Help!
I just got a call from the orthopedic surgeon I saw 2 days ago, who talked to his boss. They want me to go to the hospital at 8am tomorrow, to see the head ortho guy and potentially be ready for surgery. I really don’t want this but will go in and see what this guy has to say. Advice from recovering people please!
October 15th, 2014 at 10:31 am
If you search Cecilia protocols on this site you will find summaries of 3 modern protocols which all delivery great results with fast rehab timelines. You could spend a long time looking through blogs and find a huge range of experiences, basically the medical world is still undecided on treatment. I’m underway with a non-op recovery and am very happy- I do think it is important that you are 100% confident in the method you use, good luck with the head honcho!
October 15th, 2014 at 10:36 am
Thanks herewegoagain - I can’t find Cecilia protocols by just entering in the search engine here though.
October 15th, 2014 at 10:51 am
Found it here: http://achillesblog.com/cecilia/protocols/
for anyone else who is looking.
Thank you! Will read through this and digest!
October 15th, 2014 at 11:43 am
Update - just got a call from headhoncho’s trauma nurse who says there is no way I will have surgery tomorrow as his schedule is full - huge relief! Quite determined not to have surgery anyway but it’s good to know that I won’t be talked into it, at least not within the next 24 hours.
October 15th, 2014 at 1:42 pm
You’ve got the evidence you need to skip the op and follow one of the best new non-op studies. There’s also a newish metastudy (cited on my Case Against Surgery page) that confirms the message from the new studies and Cecilia’s summary - that fast non-op treatment produces superior results with less pain, less time off work and ADLs, no scar/wound, and lower risk of complications.
Many surgeons, websites, and even entire hospitals or regions are still pushing surgery based on obsolete evidence. If you were a medical journalist there’d be a great story in there… WAIT, you ARE a medical journalist!!
(There’s even a miserable metastudy from the usually impressive Cochrane Group, helping to obscure the message from the best evidence - AAARGH!!)
October 15th, 2014 at 1:50 pm
BTW, like herewegoagain, I’ve torn BOTH of my ATs, 8 years apart. In 2001, everybody “knew” that surgery was indicated for jocks, so I got the op, and miserably slow rehab (multiple casts), despite my protests.
In late 2009 I searched for a good surgeon to fix my other AT, and found a very fancy one who talked me out of the op based on the newest (still then unpublished!) evidence. Like herewegoagain, my non-op treatment was a breeze compared to the first, post-op.
October 15th, 2014 at 2:12 pm
Thanks normofthenorth
Just more great advice to reinforce what I’m thinking. Why would I put myself under the knife when I’m not even in that much (any?) physical pain?
What I’m more concerned about is getting the right advice about whether/when to weight bear, use crutches, take Clexane, etc - ie how to make sure I get the proper functional rehabilitation on the UK NHS when I don’t live near one of the centers of excellence.
Will ask for early referral to physio. At least I don’t have to worry about how to pay for my care…
Would anyone recommend buying the Vacoped boot? I’ve been given an Aircast boot in plaster clinic.
PS -am certainly going to suggest a story to the website I work for, which is for doctors in the US! their ortho coverage isn’t that great but we are always looking for controversial topics.
October 15th, 2014 at 2:22 pm
The anticoagulants are often dispensed with, especially non-op. DVT does occur, even non-op, but it’s arguably rare enough to justify skipping the jabs. For the rest, the best road maps are published, along with their great results! Just follow the map!
My theory is that UWO / Exeter (Sussex? Devon!) may have better protocols than Wallace, though his results are better because of his customized ankle angle “trick” - which the whole world should adopt IMMEDIATELY, IMO! (We need the perfect article on the subject, which then goes viral…)
October 15th, 2014 at 3:06 pm
Just would add that no matter what advice you get the decision is yours about surgery and no doctor can force that on you. The is no condition known to man that cannot be made worse by surgery. Try telling them that.
October 15th, 2014 at 3:32 pm
Thanks Stuart. I agree - but hearing other people say it too just reinforces that notion. Will let you all know how it goes tomorrow.
October 15th, 2014 at 4:48 pm
An ATR story would be timely, if you are able to make that happen it would be fantastic!
First things first though, managing your recovery. I don’t think that not having direct access to a centre of excellence should be a problem. I am in a smallish town and have found great practitioners. Best practices are shared and available. For now you should be 100% NWB.
As far as boot choices- I wore an Aircast for a foot stress fracture a few years back and didn’t find it very comfortable. I also think that hinging is a huge plus. The Vacoped is extremely comfortable and warm. An extra liner makes it easy to keep clean and I have found that wearing a plastic bag over the liner (under the straps) is cheap rain proofing. The rocker heel makes walking and weight bearing easy with the foot fixed in plantar flexion. Personally I delayed sleeping without the boot, just scared me thinking about it. Instead I left the straps extra loose and left off the front guard, a compromise that worked well.
You are well placed for making an informed choice and thats a great thing. 8 weeks ago I thought that non-op was madness, how wrong I was….