff in: papers/work stuff, books, pad, etc.. I usually had it hang in front as it would tend to rotate around if I tried to keep it on my back. An actual backpack could work as well, but then you have to let go of each crutch to get at it.

Crutches suck. There's no two ways about it. Your arms will tire until you build up your triceps/chest. And just when your arms are doing well, the tops will chafe the crap out of your sides until the skin toughens.
Doors, especially springloaded ones (to return them to closed), are a pain. Don't be too proud/independent not to ask or take assitance going through doors. After having been on crutches myself, I now go out of my way to help anyone I see going through doors on crutches.

That's all that comes to mind. Good luck.

[Queen Tonya]

Everything already said sounds good, do all of what they said. Especially the propping thing, you really want to keep that elevated as much as humanly possible.

Friends who offer to help are sincere, don't be embarrassed or feel like you're imposing, go ahead and tell them what kind of things you need.

Best of luck on a speedy recovery!

[Etherman]

Been there, done that. Good lists/advice so far, but here are some things that come to mind:

- if you take showers, you can get these small, narrow chairs to sit on in the shower (they are narrow enough to fit in a bathtub). Extremely helpful. Taking a shower balancing on one foot is doable, but dangerous and gets old really fast. (You'll master the plastic bag over the cast routine easily enough, though). I was lucky enough to borrow one from an aunt. But even if you can't borrow one, I'd highly recommend getting one.


This brings up a good point that I was going to mention after reading Eva Luna's post. My parents had a walker they brought me soon after my surgery. I ended up sort of wedging it into my shower as a handhold. It made things so infinitely easier when trying to shower with a cast on. I never thought of a shower stool, that would be even better.

And yes, crutches are hard work. I joke that the best weight loss program I have ever seen was humping my butt around on crutches in 100 degree heat. Instant sweat. I don't know where you are, but if it's going to be warmer than mid 70's there while you are on crutches, be prepared to sweat, with all the attendant issues that involves.

As for doors, I'm a big guy, so I just kinda turned around and went through them backwards, using my backside to hit the door opener bar, or if need be, opened the door, stuck a crutch in the opening, then pivoted and pushed through backwards. Not too hard once you get the hang of it, but 10x the effort it would normally be. You'll find that a lot, moving around is going to be hard, whether to the bathroom, or to get groceries, or whatever.

I was playing softball when mine let go. I'd passed second and let up on my way into third for an easy stand-up triple. Then pop, I hit the ground. I honestly thought the opposing shortstop had kicked my foot out from under me, as I had just passed him. It was that quick. Everyone on the field heard it. I ended up with road rash on my knees, palms and chest from hitting the ground.

I knew I had done it well since I did it on a friday, went to ER on sat morning(I'm a bit slow on things like that), saw the podiatrist on monday, was in surgery on thurs am, because that was his next scheduled surgery day. And yeah, took him all of 3 questions and a 30 second look to say "surgery," it's a pretty clear injury.

And monday is probably too soon. Narcotic pain meds leave me in a fog, and it was several days before I could even think straight, so I waited, but don't rush it, even if you aren't zoned out like I was. My doc authorized 4 weeks off.

[Lynn Bodoni]

Before you go into the hospital, be sure and mark which ankle you want them to cut, and which you don't. Seriously. The last few times I had surgery, the surgeon and at least one other person asked me who I was, what I was going to have done to me, and then they marked the knee or nipple or whatever I was having surgery on, or checked the mark. I got the impression that this is a relatively new part of the routine. But yeah, make sure the doc or SOMEBODY knows which ankle is the bad one.

[missred]

Being in the process of recuperation from surgery that has left me temporarily limited physically, my advice is to have something you can do from the couch (or bed) in additon to the tv and laptop.

Puzzle books, reading material (lay in a stack before you leave for the hospital), writing paper and tools, envelopes, stamps, some kind of craft work (if you have the bent), your iPod (or cd player and cds), audio books and your phone charger on the table beside you. In other words, make a nest.

I also second the idea of having plenty of batteries.

Hope your recovery goes well.

[outlierrn]

If you're new to crutches, figure you're about twice as wide as you used to be, it's easy to catch a crutch on a table leg or doorway until you get used to them, and falling will likely hurt. You might want to clear your hallways and such. Also best to go up and sown the stairs on your butt until you get the hang of crutches. As you get more used to them you may want to make some adjustments to there height.

[KSO]

Thanks for all the advice and comments. I'm most concerned about the crutches--I have to go up and down stairs to get into and out of my apartment building, plus through a maze of doors. Any other advice on using the crutches would be welcome.

Thanks again, everyone.

[Contrapuntal]

Before the surgery, be sure to write "THIS ONE" on one ankle and "NOT THIS ONE" on the other.

[gaffa]

If you can, see if you can scrounge up a wheelchair or walker, maybe from a thrift store. My worst problem was feeling isolated - I couldn't drive my car (hard to drive a stick shift with one leg), and my doctor had told me to avoid public transportation, which would have been a nightmare anyway. So unless someone came to get me, I basically couldn't leave the house. I was completely stir-crazy. On New Year's one year, a friend got me a wheelchair at a thrift shop for like $5, but it meant I could go out for the evening, even in snow and ice, without being totally exhausted or worrying about slipping on crutches. People could take me for walks in the park. It made a HUGE difference.
You're lucky that the thrift stores in your area will accept them. In Kansas City, Missouri, the thrift stores are apparently prevented from accepting any "medical" equipment, including a friend's late mother's walker and canes. Probably a law or city ordinance passed to benefit the medical supply industry.

[gotpasswords]

My surgery is Friday and I was planning on going to work on Monday. Is that too ambitious?
WAY too ambitious! Plan to be a lump on the couch for a week. After a week, you might feel up to leaving the house, let alone going to work. Regardless of what kind, recovering from surgery will suck a huge amount of energy out of you.

Get rid of any small rugs that might bunch up or skid under a crutch. Especially in the bathroom since it's such a small space. The last thing you want is to go skidding on something and re-breaking the ankle, or breaking something else.

Speaking of the bathroom - clear out whatever bathroom you plan on using so there's just the toilet, sink and bathtub. You don't need to be dancing around magazine racks and laundry hampers when you're on crutches. Likewise in your bedroom. You may be used to unconsciously dancing around that small table with the plant on it, but you're going to be twice your normal width on crutches.

On Surgery Day - yes, be prepared to have half a dozen or more people ask why you're there. It will get tedious after a while, but be glad they're asking. Don't just say "surgery" - tell 'em "tendon repair on my ____ ankle."

[cormac262]

Thanks for all the advice and comments. I'm most concerned about the crutches--I have to go up and down stairs to get into and out of my apartment building, plus through a maze of doors. Any other advice on using the crutches would be welcome.

Thanks again, everyone.

I don't have any experience with them myself, but I've been told the "forearm grip" type of crutches are supposed to be far superior to the standard "under the armpit" type. I'm told you have much better control, and are not as taxing as the standard type. The problem is (as you would have guessed) they are more expensive. So they usually issue the standard type. You could try to make a case for getting the forearm grip type.

The best device I've seen is a kind of "one leg kneel" scooter. There is a padded platform about knee height on a scooter-like device (wheels and a handgrip). With knee bent, you rest the bad leg on the pad, and scoot with the other foot. The handgrip has a brake to help you stop. I'm told these are for people who cannot "do" regular crutches (either too little arm strength, or just too much weight to safely do them). These devices cost even more still. And though they are great for "walking", won't help you with the stairs at all (I supposed you'd have to strap the device to your back, and hop up and down).

If you're resigned to regular crutches, you might start doing dips to start strengthening your triceps/shoulders. You'll get this workout once you get the crutches, but if you try to get a headstart, it may head off some of the muscle cramps you might get.

[Eva Luna]

Thanks for all the advice and comments. I'm most concerned about the crutches--I have to go up and down stairs to get into and out of my apartment building, plus through a maze of doors. Any other advice on using the crutches would be welcome.


It takes practice. Most likely they will have a physical therapist give you some crutch lessons before they release you from the hospital.

If you are feeling wobbly and weak, don't be ashamed to scoot down the stairs on your butt. Beats the hell out of falling.

[jormundgondir]

If they give you prescription painkillers, make *sure* to poop at least once a day, hell or high water- take a laxative if you need to, but be vigilant! The good stuff will totally stop you up, and before you even notice four or five days will have gone by, and ultimately that first final "go" can be worse than anything else related to the surgery.

Try to have the house cleaned before you go in. It's a bummer being laid up in a messy house, and so much easier to get around when you're not having to navigate hazards too.

Get a big water bottle and a way to move it around- a carabiner or something.

Stairs up aren't too bad, bu I've found that it's very easy to lose your balance going down stairs - once the immediate pain is gone, I typically just toss both crutches into one hand, hold onto the banister with the other hand, and "hop" down the stairs instead of relying on the crutches at all. For doors if possible just push them open backwards with your butt, shuffle through, and swivel around.

Beware of slippery patches in general if there's weather where you are, like the paint on the ground in crosswalks, and tile floors.

You can get little saddlebags for the crutches but you might find they just throw off your balance; I just used a messenger bag.

Last time i was on crutches for a long spell I started getting cabin fever, but it was *so* exhausting to drag myself anywhere-- a comforting outing was to go to a fairly new supermarket, one that had courtesy scooters, and just cruise around the store shopping with a friend.

Let other people spoil you! Especially at first, since later you'll be feeling better and the novelty will wear off enough that people don't offer as much anymore ;-)

[phall0106]

You're lucky that the thrift stores in your area will accept them. In Kansas City, Missouri, the thrift stores are apparently prevented from accepting any "medical" equipment, including a friend's late mother's walker and canes. Probably a law or city ordinance passed to benefit the medical supply industry.

Craigslist.

Make up a chart NOW to record when you take your pain meds. Even though you may take them every three or four hours, once they kick in, you'll find yourself wondering, "Did I take a pill at 3? Do I take one at 5 or 6?"

Yes, I speak from experience.

[Paintcharge]

Stairs up aren't too bad, bu I've found that it's very easy to lose your balance going down stairs - once the immediate pain is gone, I typically just toss both crutches into one hand, hold onto the banister with the other hand, and "hop" down the stairs instead of relying on the crutches at all. For doors if possible just push them open backwards with your butt, shuffle through, and swivel around.

Beware of slippery patches in general if there's weather where you are, like the paint on the ground in crosswalks, and tile floors.

You can get little saddlebags for the crutches but you might find they just throw off your balance; I just used a messenger bag.



That's what I came in here to say. Stairs. Even going up I found it much easier to hold both crutches in one hand, grab the railing and hop up, as well as down.

They make grippy/pointy ends for the feet of the crutches. If there is still snow & ice they might be good.

A backpack is really good. Having plastic grocery bags swinging around your knees is a real pain.

Between an ACL and two Achilles surgeries, I've been on crutches for over a year of my life. I can move around pretty good on them. Hell, I even got to where I was playing goalie in a pick up soccer game.

So don't worry too much, it's easy to pick up, just tiring.

[Nightingale]

Be sure to clear your floors or things of any throw rugs or things that might slip under your crutches. Also make sure you have plenty of room to maneuver, even if it means temporarily consigning coffee tables or potted plants or whatever to a guest room or garage.

[Quercus]

You may be thinking that heating up soup is an easy way to create food while you're on crutches. And you'd be right as far as that goes, but you're probably not thinking about carrying a bowl of soup to the table while you're on crutches. Non-spilling food is a good idea for the first few days.

I second the recommendation to lay in some metamucil and/or or stool softener. Can't hurt and might help a lot depending on how your system reacts to opiates. Also, it took me a couple rounds to realize that when I got slightly naseaous from pain pills, the best way to remedy it was (counterintuitively) to eat something.
Also second the chair for the shower (I ended up using a milk crate with a towel).

I don't know how Achilles repair is, but after ACL replacement, there was not much question of going back to work for a week, and plan for two. Mostly because four days out, heavy meds and/or not sleeping much are the order of the day. But ask your surgeon what's reasonable.

I was moderately fit and found the challenge of crutches a little bit fun (if you tore it playing volleyball you might be similar). But very slow for going even moderate distances, with more stops to rest than you might think. I'd bring lunch the first day, but see how you feel. It depends on how far you're going, most likely (if it's just 50 yards to the car, probably easy if you've been cooped up at your desk all day).

[Santo Rugger]

Sounds gross, but it hurts when the blood flows back into your leg. Getting up to pee sucks, so get a few 32 ounce or bigger bottles to use to pee in so you only have to get up to poop (which probably won't be very often due to your lack of desire to eat solid foods, as well as due to the main meds).Before the surgery, be sure to write "THIS ONE" on one ankle and "NOT THIS ONE" on the other.Similar to what Lynn Bodini said, I had the doc come in, triple check what knee we were doing, and mark where he planned to enter, as well as initial my knee, while I was still awake.

[KSO]

An update, in case anyone is interested: the surgery went off without a hitch, although my doctor described it as like "sewing together a horse tail," :eek: which I guess is standard for this type of surgery. I've had minimal pain--percocet for the first 24 hours only, and am managing to get around on the crutches. Getting to and from work is going to be a real bitch because of the stairs and doors I have to navigate, but I did it today, while my mom was visiting so I know I can manage. My washcloth is my new best friend.

Thanks again for all the tips--they've come in quite handy.

[outlierrn]

How old are you KSO? Believe me when I tell you that if you're lucky, you will live long enough to appreciate the wisdom of taking the long view of recover and rehab




Hygiene is overrated

[KSO]

42. Yes, my hygiene is definitely going to take a hit over the next month--I learned that today when I attempted a shower; hence, my washcloth being my new best friend. I know the rehab/recovery is 12-18 months and I'm prepared to do exactly what my doctor says to do and to not do what he tells me not to do.

[Etherman]

An update, in case anyone is interested: the surgery went off without a hitch, although my doctor described it as like "sewing together a horse tail,"

My doc described it as trying to sew together two mop heads. Mine was bad enough he didn't even try, but reconstructed it from what was left intact in there. He actually used the word fillet and talked of peeling tendon material off the muscle when describing what he did. That was disturbing.

I was 35 when I had my surgery, you seem to be in much better post-op shape than I was, good to hear you came out in good shape. It's an injury I wouldn't wish on anyone.

[KSO]

Believe me, I'm surprised at how I'm feeling--the first couple of days were very rough because I couldn't keep the antibiotics or percocet down. I am going to be careful not to take things too quickly.