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MeadowBlue

orthopedic surgery after gastric bypass?

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Hey guys. I have a pretty painful and prominent bone spur on my heel. My orthopedic surgeon said I could try to work on lengthening my tendons to reduce the pain but ultimately I will probably need surgery to shave it down. I've been in pain for about 3 years so I'm worried that I will end up having to do this surgery. I am currently trying to stretch and use physical therapy to keep it in check.

I do NOT want to do the surgery before gastric bypass, as I feel laying around for months will absolutely result in significant weight gain. You have to stay off the foot for a long, long time and I feel that boredom, depression and being sedentary is a recipe for disaster. If I can just do the bypass first I feel perhaps I could piggyback on that down time and at least not gain weight.

I know it take a lot out of your body to do major surgery and I dont want to overtax my healing abilities. Has anyone had to have a surgery after bypass? There is a slight chance that losing a significant amount of weight could ease my heel pain so I also want to wait for that reason.

 

Thoughts?

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I had my bypass in May last year, then a midfoot arthrodesis (screw and post through my navicular bone) the following August. Cast and non-weightbearing for three months. I really wasn't back on my feet for almost 4 months. Total recovery time I was given was 12-18 months and each recovery step along the way.... pardon the unintentional pun.... has been longer than normal in my case. I'm not going to lie to you...it was tough, and I still have moderate pain on a daily basis. It was also the best thing I've done for my mobility after approximately 5 years of what was crippling pain. Weightloss doesn't require exercise, even though it is highly recommended.  As many others pointed out here to me before my foot surgery, you can still exercise even sitting in a chair...I'll be honest and admit that I didnt....I vegged out on the lounge watching Netflix with my foot raised above heart level (as required). As my stats show I did get below goal....and am still below goal over a year later. Food prep was hard as I live by myself, I precooked three months of meals knowing that I couldn't do it non-weightbearing.... In hindsight that may well have been a saving grace having all those healthy meals pre-portioned and ready for the microwave.

Only you can judge when you need to schedule your surgery. There's never a good time to have to recover from foot surgery when it involves significant periods of immobility. For me, I believe early after my bypass was the best time. I was still in my "honeymoon period", so was going to continue to lose weight regardless of what I ate at that stage. It did slow things down somewhat as post-op I needed to eat in a way to promote bone growth. Weightloss is not recommended during recovery from the surgery I had. The big advantage is now...I can walk again, so when I feel the need to move more to stop any regain, I'm actually physically able to do that. If you have your foot surgery after your WLS you get the advantage of far less weight on your foot when you are eventually cleared to exercise on it. In my case I couldn't get the foot surgery until my BMI was <30 anyway although I managed to achieve that right at the time I had my WLS. The downside of having the foot surgery after my bypass was not being able to take any NSAIDS, and a decision had to be made about the need for blood thinners after surgery. My surgeon generally prescribes aspirin post foot surgery for 8 weeks to prevent blood clots. In the end the compromise was made to use high dose fish oil as a blood thinner instead. Had I not already managed a lower BMI at surgery time, then in the absence of NSAIDS, I would have been required to have blood thinning injections daily for the entire time I was immobile....those carry other risks as well. 

If you haven't gone through all the details with your orthopaedic surgeon regarding aftercare, eg pain management, realistic mobility post surgery, and blood clot treatment, I'd certainly be having that discussion before making any decision to plan foot surgery for shortly after bypass. I went to three different orthopaedic surgeons before finding one that would actually do it. Admittedly the first one wouldn't even help my because I was too heavy, the second helped initially but then then said I was too heavy and had to get my BMI below 30 before he would do anything surgically then after my bypass refused to do the foot surgery anyway saying the bypass made me too high risk (only found out later that he couldn't do what I needed anyway as it was too specialised), by the time I saw the third my weght was no longer an issue.

Good luck getting your answers and making the decision.

Edited by Aussie Bear
Bloody autocorrect!!!!!!

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Depending on your risk factors, they'll likely make you wait at least 8 weeks between surgeries. I'd personally choose the same way as you, and do the bari surgery first, but talk to your bariatric doc first - they may want you at a certain stage of healing or a certain level with your diet before they'd consider clearing you to tackle further surgery. Hopefully weight loss will help with your pain!

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On 11/25/2018 at 11:26 AM, Aussie Bear said:

 

Good luck getting your answers and making the decision.

Very good insight thank you. I think I'll just try to be patient and get through the bypass first then re-evaluate

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