Haglund's deformity - double surgery year

[WickerBill]

I have a condition on both of my heels at the point the achilles attaches to the heel bone, where (due to heredity I suppose) I've grown massive amounts of extra bone that grows through parts of the tendon and causes great pain.

I've lived with it for a decade, but it's gotten to the point I can't exercise at all and can barely walk up or down stairs. Therefore, 2018 is going to be a big year, as for insurance reasons, I'm going to try to get them both done in one calendar year.

The surgery carries a 60% success rate.


My question to you: Do I start with the heel that doesn't hurt as often, but when it does it almost strikes me down - or the heel that rarely has sudden excruciating pain, but always hurts, 24/7? I go to see the surgeon in a week or so and he's getting annoyed that I haven't chosen which foot yet. :)

Any suggestions?

[nrc]

It's at times like these that I really miss the Wisdom of Dando. :)

Tough question. Which is more important to your personal well being and lifestyle, minimizing episodes of reduced or no mobility or reducing constant pain? If the former than I'd start with the one that doesn't hurt as often.

I suppose the other consideration is whether some of that 40% non-success rate carries limitations to mobility. If so, I'd again start with the one that sometimes causes severe problems. I wouldn't want to risk the existing "worst case" combining with complications created on the other foot creating severe mobility problems. Does that make sense?

Whatever you decide, we wish you a speedy and complete recovery.

[SteveH]

I think I’d also go with the one that doesn’t hurt that often just to eliminate it from taking you down when it flares up. If that were to happen during recovery of the other you’d be in trouble.

My wife had both feet operated on a few years ago, but not at the same time. She used a steerable knee walker around the house rather than crutches and used a home cryotherapy machine to keep swelling down and reduce pain.

Good luck. Hope it all works out for you.

[Insomniac]

If it is that close of a decision, some factors I'd consider would be:


Which side is dominant?
If you could only get the surgery on one, which would it be? (Perhaps after the first surgery, you'll decide you don't want a second one.)
As nrc mentioned, is there a situation where given the success rate, one side is a better candidate than the other?
Can the surgeon learn from the first one to improve the procedure/chances on the second one?


Best wishes on the decision and the surgery. How long is the recovery time?

[WickerBill]

Thanks all.

My right foot is dominant and a) has the larger protrusion and the intense but less frequent pain. My brain tells me it is the correct one to do first, even though that means a loooong time without driving - and no relief from the keeps-me-up-at-night left foot pain.


And on that note, recovery is 2 to 8 weeks non-weight-bearing (depending on how the surgery goes), then ~8 weeks in a walking boot while starting therapy. No significant calf/ankle strengthening until the very end. Best case scenario is first foot is well enough for me to do the second foot 24 weeks after first surgery. The surgery includes complete removal of the achilles from the heel bone, chopping out the extra bone, strengthening the end of the tendon that has been chewed up, and re-anchoring it.


There is no clear "winner" in the success rate - because failure doesn't mean the surgery doesn't take, it means the bone grows back and causes the same issue. Every opinion I've gotten has told me there's no real way to determine whether this will happen or not, but I'll know before the 24 weeks is up. :irked:

[TravelGal]

I just saw this. TravelGuy, asks: How often are the flare ups and how long do they last? If not that often and not that long, then definitely fix the constant pain that keeps you up at night. Getting decent sleep during recovery will help a lot. He says this based on the last couple of weeks where severe back pain keeps him up at night.

[WickerBill]

I'll give you the classic "it depends" answer. Most of the sharp, someone-shot-me-in-the-back-of-my-foot-with-a-9mm pain goes away fairly quickly, but it's debilitating when it occurs. However, when it is really bad, I can go for days in a hobbled state from one of those 9mm events. I'm currently on about day 2.5 from one such event, and I'm mobile but slow and it is clearly inflamed.

Good times.

[WickerBill]

Update:

I'm two months post-op. I chose to do the left foot first - probably more accurate to say my surgeon chose the left foot first. So far, I'm just a couple of days behind schedule on what I'm supposed to be able to do, but I'm still in a walking boot (another month). Recovery is agonizingly long. My lower leg has withered from atrophy and I wish I could get busy building it back up again. I'm extremely impatient.

There's no real knowledge yet as to whether my body is recreating the bone spur.


The fun part of this whole thing was that I was on these major antibiotics post surgery, because you just cannot afford to get an infection in the foot during healing. As soon as I was done with the antibiotics, it was like I was a germ sponge. I got the flu, and then added bronchitis, pneumonia, and a c diff infection on top for good measure. Missed two weeks of work (if any indication, I've been at my current job four years and had never taken a day off for being sick before).

Still fighting the c diff, but in a far better spot than a few weeks ago. Although my foot hurts, it hurts less already than it did pre-op. Pain is just different, because it's coming from healing, my PT exercises, etc.

[Insomniac]

Update:

I'm two months post-op. I chose to do the left foot first - probably more accurate to say my surgeon chose the left foot first. So far, I'm just a couple of days behind schedule on what I'm supposed to be able to do, but I'm still in a walking boot (another month). Recovery is agonizingly long. My lower leg has withered from atrophy and I wish I could get busy building it back up again. I'm extremely impatient.

There's no real knowledge yet as to whether my body is recreating the bone spur.


The fun part of this whole thing was that I was on these major antibiotics post surgery, because you just cannot afford to get an infection in the foot during healing. As soon as I was done with the antibiotics, it was like I was a germ sponge. I got the flu, and then added bronchitis, pneumonia, and a c diff infection on top for good measure. Missed two weeks of work (if any indication, I've been at my current job four years and had never taken a day off for being sick before).

Still fighting the c diff, but in a far better spot than a few weeks ago. Although my foot hurts, it hurts less already than it did pre-op. Pain is just different, because it's coming from healing, my PT exercises, etc.

Tough break there, but only 2 days behind still shows you're a warrior. As a PT veteran, it's a tough road, but it's worth it. Keep at it WB!

[WickerBill]

Thank you sir!

I forgot to mention that when they anchored into my heel, they fractured it, which was a big concern I had going in. But since it wasn't a full break, and I'm in a boot anyway, they feel it's going to heal fine. But it does/did add to the pain - I could definitely feel that fracture.


Can't wait to do the right foot. :rolleyes::rolleyes:

[nrc]

Good to hear that you're progressing. Wishing you the best. Will you have an opportunity to get the left built up a little before taking on the right one?

[TravelGal]

So glad to know the healing is coming along. It sounds like you've done a great job of battling off everything the universe threw at you and coming out the other side. Congrats WB. :thumbup:

[WickerBill]

Thanks TGal. I'm trying!


nrc, I have the option of doing my right foot in June (assuming I progress through PT from now until then), but I'm strongly considering waiting until the November timeframe, so I can a) heal more and get stronger, and b) enjoy the summer without being on a scooter/crutches or in a boot.

[Insomniac]

Thanks TGal. I'm trying!


nrc, I have the option of doing my right foot in June (assuming I progress through PT from now until then), but I'm strongly considering waiting until the November timeframe, so I can a) heal more and get stronger, and b) enjoy the summer without being on a scooter/crutches or in a boot.

How are you sleeping now?

[WickerBill]

I'm in a bed without the boot at night. Supposed to be sleeping by myself so I don't get kicked, but I'm not, and so far so good. I realize it's a dumb risk to take.

[TravelGal]

Supposed to be sleeping by myself so I don't get kicked, but I'm not, and so far so good. I realize it's a dumb risk to take.

It's not. It matters.

[Insomniac]

I'm in a bed without the boot at night. Supposed to be sleeping by myself so I don't get kicked, but I'm not, and so far so good. I realize it's a dumb risk to take.

I meant you had said the pain in the left foot was so bad it kept you up at night. I was curious if you were sleeping better.

I'd say maybe a risk if you sleep on the right and your wife is a kicker. :) I imagine the boot affords you quite a bit of protection as well.

[WickerBill]

Goodness yes. Within a week I could tell the pain - or at least the pain I was used to for years - was gone. I couldn't believe I could tell that quickly.

There's still pain now, but it's weakness and healing, not the grinding of sharp bone spurs against a tendon. Now we see how long it lasts!