adrienne’s AchillesBlog

I know I have been quiet on this blog lately, but I’ve been frustrated with my progress. It’s hard not to feel down, but I’m trying to be positive and patient. It’s about 18 weeks now and still in a good bit of pain. Funny thing is that the pain is not in the same place as before the surgery. It’s basically where the tendon narrows just above the heel. Perhaps this is due to the vertical slice down the achilles during surgery? The area where my haglund’s was still hurts at times, but it’s a different burning pain. And it’s not always there. The pain is preventing me from doing any heel raises or eccentric heel lowerings. I’m still walking with a limp. Another issue I have is my ankle/foot feels very stuck - perhaps due to immobilization. But shouldn’t this have worked itself out by now?

I have switched back to my first PT who I really like. She’s been working on getting my foot/ankle moving better, but it always seems to snap back.

So at 18 weeks is this ‘normal’ progress? Should I be further along?

Finally made it to two shoes. Well, I think….

Saw my ortho yesterday and everything looks really good. He tested my strength which he was happy with (I’ve had 3 PT sessions so far). Then I pointed him to my left shoe that I brought along, just in case. He commented on how nice my shoes were - they were actually my heavy duty hiking boots…we’ve had so much snow here. Then asked me if those were the shoes I’d be wearing most of the time. I said that or sneakers, so he said he would give me heel lifts to reduce the stress on the achilles. Or I could wear shoes with a little bit of a heel. Continue PT and I’d see him again in 6 weeks. He then got a call he had to take and left the room. His assistant came in to give me the heel lifts and that was it.

I left the office in two shoes (and a limp) and got in the car to drive home. I’m happy and singing to the radio when it hits me. He never EXPLICITLY said I could go to two shoes. I replayed the office visit in my head. We talked about shoes and heel lifts, but…. Was it me so focused on transitioning to two shoes that I just assumed it? Argh!

I ran some errands after my doc visit and the achilles got a bit sore. So I’ve decided I’ll be in two shoes and just take it easy. If needed, I can go back into the boot to give my achilles a rest. I will confirm with my PT next Tuesday as she has access to his files.

For now it’s TWO SHOES!!!!

Since my last post I was PWB for only 4 days and then transitioned to FWB. The heel was VERY sore initially, but has since gotten better. It’s still a little tender, but easily tolerated. The gel heel insert definitely helps. My ortho told me to work on my ROM as much as possible before my first PT appointment. So any time I was at my desk, take the boot off and move my foot. I was also told that I didn’t need to wear the boot to bed.

So I have a confession. I’ve basically been in two crocs at home since transitioning fully to FWB. I just found it a bother to strap the boot on every time I had to get up from my desk (working from home). I have a small apartment, crocs, and gel inserts - i was basically peg-legging it around. Another reason for not wearing the boot much is that my foot and ankle joints have a history of freezing and lock up when immobilized. I did wear the boot anytime I went outside of my apartment. If my ortho read this, I’m sure I’d get a proper scolding.

I also had a little accident yesterday. Well more like a misstep. I was changing my bedsheets (had the boot on) and tripped over my crocs. Quite ironic, I know. (And yes I know that’s not the proper use of the word ironic) Nothing bad happened, but I did jolt the achilles. It was quite sore afterwards and I was worried that I did something. Reading all the different stories on this blog has made me somewhat of a hypochondriac - either ‘I think that’s what I have’ or ‘why am I not doing as well’. But it’s feeling fine now. Disaster averted!

My PT session was pretty much a non-event. She took some measurements and showed me a few exercises to do at home. No soft tissue work, no working on loosening the joints. She did a little massaging of the incision (for like 10 seconds), but it didn’t hurt at all. I guess I was expecting a more aggressive approach. My last PT was very aggressive - to the point where I would break out in a sweat. I’ll see what happens at the next session.

Below is what my scar looks like today (excuse the sock imprint). There’s just a bit of scabbing near the bottom, but looking good I think. The scar feels a bit lumpy and I’m hoping that will even out with some self-massage. On either side of the scar there’s a bit of swelling still and it’s here that I still feel some pain. I’m not sure what it’s from. Would the anchors hurt? Or is it just the tightness of the achilles? Has anyone with Haglund’s had any post-op pain in this area? I’m hoping it’s normal.

Next week, 2 more PT sessions and a visit with the ortho…

Just thought I’d share an article I found on scar prevention. In a nutshell, Vitamin E oil, Mederma and Aquaphor all perform about the same.

Scar Prevention

Jan. 10, 2014 - 2nd Post Op

Had a huge surprise at my 2nd post-op. No more cast! After the PA sawed off the cast and removed the last of my stitches (which didn’t hurt), the doc came in looked at the incision and said it looked great. He tested the dorsi flexion and i was pretty close to 90 degrees (90 being 0% and I was at 2%). He put me into a walking boot with only the last section of the wedge and partial weight bearing. Yay PWB!!!! After 4 days I’m to remove the wedge and try to get to FWB. And of course range of motion exercises - as much as I can do before physical therapy which I start in two and a half weeks. Yay PT!!!

A couple things I noticed right after coming out of the cast is that my achilles and ankle were both more swollen than after getting out of the splint. I guess it might have been that the first two weeks after surgery, I was spending most of my time in bed with my leg above heart-level. I’m really happy with how the incision is looking.

I was surprised how stiff my ankle and foot were. From everything I read in these blogs, I was expecting some stiffness, but wasn’t prepared for how bad it was. It was so stiff that it hurt putting a bit of weight on it. In these last few days I’ve been trying to loosen the bones in my foot. It’s like I’m giving myself chiropractic adjustments every hour. Most notable are the first metatarsal and the talus.

As of now, I’ve been PWB for 2 days with the walking boot and wedge. The achilles is definitely lengthening. My ankle is swollen and warm to the touch. I’m assuming this is normal as it’s been completely immoblized for 4 weeks and I’m making it work now. I’m also feeling pain in the heel - I think that’s the nerves waking up. Overall, the ankle is just sore. But I have been able to put a little more weight on it today than yesterday.

So a couple questions for those ahead of me in the recovery timeline:

1. For the swelling and warmth, is it okay to ice it every once in a while? I’ve read recommendations of soaking the ankle in warm to hot water to loosen up the joints. Haven’t done any soaking yet as I feel the foot is warm enough. I just don’t want to ice if it’s going to have a negative affect.
2. Any suggestions for scar prevention or incision skin care? The incision is feeling a bit hard. Is that normal?

Last thing, I measured my calves today. The ATR side is 12 3/4 inches while the normal one is just over 14. Looks like I have my work cut out for me….