Right Achilles Haglunds lengthening surgery then pneumonia

by Lesia McKenzie
(Florence, SC)

41 year old, overweight but active, RN with no significant health problems. Kidey function great, no diabetes, lungs were great, heart fantastic, no arthritis, don't smoke, dont drink. No routine medications, blood pressure runs about 100/60.


I have Haglunds deformity on my feet. Both. Every step I took was painful. So, I went to see a podiatrist and after X-rays, failed orthotics, failed anti-inflammatory meds, and stretching exercises, he recommended lengthening the tendon instead of working on the bones. He said recovery was more successful and much shorter. 4 weeks no weight bearing with no PT. sounded great to me.

June 15, 2012 I had my right Achilles tendon done and a "stabilizing" implant placed in the ankle. That was Fathers Day weekend. went home with no meds except Percocet.

My first complication was thrush. I'm a nurse of 17 years so I thought it no big deal. Did the swish n swallow thing. All was good.

The follow up appt, June 19, doc expressed a tiny bit of concern and put me on Clindamycin 300 mg TID x 10 days he said as a precaution.

I started to get weak but thought that was just normal. The cold sweats started on June 25. I attributed that to no longer taking the Percocet. Wrong. I also started to smell the clindamycin in my hair, on my skin, and everything I touched. No one else could smell it but me. I found it very nauseating.

By June27, I was so cold and clammy....too weak to pick my head up, no appetite, and sicker than I've ever felt. I got my husband to take me to the ER. After a battery of tests, and four solid hours freezing in the waiting room crying like a two year old because I felt so sick, I was told I had left lower lobe pneumonia. Great. But at least we now know what it is.

They gave me one bag of levaquin 750 mg, one bag of IV fluids, and sent me home with a script for ten more days of levaquin 750 mg. withinh 12 hours I was back at the hospital feeling like I was losing the battle with pneumonia. That was Thursday, June 28.

This time I was admitted. Stayed until the following Monday. But, I continued to feel like I was just getting sicker. Discharged me home on five more days of the same levaquin.

Cold sweats and chils hit me again, harder. Still absolutely no appetite. By the following Thursday, I was so weak I could barely hold my head up. Called my family practitioner who recommended I go to what we call urgent care, one step down from the ER.

The doctor there did another chest X-ray and blood work. WBC was stil high and CXR showed no change. He sent me back to the same hospital ER to get a CT of my chest to see if it was pneumonia, an abscess, or a possible pulmonary embolism which scared me half to death. Nurses make the worst patients.

July 5 th and I was back at the hospital, another four hour wait sick, weak, and freezing, the CT showed it was just left lower lobe pneumonia but it was not responding to treatment. Since the levaquin wasn't working they called in Infectious disease consult. He said it was Mycoplasma pneumonia and not sensitive to the levaquin at all. He changed me over to Azithromycin and within 24 hours I could tell it was working because the chills stopped.

The test for mycoplasma pneumonia however was negative. But, the treatment was working.

I was sent home from the hospital last Saturday, July7 th, with orders for Azithromycin x 3 more days. July 9th, my follow up with my family doc went well. I still feel like I have this brick in my chest, but he's released me to go back to work next Monday, July 16.

I am supposed to get the stitches and staples removed this Thursday, July 12. I hope this is a million dollar foot because I've been fighting pneumonia since at least June 25 th. not sure about getting this other foot done ever. Too scared right now.

The right foot, however, has not caused me one single bit of discomfort from day one. Ironic Hunh?

Comments, suggestions, ideas are more than welcome. I do not have it in me to go through that twice. I just can't.


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Joshua Answers:


Hi Leisa.

Wow. What an adventure.....

Blech.

Ok, so.

1. I highly suggest that you do not take Levaquin again. It doesn't particularly sound like you suffered side effects, but you want to avoid them at all costs. Bad, bad stuff when a person is negatively affected by it. See: Levaquin

2. As far as the pneumonia itself, I can't say anything about that as I really don't know anything about that.


3. On the topic of Haglunds:

Haglunds 'deformity' is not a disease, it's a symptom of a bigger dynamic.

As a natural rule of how the body works, the body shapes itself to the forces placed upon it. Muscle attaches to tendon/connective tissue. Tight muscle pulls on that tendon/connective tissue. That tendon/connective tissue is connected to bone (heel bone, specifically), and pulls on it 24/7, slowly pulling more and more over time as muscle slowly gets tighter and tighter over time.

Thus the bone growth/formation develops as the body tries to 'strengthen' itself to deal with the increasing load/force being applied.

Haglunds and Bone Spurs are a function of the Tendonitis dynamic.

See: What Is Tendonitis

And as you implied, you have Haglunds in one side with not pain at all. Thus making my case that Haglunds is a symptom of a bigger dynamic, and not even actually the CAUSE of your foot pain.

The doctor had the right idea with the 'lengthening', but picked the worst possible method with which to attain that. Granted, he's a surgeon so surgery always seems like the best idea.

But it's not. Almost never in tendonitis/soft tissue situations.

There are better, more effective, no-downside-no-negative-side-effect, options. Options other than cutting into and injuring the body.


But you're where you're at now. So let's deal with that.

(I'm off to work out right now, I'll continue my response later today. Go ahead and comment with an update of what's been happening when you posted this.)

Also see: http://www.tendonitisexpert.com/43-year-old-runner-achilles-debridement-and-haglands-excisiongetting-there.html



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Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Comments for Right Achilles Haglunds lengthening surgery then pneumonia

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Dec 20, 2014
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Haglund's Deformity that turned into a complete rupture
by: Kelliblw

I am currently 12 weeks post-op for Haglund's deformity/achilles tendon rupture, but mine is a strange story.

I had limped along with a sore achilles for a few weeks before going to my family doctor. She gave me a few little exercises, told me to look more up on the internet, and that achilles strains were 6-9 months before they felt better.

I did the stretchy exercises for the 6-9 months but was not getting any better. Finally made an appointment with Orthopedic Doctor #1. He ordered gave me a cortisone shot in my knee. By this time I had crippled around long enough, I wasn't fully extending my leg to walk right.

I walked kind of like you would in marching band, putting the ball of my foot down first. The first cortisone shot did wonders. It made my knee straighten, helped my achilles, and felt good for 3 weeks. But, you can only get a cortisone shot every 4 months.

After 4 months, I received a 2nd cortisone shot, which hurt like the devil, and never did any good, and the orthopedic doctor ordered some sessions of physical therapy. He also took x-rays and said I had a bone spur on the back of my heel which was pushing on the achilles tendon.

I did about 20 sessions of physical therapy, heel cups, orthotics, ice massage, you name it and I wasn't getting any better.

Finally, I went to doctor #2. He took one look at my heel, ran his finger across the bump and said I needed surgery soon. THis was November of 2012. I asked if surgery could wait until after the holidays. He agreed.

After more x-rays and an MRI, surgery was scheduled for January, 2013. Then I got the stupid shingles. Not once, but two outbreaks of shingles. The first outbreak wasn't bad because they put me on prednisone. This even made my achilles not hurt. The 2nd outbreak of shingles I thought I was going to DIE. I had to wait until March 2013 for my achilles surgery.


By then, the achilles had slowly, but surely been gnawed in half. The surgery was over 2 hours instead of the 45 minutes they thought it would be.

I felt so good right after surgery, no pain, nothing. I thought I would be ready to go back to teaching. WRONG. I was ordered to take off about 10 weeks. The pain started about 5 weeks after surgery. I am currently in PT and things seems to be going so slowly. The doctor said I must be patient as I had 3 surgeries in one.

I had the bone spur shaved off, the achilles debrided, and had it attached to my heel with 2 anchors. I just want to be better. I just got out of the boot at 11 weeks post op, and I am currently trying to walk in 2 shoes.

I still have to use one crutch, occassionally.

But, my heel feels like the bone spur is growing back. THe doctor says that it it is just inflammation. Then in PT, I was receiving an ultrasound treatment, and somehow, someway, I felt this horrible pain that jolted me off the table and ran clear up my calf and hamstring.

The achilles was so bad for so long, that it still pulls my calf up to my hamstring. I know recovery can take awhile, but I am getting so impatient. I am tired of crippling around !!!


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Joshua Comments:


Hi Kellieblw.

Injury to the bone (grinding off the bone spur/bone growth/etc) is a significant trauma to the body/tissue. Bone does NOT like that.

Pain and lasting pain is to be expected.

And you were already short on nutrition, and the stress of surgery uses up nutrition. Without it, recovery is slower.

And surgery doesn't affect any of the causes of the problem(s) you had surgery for.

Give me an update on where you're at now.

If you still hurt, it's time to get to work to reverse the dynamic.





See Related: Haglund's Operation And Everything



Apr 21, 2014
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Nurse Scheduled for achilles tendon surgery
by: Danielle

I have had Achilles tendon problems off and on for about 3 years, consistently for 1 1/2 years. I ran 10 miles last August and felt good at the time, but walking was extremely painful the next day.

I haven't been able to run since. I tried a month of eccentric exercise. One month of a stabilizing walking boot. It felt good in the boot but otherwise was still painful. I really don't want surgery but still have a lot of pain and can only wear dansko clogs with a thick heel, no tennis shoes. I am a nurse on my feet all day. I haven't been exercising and have gained some weight. Very frustrated, wish I could just walk pain free, even if I can't run again. Any suggestions?

Seems like mixed reviews on surgery. My orthopaedic says he will cut the tendon, open it like a book, debride the frayed tissue and reinforce/suture it back together.

Also what type of fitness exercise would be good for getting back into shape?


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Joshua Comments:

Hi Danielle.

Do you for sure have 'frayed' tissue?

Do you for sure have frayed tissue in the middle of your tendon (if the tendon is opened up like a book?

Did you Quiz Your Doctor about surgery?


As far as excercise for recovery, exercise is farther down the line. First have to heal from the trauma/injury of surgery. Then work on mobility, then strength/endurance.

One thing at a time. Did you have surgery? If so, how'd it go, etc? If not, how are things now?



RELATED:



Jan 06, 2013
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Achilles and bursa debrigement and haglund's removal
by: Val

I started having noticeable pain in both feet Feb 2012. Waited until March of 2012 to see the Dr. By April 2012 it was painful to touch the back/bottom of my feet!

I left work April 15, 2012 at the orders of my primary Dr for unrelated medical issues. I suffer from stage 4 CKD and can not take NSAIDs which limited my treatment options. We tried other conservative treatments, but ultimately I had surgery July 30, 2012. The pain wasn't that bad.

My nerve block didn't wear off until 2 days later. But the area where the tourniquet was hurt immediately after surgery. It was sore to the touch for about a day. I was given almost 90 pain pills, I only took 5 because my mother feared that my pain would equal the pain that my sister had after shattering her foot. Luckily it wasn't.

I spent 2 wks in a surgical splint and will be in a cast until Sept 5. Then I will go into a walking boot until I see the Dr. I am still having pain when I my foot is not elevated for 5-10 mins or longer. I have accidentally put weight on my foot....not a good feeling.

I'm not scheduled to see my Dr again until the last wk of Sept.

I am hoping to go back to work by Mid-Oct, but I'm not sure how realistic that is.

Jul 16, 2012
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Thank you
by: Lesia

Day one back at work July 16. No pain meds at all for better than 2 weeks. The right foot isn't healing quite as quickly as I'd like so I still have a little draining going on and 6 staples remain. The incision site does have some scabbing and a little yellow tissue around the scab. But, there is no purulent drainage and no redness, swelling at the site (but a little swelling to the entire foot), heat, or tenderness. He did say that area was very slow to heal and he did not appear surprised. I have another appt with him tomorrow afternoon to see if he's going to remove the rest of the staples. The stitches on the lateral aspect of my ankle came out and site has healed nicely.

The foot that was operated on continues to cause me no real "grief". Its pretty useless though. I am still in my walking boot, which I am now permitted partial weight bearing. A tad concerned that the ankle and muslce tissue is very weak after having not been used for a month. Praying this surgery was successful and worth it. Scared of having to have anything else done to it.

The left foot is causing me some tenderness on the bottom of the heel bone and the back at the insertion site of the achilles tendon; perhaps for having to over compensate for the right foot. If avoidable, at this time, I would really rather NOT have the left foot done. This has been a roller coaster ride for me and I'd rather not ride again.

Question...what kind of tennis shoe would be best for me given my circumstances? I have orthotic inserts but if you don't put those into a good shoe its a waste of time. I have too much invested now to throw it away. Being a nurse, I have to take care of my feet.

Thank you for getting back to me and responding as you have. The information is verymuch appreciated!! Wish I'd found your site 6 months ago.


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Joshua Comments:

I wish you'd found us 6 months earlier too!

Unfortunately I'm not a shoe expert. I'm generally a fan of barefoot/minimalist shoes...but a soft padded shoe is very likely a good thing for you for a while, until you heal/strengthen up enough to move towards barefoot/minimalist.

I hate it when I don't have answers....



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