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.
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Good attitude, adrianb! “Welcome” to (as someone else on the site put it) “The club nobody wants to be in”.
On the bright side, once you’re in the boot, full-weight bearing, it’s really not that bad. Although most sports are out for a while, you can really still lead a pretty fun life. You can still go to the movies, out to bars, play pool or darts, draw, paint, swim and/or sit in hot tubs (if you’re in the VACOcast), grocery shop, etc. Not too bad. Also, you can get sweet parking spots w/the handicap tag :).
Anyway…glad you’ve got a good doctor that explains things well. That goes a long way!
Stay positive, good luck at surgery, and happy healing!
Adrian, if I were you I’d start bugging the surgeon NOW about what he bases his 4-6 weeks of NWB on. Studies, statistically-significant results somewhere? Something particular about your leg? In my experience, a surgeon who says “4-6 weeks of NWB” pre-op usually means “6-plus weeks of NWB”, based on the mistaken-but-logical-sounding belief that waiting longer improves results and decreases re-rupture risks.
The data seems to show that hustling along with rehab is not only easier on the patient and their friends and relations, it’s also better for the leg.
It also sounds as if he’s planning for you to spend the NWB period in a cast, rather than the same “walking boot” you’ll use later for walking. Ask him to justify that, since the studies with the best results (with and without surgery) have used a boot for NWB (usually following a week or so in a splinted wrap or similar).
He may be a wizard with a scalpel and a needle, but most surgeons don’t spend a lot of time reading the literature on rehabilitation protocols, especially for “boring” surgeries like ATs. And you’ve probably got more leverage now than you’ll have post-op.
If you haven’t found it, the biggest, newest, and probably best study with a fast modern protocol is now on this site, at achillesblog.com/files/2008/03/jbjsi01401v1.pdf . They got great results with and without surgery. There’s a link in the file to the protocol they used, and it’s basically the same as the one I posted (from the authors of that study) at bit.ly/UWOProtocol .
If your surgeon follows that schedule, you’ll get off the crutches and “back on your feet” sooner — PWB at 2 weeks, FWB “as tolerated” at 4 weeks. You’ll also start PT and exercise sooner (at 2 weeks), during the time he plans to have you locked in a cast.
adrianb, If you get a chance to look at my blog you will see that “in the beginning” I was feeling just like you. I’m a bit older(52) but a similar story. The first time I saw doc he wanted to operate(mri) and I held off. My achilles(both of mine too) got soooo painful that I was stiff legged by the afternoon and really couldn’t participate in the things I love. I’m not a “can’t” kind of gal. I was almost crippled by the time I shredded my left one and had surgery. My right one has been irritated during recovery. Remeber to wear a heel raise when you are in your cast on your opposite leg as it will alleviate some of that. Bare feet are the worst things for it and I liked slipping around in my socks…not good.
“4-6 weeks of NWB” pre-op usually means “6-plus weeks of NWB”,
I blocked it out but I think mine was close to 8 weeks.