Oct 1st - Simple Progress
There isn’t much left to report on so at best I’ll probably be dropping down to monthly posts - if that often. Nothing spectacular or stunning is happening and progress is slow so not exciting.
I’ve started back at the gym twice a week, once with a trainer and once on my own. I also have decided to do as much as boredom will allow me to do on the bike trainer. Its deadly dull but its the best thing I’ve got in the house to help me rebuild my calf, if I can manage a half-hour a day or more I should be back to the strength I need to get back to commuting by mid November, after the death of Darcy Sheppard I’m actually looking forward to getting back on the road, I know at least one aggressive driver is off the road for a while.
Unlike most of the people I read here I’m not involved with a Physiotherapist in any capacity, my personal trainer does know a fair bit but it isn’t his forte. My initial idea is to follow the protocol outlined by the Carleton University Sports Medicine Clinic for the rehab for Chronic Achilles Tendinitis. Which is ironic because I suffer from that in my left foot.
My surgeon was understandably conservative with my rehabilitation, what with considering my age… rotten bugger. But I believe this is the first time he’s done a repair on an Achilles Avulsion which also made him a little more conservative. Apparently I am supposed to avoid gastrocnemius-soleus strengthening exercises ie calf-raises, but I’m pretending that I haven’t heard that. My surgeon did say I was ready to return to the mosh pit…
The waste and profile of my calf have pretty much returned to my pre-injury look, but the strength is definitely lacking - I’d put it at about 40% of what I expect. Still I’m hoping the cycling will handle that - I’m a hill climber (at least in comparison to the other aero-bellied old men I ride with) so I want that strength back soonish.
If I get enough sleep then I typically can make it through the first half of a work day without pain, without the limp and without needing the handrail’s assistance on the stairs. I’m hoping that between a change in schedule at work, a more disciplined attitude towards food (and beverage) and more physical activity I’ll achieve something.
As it stands I continue to rip my LPs, try to figure out how to get Garmin Connect to accept rides that don’t have GPS data and rebuild a kitchen table.
Pictures
The bulk of the suture as it appears after a day of walking around.
This is what the scar looks like 6 months on. There happens to be a little irritation but thats because I spent the whole day walking around in steel toe boots before taking this picture. There is a tiny bit of swelling but the bulk of the misshapeness is from the sutures and suture pins.
Notice that the holes that were drilled through my heel are completely gone. not even a scar left.
The heel, all healed. In fact there is no indication that there were two holes drilled through my foot 6 months ago, and that even though I haven’t built the callous back up!
music used to inspire this post - public enemy ‘millennium collection’, nine inch nails ‘pretty hate machine’, the prodigy ‘experience’, metric ‘fantasies
June 5th - September 10th
So after walking out of the clinic with permission to go two shoes I wandered back to the office by way of the local food court for a little celebratory lunch. I got back to my desk sat down and immediately took off the boot and tried on my shoe. Luckily I had gone shoe shopping on the previous weekend. I’d tried on my work shoes and they were both too small and seemed to crush my heel with a vice like grip. So I get back to my desk, pull my right shoe out of my backpack and fit it on. Pretty much free now.
Putting the shoe on was liberating, working the rest of the day was exceptional but taking transit home that night was sobering. I no longer had anything to mark me as requiring assistance - you certainly don’t garner much sympathy for carrying an aircast. And it hurt, there was some swelling and the strength wasn’t there and there really wasn’t much I could do about the limp.
For the next week I worked into going to the shoes full time. It was mostly because I wanted to keep myself from over-reaching. I figured to show some improvement my muscles would need extra rest, so I took a couple of days wearing the aircast for transit but otherwise use the shoes or sandals or go barefoot.
So I got my birthday wish.
I also now get to go grocery shopping on my own, work in the yard without assistance, fetch things from the kitchen or the basement - pretty much loosing the hand-and-foot waiting on I’d been getting. But I also was now able to ride my bike in the trainer and spend some time trying to regain the fitness I had allowed to disappear when I stopped using the crutches, and to start trying to lose the 30 lbs that I gained at the same time.
My mother’s birthday is in July which proved to be my first test of endurance, its a 3.5 hour drive and except for a stop for Tim Hortons I made it all the way without an issue, the next day the same.
August is the month of an annual conference that my friends and I go to, typically without our wives but this year they tagged along meaning that a second vehicle was required. For people who like driving I would highly recommend the Ford Flex, it was exceptionally comfortable, except in the last row which is essentially a cushioned pit. Still I drove all 8 hours down and back which was good. There was also 5 to 7 hours of walking and standing required every day, which made the hot tub and the pool at the hotel very welcome.
I did experience some swelling at the end of those days, but it was nowhere near the swelling I experienced when visiting my brother a month earlier and standing on his back stoop chatting until 3am - my foot ballooned around the straps of my sandal looking for all the world like a loaf of white bread rising. That was the last significant swelling I experienced.
Part of the walking around the conference floor I spent concentrating on recovering my gait and eliminating my limp but by day 3 the leg was tired enough that I did stop off at a both and purchase a cane, which helped considerably. I tried to get over to see the Indianapolis Criterium to support the US bike culture and maybe see some shiny new toys before Interbike but we left late, it was a long walk and my leg really did not want to go that far. I’m disappointed that I missed it because I was able to get to see this year’s Toronto Criterium (and I’m looking forward to seeing some CycloCross this year), its exciting and fun for a bike race, at least you get to see the riders more than once unlike a stage race.
By the end of August I was back to being capable of pretty much anything but running. Without the physio I didn’t have the strength to support, which is fine by me because it aggravates my left achilles something fierce.
September 10th actually arrived very quickly, surprisingly fast actually, except for that last three days while I was waiting for the appointment to arrive.
I took the morning since I was fairly certain I’d be low on the priority list to see the surgeon and my appointment was at 10am. I wasn’t too far off, I didn’t get into the examination room until 11:15 and then I waited another 15 minutes before the attending popped in to see me.
Warning - don’t let the attending make decisions about the mechanical fix, always wait for the surgeon!
The attending had the best of intentions, he’d passed by my examination room three times in that 15 minutes and was considerate enough to check in on me, he must have also thought that getting the bed cleared was a good idea because I looked perfectly ambulatory.
He comes in and picks up my chart, reading only the top page he summarizes with “So, you were an Achilles Rupture huh?” and I hit him with it - both barrels: “Nope, an avulsion.”
He looked shocked for maybe a tenth of a second before he turned to the computer to pull up my images. “Avulsion? Wow.” So I explained to him how the diagnostics were mistaken and how my surgeon hadn’t known it was an avulsion until he opened me up. So finally he pulls up my x-rays and looks at them thoughfully “Oh, yeah, minimal bone fragments, that was lucky.”
This is what illustrates that the surgeon is the best person to determine how mechanically sound your fix is. I didn’t have x-rays until after my surgery, he couldn’t have been seeing any bone fragments.
Still he did start the examination and checked the tendon, my strength and my range of motion before my surgeon came in. They exchanged a couple of sentences before my surgeon sat down and eyeballed the tendon while asking about pain, strength and flexion. When the attending mentions that my dorsi-flexion was exceptional the surgeon got a concerned look on his face. Because of this site I knew right away what he was thinking and both the attending and myself blurted out how it was okay, there was no indication of the tendon lengthening.
The surgeon seemed satisfied, signed off on the clinical release and told me I was good to go, just to come see him if there’s a noticeable problem or I need a tune up. He actually took my pronouncement of attempting to find the closest mosh pit and start pogo-ing in stride.
So that’s where that leaves off. I’m now on my own and its a little scary. Probably why I came back to this site and decided to post my experience. Its good to have some people around who understand and will pay attention to your ramblings. Well my ramblings really, everyone else is so succinct its annoying!
