PTT Insufficiency: First week at home

First week at home

I am definitely bedridden. I can move around on crutches, but not for very long. The key to the next few weeks is to keep the swelling down. This is done my keeping the foot above the heart ("toes above the nose") for ninety percent of the time. I still need to get up and walk around a bit: one much avoid blood clots and bed sores.

So I can lie on my back in bed and go through my reading pile. I can read text on the laptop, and do a little typing. (I am using some of the remaining 10% of the time to sit up and type this. The toes are just below the nose.) The inability to type easily is just part of the recovery right now. If it goes on for a month or more, it will become a full-fledged disability.

What's next

The splint I am wearing comes off two weeks after surgery. We already have the appointment. It is then replaced with a fiberglass cast that I wear for six weeks, bringing me to early August. Then we start working on weight bearing with the same removable cast I used before the operation. I should be in that for five months (see below).

After that, the physical therapy starts. The bone will have long been healed, but the tendons take a long time. My next scheduled travel and talk is the Usenix security conference in January. At least I'll have plenty of time to work on my slides.

I have obtained a temporary handicap card, which is good for twelve months, including a renewal at six months. Those crip spots help, and will probably help more when I am on crutches.

I have also consulted various catalogs for assistive devices the code words for stuff that makes the life of a disabled person easier. I have not yet found what I really need: something that will hold this laptop for me as I lie in bed flat on my back. Perhaps I could build something out of the rods and clamps found in the chemical stockroom.


It is hard to get a frank estimate out of a doctor, especially for a procedure that was never billed as perfect. Dr. Deland spoke to me the day after the operation, and said that we have given it our best shot, assuming of course that I give my full commitment to post-op care.

Reading between the lines, I take it that he had some unusual troubles, and might not stick with the original 90% recovery if asked. The operation took substantially longer than expected. Perhaps he found that the proposed replacement tendon on the bottom of my foot wasn't as strong and useful as expected. (I understand that there are two tendons to the toe, so most normal toe-curling function is retained.)

The original estimate for use of the removable cast was two months. He cranked that up to five. Sounds like extra care is needed.

I am not complaining, I am in good spirits and have plenty of optimism. But I do want to know the whole story, and a recounting of such surgical glitches would be appreciated. This is definitely at odds with the traditional paternalistic let-me-worry-about-it approach that many doctors have had.

Dr. Deland is a busy man, and I have flooded him with questions at each of our meetings. I will ask more about the above at the next meeting.


I cannot imagine what it would be like to go through this without the help of my family. Lorette remains cheerful and vastly useful, dealing with appointments, meals (no surprise: I did not eat much hospital food), the medical and insurance business, and all the details of running a house with kids in it. This weekend she even went off to help run the Girl Scout Camporee.

Lorette's mother came and watched the kids and helped out. Alas, she is returning to her own home tomorrow.

My parents loaned me an automatic transmission vehicle. The first doctor had said that I would have to drive my wife's car for a year. Both our cars are manual transmission. I am lucky that the left foot was involved, rather than the right.

I cannot imagine what all this would be like for a single person without any help. I am certainly grateful to my family, friends, and the folks at the hospital for all they have done.

Update: Two weeks post-op.

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