aileenscotland’s AchillesBlog


First post - 3weeks 6 days
November 13, 2010, 4:39 pm
Filed under: Uncategorized

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Dennis


12 Comments so far
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That’s a start, Aileen, and welcome!

Comment by normofthenorth 11.15.10 @ 4:48 pm

I’m now officially addicted to this site and searching out other non-surgical cases. I found Liverpoollass’s blog great and it really cheered me up.

The last doctor I saw didn’t tell me anything other than 6 more weeks in a cast (8 in total) but now I see LL was in a boot after 4 weeks. I have my four week appointment next Tuesday so fingers crossed.

Can someone tell me again how long is the average to be in a boot plus crutches? I am desperate to get off the crutches and back to some kind of normality.

I found the consultant pretty good but I’ve only seen him once and the doc at the last appointment didn’t want to answer my questions. I was talking and he was edging out the door! I felt he was almost at the stage of patting me on the head and telling me to be a good and patient little girl.

Norm, I saw your comment about being in control and that is my big problem - I like things done my way. But it’s great the satisfaction you get out of finding ways to do things that seemed impossible in the beginning.

thanks to everyone on here for keeping me sane

Comment by aileenscotland 11.16.10 @ 7:30 am

Hi Aileen: If you read my blog you’ll track my journey on the non surgical path. I also went to the boot after about 3 weeks and, thanks to Norm, found the
Vaco Cast which permits walking without a cast for limited duration and makes using a cane possible right away. I strongly recommend it. I see the product now advertised on this site so check it out. You won’t regret it.

Comment by gunner 11.16.10 @ 12:42 pm

Hey Aileen…I’m also non-surgical, at 14 weeks. Was in cast to the knee for 4 weeks, then further 4 wks in moon boot. Went from NWB to FWB at 6 weeks. I ditched the crutches the day after going FWB, but I’m not sure that’s standard. I was really stable.

I don’t think an average is necessarily relevant BUT if you’ve read the studies (see norm’s blog) you’ll see that early mobilisation is key to good non-surgical outcomes. MANY people on this site have shown 8 wks is not necessary and moreover, its likely (based on historical data when a long period in plaster was the normal non-op approach) to be detrimental because the muscle loss is so huge. Also, its hard enough re-teaching your motor system after 4 wwk immobilisation let alone 8. Do some research before you see your doc again, and seek from the doctor what you want. Sadly, we are more informed than many of the docs on recent research on this topic…

Comment by bronny 11.16.10 @ 2:07 pm

Hi Aileen, only just read your blog. I expected to be in a cast for 8 weeks but the ortho nurse was so happy that I could almost achieve 90 degrees with a bit of help that she chatted to the consultant and low and behold I was in a cast. At first I hated it but it has since become my friend. I am putting about 30% of weight through it at the moment and mainly thats ok. Initially I was disappointed that things weren’t moving as fast as I wanted to but I think that is a constant feeling with this injury. I go back to clinic on Fri so I’ll let you know what happens I’ll be 8 and half weeks post injury then so wish me luck.

Comment by liverpoollass 11.17.10 @ 1:14 pm

Hi again! Obviously, LL meant “and lo and behold I was in a BOOT (not another cast)”, which has since become her friend. Boots do everything casts do, and do it better, and also do much more, IMHO!

I recommend the schedule posted at bit.ly/UWOProtocol , which was used in the study at bit.ly/UWOStudyPub . The results were generally excellent, both with and without surgery, and identical both ways, except for a few surgical complications.

I also recommend giving your Doc the “one-two punch” — meaning hand over copies of BOTH documents. The protocol is the “recipe”, and the study shows how delicious the results are from following that recipe! If that isn’t enough, ask your Doc to give you a copy of his or her written protocol, and a similarly careful analysis of his or her results — so you can see if they’re anywhere near as good as those you just handed over!!

The gist of that schedule is: only TWO WEEKS of total NWB and total immobilization. Gentle out-of-boot exercise and PT start at 2 weeks, as does the beginning of PWB (still with crutches). At 4 weeks, you go from PWB to WBAT = FWB “as tolerated”. For most of us, that means a couple of days with a cane or a crutch, then just FWB, well before 5 weeks in. At 6 weeks, the 2cm of heel wedges come out, and at 8 weeks it’s “wean off boot” and into 2 shoes.

If you’ve got a hinged boot like the Vaco or the Donjoy MC Walker, etc., you can start letting it hinge (only between neutral and plantarflexion) at maybe 7 weeks, and continue to use it past 8 weeks to protect you in higher-risk places. At home, etc., you can pad around in bare feet or comfy shoes, maybe Crocs, starting at 8 weeks.

Almost all of that is straight from that protocol, except the part with the hinged boot, which is my variation on their theme. (They used fixed boots, partly because AirCast sponsored the study — and God Bless them for doing so!)

Good luck and good healing, and welcome to a great crowd, and a hard addiction to shake!!

Comment by normofthenorth 11.18.10 @ 4:06 am

Yes your right I did mean boot!!! sorry

Comment by liverpoollass 11.18.10 @ 5:22 pm

Hi all - thank you so much to everyone who replied.

Liverpoollass, I realised that you meant ‘boot’ - a wee slip of the typing, but it made perfect sense to me. I’m following your progress with interest as I’m about 4 weeks behind you I think. Every time I see you progress, I think ‘that will be me in 4 weeks’ Looking forward to hearing how you got on today - fingers crossed.

Bronny and Gunner, thanks to you too for your encouragement. You’ve all given me the courage to go to hospital on Tuesday and be prepared to tackle my doc. I’m 5 weeks and 2 days by then and I feel I’m barely started yet.

Norm - father and guru of the blog. I really believe that you’re a world expert on all of this! I apologise if I am being completely dense but I can’t get into your protocol/get the bit.ly connection to work. I have followed all the links on the ‘Treatment Protocols’ section from the homepage here and I have printed out all 12 of the reports. I have had my highlighter pen out (does that sound sad?) and I’m all ready for Tuesday, but I would really like to have your main protocol with me. I LOVE the idea of your ‘one-two punch’ approach. I’m normally pretty passive, but I’ve been practicing my assertive approach.

I’ve been thinking a lot about the mental battle and it really is so important. In my first few days, I didn’t do very much, but as time has gone on, I am doing more and more around the house. It is a good feeling finding ways to carry out simple things. I did all my ironing this week. I was really tired afterwards, but had a huge sense of achievement. Although it was really funny (afterwards!) – I never knew it could be so difficult to set up an ironing table and manoeuvre a chair into place.

Can you give me some feedback on your working lives? I have to say that I’ve been off work since this happened, although trying to do as much as I can from the laptop. I am scared to attempt the office. I live 35 miles from work, which is on the 8th floor of a modern building. Between worrying about the journeys, getting to my desk, getting to the toilet, etc, I just haven’t been able to face it. They have been really good but I’m starting to get a bit anxious about it.

Good luck to everyone out there!

Comment by aileenscotland 11.19.10 @ 2:08 pm

Aileen, I just entered that bit.ly address into my browser, and it worked, so I’m not sure why it’s failing you. But the real address is achillesblog.com/normofthenorth/the-non-surgical-protocol-ive-been-following/ . If THAT doesn’t work. . . hmmm.

The group I work with has an office building, and I USED to have a desk and a computer and a phone there. But over the past decade or so, I found myself sitting here at my laptop more and more, so my colleagues reassigned it all!

I’ve still got a phone extension number there, but I don’t think there’s even a physical phone any more. When somebody leaves me a message, I immediately get a “Message Notification” call at home. E-mail’s no problem, of course, nobody knows where I am! When I’m representing the group in a hearing, our Case Manager often drops in and brings me my “snail mail”, which is usually all low-grade boring stuff anyway.

Some courier packages get delivered here, and I can receive a fax here in a pinch, though almost nobody uses fax any more in my circle.

In short, I VIRTUALLY go to the office. And I didn’t miss a day of work because of the AT. But even if I had to go to the office, I don’t think I would have missed more than a few days. Elevating a leg is pretty easy with a desk job.

I was on a 1-hour panel on a TV show while I was in the boot — and MAYBE still on crutches, though I think I was actually FWB by then. Nobody could see the boot at home. But in his final wrap-up, the host referred to my “ligaments”, and said he hoped they healed quickly. Cute! (And they have! :-) )

Comment by normofthenorth 11.19.10 @ 3:44 pm

If you’re cutting and pasting an Internet address that has a line break in it, make sure it all gets pasted, and that the operation doesn’t introduce a space where the line break used to be. (If it does, then neither the bit.ly nor the full link will work!)

Comment by normofthenorth 11.19.10 @ 3:46 pm

I got it, finally

Thank you :0)

Comment by aileenscotland 11.19.10 @ 5:08 pm

Hey Aileen, what is your line of work?
I work as a contractor and taking an extended holiday at the time of my ATR. I realised very quickly that i’d go mad staying home for weeks and happened to have been offered a contract the day before I did it, so I called them back and said yeeeees, but… Its an office job in town, once you are there its fine (better than home actually as people are very helpful and bring you coffee!), but getting there is probably the challenge. Luckily the compulsory accident insurance where I am paid for taxis to and from until I reached 12 weeks. If i’d had to take buses, and get to the bus stop etc, I’d probably have worked from home most of the time. As it was I’d get to Wed or Thurs and be so tired i’d have a day at home on the couch with laptop.

Good luck!

Comment by bronny 11.19.10 @ 10:08 pm



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