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Boot problems

very thankful for everyone’s thoughts/well wishes/advice…we’re in this together!

I’ve had a vacocast fit (the pro killed when it was fitted) for 1x week which I think is too big.  It’s very wide and heaps of space in the length.  It’s a medium and I wear an asics US 8 trainer, if that helps.  When the lining is wrapped around securely it’s fine when I’m upright. It’s when laying that I have problems.  It’s like the lining forces the bottom wedge, of which there’s 4, to slightly curve in, and the pointy bit digs in to the soft part of my foot, about wear the arch is.   But it’s the same even when the straps are released/loosened.  In the night i have to sit up and hang my feet off the side of the bed to relieve it.  Does anyone else find this?

My ball if my foot kinda burns a lot when laying elevated, like the boot places extra pressure from the weight of it….not pleasant.

Maybe it’s just the wedges and not the boot size.  I think going to order one of the even ups for my right foot has anyone used these, good / bad idea?

I start work again on Monday so trying to prepare myself a bit.  Fortunately I’m 4-6 hours a day (work cover) so can elevate or snooze in the day if needed…not really ready for a commute and full days work yet!

Safe healing! xx

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  1. 7 Comment(s)

  2. By normofthenorth on Nov 21, 2012 | Reply

    The Even-Up — or some other “platform” to build up your UN-booted foot so you can walk straight — is extremely important when you are FWB, walking in the boot without crutches. Before that it’s less important, but you should get ready to re-learn how to walk normally.

    Sorry I can’t really help with the VacoCast fitting problem. If adjusting and adding and subtracting padding and liners and such doesn’t help, it’s possible that the boot is the wrong size.

  3. By mandy000 on Nov 22, 2012 | Reply

    Normofthenorth. Thank you. You are just so helpful to everyone,always williing to share some advice, insight or lesson. How are you doing?

  4. By Hillie on Nov 22, 2012 | Reply

    Hi Mandy

    I’m not familiar with the ‘Fit’ version as I had the Pro Achilles version which was hinged and had no internal wedges. However, I was on the overlap between sizes and my physio fitted me with a Large boot. I subsequently had a few issues, including what seemed like too much space in the foot area and too much liner (i.e. even the velcro fasteners couldn’t cope especially as I lost some muscle mass in the calf).

    After discussing the issue with the experts I was fitted with a size Medium, but with the extending sole plate pulled out. This made a big difference - the fit was comfortable and seemed more supportive too. It also helped with FWB and ditching the crutches completely - in confidence at least.

    I don’t know how aggressive or conservative your protocol is but I would expect that you should very soon be able to take off the boot when lying down.

    As for the Even-Up, go for it. In my first few weeks I was hurting my good leg because of the left / right imbalance. The Even-Up wasn’t in the UK at the time (earlier this year) so I used a thick soled hiking shoe, thick socks, etc. Vital that you do something soon and avoid damage to the good leg - it’s under plenty of extra strain as it is.

  5. By mandy000 on Nov 22, 2012 | Reply

    Thanks Hillie! Overnight I got an email back from the oped people - the vaocast fit is not designed to have wedges placed in it….no wonder they cut in. They will swap it over for the Achilles pro, told me to keep the linings and the pump as they are the same. So have been nagging the surgeons assistant all morning. I’m not usually a nagger more a grin and bear it type, but this time I’m glad I persevered. I hope it gets swapped today don’t think I can last the weekend. I’m sure the wedge as almost broken the skin despite extra socks and not even standing on it. At least the pain theres distracts me from my heel..not good.

    Good idea on the even ups, the Australian dealer doesn’t sell them, so I need to track down a supplier. Thanks again. Keep well!

  6. By normofthenorth on Nov 22, 2012 | Reply

    Thanks for the thanks, Mandy. I’m doing fine, approaching 2 years after my second ATR (or maybe it just passed?), and a year after getting a heart valve replaced(!). I’m back to full-on competitive volleyball with a bunch of folks 25-45 years my junior — mostly 4-on-4 beach 1x/week in a competitive league, and mostly 2-on-2 beach pickup 1x/week.

    We just finished a 10-week season Monday before last. We finished first during the regular season, despite losing the first game in almost every match. Then in the playoffs, we only played one game against each opposing team! :-( We did win a few, but we also lost a few, to teams we probably could have beaten in a 3-game match. Oh, well, I don’t really need another cotton T-shirt!!

    More details on my blog pages. Actually, neither of my two ATRs (1 op, 1 non-op) healed perfectly, but they’re both working well enough to keep this 67-yr-old running and jumping and cycling and skiing and hanging out the side of a small sailboat all summer — and most of it with some style and some competitive success, too!

    If the Vaco “Fit” is a hinged boot, as I assume, with the ankle angle adjustable, the normal approach is to use that feature instead of heel wedges. E.g., if you and your Doc want your heel to be immobilized (say) 2 cm higher than the ball of your foot, then you’d get 2cm of heel wedges if you were in an Aircast or some other “fixed” (non-hinged) boot. But in a hinged boot, you’d just fool with the hinge pins or setscrews or whatever, until it took the same (planter-flexed or “equinus”) angle.

    Now I’m curious about how the “Achilles Pro” is going to solve your problem — which frankly sounds more like a “software” problem than a “hardware” problem, if you know what I mean.

    Good luck and good healing. If the Australian Vaco dealer won’t order an Even-Up (or equivalent) for you, you should either (a) beat him up, or (b) get the Vaco people to beat him up! :-) Mind you, there are a number of similar “cast shoes” available at good medical-supply stores and hospital stores and online at eBay etc.. As long as it can attach to a shoe or hiking boot and add the appropriate amount of “lift” so your hips are straight when you stand and walk, you’ll be a winner.

  7. By normofthenorth on Nov 22, 2012 | Reply

    I have no idea why that last comment of mine is “awaiting moderation”, but please approve it and let it be seen. There may be a tunable anti-spam filter somewhere in the settings that’s on High Alert. . .

  8. By mandy000 on Nov 22, 2012 | Reply

    Heya Norm, I don’t know why yours didn’t automatically come up, weird! I just fixed it..

    Vacocast (in Australia) I think is the Vacocast fit in the USA no hinges fixed boot. I think perhaps it’s more a cast. The pro one has hinges for different levels of flex, aka Achilles pro.

    I’ve got 4 wedges in at the moment, and three of them cut in at the pointy bit of the wedge into my soft foot. I think the main difference in the fitting will be my foot will be flush with the lining. At the moment the only time it hurts is when I’m laying down, plus where it’s rubbed a welt.

    It’s odd they don’t stock them, maybe it’s a licensing thing, they did give me a contact for someone they know though. Friendly folk, no beatings required :)

    The vacocast people said they’d swap it over and I (work cover) pay the $ difference. I retain the current linings and pump as they are the same. On Tuesday I can try on the small and see if less width/length is better, at the moment the medium has 4cm space from my toe to the top of the boot, and the Velcro is wrapped as tight as it can go.

    You are doing so well, I’m glad to read such great news….I hope you win more games next season :). We all need shirts that say I’m a winner again ;)

    Stay well! Xx

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    • Name: mandy000
      Location: Sydney
      Injured during: The Amazing Race
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