Jun 22, 2014

My Upcoming Surgery for Foot Drop, aka My 50/50 Gamble

This may be my last post until my surgery on July 14th. Or maybe not. Anyway, I'll update you as soon as I can on the surgery. As usual, here's some background on the operation.

Ever since the stroke, I developed foot drop (or drop foot--I've heard it both ways), meaning the muscles and tendons that pull the foot and toes up are no longer working substantially. I walk on the side of my foot and the toes are not flat on the ground.


The American Orthopedic Foot and Ankle Society (AOFAS) says, "The surgical procedure for a foot drop is called a tendon transfer. In general, a tendon transfer is a procedure in which a tendon (and attached muscle) that is still working is taken from one part of the foot and moved to another part of the foot to try to replace the muscle function that is missing. The most common tendon transferred is the posterior tibial tendon." 

There's more. A second tendon, the peroneus longus, is severed above the ankle on the outside side of the leg. 


This tendon is then transported to the front of the ankle and the free end "is attached to the posterior tibial tendon and the anterior tibial tendon in a bridle configuration. With this construct, the posterior tibial muscle pulls on all three tendons to pull the foot up. The posterior tibial tendon is routed to the top of the foot as described above," says the AOFAS. Clever, huh!

Here's what it looks like when it's finished:  



Am I scared? Sort of. Anything could happen during surgery: anesthesia going south, infections. But do I have confidence in Dr. Dane K. Wukich? Absolutely!

As his website says, "Dr. Wukich is the chief of the foot and ankle division and associate professor of orthopaedic surgery at the University of Pittsburgh Medical Center. He is recognized nationally and internationally in this field and practices within the UPMC system and the Veterans Administration Medical Center is Pittsburgh. 

"His 80 publications include scientific articles, reviews and book chapters and he has presented over 150 medical lectures during his career. As a board certified orthopaedic surgeon with subspecialty training in foot and ankle surgery, Dr. Wukich is uniquely qualified to treat traumatic, degenerative, congenital and acquired disorders of the lower extremity. His orthopaedic training included comprehensive education in:

Amputations of the Lower Extremity  
Amputation Prevention 
Arthritis 
Biomechanics 
Degenerative Joint Disease 
Diabetes and its Impact on the Foot and Ankle 
Joint Arthroplasty 
Limb Salvage 
Metabolic Bone Disease and its Impact on the
Musculoskeletal System 
Neuromuscular Disorders and Spasticity 
Rehabilitation 
Sports Related Issues and Overuse Disorders 
Trauma"

Dr. Wukich examined my foot and said I am a candidate for this surgery because I have some minimally working muscles in my ankle and foot. If the operation is successful, I won't have to wear the cumbersome brace anymore. The doc said my chances are 50/50. 

How come no one in Philadelphia or South Jersey, where I am from, recommended this surgery? I haven't a clue. But I'm glad I came to Pittsburgh to find this information. 

By the way, Dr. Wukich doesn't know anything about this post. I won't tell him, either. He's a humble man, I think. But people who have drop foot will be educated on what they can do about it. "Options" is my middle name.

So I won't say "goodbye." That word is so final. Rather, I'll say, "See you later." 
------------------------------------------
3 months later:
Surgery is a success! No foot drop and my foot is flat on the floor! I'm wearing the brace for now, but who knows what the future will bring? But I'm staying positive and maybe....