The decision

It was kind of surreal yesterday, driving to the same hospital where I found myself on March 5th of last year with my wife in an ICU. On this date last year I couldn’t have imagined myself ever having a need to go to that hospital, ever. But I digress.

Taking the advice of a friend and having read many of the posts here I decided to seek another opinion. I couldn’t get into see my first option as our schedules weren’t going to mesh with my looming surgery date and having a couple of long weekend trips. Luckily there was a major winter storm that closed off the mountain passes and caused some cancellations.

I got checked and waited. I love waiting.

A nurse finally comes to get me. She looked a little quizzically when I confirmed I was her patient. She said she thought I’d be in a cast o on crutches. She commented on how I was walking well.

She chatted me up for a little and found out that we both play in the same flag football org and she had explained she tore her gastroc also last year. I then told her my history of what brought me to them.¬† And then that I was scheduled for surgery. And that the surgeon was a Podiatrist. She stopped and said, as one flag football friend to another to cancel that surgery immediately. But but but…she explained that the only surgery they do is on professional athletes and/or college athletes and that I didn’t need it. Ok. She explained that I’ll either be seeing a Nurse Practitioner or a med student (as I was at a teaching hospital) then likely the Chief of Service for Orthopedics.

But first, more X-rays!

X-rays out of the way here comes the Nurse Practitioner. I tell him the story and he starts doing some strength tests, pushing, pulling etc. Checks for pain and we talk more about how this came to be and what the Podiatrist said. Wait, podiatrist? You don’t want surgery from him is what he said. More talking. He’s off then to get the Doctor.

The doctor comes in, does the same tests, looks at the X-rays (presumably looked at the MRI disk I gave him as well) and pointed out my Haglund’s deformity and the complications it can have with the Achilles and talked about a gastroc slide possibly but that will come after the Achilles heals up. His recommendation was no surgery. Says to live life and heal. I’ve been full weight bearing coming up 6 weeks. Stay away from anything that involves resistance, save for walking and weight bearing.

12 weeks post injury they say I can begin rehab. That’s it, he leaves.

I talk further with the NP. He continues to stress that surgery is not needed and that in his 18 months in the clinic, he hasn’t seen one Achilles surgeries but they see plenty of Achilles surgery failures.

So here I sit. The decision is made. I’ve cancelled my surgery. No cast, no boot no further appointments. It came down to a doctor friend I trust saying to avoid surgery (for anything) if you can and the medical staff at the Sigvard T. Hansen Jr. Foot and Ankle Institute make strong recommendations to avoid the surgery. On top of being able to live a life while they feel I can heal myself.

I’m satisfied with the opinion they provided. I’m still out for my baseball season more than likely but my stretch goal is to return in August.

They follow the Twaddle Protocol. I’ve searched but can’t find a timeline for that, anyone have info?

Another visit

Heading to visit an Orthopedist today. After a lot of thought, some reading and a talk with a doctor friend I am going to seek a second opinion on treatment.

My Achilles area feels good. No pain like I experienced in the few weeks after tearing my gastroc and I think this in part is what is driving me to seek our more medical advice. I’m walking fine. I took batting practice the other day and had no pain. Maybe it’s a false sense of security.

I’ve been told that the doctor I am seeing doesn’t perform surgery on the Achilles. This came from the person I scheduled the appointment with. I had no idea, I was just going off a referral from my doctor friend. I don’t think he knew either but he holds him in high regard.

The scheduler said something to the effect that there are studies out that indicate the non surgical option is as good an alternative.

We’ll see what he thinks.

Knowing what I didn’t know

Yesterday I had the chance to meet the surgeon I was referred to.

It was great to finally get some clarity on the issue at hand, the future and another diagnosis.

He was of the opinion that my injury, while technically a tear was more of a war of attrition and finally my Achilles couldn’t hold up.

He took the time to show me what was going on and his theory on what had happened. He took a couple of x-rays also and showed me specifics on the MRI. It was a good meeting. I spent more time with him than I had the Dr. I have been seeing combined.

Bottom line is that there is damage and left untreated it will likely fully rupture at some point. When, of course nobody knows. Ticking time bomb was the descriptor (he wasn’t going for anything dramatic) . I am in no pain right now, can walk normally but am still weak from the calf tear (stopped PT 2+ weeks ago). He gave me the surgery and non-surgery options.

And I have chosen surgery.

He advised 4-6 weeks NWB and then assuming all is going well moving to a walking boot. My vision of having to be a hermit bound in a hard cast for 3 months and not being able to leave the house was cleared up.

I hate that I’ll miss my baseball seasons and that 4-6 weeks, but booting for a couple of months hoping for recovery and still having pain after activity (spurs, calcification) that isn’t being addressed was unappealing looking years down the road.

The comments left on my first entry and re-assurance from my doctor friend and the surgeon that it’s really a fresh start made it a pretty clear cut (rimshot) choice for me.

Now the wait. Surgery isn’t until 3/21 but thankfully I have a couple of trips to Las Vegas on the books between now and then to have some fun.

The only bad news that came from the meeting was that he feels my left Achilles is in a similar situation. I had that feeling already but it was just confirmation. He doesn’t think surgery is needed on that one at this point and the fact I’ll be taking it easy will give it chance to heal up some.

In the mean time I need to have a come to Jesus moment with myself. I have to drop weight and take care of my body. That means stretching and getting ready before hard core activity. To me that is like reading the instruction booklet :D. But unless I want to be in my 40’s suffering chronically I should learn those lessons now.

I’ll keep posting my thoughts as this will be a great outlet and interacting with my soon to be brethren.

You don’t know what you don’t know

I don’t even know where to begin. Right now if I read through some of the blogs on this site, I almost break down and cry.

I’m bitter and angry that I have to go through this and yet, what this is, I do not know.

5 weeks ago while playing flag football I felt like I got cleated or whipped in the calf with a solid object. It hurt. I got a little queasy and almost started crying. I didn’t though because me man. Ok, I am not some badass toughguy. It just didn’t hurt that bad and the weight of what I know now really couldn’t be felt.

Don’t get me wrong, it did in fact hurt but not like I’d expect and Achilles injury to feel like. But you don’t know what you don’t know.

Luckily I had a doctor on my team who took a preliminary look at it and did the Thompson test. My Achilles was at least partially intact. He said he didn’t think I needed to go to the ER so I went home.

Pain pain pain. Dang, nothing ever hurt like this before. I was holding out hope that I did get stepped on, then I saw a doctor the next day. Said hope was gone. I was diagnosed with a partial tear of the gastrocnemius medial head. Fabulous.

They did an xray to make sure nothing was broken and that came back ok but the first thing the doctor asked was if I had ever had Achilles problems. I explained that the back of my foot and Achilles did get sore often. What I didn’t tell him is that it usually loosened up after playing and I had been taking vicodin to get through the initial pain.

He said I could tell there was likely tendinitis and there was some calcification I believe but he said we could work through that in PT. So off to PT immediately after my doctors appointment.

Flash forward a week. PT has gone ok, I’m officially approved to get off my crutches. Still gimpy but it’s a lot better. Prescribes more PT and another appointment. Achilles area is really tender. And I am still swollen pretty good.

Flash forward another week. PT ok, swelling almost gone totally. Achilles area still hurts (can you tell where this is going?). More PT RX. Come back in two weeks.

Flash forward two weeks. Walking almost normal. He can feel a difference between my injured side Achilles and my non trauma side Achilles. For that matter, I can to. Next steps are an MRI.

Wow, MRIs suck. Thankfully she tells me we are down just as I am starting to almost lose it. I can’t imagine a fully body MRI.

Next day I am in the doctors office waiting and I text Joy that I don’t have a good feeling about this. 3 minutes later he’s telling me the diagnosis.

Diffuse severe Achilles tendinitis with insertional intrasubstance partial tear involving approximately 2 cm longitudinal extent and 60% cross-sectional thickness of the distal Achilles’ tendon. Note is made that on this extremity MRI, only the distal 6.5 cm of the Achilles’ tendon is visualized and the entire visualized tendon is abnormal.

In other words he says I need surgery. FFFFFFFFFFFFFFFFFF.

Exactly what I didn’t want to hear. When asked how long until I’d be semi-normal again he stated 3 months. That was a bit of ¬†relief. Then I tell my doctor friend and I can just read through his text that 3 months is not realistic. He’s thinking 5-6 months.

So here I sit. I’ve told the 3 baseball teams I was going to play on this summer I am out. The tournament team I was playing in LasVegas in 2 weeks that I am out. Have had numerous spats with the wife my convalescence and how miserable it will make both of us. Told work to expect me to be out on disability for a some time. Booked a Caribbean cruise for December and am writing this blog. Oh yeah, I haven’t even seen the surgeon yet.

That glorious meeting happens Tuesday. I assume you don’t get referred to a surgeon only to have him not want to perform surgery. So I’ll be looking to set a date toward the end of March because I have 2 trips planned and am looking to do another before I get homebound for god knows how long.

We shall see what happens next.

If anyone reads this, and has had a similar injury (partial tear, I assume there is a difference between a full one) please leave a comment and let me know you long it was or a link to your own blog. I’m going crazy in my head not knowing what to expect.