Operation Achilles Heel Heal

First of all, many thanks to MaryK, diane, 2ndtime, Ultidad, Kevin, Highflyer, normofthenorth and Frouchie. Whether or not positive thoughts and vibes will result in the accelerated cosmic healing of my achilles, they have helped no end in keeping me chipper.  Thank you.

I went for my follow-up with my surgeon yesterday.  The surgical wound appears to be healing really well - obviously good news.  Those long days of lying down with my leg raised have clearly paid off.

I’ve been put straight in to an Aircast boot with five wedges.  That was a surprise.  He’d told me he wanted to get me in the boot ASAP but I wasn’t expecting it quite so soon.  That said, I am strictly NWB, and have to treat the boot like a cast for four weeks.  That is, no weight at all on it, and avoid taking it off.

After four weeks, I work my way down the wedges over the next eight weeks, allowing weight on it as is comfortable.

This is clearly an aggressive approach.  I had the option of going in to a series of casts over eight weeks, but his reasoning for the boot was that early, small movement and eventually pressure on the tendon encourages stronger healing.  I’m delighted that’s a good option.  I can even loosen the boot to have a good (careful) scratch if needed.

However, it’s all resulted in me “going commando” today. The key question I forgot to ask my surgeon was: How do I get my trousers on and off?

After washing this morning, I carefully took the boot off to get my trousers on.  I managed that before putting the boot on, then realising I hadn’t put my boxers on!  It’s a very precarious affair getting in and out of the boot so that’s how I stayed today.

Apologies for the detail, but it’s my first lesson in my new situation.  Put your boxer shorts on first!

I also discovered last night I’d been given the wrong wedges for my boot. I’ve been given left foot wedges for my right foot.  I didn’t notice in the day, as I’m not putting any weight on the boot.  But they begin to dig in to the outside of your foot when you lie down in the boot.  With Aircast boot wedges, the long bit should be on the instep.  I’m back to the fractures clinic tomorrow to get the right ones.

If it does nothing else for you, an ATR keeps you thinking.  You could say it keeps you on your toes…

I’m sure I’m not the first to use the comparison, but ATR recovery is like a game of snakes and ladders.

Unfortunately I’ve landed on the big snake that takes you back to the start, after suffering a full re-rupture last week.

It was 14 weeks after my ATR playing football.  I went the conservative way and things had been progressing well, apparently.  I’d gone in to the boot before Christmas and then in to two shoes mid Jan.  Indoors I was walking confidently, if with a big limp.

I won’t focus on the gory details but I got up from the sofa last Tuesday in the wrong way, on my toes, and that was that.

It took me a day or two to accept something serious was wrong as I still had good strength in my foot.  The pain hadn’t been severe, there was no ‘pop’, but clearly something had happened.

I went to A&E where an orthopedic chap said he thought I’d redone it so he admitted me.  The next day I saw two consultants.  Both were hopeful I hadn’t done severe damage but wanted an ultrasound to check.  That took a day to arrange with the right person.  It took one second for her to see the full rupture.

So I was in to surgery first thing the next morning - conservative treatment is not the same kind of option second time round.  The Surgery itself was fine (great painkillers!) and once again I’ve been lucky not to suffer too much pain.  My surgeon says it all went to plan and I now need to do what I can to help heal the wound and avoid infection, i.e. don’t move much, no football or pub crawls, and keep my leg up.

I’m staying with my parents for a week while I keep my leg up.  My Mum’s just retired so needs to keep busy to help herself manage the transition to life without work!  I’ll make sure I keep her working with requests for tea and cakes.

The whole event has been odd, to say the least.  It’s been emotionally draining - the thought of going back to square 1.  But I’m working out ways to keep positive.

For starters, it’s a different square 1 and I’m on a different board with new ladders to look for and new snakes to avoid.  Having tried conservative, and now having undergone surgery the injury feels like a different one.

On the note of conservative vs surgery, I wouldn’t urge anyone to use my experience to sway them either way if considering their own treatment.

I don’t regret going conservatively.  I really felt my progress was going well, but I fall in to the 8%/10%/15%/20% (depending on which study you favour) who have been unlucky.  That’s what my surgeon said: “You’re just one of the unlucky ones”.  That was strangely reassuring for some reason.

That said, I now have to put my full confidence in the surgical approach.

I won’t go on now.  There’s plenty of time for that in the next week or two once I’ve got my thoughts together.  As ever, it’s a great help to have somewhere to share this experience.

My cast was taken off last Tuesday, seven weeks and six days after my ATR.  I’ve now got an Aircast boot with one wedge in it.

Just after the cast came off the consultant did the Thompson test and my toes moved, which was quite a relief.  He asked me to push my foot down on his hand, and I was able to put some pressure on.  Likewise lifting it was fine too.  So that was all excellent news, and seemed to show things are going to plan.

My calf muscle is much smaller but there’s still quite a bit of mass there, even if I can’t tense it fully at the moment.

So, I was given an Aircast boot, and told everything looked fine and I was discharged.  I had my physio assessment booked for the next day.

It all felt like great progress, but I left the first physio session feeling confused.  The chap I saw was fine in that he checked the tendon again and was reasonably upbeat about how things were going.  But he wouldn’t give me a good idea on how things might develop from here.

He said the Aircast boot was not totally necessary as I could be doing my PWB in shoes.  This was surprising, but he said I should keep using it until my next appointment, which is on 6th January.    I have a maximum of six sessions on the NHS, but I might only need 2 or 3.

Does that sound right?  I have a sheet with some exercises I can do at home, but I get the feeling from other blogs that some physio is very hands on and more frequent.

Anyway, I am taking it as an indication that things are going well.  But, I’d really like to spend a decent session with a physio who’ll take me through the exercises, and give me strong indication of how much I can push the tendon.  Hopefully that will happen in the new year.

I don’t want to sound like I’m moaning, but some more answers from consultants and physios who are treating me would be very, very welcome.  Thank goodness for this website!  Happy Christmas!

I managed to get back to work today, eight days after the ATR.  I mainly work in an office so should be able to get my job done without any great problems. 

I’ve found that using crutches has become much easier, even after a week.  It’s not necessarily the control, but my stamina seems to have increased so I can go further.  Still, I think a couple of hundred metres is my limit at the moment.

How have others got on with crutches?  Do you find yourself able to go further and stay on them for longer?

Of course, everyone wants to know what I’ve done, which is really nice, of course.  But it can get a bit repetitive.  I’m currently developing three versions of my story. 

The full version, for family, friends,  those who are really interested, or those I think I can get car lifts from in future.

The medium version for most work colleagues.

And the short version for those who are just being polite, or look like they’re in a hurry.  This one is:  “I’ve just stretched some ligaments in my ankle.”

I’ve found the moment you mention the Achilles tendon, people want to know everything.  It’s great as most people have exactly the same reation.  Their lips purse, there’s a sharp intake of breath, the nose scunches up towards the eyes, and the forehead comes out in deep furrows.  It’s what I now call ‘The Achilles Face’, and it’s followed by ‘The Achilles Sound’.  This is a long ‘oooooooooooo’.  Like the vowel in ‘boot’, but longer.  It’s certainly an injury people feel particularly squeamish about.

My next goal is to start exercising what I can.  I obviously won’t be going jogging, but assume I can do other stuff to try and keep in some kind of shape.  I would welcome any advice or suggestions on this as I haven’t read up on it yet.

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