The Stereotypical Rupture

So with the holidays I wasn’t able to give an update after my 5 week post op last Tuesday.  I first had some PT with DaRinda and then my appointment with Dr. Askew.  PT went really well, and my foot can get to neutral!  90 degrees is a great thing!  :)  My appointment with Dr. Askew also went well–he said it is looking perfect and as good as possible 5 weeks after surgery and there was no scar tissue build up (awesome!).  He also commented that is why he likes early movement in such surgeries as scar buildup is less likely.  I told him DaRinda said I was neutral, which he said was good but said I shouldn’t try to go any further quite yet.  He said DaRinda might try some light strengthening this coming week, too.  I asked how long before the tendon is actually healed, and he said anywhere from 8 to 12 weeks, with 12 weeks when you are usually pretty good to go (aside from gaining flexibility, mobility and strength back).  So 1/2 done with being very careful, and then who knows how long of being just plain careful!

I also asked about my crutches, as I had been cheating a little at home and not using them often.  He said “oh sure, you don’t have to use them anymore unless you want to” which was also pretty cool.  That being said, I have been crutch free since last Wednesday–sometimes the AT gets a little tender and ankle sore from moving more than it has in a month, but overall it is not too bad.  I still have 2 heel lifts for the time being, but may go to one this week.  I still walk slowly and with an obvious hitch in my gait.  Funny, what actually hurts is the bottom of my heel because of the heel lifts–the things are like standing on little mini cinder blocks!!

Happy holidays to all and I hope all ATR recoveries are moving along nicely.

So it has been one month yesterday since my surgery, and a week and change on 2 feet.  So far so good, and I am still not trying to get too crazy.  However, since this IS North Dakota, winter strikes with a vengeance.  This week brought 18 hours of 54 MPH winds while dumping 10 inches of snow…wonderful.  Thankfully I have great neighbors who had my whole driveway cleaned up, mutlitple times!  I think there are some gift cards coming their way in the near future. 

On Monday night though I did some shoveling, as our front door steps and a few feet out had banks about 3 feet high…and given the -10 degrees F temp there was no way I was letting  5.5 month pregant Kasey out there.  She was still able to finger wag me with a sterm look on her face from the window, though–”WHAT ARE YOU DOING” was mouthed to me I think…I just pretended I couldn’t hear her.  It actually wasn’t bad, I just kind of stayed in one spot until some was done, then moved forward, etc.  My back was not a big fan since I didn’t use my legs much, but my guess is my Achilles was thankful.

My incision finally looks great, but I still wear my compression sleeve as it is supposed to really help with scar tissue and assisting the incision to heal flat.  I find that I can walk almost as well with no cruthes now, but still keep one around to assist.  With 2 crutches I can really control how much weight is on it, so I use one or two depending on how long I have been on my feet or if the AT is tender or not.

At PT yesterday I got to ride a recumbent bike!  Wow, that kind of feels weird but no pain.  I wonder if I just sort of “get ready” for pain?  In any case after DaRinda massaged the leg and the AT today it felt great…walking on it after getting it all warmed up from the massage was much better.  I have also been lifting upper body now too and it feels good to not be such a couch tater anymore.  Anyhoo back to work and healing.

First off I hope I’m not offending anyone or rubbing it in any faces that I am on 2 feet so soon…I consider myself pretty damn lucky!  So I am on day #5 with wearing two shoes, 2 heel lifts on my bum foot.  I am actually amazed at how good it feels to get some blood flowing to that area!  I have to be really disciplined not to want to skip the crutch(es) completely…Kasey let me have it last night as I was scooting around the kitchen sans any walking aids.  Truthfully though I feel pretty luck to be at this point.

At PT yesterday I asked about no CAM boot, and DaRinda (my PT) and crew just laughed and said, “Sorry, you’re kind of in uncharted territory for us!”  I take that as a good thing, and asked to measure my range of motion again–I am 6 degrees from 90 when I push my foot up, so that was cool.  The other ATR patient they have right now is a woman who is at 6 mos post op and still having trouble walking, has built up scar tissue, etc.–I feel for her and really hope things turn around.  As for PT for the next 3 weeks or so it will just be massaging the foot, calf and tendon to try to prevent scar tissue, and then I can start some light strength training on it.  (Not sure if DaRinda meant 6 wks post op, or 6 wks from now…in any case I’m chilling out for a few weeks.)

As far as walking it turns out when I was using one crutch I was using the wrong arm (d’oh!)!  Yeah, Andy is S-M-R-T smart smart smart.  It’s funny though–I move slowly with my one crutch and people still give all the sympathy looks and stuff, but I think to myself “you have no idea how nice this is compared to where I was 2 weeks ago”!  Actually though people are great and do their best to get out of my way–except for the Menonite/Huderite lady at Wal-Mart last night who about took me out just outside the door in her mad dash to meet her party.  I just about whacked her with my crutch!  (OK just kidding, it was nice to be totally ignored for once.  )

Anyway, I still go pretty slow and am still pretty paranoid about doing too much right now but love the 2 feet stage. 

So I just go back from a PT appointment this morning, and was anticipating whether or not I would be in a boot yet or have to wait another week.  Needless to say I was shocked when, after speaking with my surgeon, DaRinda came out with 2 heel lifts.  I was instructed to use one or two crutches as necessary and focus on the proper walking gate–use more crutch to ensure I walk smoothly rather than hop or skip to compensate for my bum foot.  Dr. Askew said he was going to be aggressive with me, but wow I had no idea THIS aggressive.

So far so good, I can walk slowly with one or two crutches and it feels OK.  I am a little nervous to say the least, based on people far further along than I am who have suffered a rerupture.  I’m not sure how long this goes on, and was so surprised by this course of action that I never did ask “where’s the CAM boot??” 

Anyone who has any comments, suggestions, or similar rehab please post a comment, and I will keep updating moving foward.

One cool thing I read about, and not sure if anyone reading this has had this done, but the minimally invasive version of Achilles rupture surgery.  (Waring: vid not suitable for queezy tummies.)  A tiny incision made cross-ways across the back of your leg, and then the sewing done via needles going in above and below the cut…crazy!  There is a dr in Maryland, Mark S. Myers, who seems to have pioneered this surgery and faster recovery.  He has dones studies where he has weight bearing in as soon as 10 days following surgery, with amazing results and low rerupture rates.   The theory behind it seems to be increased blood flow due to movement, which in turn encourages better/faster healing, all in a controlled weight bearing scenario.  I would be interested to read any stories of anyone who has had this done.  It’s too late for me but still fun to hear/read about actual people who recovered this way.

To quote the great (?) David Hasselhoff, I’ve been lookin’ for freeeedddommm!!”.   For those of you lucky enough to be unfamiliar with Dave’s fine display of musical skills (complete with Christmas light jacket and piano scarf), check it out here.  I also changed my blog theme. as the pink and light blue screamed a little bit too much Hasselhoff.  The reason for my freedom obsession is the recent rental of a Roller Aid!!  OK, so I look like I should have a helmet to use this but I can actually scoot around pretty good–and have a free hand.  I was able to pick up my 2 yr old Charlie last week and carry him for the first time in 2 weeks!  My wife Kasey thinks I need some plactic flowers and maybe a bell, too.  :)  It is just so nice to be able to hang up the crutches for awhile…I really only use them to get to the car from the house now and back…otherwise it’s straight Roller Aid!  A friend I work with has some messed up feet and has to have the bones broken and tendons streched in each, and he had elective surgery to get this done about a week before I ruptured my Achilles and was on crutches.  He test drove the Roller Aid on Monday and went and got one about 2 hrs later!   For anyone who reads this and can’t stand the immobility of crutches, the Roller Aid is worth a look.  I rented it for $60 for a month.  I also looked online at the one crutch (cheap and a free hand but not as risk free as the Roller Aid) and the I Walk Free (crazy expensive and limited places to rent, plus risky as well in terms of balance, IMO).  I thought about buying the I walk free and then reselling on eBay, but the time to wait for it to get here kind of makes it moot…which is a great segue too…

…possibly getting a walking boot next week!  As I wrote earlier I should find out Monday if I get a CAM boot or if I have to wait another week.  Right now my Achilles feels great, I have been good about wearing my compression sock and splint like a good patient so I think it is coming along.  I take no pain medication at all, not even ibuprofin.  My incision is not doing the greatest…the steri-strips covering the incision would end up trapping water and keeping it pretty wet.  It is not infected as of now (knock on wood!!) but I am being diligent about keeping it dry and clean–I dry it after the shower, let it air dry while eating breakfast, and then put breathable gauze on it under my compression sock.  Since I have read the number 1 problem post-Achilles surgery is infection in the incision I am a little nervous.

How does  Ear Infection + tonsilitis” relate to David Hasselhoff you might ask?  Well, it doesn’t, except that Charlie has had both the last 10 days.  Add that to not being able to help Kasey very much and not getting much sleep because of it and our household is one big mess!  Finally we seem to have turned the corner on that, after Kasey and I each worked only about 20 hrs. this week because of dr. appointments and the fact Charlie can’t be in daycare with a high temp.  (Don’t get me started on that…his health and well being is my first concern but he can’t give another child tonsilitis or an ear infection…grrrrr!)  The dogs think we have just given up on them since they get a short walk about 2-3 times a week vs. everyday when I am mobile.    Once again though…no complaints as it could be much worse.

This morning was my 3rd PT appointment.  What was interesting was that the PT (DaRinda) massaged my actual Achilles!  Wow, it just about put me through the roof…tender to say the least!  Prior to that the massage was just around my foot, ankle, and calf to help bring the swelling down, but since the incision is healing nicely she was able to hit the tendon itself.  Funny though, as “hurts to good” comes to mind–it was tender but at the same time felt good to get it massaged.

More (possibly) good news!  I have 2 PT appointments a week, and DaRinda suggested I make next week’s appointments and to make one on Monday midday, as Dr. Askew will be in.  As that will be 3 weeks post op she wants to see if Dr. Askew would like a CAM boot yet or straight crutches for another week.  I am open to either–excited to possibly get a boot, but at the same time apprehensive as to if it is OK yet!  I don’t have an appointment with Dr. Askew himself for another 3 weeks.  I did ask about putting my foot down for balance, like on my toes, and got the thumbs up to do that!

Tonight after work I am going to MeritCare Healthcare Accessories to test drive a knee roller.  That should help me ditch the crutches at work or home and provide a little more freedom to do stuff like carry my own water or coffee!  $50 for a few weeks of rented freedom sounds like a GRRREEAATT deal!  (To quote Tony the Tiger.) 

Other exiting news…I got a new test server at work (quad core w/ 8GB of RAM) AND my new smartphone (http://www.htc.com/www/product/touchpro/overview.html) came in the mail today too!  OK, I guess my inner nerd peeked out again there.

Back to work again!

Hey all-I got to go to my first post op dr. visit yesterday: Surgery + 7 days.  My foot has been HUGE, even after eleveting and icing quite a bit, but Dr. Askew said it looked great, so I was pumped about that.  I was able to get my staples removed (yes, STAPLES) from my incision.  I tell you, looking down and seeing two parts of your skin STAPLED together, looking away for a minute, then looking back and realizing that yes, that was my appendage, was kind of freaky.  Oh well, they came out without a hitch.  It was nice to get my leg out of the splint/wrap…mostly because of the swelling pushing against the finite space of the wrap…ouch. 

I went straight to my first physical therapy (PT) session, where my leg was worked over a little bit and then massaged, and finally put in this crazy ice machine-type wrap to help reduce the swelling…that felt like a million bucks!  My range of motion is way ahead of schedule, which they were amazed with.  I credit Dr. Askew more than genetics, but my goodAchilles had above average range as well, so maybe.  They asked Dr. Askew if they could accelerate things–he was hesitant, mostly because only time can actually heal the tendon.  So still crutches for another 2-3 weeks…<sigh>.  I asked when I would be able to walk again, and was kind of looked at funny, like “hold on there buddy.”  Alas it sounds like 2 weeks minimum before the CAM boot….<sigh again>.  I kind of got on my pity pot after that…reality sinks in that no matter how good of shape I was in I am limited in what I can do and how long things take.

One thing that was painful was a big half a golf ball sized blister on the inside of my ankle.  I was told it was from surgery.  I had felt pain their all week, including a few hours after surgery.  Since the surgery center is about 2 blocks from my house I had it checked then and it was nothing.  Now a week later and this huge thing.  Needless to say…a rubbing alcohol scrubbed pin and a few kleenex later and it was gone.  The fluid that came out smelled a lot like betadyne (sp?) or heavily medicated…wonder if it is something from surgery that is put in my leg to prevent infection that might have gotten out of control.

Anyway, I know have a splint on the TOP side of my leg, which I thought was weird; leaving the bottom incision and repaired tendon exposed to the world.  I guess the main goal is to prevent upward movement of my foot to prevent stretching the tendon right now.  I have some plantar flexion (point down) exercises to do whenever and whereever to help aid in the swelling.  I guess I will just grin and bear it and hope my leg is well enough in 2 weeks to get the CAM boot fitted…I SO want to walk again.  My 2 yr old and 2 golden retrievers think this guy who used to do EVERYTHING with them is now a worthless pile of couch potato.   (OK, maybe that is just me but sure feel like a waste of space right now…plus can’t help my pregnant wife-5 mos-either.  Makes you feel like a real loser.)

Back to work now and hopefully things start looking up!

I am not a big fan of numbing drugs in general…I feel like it just removes me from my body and that pain you feel is supposed to happend–it keeps you in tune with your body to make sure you protect it.  That being said, I have enjoyed the oxycodone (Percocet) given for the pain.  It makes gives me some nausea, but I was thankfully given something else to combat that (exact name to be entered later, as they are a long way away on the kitchen counter ).  I was also instructed to take on aspirin a day and ibuprofin/acetametaphine as well.  I was also given some hydrocodone (Vicodin), which does nothing but make me sleepy–3 ibuprofin do far more in the pain deparment, so those might hit the trash.  The bad thing about the Percocet is the overall impact on my mental state:  tired and a little loopy–not a good combination to work or type or do anything besides veg on the couch.  Not exactly my style, so hopefully on a couple days left of this.  Of course my kidneys will lament the day the ibuprofin was increased to make up for the lack of other pain killing drugs!

Good day…my name is Andy, and the name of my blog fits my unjury.  I am Mr. Statistic–a 34 year old male who was gearing up to play hoops for the season when WHAM!!  Blown Achilles in my second game on Sunday, November 16th.  !  I have the same story as just about everyone else–it felt like someone kicked my right heel or ran into it at high speed.  In talking to my teammates, however, no one was around me!  I knew right away…and strangely enough it was the one injury I was always worried about and heard horror stories about…the irony of what happened is not lost on me!  My right calf had been sore for a few months and I had strained it a couple of times, which most likely led to the Achilles rupture.  I want to kick myself (no pun intended) for not paying better attention to my body.  I have always been active, lift weights and run regularly, and had 20+ years of playing basketball with nothing more than a rolled ankle or pulled muscle. 

I was able to get the best ortho hospital in my town of Fargo, ND, the next day (Monday) with a great doctor, Dr. Mark Askew.  No x-rays or MRI’s needed–Dr. Askew took one look after hearing my story and felt the gap in my right Achilles in about 2 seconds.  We both agreed on surgery (the rerupture rates of non-surgical treatment scared me, 15-40%?) and much to my surprise I was able to get in the next day, Tuesday, November 18th.  (Once again, THANK YOU to Dr. Askew and his amazing staff for making this happen so quickly!)

Needless to say I am now at home with my foot up.  God bless the internet and my laptop!  Last night I slipped in the bathroom and had to put quite a bit of weight on my right foot–OOOOWWWWWW!!  I hope nothing serious was done, and will hold out the next day or so to see if I need to go in.  If everything goes well, Dr. Askew wants me to start putting weight on it in a week–an agressive schedule I am great with.  Hopefully things go well, and I hope to keep the story going in this blog.  Good luck to all who have come before me, and all who come after.  Congratulations on your successes and hang in there with any challenge you run into!  Now time to read some of those stories!