Speed bump on the road to recovery

Posted on September 19th, 2017 by amurfey

Last Thursday I went in for my 2 week appointment with the Ortho surgeon to have my first cast removed, and get checked out and have a second cast put on for an additional 2 weeks.

All seemed to be going well until I mentioned to the doc that I was feeling a slight tenderness in my calf, and was also experiencing occasional, very short duration, rapid heartbeats. He immediately became concerned about potential clots/DVT, and ordered an Ultrasound for me.

Well it turned out that the Ultrasound did find a DVT clot in my left leg. I also was sent in for a chest CT scan to rule out any PE (which maybe causing the rapid heart rate). The CT scan was negative.

The ER doc put me on Xarelto blood thinner for the next 21 days, and then beyond that probably for another 20 days.

I am feeling pretty good now. Have been trying to be more active, and getting out riding around town on my knee scooter. Also, trying to drink a lot more water. Inactivity and dehydration can definitely contribute to DVT and clotting. The rapid heart rate has significantly subsided over the past day or so, so hopefully that is a good sign.

I am scheduled for a follow-up visit with the Ortho doc this week just for a quick checkup since the DVT diagnosis. Then, I am scheduled to get out of the cast on the following Thursday and into a boot. I am definitely looking forward to that day!

Anyone else have a similar experience going with the non-surgical approach?

2 Comments »

My ATR story

Posted on September 4th, 2017 by amurfey

My Achilles rupture occurred last Saturday, August 26, while playing tennis. I started to push off my left foot running for a ball, and that’s when the pop happened. I felt a stinging sensation in back of my left leg, but no real intense pain. I wasn’t able to put any weight on my left foot, and deep down I was pretty sure what had happened.

Within an hour I was at the urgent care clinic, and they diagnosed the rupture, and put me in a temporary cast with my toes pointing slightly downward (about 20 degrees).

I made two appointments for that week - one with a Podiatrist, and one with a Orthopedic surgeon. Interestingly, the DPM recommended surgery, and the Ortho doc recommended the conservative, non-op approach. I decided to take the conservative approach, and was put into a cast on this past Thursday. I am scheduled to see the doc after two weeks in the cast.

So far I feel pretty good. Using crutches has been a learning experience! I’ve had a couple minor spills, but didn’t damage anything - furniture or body parts!

I purchased a knee-scooter on Amazon, and that arrived today. It definitely makes getting around a lot easier. I haven’t ventured to far with it yet, but am looking forward to getting out and out with it. Purchasing it was more economical than renting one - and I will use my HSA funds to pay for it. I can donate it to a needy organization when I am done with it.

I’m 56 years old, and had started playing tennis again this past summer. In hindsight, I should have done more conditioning in combination with the tennis. Instead, I was more of the typical weekend warrior that played a couple times a week, and really didn’t have any other fitness program. That said, I was feeling great up until the ATR! I was somewhat shocked when my Dr. told me that playing tennis is probably not a good idea at this age (possibly doubles is OK, but not singles!). That was pretty disheartening to hear, as I was really enjoying getting back into tennis for the exercise, competition, and the social aspect of the sport.

I’d be interested to hear from others that may have been given similar advice, and how you dealt with it.

I’m encouraged by all the success stories that I’ve read on this site, but realize that I will need to be patient, and it will be a lengthy recovery process.

I’ll try to keep updates posted here on my recovery.

-Alex

10 Comments »

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  • Recent Comments

  • vicky3177 | October 3rd, 2017 | 5:17 am

    In the uk if we are in a cast or a boot we are given enoxaprin blood thinner injections (at least we are at my local hospital) as standard preventative treatment. Am glad u are now on the mend xx

  • cserpent | September 21st, 2017 | 3:10 pm

    Glad you’re doing better! It is a relief to get in the boot! Just remember to wear socks covering your entire leg so the boot doesn’t get scrungy inside.

  • pausuz | September 12th, 2017 | 8:47 am

    When I ruptured my achilles 10 weeks ago surgery was suggested instead of conservative treatment which is what my surgeon now usually recommends.. Placed in point for the ultra sound the gap was quite large- the ends nowhere near touching. To be sure conservative treatment will work the fibres have to mesh so if they don’t come together it won’t work.
    I know 2 people who went the no op way, wearing a boot for weeks and then ended up having to have surgery.
    Everyone makes their own choice but if you are a healthy candidate for surgery at least you know the ends are being sewn together. I am a very active 55 year old female- and plan to keep active. Keep that tennis up when you recover! I booked a trip j for January 2018 just before my rupture- jungle trekking and volcano hiking in Africa so I am hoping to be nearly 100% by then.

  • emupilot | September 5th, 2017 | 4:17 pm

    Thanks very much for sharing your story, amurfey. Good luck and please keep us up to date on your progress.

  • amurfey | September 5th, 2017 | 3:43 pm

    Wow. I wasn’t expecting to start such a heated exchange with my initial post…

    My doctor and his NP (who initially looked at my injury) said that he takes the non-operative approach for the majority of his ATR patients - and only recommends surgery in about 2-3 cases per year. I was hoping that he would recommend that in my case, as I had read a lot of good articles regarding this approach, and I was willing to give it a try. He did say that many of the Orthopedic docs were recommending surgery as the default treatment for this injury. Despite his comment about playing tennis, I still feel he is a very competent physician.

    I met with a PT near my home today for an initial screening, and he treats a lot of ATR patients (from my Doctor). Most of this patients are going with the non-surgical approach, and have seen very good results. He also highly recommended the Doctor that I am seeing, but he did disagree with his comment about me not playing singles tennis again. He felt that is something that I should be able to do with time, and proper rehab. He felt, as I did, that Drs making those comments can create a sense of

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  • emupilot | September 5th, 2017 | 3:16 pm

    Are you referring to the paper by Soroceanu et. al.? It is very interesting, although it does of course have its critics. My surgeon was actually very careful about explaining my options without recommending anything. This was both a pleasant surprise, as I expected a surgeon to recommend surgery because that’s what he does, and annoying as I wanted the expert opinion of someone who was familiar with me and my particular case. I chose the surgery (done percutaneously) because the preponderance of my research indicated that I was less likely to regret surgery than not getting surgery. After the surgery, my surgeon said it was a good thing that I chose surgery based on what he saw on the inside. My concern for amurphey was that his doctor seemed to have an odd bias toward what activities amurphey should or should not participate in and that bias might color their recommendation. I don’t want to pretend to be a doctor and all I know of amurphey’s case is what he wrote, but something just seemed a little bit off in how he described the situation. amurphey, it would be interesting if you could provide more on how you chose to go

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  • agnesatr | September 5th, 2017 | 2:38 pm

    Emupilot - surgery does not necessarily provide better outcomes. That is old school thinking. The newer studies show that op patients and appropriate candidates for non-op treatment can have the same recovery if early weight bearing and early mobilization protocol is applied. The re-rupture rate is almost the same if the above protocols are applied. The conservative treatment has couple disadvantages, the initial 3-4 months are bit slower, but that equalized after that and the recovery is the same afterwards. Secondly there is a higher risk of healing long for non-ops, but if one does not stretch too early, that can be avoided. The risks of the surgery are wound infection, scar complications, like inability to wear snickers for a while and nerve damage.

    I was 40 in perfect health, doing sports every day and according to USA orthopedic template for ATR I was a perfect candidate for ATR surgery. 2 out of 3 orthopedic doctors gave me a choice of surgery or no surgery telling me I will have the same outcome. They both were sports medicine doctors and they take care of athletes daily. I mede a choice to go non-op, recovered ahead of s

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  • emupilot | September 5th, 2017 | 1:56 pm

    I of course know nothing about your particular rupture or your conversation with your doctor, but I’m a little concerned about your doctor’s recommendation not to play tennis combined with the recommendation not to have surgery. Since surgery tends to provide better outcomes in terms of physical ability and less risk or re-rupture, it is generally recommended for people who want to maintain an athletic lifestyle. I’m concerned that the doctor’s opinion that you shouldn’t play tennis anymore could be part of their recommendation not to have surgery. You might want to seek a second opinion from another orthopedic surgeon while your injury is still fresh.

  • agnesatr | September 5th, 2017 | 1:30 pm

    I am totally with Cserpent and PJ - 56 is definitely NOT too old to play tennis!!! You probably need to take care of your body better in conjunction with playing tennis though.

    I usually play tennis, but last year decided to try pickleball as well, was playing doubles and ruptured that way. I was 40 then and in my case it was just overuse due to long hikes, house remodel (up and down the ladder and lots of squatting), my sports and not enough recovery time. I am younger, yes, but living in PNW part of USA I see people in their 70s kicking butt playing tennis, road and mountain biking and running to name few. My 70+ year old neighbor can smoke me road biking and he summits volcanic mountains in the area putting us younger folks to shame, haha. I mention these just to give you perspective that fitness is not related to age, but to how you treat and condition your body appropriate to the age. I know at age 41 now I cannot be as careless about my body as I was at 30. It is probably even more true for 56. So, with a proper rehab and training of your body, you can definitely get back on the court again and enjoy all aspects of tennis!

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  • pjhalifax | September 5th, 2017 | 8:12 am

    Very sorry to hear about the rupture - it’s not a fun club to join.

    I agree with cserpent regarding the doctor’s “advice” on not playing tennis at 56. Sounds ridiculous to me (unless there’s some other factor you didn’t mention). I’ve played with many people 55+, heck, 70+, and I plan on playing for a long time.

    I think the main lesson, which I learned myself with my right ATR on the tennis court at age 41, is that you have to pay more attention to overall fitness and rest days than you might have before.

    For what it’s worth, I’m right at 6 months after surgery and I’m about to start some light tennis practice. I don’t have much spring in my step, but I feel like I could stand at the net and take some volleys, moving side to side, etc. I probably won’t start playing with more movement involved for a couple more months - I want to get some more treadmill time and calf strengthening in before that.

  • cserpent | September 5th, 2017 | 12:48 am

    Get yourself an evenup for your good foot. You’ll absolutely need it when you start walking. I agree with the value of the knee scooter. I was a total disaster with crutches so the knee scooter kept me from reinjuring myself - LOL!

  • cserpent | September 5th, 2017 | 12:46 am

    Sorry but your doctor is an idiot if s/he says playing tennis at your “age” is not advisable. Seriously????? Ignore him/her and get back to it when you recover. I would say being a weekend warrior and not doing much else during the week is more of a problem at any age than playing a sport. We have women in their 70’s still playing soccer. I’m your age, had a large heel spur removed (so cut achilles, grind off bunches of bone, reattach achilles) and was back playing soccer at 6 months. I’m not playing it as fast or as long as I did before surgery but I will. It is taking a long time to get the legs back in shape - my foot is absolutely fine! Fortunately with the new ATR protocols your leg shouldn’t atrophy as much as mine since I was 6 weeks NWB. When I was talking to surgeons as I planned for this surgery I didn’t go with the first surgeon since he thought I was a soccer addict (3-4 games a week) and didn’t seem too concerned about me being able to play when I recovered. A soccer addict plays 3-4 games a day (at least in my group of gal pals) so I was not impressed with this doc and he was not the person I wanted in charge

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