Ankle Fusion

So Jim1960,

Did you have any surgey before getting out? Fusion? ANything that thay migh thave tried.

Where did you get the BTK Amputation? VA? PCM? Wher eand what. Sorry if the question is wrong to ask.

Slorcoe
 
I had destroyed my Achilles tendon and after two surgeries and then falling and braking my big toe and re-damaging the tendon I had no movement of any toes, nothing in the foot would move. Because of the lack of movement in the foot no one recommended fusion and the surgery the Army wanted to "try" I did not believe in nor did other surgeons I spoke with. I had also lived with a foot that was stuck at 90 degrees for a long time and did not like it, then after my fall it dropped to -20 degrees and I decided I was done. It is no light decision to make but for me it was the right decision.

I used a civilian surgeon and had an Ertl procedure.

PM me if you like
 
OK Here is the Scoop,
4+ weeks post total ankle fusion with 200mm intermedullary rod placement through Calcanus/Talus and up into Tibia. Was never placed in a cast just sent home for bed rest. The pain is a constant 8/10 almost daily but went back to work yesterday. Just to much madness sitting around all the time. I have been going to PT twice a week and had some fun with aqua-therapy yesterday. I am wearing a size 12 shoe on the bad foot (2 sizes bigger then the other side) and cannot wait to get off these damn crutches.

I have mid-foot movement, toe movement and passive less then 5 degrees of ankle movement when the PT guru has me relaxed and just slowly moves things around. Other than that not much I will begin my LIMDU this Thursday.

So whats up with all of you?

Slorcoe
 
Question for Jason and all the like,

If something is Permanent such as my ankle, hat eto say it but its not going to do anything but sit at 90 degrees, for the rest of my life. What is the defining factor of:

PDRL v. TDRL?

I read the forums and beside the Fit v. Unfit I cannot find out.

It seems there has to be something, somewhere, by somebody that makes that determination so when it gets to or goes to a board they can have the firm decision.

Is this just way to open minded thinking, hoping or what?

Slorcoe
 
Dear Slorcoe,

You will not really find any hard and fast guidance on rating this as TDRL v. PDRL. In all but one recent case, it was necessary to go to the FPEB hearing before it was accepted that all means of treatment had been exhausted, no improvement was likely, etc.

One case came back PDRL right from the outset, but that was puzzling as the NARSUM narrative was quite vague and not as well written as others. While I would like to say that it was our rebuttal that put us over the top, I think that it was simply the mindset of the medical officer on the IPEB.

My advice- ensure that the NARSUM shows that you have reached the maximum benefit of medical treatment, no improvement is likely and all other means of treatment have been exhausted.

v/r

Jack Gately
 
Who knows what a PEB will decide in the PDRL v. TDRL, but I would guess PDRL as the Doc is sure to say we have done every thing that can be done. What you need to watch out for is the rating. Again I would guess you will get loss of ankle motion with a max of 20% and severance pay, I hope this is not the case and you get a 30% and retirement.

I am glad to hear you are doing well, I understand the crutches thig I have been on them over two years. I hope the pain starts going away, it gets old being in pain all the time.
 
This day is the beginning of my walk of LIMDU. I am officially in the program and lets see what becomes of it.

Had Physical Aqua THerapy yesterday and was re-learning how to walk without an ankle. Let me tell you I felt like a 2 year old trying to learn. My brain just wasn't sending the right signals to the foot. and the ankle was saying.. "yeah right, I don't think so!"

Really a weird sensation not to be able to do something after doing it for what 39 years.

Slorcoe
 
Question,

Looking through the VASRD and cannto find what specifically indentifies my right Calf atrophy. Currently it is probly 50-75% gone now and since I cannot engage it at all I fear its going to just all turn to fat. I will add it to my LIMDU part 2 in Feb but I need to find it somewhere in the VASRD or ICD-9 code.

THx

Slorcoe
 
Ok,

Update time. Well it looks like I will be going back to surgery for a re-do to my ankle. The total fusion didn't totally work so I get a touch-up on the medial side of the ankle. The xrays show spacing instead of fusing. It happens so I am not worried and just want it to be done with. I just want to make sure this ankle gets the complete fuse.


Slorcoe
 
Sorry you are having to have more surgery, I can relate to how old that gets. I hope that this one will get it done and the results will be what you are looking for.
 
Ok relates and doesn't at the same time.

As stated Surgery Part IV 30 NOV09. That being said I was diagnosed with Diabetes yeasterday. Non-insulin currently (medication only trial so far) but I have been on Metformin for the lats 2 years to try to prevent it from occuring. Well time does tell and it did and no longer am I pre-d I am officially D.

Will this affect my MEB/PEB or is this a VA only thing to worry about?

Thx as usual,
Slorcoe
 
This could possibly affect your packet, you need to talk to your PEBLO or case manager to know for sure. What they do in some cases if is something new is added that will definitely have a bearing on the case is the packet will be suspended until the issue is resolved. However, since you are still early in the diagnosis process for the diabetes then they may not do anything to your packet until it does present itself as a factor. I know for my leg they have been making me keep a journal for anything new that pops up for use on any appeals, but told me if I do have an appointment with my leg for the new symptoms I am having that they will cancel my packet and restart a new one to update everything... which I definitely don't want to do since I am in the QA process now.
 
Does it have any bearing of outcome based on time left on your enlistment? That being said, I am re-enlisted to my 20 year mark so will the board look at that? Verses someone who doesn't have time left AD and keep getting extensions? I keep hearing oh your over 15 and upped to 20.... you'll get Retirement so don't worry.

Just thought I would get some insight.

Slorcoe
 
Yes. For those within a year of approved non-disability separation or retirement, you will fall under Presumption of Fitness Rule.
 
And those who fall outside of that, like me at currently 15.5 years, just hit or miss and no gurenteed "retirement" medical or otherwise.
 
Hey All,

Just an update. Currently still in limdu and was released from my Ankle Specialist back in March after he found me good to go after my 4th surgery in December. Well the Navy didn't like the pain I was in so they go a 2nd opinion and the new ortho after xrays said" no union of ankle and incomplete fusion." So, off to another ankly guy to say either:
1. Your as good to go and will have to suck it up the rest of your life. or
2. Wow, the other guy said your good to go well he was wrong and we need to (insert surgery name here).

I hope to have the news after my appointment next month.

Oh additionally it looks like I'm unfortunatly going to have to start insulin for my DM and got diagnosed with Sleep apnea with need for CPAP. Oh well more VA benefits. Just wondering when I should stop building up the different disabilities..... till later ya'll


Slorcoe
 
Ok well, I just got finished with my New Ortho doc and was given 2 weeks to decide:
1) My ankle CT showed non-union non-fusion 13 months after my surgery so I can have a complete redo on the furion from scratch or
2) Below the Knee Amputation and get most of my functionality (walk, run play with kids and such) back.

I am leaning towards #2
 
Well I had #2 in May of 09 and am doing well, doing some long walks, some running, biking and swimming. Normal walking is pretty good. Drop me a PM if you want.
 
I will be having a Below The Knee amputaion within the next week...... Just an update... I guess that's %40 and no doubt about it.
 
Where are you having the surgery done? Are you having an Ertl procedure done? Best of luck to you
 
You must log in or register to reply here.
Top