Week 3 – 5 from Joseph Loria

Joseph Loria Weeks 3-5 direct from Joe on his Hyprocure implant surgery by Mr Barry Francis.

A great deal of week 3 was spent walking for long periods using the ‘Aircast’ and crutches. It is becoming second nature now and rarely notice any discomfort in my ankle region. I still elevate my foot occasionally as it swells if I remain on it too often. At the end of the week I removed the dressing and applied the plaster over the incision area as directed. The wound is healing well and my foot displays a noticeable arch and straight ankle. I am also happy to be able to use the bath again as this helps release a lot of the tension built up from using the crutches.

I continued into week 4 in much the same vein; progressing with the walking and elevating
as necessary. There is more freedom in my ankle without the dressing and this makes wearing the boot a lot easier. As each day passes, the perceived flexibility increases as I begin to stand more comfortably at a right angle to the floor. I also notice my weight distribution is towards the outside of the foot, which I recognize is a common issue during the early stages following surgery. By the end of the week I feel confident enough to try replacing the ‘Aircast’ with regular footwear.

Week 5 began by wearing trainers momentarily to see how I could cope. I have a wide
fitting pair with plenty cushioning which helped the transition as the boot is very forgiving. Initially, I felt a minor pain set back due to the latter being so supportive and managed this by taking the first few days very slowly. Wearing thick socks softens the impact and now at roughly a month since the operation, I am pleased to be back in trainers and glad the recovery has been so rapid. The remainder of the week was spent building on this improvement.

There is fair way to go until I reach full fitness, highlighted by the amount of back/neck ache I frequently have. My pelvis remains constantly rotated despite being manipulated in the past and I am hoping these symptoms will be addressed once the left foot surgery I plan to have is performed. I notice how much it pronates now in comparison to the corrected foot and am keen to see how the upcoming procedure completes the picture. I will continue using crutches for the next 3 weeks until the next appointment with Mr Francis is due.

For more information on Hyprocure Implant Surgery please do not hesitate to contact direct Mr Barry Francis the foot surgeon” at the Fyfield Clinic.

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Comment from Barry Francis

After our last few blogs and testimonials it’s only fare to expect a comment from Mr Francis relating to the two patients giving weekly updates on their Hyprocure implant surgery. Susan Knott and Joseph Loria.

Both patients are doing well and so far their treatment is running to plan. It is important not to over-stabilise the foot, that is, some degree of movement inwards (pronation must be permitted to allow good shock absorption).  I am pleased that pain levels have been low.

The idea of the boot is to stabilize the foot during the initial healing phase but, more importantly, to allow the patient to put the whole foot on the ground as this is particularly important at an early stage after the Hyprocure implant surgery carried out by the Fyfield Clinic.

Barry Francis

“the foot surgeon”

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Flat Feet 2 by Joseph.

Joseph Loria Hyprocure implant surgery 

Week 2

The main concern this week was to become accustomed to the ‘Aircast’ and mobilise myself as much as possible. I began by walking the length of my hallway for short
periods of time at regular intervals throughout the day. I tried to structure it sensibly to avoid over doing it and gauge how I was recovering. The first few days felt like bearing weight on a sprained ankle although this settled once I built some momentum. I then progressed to circling the outside of my house around midweek and gradually felt less inhibited by the boot. Towards the latter stages of the week I noticed a marked improvement not only in pain reduction but natural walking motion also. The ‘Arnica’ helped with the bruising and I took Paracetamol sparingly to alleviate my long term back
trouble, stemming from being ‘flat footed’ and hyper mobile. By the time I was due back to see Mr Francis at the Fyfield Clinic for my second review I was leading a more ‘normal’ lifestyle and socialised a lot more. The follow up involved removal of the suture and a final redressing. Mr Francis was happy with the healing rate and advised wearing the ‘Aircast’ for approximately 2 additional weeks until the transition to wearing regular footwear could be made. The redressing will be replaced in a week’s time with a plaster to cover the incision area and I must continue using crutches for the short term. The next review appointment takes place in 6 weeks. My aim now is to really step up the walking to see how much recovery can be achieved by this date.

Joseph Loria

For more help and advice please do not hesitate to contact Mr Barry Francis “the Foot Surgeon” and his staff at the Fyfield Clinic Enfield or at Number 9 Harley Street, London.

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Flat Feet by Joseph Loria Week 1.

Another great Testimonial about Mr Barry Francis “the foot surgeon” and the Hyprocure Implant service at the Fyfield Clinic. My name is Joe and I am a 31 yr old male. I chose the ‘Hyprocure’ sinus tarsi implant in an attempt to stabilise my ‘flat feet’ and relieve their associated symptoms. This blog documents my progress and aims to help anyone considering the operation.

Day of surgery

As it was possible to have the procedure performed under local anaesthetic, I ate and drank as normal ahead of my appointment. Upon arrival I was greeted by Mr Francis and his team who discussed the surgery and informed of any potential complications before welcoming any final questions. I was offered refreshments and plenty reassurance which helped matters. I was then taken into a room adjacent to the operating theatre and given the anaesthetic in the ankle region of my right foot. There was roughly 15 mins waiting here then I was moved through. During the operation, the screen was drawn across the surgical area and I read a newspaper to try and focus my attention elsewhere. It took 20 mins to complete and felt no discomfort. The team checked I was happy throughout and
brought me back to the previous area once the suture and dressing had been applied. Mr Francis then prescribed a short course of painkillers, anti-inflammatories and antibiotics. A team member took an x-ray and fitted an open-ended sock/post-operative shoe ready to be discharged. The whole process was a pain free experience, delivered in good spirits in under an hr. I left using the self provided crutches and rested in the back of the car with my leg elevated for the return journey. The rest of the evening was spent relaxing in
bed. I woke a few times during the night due to a mixture of soreness and difficulty finding a comfortable resting position.

Week 1

I felt pain and tenderness in my ankle the morning after though this soon subsided once I took the medication. The vast majority of the day was spent in bed only moving to use the bathroom. I created a temporary living space downstairs ahead of surgery with everything close to hand. This made a considerable difference as attempting the stairs later in the week proved to be such an ordeal. Learning to accept the limitations was frustrating initially as I tend to move around a lot and tried to resist remaining stationary. I was also lucky to have a parent at home to provide meals and company. Mr Francis’ P.A called
to enquire how I was feeling and check the operation went well. The whole week’s events generally mirrored this day; immersing myself in media whilst elevating my foot and taking the medication. In hindsight, I could have eased off the tablets after a few days and became slightly more active as the pain and swelling had greatly diminished by this time. I was perhaps overcautious due to it being a new experience and for fear of migrating the stent. My sleep became more restful with each night and as the follow up appointment
approached, I felt much stronger and more positive. The return to the clinic involved a redressing and check of the incision area. Everything was fine and I was issued an ‘Aircast’ to resume walking, still aided by crutches for balance and weight distribution. Mr Francis advised switching to mild pain killers and ‘Arnica’ to reduce the bruising still present. A further review was made for a week’s time.

Joseph Loria

This testimonial from Joseph will continue about Hyprocure Implant and Mr Barry Francis “the foot surgeon” and his staff at the Fyfield Clinic Enfield and 9 Harley Street, London.

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Hyprocure Implant

Following on from the testimonaial and first week from Susan here is week 2.

“Week 2 began with a trip to my local podiatrist to have the dressing changed and to be fitted with a boot supplied by Mr. Francis.  I’m not sure what I was expecting, but the image conjured up by the word “boot” is certainly not the jaw-dropping, knee high contraption I was presented with! 

I’m now the proud owner/user of an Aircast XP Walker Extra Pneumatic which takes a little while to get on and inflated correctly each time, but makes it amazingly easy to get around on two feet again.  Having nothing at all in common with a mountain goat when it comes to sure-footedness, I’d put off trying to shower balancing on one leg for fear of slipping.   However, although it’s a bit of a struggle to get the recommended Limbo waterproof cast protector over the Aircast, it is manageable and having a shower for the first time in what seems like forever was very nice. 

At the moment wearing the boot does aggravate the wound site which starts to throb after a short while. Leaving it on whilst resting (even if deflated) is also not very comfortable as the foot is kept at a rigid right angle position to the leg and everything goes numb unless you constantly wiggle your toes.   I therefore tend to take it off and rest at regular intervals which keeps the discomfort to a minimum.  Hopefully, as the wound heals completely the soreness when wearing the boot will subside.  In any event, life is definitely much easier with the mobility that the Aircast provides.”

Susan Knott

For more help and advice on Hyprocure Implants please do not hesitate to contact Mr Bary Francis “the foot surgeon” at eithe the Fyfield Clinic in Enfield or in Harley Street, London.

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Small bone

Mr Barry Francis  “the Foot Surgeon” picked this up while on the train reading the Daily Mail last week. One of the less common problems that can occur with the foot is a small extra bone at the back of the ankle.  Often people go through life happily with this but if it becomes amaged then it can cause pain and a change in function.  The bean-shaped bone is called an os trigonum.  In the Daily Mail last Tuesday a keyhole surgery approach is described in removing this bone.

Problems with it often follow a small accident, such as a wrench of the ankle or sprain, and the patient will often experience a clicking sensation in the ankle with pain.  The ankle itself might feel unstable.  Proper diagnosis is important and this often requires a CT and/or MRI scan.  The procedure can be carried out under minimal incision or perhaps more often through open incision from the side of the ankle.

Until the next time Barry.

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Mr Barry Francis the foot surgeon” thought he would put a recent testimonial from Sue Knott on a Hyprocure Implant.

“I have worn expensive custom-made orthotics for several years now and, although they relieved a lot of the discomfort I experienced daily due to hyperpronation, this never truly disappeared.  Wearing fashionable shoes with a small heel at my son’s wedding for a few hours resulted in no sleep at all that night due to aching and a throbbing pain which did not respond to painkillers and only subsided with a few days rest.  At that point it was either continue wearing flat shoes with orthotics to keep the discomfort minimal or investigate a more suitable and, hopefully, successful alternative.

An internet search led me to the Hyprocure site and eventually, through a local podiatrist, to Barry Francis.  X-rays and an ultrasound were carried out to make sure I was a suitable candidate for the procedure and, this being the case, the surgery took place on 8 September 2011.

I felt at ease at the clinic as the atmosphere was relaxed and friendly and the only slight discomfort I experienced during the whole procedure was the administration of local anaesthetic injections prior to having the stent inserted.  Probably my biggest fear at having the procedure carried out under local anaesthetic was that the latter might not work effectively, but Mr. Francis tested several areas around the operation site prior to making the first incision and I can honestly say that, other than being aware that something was being done to my foot through feeling pressure being exerted, I was in no pain at all from start to finish.  The operation is quite quick and, in fact, the longest part of the procedure is having the anaesthetic
injected and waiting for it to take full effect.  A post-op X-ray was taken to confirm that the stent was in the correct position and, with my foot heavily bandaged and sporting a trendy velcro fastening black boot, I was discharged home to the sofa with the instruction to remain non-weight bearing on the foot for a full seven days.

Six days later I can report that, aside from numbness in three toes which has now gone, I’ve experience very little discomfort from the foot itself, despite having to stop taking the co-codamol painkillers after one day as they made me feel queasy and lightheaded.  I’ve continued to take the anti-inflammatory medication three times a day and, apart from slightly swollen toes which appear to be turning green with bruising and muscles I never knew I had strained from trying to get about on crutches, I’m getting along just fine
with no other painkilling medication.”

Sue Knott

For help and advice please do not hesitate to contact Mr Barry Francis the foot surgeon” or his staff at The Fyfield Clinic, Enfield or in Harley Street, London. For details please visit our website at www.thefootsurgeon.co.uk

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