Helpful ideas for after calcaneal osteotomy or ankle fusion

A collection of ideas that others have found helpful.

Getting Around

• Before you head off for surgery take time to assess your home for obstacles and clear them away as best you can.  It is useful to  rearrange furniture to clear pathways.
• Practice using your chosen locomotion devices—knee-walker, crutches (on stairs, remember “Good goes to heaven, bad goes to hell.”), wheelchair, and/or walker. If you are hiring many places will let you have them a few days before surgery. Also check pricing - I found it cheaper to buy crutches than to hire them for six weeks and the same went for the iwalk 2.0. You can always on-sell.
• A knee scooter with a basket on is a good way to have a bit of independence in the house. You also have your important things, such as your drugs, handy in the basket.
• A knee scooter is fine in a single level dwelling but if you have stairs you are going to want a knee crutch - The iWalk 2.0 it gives you two free hands to carry stuff, makes climbing stairs much easier - using crutches on stairs while non-weight bearing can be terrifying and crawling up gets old really quick.
  
  
  
  choosing between a knee scooter or crutch
  
  
• There's going to be a lot of getting up at night. If you share your home then consider plug-in automatic night-lights throughout your home.
• You may be able to get a temporary mobility permit placard  - your doctor can fill out a form for this.
• Here's how someone dealt with the stairs situation:
  
  Going up:
  "Standing in front of the stairs I lean a bit forward and put the pillow on the third step. I then put my "bad" knee (i.e. the one of the bad foot) on the pillow, and pull myself up 
  putting the "good" foot on the stair below the pillow. This foot is my lever! I then repeat the process: Taking the pillow, putting it on the third step. Knee, "good" foot, etc. Please note: I am rather tall; therefore the 2 stairs interval is right for me. Shorter people will do it with 1 stair intervals. When I get to the end of the stairs I use the rails and/or the wall to raise myself and hold the walker which awaits me there, to go wherever I need. You can also use a chair but you still have to push yourself up. This is the trickier part."
  
  Going down:
  "The lady who first suggested this method advised to go down on your butt. I tried this, but found it abused my upper arms and shoulders, as I also have a "frozen shoulder" situation. Therefore, a revised technique… which is basically the same as going up. You just have to figure a way to get down to the floor level. Facing upwards, you put a/the pillow on the first or second stair, where you rest your bad knee. Then you send 
  your good foot down to wherever it reaches on the stairs, take the pillow and repeat the process downstairs till you meet your walker.
  I use a square 15 inches pillow.
  Thru all this process you must hold the rails."

Coping with the house

• Arrange to have someone home with you for at least the first two weeks after surgery, if possible.
• Set up camp in an area you can stock with books and magazines, laptop, phone, pen and paper, tv remote, reading light, tissues, lip balm, lotion, hobby supplies, a light blanket, An electric jug and drink making supplies -  mini-fridge if great otherwise a chilli Bin (Eski, cooler),drinks and snacks, hand wipes, etc.
• Plan your daily tasks - bathing, dressing, dining, etc. and organize what you need—get a helper to put all your after-shower supplies in a basket, or to lay out your clothes in the order you will put them on if possible.
• Make your bed up with the covers untucked at the foot of the bed.
• Get your freezer stocked with easy meals.
• Take all offers of help - be specific about what you need -laundry done, transportation needed, children picked up from school, etc.
• Do not stay in your bedroom when at home—avoid cabin-fever. Set yourself up in the living room. Get outside the house, even if just out to the backyard.

The day to day necessities

• Have a bottle of hand sanitiser next to the toilet so you don't have to bother about struggling with taps at the basin. You just clean up while seated.
• Still on the toilet figuratively - have a box with a cushion in it or a footstool with a cushion on beside the toilet to rest your foot on.
• If you prefer baths to showers then have a dry run see if you can safely get up and out of a wet tub without the use of one foot. It’s extremely difficult. If you have to bath the best way is to put a towel on the side of the bath to rest your leg over and have a chair to rest your foot on and keep it out of the way.
• Proper cast covers are great but you can manage with a tie top rubbish sack and a towel to catch the drips.
• When at home, wear knee-length bathrobes, no undies—much easier to manoeuvre in the bathroom. When out, sweatpants or other stretchy knit pants will fit over your splint.
• Tuck a hand towel into your neckline while eating with your foot propped up to avoid mess.
• Take your pain meds on schedule—it’s easier to keep ahead of pain than to quell it. Write down when you took them or use a smartphone app to keep track.

Leg maintenance

• Exfoliate your foot and leg pre-op—it'll be less clean up work for when your cast comes off.
• If possible get popliteal AND saphenous nerve blocks to help you avoid the brunt of post-op pain . Nerve blocks can last up to eighteen hours. Whether this is offered varies worldwide.
• Make sure you pack something that will fit over your cast or splint for coming home from hospital. A good test is trying to put whatever you choose on while wearing a shoe and keeping it at right angles to your leg.
• Keep your foot elevated (toes above the nose) while eating, sleeping, in the bathroom, etc.
• Take your pain meds before you have your splint or your cast removed. The splint bandage can stick to your foot and that can be quite sore removing. The 'tickle saw' vibrations can make some people feel dizzy or faint. Something to do with the vibrations.

Useful stuff to have:

• Knee-scooter, crutches, knee-crutch, wheelchair, (preferably with a foot board to elevate your leg) and/or walker  if you ever want to go anywhere
• Weight lifter’s or cycling gloves (if using crutches, wheelchair, or walker).
• Walker tray (if using walker)—useful for carrying things.
• Shower chair or transfer bench 
• Suction mounted grab bars by toilet and in shower
• Toilet chair  (with arms, so you can get up easily).
• Backpack, messenger bag, or tote bag to carry things while your hands are busy with crutches, etc.
• Lightweight, portable stool the right height to prop your foot while sitting in the shower, on the toilet, etc.
• Hand-held shower to use in the bath tub.
• Flexible ice-packs with Velcro straps and cloth covers—get more than you think you need. Placing an ice pack behind your knee is great for pain and swelling relief.
• Extendable “grabber” - one with a clip to attach to your crutch or walker is best so you don't need to worry about dropping it.
  
• Portable phone
• Chilly bin, Cooler bags , mini-fridge - to keep drinks cold.
• Contour memory foam bed pillow to cushion your knee on the knee-walker, in bed etc
• Wedge pillow (polygon, not triangle shaped) for elevating your foot. Get one wide enough to prop both legs on.
• If you can't ignore the itch then a long handled shoehorn is smooth and should not irritate the skin or wound site when it's slipped in the cast and gently moved around.