11 weeks post op

I’ve been walking in two shoes for almost two weeks and every day it gets better. I walk with a slight limp but i’m stretching it more each day. I thought i would wean off the boot but once I haven’t needed to. I’m working in hospital with Hoka brand sneakers instead of my danskos as those have a bit of a heel height to them. Just today i’ve stopped using the scooter as I can walk almost at normal pace now. I can’t walk fast though.

PT is good. I really like that she gives me the confidence to push forward. I’m a bit PTSD from the injury and keep thinking i’m going to pop it while stretching. The ortho said no running, lol, until we meet up again in 4 weeks. I hope to be able to do that by then which will be week 15 post op, almost 4 months post injury.

8 weeks post op

I have had four PT sessions now. I’m going twice a week for six weeks. My therapist warms up my ankle with warm towels then massages my leg and foot for a bit. Then i perform supervised exercises using the theraband and wobble board. I’ve been shifting my weight on to my injured foot. The bone under my pinky toe is super tender. Not sure what i did, but it’s preventing me from really putting full weight on my foot evenly. I’ve walked across the PT floor barefoot. I also walk barefoot to the bathroom in my house. I do have my boot on otherwise.

I feel my incision looks bad. The red spots are still there, but appear to be diminishing somewhat. There is a bit of wrinkle in the skin at the base of the incision that looks horrible. I’m hoping it flattens out.

There is a bit of edema now that i’m working back at the hospital and just generally walking more. I was afraid of going back to the hospital because i wasn’t sure how i’d handle performing my job while in the boot. I’m doing just fine though and on my first day back caught a baby in a challenging position - mom was standing up in the bathroom. I cover my boot with a surgical bootie to keep the fluids off. It works just fine. One of the nurses brought in a scooter for me to use at the hospital and it’s great. I can really get to all the rooms without tiring myself out. I figured out my “crab walk” to go faster. If i walk sideways i can walk faster!

I see my ortho doctor next week and he’ll OK to go to shoes. I’ll wear the boot at hospital for some time though, to protect my ATR. I’m going to ask him if i can set the boot to articulate so I can walk in it better.

Week 6 post op

I saw the ortho a few days ago and he said- OK put the boot flat. I was not ready to do that so i told him i’d take it from 20 degrees to 10 for a few days then work it to 0. That’s where i am now. When i put it to 10 degrees i felt a pull on my tendon and little soreness and ache but nothing extreme. I went to work the next day and walked around without crutches in a sort of stunted gait. I did that the next day too, but this time my tendon was less tender. So, the next day after that i took it flat and i’ve been at that for two days. My tendon still aches when i try and put it in the boot after having been out of it, like overnight. I’ve been sleeping without the boot for two weeks now and feel fine about it.

PT - I called the PT and have my first meeting with her this week, so that would be in week 7. He told me i’d be in shoes in three weeks, so that would be week 9. I continue to work my foot three times a day, massaging arnica oil in to it. I use a TENS unit in the morning applied to the calf for muscle stimulation. It has a timer on it so it helps me get through the tediousness of home PT.

Incision - There is a concern as there continues to be this red area that cannot be explained, near the incision. It hasn’t spread and it’s not tender. It’s been there from when I first saw the incision. He thinks it may be cellulitis? He gave me some antibiotics, but i’m on day 4 and nothing has changed. I’m super concerned about it.

Pain - That searing pain right at the heal reduces everyday and I don’t even notice it anymore.

Gait/strength- I’ve been able to put all of my weight on my injured foot for about a week or so. My leg feels super strong and my calf really has minimal atrophy. I was working on a more regular gait when i had the achilles sole on the boot, but now that it has the flat sole and i’m at 0 degrees, i’m back to this shuffle walk. I take a step with my injured leg and then i can only bring my non-injured leg up to meet it as i feel too much stretch in my tendon if i try and roll through my foot. It will come i guess.

Week 5 post op

i’m so looking forward to my week 6 post op appointment. i’m ready to go down in angle with the boot and try and put the flatter heal on. i can put all my weight on my foot but balancing on that rocker heel and walking in it is slowing me down. i continue to have some periods of searing pain where the incision is and i don’t know what that means. my home PT of getting foot out and flex/point and wiggle toes 3x day doesn’t seem to feel like there is an improvement in range of motion. my ortho said formal PT can start next week and i’m anxious to talk to him about that. i slept with the boot off for the first time last night. i kept the cloth insert of the boot on, to remind my brain i need the boot if i get out of bed. i told my work i’d be ready to see patients in the hospital and catch babies by week 7. it’s going to be hard, mainly because of the anticipated swelling. i hope to be cranked down in the angle of the boot with the flat sole and just walking without too much of a weird gait.

Week 4 Post op- PWB

After my 3 week post op visit with my ortho i began the task of PWB.  Each day i’m able to put more and more weight on the foot. I’m back at work seeing patients in the office and once i’m in the exam room i’m able to hobble along without the crutches to perform the exam. I keep my foot up on my desk between seeing patients. I had minimal swelling while NWB but now it has increased a bit. I have a long commute home by car and put my foot up on the dash while driving! Once home I’m really just in bed with leg up and lots of massage. Getting foot out for PT at home three times a day for 10 minutes with gentle active point and flex and wiggling toes. Incision still is oozing just a speck at the end of the day on the gauze but looks clean and no redness. I think this is due to the swelling. Working on trying to be walking in a boot, without crutches by next week. I’m still at 20 degrees so that makes it a funny looking hobble-like walk.

Week 3 post op

I saw my orthopedist yesterday at 3w1d post surgery. They took the stitches out and washed the incision and put some steri-strips on it. It looks like it’s healing well. The doctor felt the tendon as i he flexed my foot back a bit and it felt tight and he said that’s good. I told him that i’m still experiencing some stinging and burning along the incision and heel. He said that that was the nerves. I have sensation all over my foot, it’s just this searing pain. He said as I move my foot more it should resolve. I’m not happy about that. He said i can shower without boot.

Rehab - He said to take leg out of boot three times a day and for 10 minutes focus on flexing (not past neutral) and pointing. I asked him about deep water walking or cycling. He said - for you, no lets wait until 6 weeks. I suppose he said that because i am a 50yo female, but he never asked about my activity level, which was active - kick boxing classes etc… He said do pilates. Whatever. Ill just continue my strengthening routine at home. He said no to acupuncture before six weeks. He said yes to TENS therapy on calf. He said to go to 20 degrees on boot and try and wean off crutches over the next week, but leave at 20 degrees. I got right on that and am experimenting with the one crutch walk.

Work- I’ve worked two days now and it’s ok. I have an hour commute home by car. I see patients in the clinical setting. I came home today and put leg up and found that the area not covered by the internal soft boot was fairly swollen. i think i’ll put on a knee sock for tomorrow.

Pain - May try some CBD oil for the nerve pain. Super bummed about this aspect.

Surgical report - I asked for the surgical report. All pretty standard except for this bit: “Deep fascia overlying the FHL muscle belly was identified. An FHL fasciotomy was performed at this time. This was necessary for a tension-free paratenon closure as well as to increase vascular supply to the Achilles tendon repair site.”  I  googled around a bit and this didn’t seem a too common procedure. My only concern is that a complication of this is reduced flexibility of the big toe. When he was examining me he asked me to curl my toes and the big toe didn’t want to go. It can move up and down, but not curl. He said he saw it “want to.” At the time of this exchange I hadn’t read the surgical report so didn’t know the significance of his assessment of the big toe. Hope this big toe is not damaged.

Mood - With the nerve pain and concern over big toe and being tasked with getting to walking without crutches in three weeks, i’m not very chipper. The caps play the first game of the playoffs tonight and we are going to watch and order wings. Maybe some whiskey…

Yoga while recovering

i found a nice youtube series on yoga while recovering.
http://physioyoga.ca/medical-therapeutic-yoga-for-achilles-tendon-rupture-the-missing-link-in-rehabilitation

Week 2 post op completed.

Tomorrow will mark two completed weeks post op. This was Easter weekend and I did get up and make lamb and my beans, as well as go get my nails done. Small outings. Sitting on the bench in the park with my leg up, but not above my heart, made my leg throb. I go through short phases of - WTH just happened. I think i still can’t believe this is happening to me.

Pain - This week i had some stabbing pains in my heel and where the incision is. I’m taking the aspirin and at night a take 1,000 acetaminophen for the throbbing.

Vacoped boot - I have found myself messing with this to get the right comfort. I developed a sore right on top of my foot where it was rubbing. I found that other people had this happen to them too. I bought some thick moleskine and put a big pad of it on the top of my foot and it solved the problem. I take the straps off and let my leg air out a bit. I stroke the leg gently with a light massage for comfort and for circulation.

Diet - Comfort chocolate is on the regular…. I did have a drink to celebrate my first born’s 21st birthday at the Brazilian steak house. I did have a wine or two with Easter picnic. I have been eating the same stuff every day mostly as my husband isn’t good in the kitchen and I don’t mind. I try and focus on protein/veggies. Breakfast - one coffee, one macadamia nut milk matcha latte with a scoop of collagen powder, 1-2 hard boiled eggs, scoop of hummos or 1/4 avocado, squeeze of lemon, s/p. Lunch - leftover dinner or Amy’s organic lentil soup. Dinner - protein/veggies. Snack - Siggi plain yogurt with spirulina, coconut flakes, cocoa nibs, nuts, seeds, collagen powder, a few berries. Tea. Pelligrino.  All my supplements i mentioned before.

Exercise - I found a rehab protocol that I like. https://tinyurl.com/nsj29mz It’s the Banff  Sports Medicine rehab. I have been doing this protocol for week two, which has some added exercises from week one. I also have been doing some push ups on my knees, yoga- cat/cow, down dog, and some breathing meditation. I plan to talk with my Ortho about the protocol as it’s what I would like to follow. I see him next week for stitches out.

Shower - It’s a field trip/adventure.

Work - I’m hoping to go back on Thursday, which would be 2 1/2 weeks post surgery. I see patients in an office, maybe 15-20 a day. I’m good on the crutches so just plan on that. My only concern is pain/throbbing at end of day with my leg down so much. We shall see.

Day 7 Post Op appointment

I”m one week post op and i was scheduled to go in for wound check and to be fitted in to the CAM boot. I purchased the Vacoped in small. I’m a 39 Europe sizing and 81/2 female American sizing. I was right on the border between small and medium. I called the customer service and we talked it through and I ordered a small.

The medical assistant took the puffy bandages and splint off to expose the leg. I was prepared because i had looked through many pictures but it was still shocking. I’ll post a picture below. She cleaned the wound and put a strip of ointment infused gauze on the stitches and then wrapped a gauze around ankle and then put on a gauzy-type sock thing. We futzed around with the boot and got it on OK. I was then told to come back week 3 post op to get stitches out and see my doctor. No weight bearing.

He had given me a rehab plan that seemed moderately conservative when compared to the two dozen or so plans I had read. I plan to talk with him about my rehab pan. Will post more on that when it gets sorted. Since about three days post op I have been doing some exercises. The first week i did, all while reclining in bed, quad squeezes, 20 every hour; leg lifts, 20 every hour; leg abduction 20 every hour; toe wiggles and toe points 20 x 3 every hour, all from 8am to 8pm.  These were not proscribed by my doctor, but i found them in some rehab protocols. It felt good to do them. I also massaged my toes every hour as they were still numb and i wanted to encourage circulation and wake the nerves up.

Pain  the pain is odd, some nights i had a searing pain where the incision is, but it would be momentary. There is always sort of a pulsing after i’ve been up to walk around. There is a tingling feeling most of the time. I took a few oxycodone when the block wore off, some acetaminophen a few times and twice a day aspirin, for DVT prophylaxis and pain. This is all what I had expected, except for the extended nerve block, from reading through the achilles blog site. I’m writing this for therapy, but also to give back to the ATR community here. What a cool find and so therapeutic for me.
http://AchillesBlog.com/afkv/files/2018/03/kelly_ankle_resized4.jpg

Post op day 1 and 2 and 3 and 4

I was supposed to be in Las Vegas for a board meeting this week. I woke up with leg completely numb still, now 24 hours post surgery. I decided to conference call in to the meeting. Did the board meeting all day until 8pm. My leg was still completely numb. I started to get a little worried. The anesthesiologist said 18-24 hours and i’m now at 36 hours with no ability to move toes. It was now after hours and so i called the doctor to see if this is something to be concerned with. My doctor was out of town, but the doctor I spoke with said that it is rare that the block would last more than 24 hours, but does happen. I told her i was starting to feel some tingles and she said that was a good sign. She also said to monitor for toe color and temperature. I kept asking my husband to check my toes. Like a jackass he would say - they are green! I didn’t think it was funny. And, part of my tongue was numb - more on this below. And, my throat was sore so was sucking on lozenges.

Day 2 post op I start to be able to feel light tingles when my toes are touched but i still can’t move them. This is now 48 hours post op. I call the surgery center and speak with the anesthesiologist. Another weird thing was that a spot on my tongue is numb. The google tells me that this is glosseal nerve damage from the LMA used to keep my airway open. I tell the anesthesiologist about numb at 48 hours and tongue thing. He said both are rare and that they should resolve in days to weeks. Great. I still haven’t taken any pain meds, but start to worry i’ll miss a DVT as i can’t feel anything. By evening the tingles get more intense and i can start to just wiggle my toes a bit.

Day 3 post op - I took 5mg oxycodone during the night as the block really started to wear off. It worked well. I didn’t use any pain meds during the day. I just lay in bed with leg up on two firm pillows. Goal is leg elevation above heart 23/24 hours the first week.

Day 4 post op - holy crap! i was taking the smooth move tea and the magnesium but nothing prepared me for the constipation. geez, i only took a total of 5 oxycodone over three days and the situation is intense. Screw the oxycodone, ill keep with the acetaminophen and aspirin.