Avulsion for once

Admission

The surgery was set for Friday the 13th at 11:30 and of course I had to show up hours early and hungry to boot. We got to the hospital at 8:30, wound our way through the corridors and elevators to a very unexpected waiting area. Told to wait in the Rocking Room I wasn’t sure what to expect but the room was full of rocking chairs, I suspect as a way to help patients eliminate nervous energy and relax.

The wait in the rocking room was about 40 minutes long and then I was taken in to the change room. Stripped down to my skivvies and putting everything into a plastic baggy with my name on it I got to wait an incredibly long time before a nurse came in, explained what was coming next in the procedures and then went through the question and answer session in the binder.

Eventually an orderly showed up with a wheelchair and I hobbled on board since by this time my crutches had been taken away and locked up. Again we wound our way through various corridors, back alleys and seedy neighbourhoods to end up in the pre-surgery waiting area.

This is the first area that really looks like it could do with a newer coat of paint, and some electronics that weren’t purchased from Radio Shack in 1982.

The Terrence Donnelly Day Surgery center is a beautifully built section with full sofas and gorgeous oak wainscoting, plenty of room and a very relaxed atmosphere, the Rocker Room is just off of it and nice enough on its own, even the newspaper was up to date.

Pre-Surgery

By contrast the pre-surgery waiting room is somewhat antiseptic and lonely, not that we were actually left alone. Again my binder showed up and again a series of questions were asked out of it, most of which I had answered previously. Once that was done I was sat down in a relatively comfortable recliner. The room sat 10 or 12 but my wife and I were the only non-staff in the room until I left, the nurse was checking someone in as I was leaving.

This is where I first met my surgeon Dr Whelan. He was confident, concise and put up with my flippancy well. He performed a cursory examination of my achilles and explained the procedure. He admitted that they were a little behind schedule but that the surgery itself should take no more than 45 minutes and I should be back into the recovery room by 1pm or so. Then he initialed my leg and disappeared, hopefully to do something about the caffeine from his large double double.

I can’t really tell how long I sat there after that but I do know that we were in danger of missing our tee off by the time the anesthesiologist came round and asked the final round of questions and I was lead into the surgery on time.

They popped me up on a gurney and wheeled me down a couple more corridors and then into a well lit room filled with busy people. I was asked a couple of questions again so they could complete their check boxes and then things got interesting.

There seemed to be about thirty dozen people in the room at any one time but I really think there were only six or eight. It was like watching an orchestra tune up, people were unboxing things and hanging things and polishing things and organizing things and in the middle of the room was the strangest bed I’ve seen.

The surgery bed for me was a regular face down surgery bed with jelly bollards lined up in a more or less man human shaped pattern, it was obvious that I’d be lying face down and it didn’t look particularly comfortable. It also made me greatful that I’d not only retained my underwear, but that I’d worn the good stuff.

First the anesthesiologist resident had problems getting the IV in, apparently my valves are in all the wrong places. When I asked what that meant I was told that I was just a little mutated but it wasn’t anything they couldn’t handle. Then Dr Whelan came in and in the first of many shots at my infirmity he looked at me, looked at the bollards on the surgery table and then asked if there should be more put on the table.

“So I’m fat then am I?” I couldn’t help myself and sarcasm probably isn’t the best way to address your surgeon before he puts the scalpel to you but it came out. Luckily it earned a chuckle from most everyone.

I asked at this point if they could take pictures but Dr Whelan didn’t bring his camera, then it was time for the anesthetic. I looked at the anesthesiologist as he said they were about to apply it, let myself get comfortable and almost immediately saw a tunnel with white light.

Post Surgery

I think that the hospitals have finally learned to move lights out of the line of sight of patients in post surgery recovery, it was confusing enough just to have a gaggle of white lab coats standing at the end of my bed when I first came out of the anesthetic but having the afternoon sun glancing off of the white lab coats was pretty bright.

I was awake long enough to recognize Dr Whelan’s voice, hear the term “there was a bit of a complication” and realize that the clock seemed to say it was 1:30.

I woke up maybe a dozen times after that before I caught on that someone was watching me pass out but eventually I stayed awake long enough for the recovery nurse to ask me some questions. “How are your feeling? Would you like some ice chips? How is the pain?”

It was probably about 2:30 or so before I woke up enough for them to give me instructions on how to operate the morphine pump and to tell me that they had no idea what the complication was.

The next time I woke up they asked me how the pain was, I said it was bearable so they asked me to hit the pump until the pain went away.

Cool.

I must have hit the pump 6 or 7 times because the nurse got up from her chair and came to check the machine before asking me about the pain. “Bearable”, so she hit me with an injection of morphine from a syringe. I passed out again right after that.

Eventually I was awake enough to realize that my wife was there and that I could make some kind of attempt at a conversation, eventually it was even deemed safe for me to go to the ward for my overnight observation.

Lucky, probably never again so lucky.

When I signed up for the surgery I asked for a ward for recovery, I thought it might make for a nice little adventure and I’d get to talk to some people while I didn’t sleep.

So they wheeled me out of the recovery room, down a couple corridors, through an elevator and into a semi-private room that I was to occupy alone, I had free television and I was located right next to a window, which was necessary because the room felt like it was about 3 billion degrees hotter than the sun and the only way I could keep a decent temperature was to have that window open to the nice brisk March night air (apparently during a cold snap).

They seemed to serve me dinner almost immediately and I have to say if St Michaels has a good reputation for orthopedic surgery they should have a sterling reputation for their food.

It seemed to be a nice thin shaved roast beef wrapped around a savory rice pilaf with carrots and green beans, coffee, milk and vanilla pudding. I don’t know how they got the menu without asking me but man did it smell good.

And taste like ash.

Apparently anesthetic does a lot to kill off the taste buds and was I disappointed. Of course the fact that I would fall asleep between mouthfuls, while my fork was suspended in mid air with food on it didn’t help any. Eventually I ended up with a can of ginger ale and just the vanilla pudding. Disappointingly I had to refuse the rest of the food which as it turned out was a good thing.

About half and hour after the food tray was taken I started hearing from my fellow recovery patients as sounds of retching echoed up and down the hallway. One patient’s concerned loved one asked about it and that is where I got the rumour from: “retching is the best way to start the stomach muscles moving and a person will retch if they are fed while the stomach is still.”

By this time my wife had given up on me being any kind of entertaining and gone home, and frankly I’m glad she did - it must have been terminally boring to watch me lie there.

So over the course of the night I watched crappy late night television and an episode of Knight Rider or two, filled up inumerous bottles of urine and argued with the night nurse over whether or not the window should be left open. I think she managed to sneak out of the room once without me catching her closing the window, but I was on to her, sly to her ways. I slept the night in the flimsy hospital gown under a single cotton sheet and was still warm.

Through all of this I still hadn’t heard anything about the ‘complication’ and vowed to not check out of the room until I’d heard what had gone on.

Going in

I had a couple of interesting bits of advice going in to the surgery, some from here and some from co-workers and some from family.

• “Don’t go in alone.” That came from here and I took it to heart (reportedly I took it too much to heart but I was drugged!)
• “Going under the general you’ll struggle to stay awake.” Was interesting.
• “They make you eat so you’ll throw up.” that one actually came at me post surgery but it should have come before.

Don’t Go In Alone

I have counted myself fortunate in having the support of my wife as I have so yes I did have her come in despite the political pressures at her work, actually she came in spite of the pressures, politics are stoopid.

So my wife helped me sit through the really boring parts and helped me get through the nervous parts. Patient was a great word of the day, I was one and she was as well. I did have some additional help though, I asked a good friend to come down to take my wife out for tea as I was going into surgery, it helped me to think that if she needed it there was an ear to bend that was local.

Struggling Awake

Its probably true, I can see it being so. When they finally insert the anesthetic you fight to stay awake, struggling to stay conscious because things are pretty darn scary, really.I suspect unless you’ve gone under the knife for something else other that wart removal this is one of those things to get stressed about.

Or you could be curious. I did ask about doing the surgery under a local so I could watch but they said its better under general because the muscle profile is much more relaxed. I still sometimes suspect they were lying and simply didn’t want me asking a bunch of questions.

I did ask the surgeon if he could take some pictures, but he said he’d forgotten his camera. Hey, its a learning experience! I figure if you know what was done to your body you can help yourself heal by visualizing the damage knitting back up.

So of course I did the opposite, in went the needle, a little relaxation and the next thing I saw was a bright light.

They That Make You Ralllph

A general anesthetic is meant to reduce involuntary muscle use as well as knock you out and in many cases it overrides the contractions used by the stomach and intestines for digestion. Many hospitals (and I’ll include St Michaels in that lot) seem to subscribe to the idea that the digestive process starts most effectively if the patient throws up. This was cobbled together from snippets of conversation I overheard as I slipped in and out of a comatose state after being placed in the recovery ward. It may not be true but it is truthy enough to repeat.

I was lucky, I was so zonked from the anesthetic that I didn’t actually get a chance to eat enough of my food to throw up and during the course of the night while I drifted in and out of consciousness I managed to attend to some stomach exercises I learned from a friend in elementary school that he picked up from his belly dancer mom.

Advice From Me

Some things that I’d pass on that I’ve learned as well, just in the course of the play. Its not like any of it has been repeated back to me, repeatedly.

• Don’t be ‘not alone’ for too long, let people go home! (Or force them too)
• Make sure your drip lines and intravenous are correctly situated!
• Bring some entertainment

Be Alone

Yes, its good to have people there when you’re wheeled off half-naked into the presence of strangers who will have you lying butt up and unconscious, and its good for them to be around when you come out of the haze that is a general anesthetic. But don’t force them to stay, drooling really isn’t that entertaining.

If you’re in for an overnight recovery you’ll understand the boredom and those first few hours that you are recovering from the anesthetic are going to be dull, at least once the teasing is over with. Get your use out of your people, let them bring you your glasses, something to read and your MP3 player and then let them go home, even force them to go. They know you’re alright so let them get their own rest and let them relax because if they share your bed they won’t get much of either for a while after you get home!

Drip Drip Drip

If you have the good fortune to be hooked up to a morphine drip and IV (that is of course if opiate based painkillers work on you) you’ll want to make sure of two things:

1. That the IV pole is on the correct side of the bed for your sleeping patterns. I’m a stomach sleeper so I needed the drip moved
2. That the IV and oxy lines are long enough for you to sit on the edge of the bed or kneel in bed so you can pee!

Believe me, being on an IV does wonders for keeping you hydrated and all that liquid has to come out as well. I ended up getting a second bottle and I needed it before the night was through despite the night nurse emptying it every hour. And yes, using one of those bottles isn’t easy when you’re lying down, be confident. The post surgery splint should be more than sufficient for providing you enough support to kneel to pee.

Entertain Me!

Yes, its going to be dull and you may not have my kind of luck and be able to ride on the coattails of the previous patient’s television rental. Your sleep patterns are likely to be screwed up royally and you’ll be bored. Make sure that you’ve got things to do. Read, listen to music, bring in your portable DVD player but remember if  you’re in a semi-private room or a ward to be considerate of your fellows and keep the volume down.

One game I can give you is “Is Morphine Effective?” I played it three times and came out with some disappointing results.

Lastly

Just some last little bits:

• The staff are your friends
• Look for the things to enjoy
• Take a camera

Friendly Staff

90% of the time the nurses and orderlies that you deal with are just people doing their jobs. The one’s that are good at it can also see you as a human being in need of compassion. You again may not have my luck in being in an orthopedic surgery recovery ward and may be sharing your hospital convalescence with much more seriously ill people.

Try to lighten the load of the staff as much as you can, if you treat this as an adventure its easy and they get to do something they rarely do, impart knowledge and wisdom.

Enjoy It

Yeah, Huh? But that’s what I view as the single greatest strength I had going into this - a positive attitude and a willingness to attempt to learn something, to gain from it. You’re in a hospital for surgery, hopefully a unique experience in your life, take it for all its worth. Get desert with breakfast, ask about the drip machine and ask your fellow recovery patients about why they’re there. Is there a difference between Vicadin and Percocet? and why isn’t Vicadin available in Ontario?

Lights! Camera! Cut!

I regret not doing this, and I think my surgeon may be as well.

I wanted to know what they were going to be doing inside my leg and I really am a proponent of visualization. I learned how to swim, skate and drive stick through visualization (severely disappointing my father). I would swear that you can also speed healing as long as you know what needs to stick back together.

And you can gross people out!

Attitude is Everything

“A positive attitude may not solve all your problems, but it will annoy enough people to make it worth the effort.”  ~Herm Albright, quoted in Reader’s Digest, June 1995

I thought by now a practical note about something rather than more anecdotal monologue-ing  would be good, a note about what I was actually ‘going through’ rather than what happened to me.

When my Achilles blew I knew immediately what had happened and as I lay on the floor of the group exercise room convincing my personal trainer that I had indeed blown out my Achilles and writhing in a pain I just couldn’t understand because it was so different I also came to realize some things.

Firstly pain is an excellent catalyzer for thought. The right kind of pain can actually help you focus on things and get them sorted. The first images that flitted through my mind was the torture scene in the Firefly episode “War Stories”. Not because I was thinking that I now knew what kind of pain Nishka was inflicting but because it was one of those things that allowed me to focus on the important things. To paraphrase a quote in that episode from the famous Xiang Yu “To meet yourself you must deprive yourself of safety.”

I realized while I was writing on that floor that I could approach this in two ways. I could try to deny it or I could embrace it. I could wail and rail against the perceived injustice which is really simple the inconvenience, or I could see this as a new experience, something to be savoured and enjoyed.

Well since I am a bit of a gourmand savouring seemed like a good deal and cynicism is easier for others to take if you happen to be good hearted about it.

It was all a new experience. I’ve never felt a pain like that, never had an injury like that and so I dove into it, examined what the wound felt like and how it appeared. I experimented with how much movement I could get out of the injury and what I could do to move around on my own.

I’d get to see what it would be like to have a relatively important trauma, to experience how a person is treated in hospital, get a chance to get first hand experience of what the Canadian medical system offers so I could make arguments with first hand knowledge, get an understanding of what kind of bureaucracy is involved in a hospital and maybe get to have surgery.

If you don’t like something change it; if you can’t change it, change the way you think about it.  ~Mary Engelbreit

I decided that the best approach was to think “I get to have” rather than “I have to have”. There are a lot of ways of viewing something and I’ve experienced an appropriate amount of grief in my 40 years to understand that the five stages of the Kubler-Ross model exist for every loss, they just don’t have the same impact all the time and each stage has a different amount of importance for each different loss.

Denial - This was eay to overcome, there was no way in reality I could hope to deny this out of existence, the pain simply was too real.

Anger - Oh yeah that was there too, I mean come on, I had plans and really wanted to not have my life screwed up, surely this didn’t need to happen now! But it did, its done, why should I be angry about something I had no real control over?

Bargaining - So yeah, perhaps the higher power could be appeased with some sacrifice out of my life and this could be a partial, or maybe just a sprain or a pulled muscle? But in turn who honestly doesn’t sacrifice the things they don’t want or need first and then work their way up the scale never quite approaching a sacrifice that would be just as inconvenient or painful? The only way to not be hypocritical when bargaining is to offer something of equal value, and where is the value in that?

Depression - yeah, this thing happened and damn if it weren’t going to screw up my life, I really did have plans, there were things I really wanted to do that required two good legs and who wants the inconvenience of crutches and isn’t this typical that it would happen to me what am I going to do with my life now? Well I guess I could simply live my life, other people have more taken from them and they do well enough, I can’t be that strong?

Acceptance - Yes, this happened to me and how I deal with it will model my life from this point forward. I could carry my hurt, anger and depression with me or I could offload them as excessive baggage and look at this as another challenge. I’d been working out at the gym, challenging myself physically. I’d done several ultra-marathon rides in the past and on each encountered challenges that didn’t show up before. Why not simply take this as a chance to travel a new road, perhaps in the process I could become better in other ways too?

Nothing contributes so much to tranquilize the mind as a steady purpose - a point on which the soul may fix its intellectual eye.  ~Mary Wollstonecraft Shelley, Frankenstein, 1818

This is when I got up into a sitting position, all of the above had taken the amount of time it takes for the body to decide whether it is going to fall into shock or deal with the trauma by desnsitizing. Minutes may have passed but it felt like eternities in seconds.

Life was going to be a new adventure. I knew there were things I was going to have to experience and I knew that there were challenges I was going to have to face and I knew that I was going to survive, and that is the key.

Why do we fall, sir? So that we might better learn to pick ourselves up. - Alfred Pennyworth

Keep on Keeping on

Its a trying and traumatic thing, every major injury is. Every major injury is a loss and this one doubly so for most of us. It not just marks the loss of mobility and the possibility of being forever scarred and possibly hampered by disability to some degree, but for some of us it also marks the demise of our youth.

I took to joking about it “Why did it happen?” people would ask, and the only honest answer I had was “My warranty ran out.”

But this isn’t really an end. If you approach it as a challenge, and this is supported by a lot of the posts I’ve read here, if you approach this as a challenge, take it as an adventure, then you’ll heal faster and suffer less and frankly have a much better time.

Busy Busy Week - Saturday

I never get up early on a Saturday not unless I’m doing a ride and someone is expecting me, so getting up at 6 am to make sure that I was at the hospital for 8:30 was unusual. We cabbed down to the emergency room at St Mike’s and found out two things:

1. The Imaging department doesn’t open until 9:30
2. The imaging residents don’t show up until 10:00
3. The nurse practitioner was ensuring I got to the front of the line.

Saturday mornings in an emergency room in downtown Toronto are a bit different than Friday nights. We didn’t have to wait too long, but the waiting really was interesting. I just hope that the TTC held that’s woman’s prescription and that the people who urinated on her things in the shelter at least replaced her cigarettes and that the shelter apologized for kicking her out and that… yeah, it was interesting. But there were only about a dozen people there ranging from the homeless woman with the wet cigarettes to the elderly couple who called their driver as they were leaving.

The imaging technician was quick, competent and knew her stuff.

The imaging resident? Well the bone is the calcaneous just so you know next time.

I’m not sure why I was sent to ultrasound but I suspect there was a darn good reason that had to do with expedience. Ultrasound isn’t the best imaging technique for diagnosing an ankle injury, partly because the images are so dirty, partly because interpreting them is less than easy but mostly because it requires contact with the injury. I actually believe that the pressure from the imaging head of the ultrasound caused more pain than the original injury, and I don’t know how far along in their training the residents were but I was less than confident.

Still they identified the rupture area and were able to isolate the location so I wasn’t going to complain too loudly, but the next person to use that imaging table would be able to read my reaction to the ultrasound if they knew braille. I think its the first time I’ve ever been able to dent steel tubing… well I exaggerate but I’m sure I felt it flex.

From there is was back home via a local restaurant where not only did they ensure that they say us as far from the entrance as possible, but also that we had to navigate the narrowest possible path to get there. Oddly this was typical of all the restaurants I went to while on crutches, either they sat me as far from the door as possible or they made us pass by the doors to the kitchen crossing the inevitable clay tiles  slick with moisture (or something else).

Busy Busy Week - Monday

Yes I skipped Sunday because I spent the day in front of the television, though I also did do some telecommuting, descending the stairs to the office on my butt like I used to slide down the hardwood stairs when I was a child (it toughens one up for spankings I can tell you!) and crawling up the stairs on my hands and knees also as I did as a child.

Monday was the 8:30 appointment at the fracture clinic to be assessed by an Orthopedic surgeon for a proper diagnosis and have my surgery confirmed if necessary.

We arrived at the main entrance to St Michael’s early enough that we were actually able to navigate through the 200 meters of interior hallway to get to the fracture clinic, rather than use the 30 meter exterior route. I think for my fourth day on crutches I was actually doing well, especially since it was my first time on crutches.

We registered and then sat in the waiting room with about a dozen other patients and I was called in almost immediately to see Dr Schemitsch. He asked me the same questions the triage nurse, the admitting nurse and the nurse practitioner asked, failed me at my Thompson’s test and examined the ultrasound images. Then he confirmed a total achilles rupture, identified it as 6.3cm from the mount and told me I’d be in for surgery on the Friday, then he sent me home.

Once again, in the visit to the hospital was over and done with before I really knew it, in at 8:30 and out with a diagnosis and three appointments, one for the surgery admission, one for the pre-surgery assessment and one for the surgery itself and out of the hospital by 11:30. Canada’s health care system is obviously screwed.

Busy Busy Week - Tuesday

Tuesday I had both my surgery admission appointment (at 10:30) and my pre-surgery assessment (at: 2:30). It took about 30 minutes to go through the admissions appointment and while we were waiting for the assessment we found the Tim Horton’s at St Michaels, which was a nice treat. My wife and I sat in the hospital entrance simply talking, making up stories about doctors and nurses, making fun of other patients - you know how it is, and it passed the time quite quickly.

The pre-surgery assessment was also pretty quick and this is when they started filling out my binder.

Now it might have simply been pre-surgical nerves causing me to hallucinate but I’m sure that the assessment questionnaire had close to two billion items in it and I’m pretty sure there were three columns of check boxes because only the assessment nurse wrote anything down, when the surgery admissions nurse asked me the same questions I’m sure all he did was tick off some boxes, and again with the pre-surgery nurse I think she did the same. Still if there were an inconsistency that might be diagnostically relevant.

By 4:30 we were on our way home. Lots of waiting but the actual appointments were quick and easy and the staff not only were confident and competent but they took my sarcasm and facetiousness as humour, which was nice.

Busy Busy Week - Wednesday

Went to work, sure I arrived lat and left early but still why should I show up? Its not like I type with my toes.

Busy Busy Week - Thursday

Went to work again, arrived a little earlier but also left a little earlier, it is remarkable how much energy your body needs to try to repair itself, and I suppose I was excited by the prospects of the surgery. This is also the day that I first found achillesblog.com and started reading up on what people experienced and how they were able to cope.

It was a good day.

Busy Busy Week - Friday

Surgery day, that should really have an entry on its own.

That one fateful day - 03-06-2009

I had my gym appointments late in the day, mostly because I’m lazy and want the end of the day to go as quickly as possible. So it’s 2:30 in the afternoon when I hit the gym. Its not a bad day planned, footwork for the most part, and some stuff with the medicine ball but not too strenuous really.

We warm up with the medicine ball, tossing it back and forth do some chase downs. Things are loose and the blood is flowing.

My PT takes out what he calls an ‘Agility Ladder’ the purpose of the device is just like all those tyre exercises you see football players do in training camp. Simply put you move across the fabric ladder and attempt to do toe touch kinds of exercises without tagging the fabric. Its all lateral lunges, hopskotchy type things and to wrap it up is the lateral hop. You stand on one leg and hop the length of the ladder and back again, switching over after doing a circuit.

First circuit down and back and everything is fine, except it doesn’t feel like a hard enough workout so I commit myself to going deeper into the squat so my quads have more say in the exercise.

First circuit is on my left leg. The trip down the ladder is fine except for a bit of heel pain but coming back up I realize it isn’t heel pain, its the tendinitis flaring up again in the Achilles. I make note of this and intend to tell my PT when I finish the circuit on my right leg. Except I don’t.

About two thirds of the way down the ladder comes that dreaded POP! we all know so well. The pain didn’t come until I actually hit the floor and I crumpled intentionally knowing what had happened and wanting to minimize the potential for damage.

My father was a wireless operator in the RCAF in WWII and he had this story about a dance he went to with WRENS and WAVES and many other 5 lettered acronym groups for women in the armed forces. This of course was the height of the era of big band music and dances like the Jitterbug and the Charleston. My father was witness to an Achilles rupture caused by one of those dances.

A young woman was dancing most energetically with one of my father’s friends and had been for some time when that dreaded POP! sound erupted from her leg. My father said he actually saw the tendon and muscle complex curl right up and form a ball bulging out her stockings.

So I knew when that POP! echoed through the group exercise room and felt that tendon slide, I knew what was going on.

My PT thought I had kicked myself and was simple arsing around until he got a look at my face.

Twenty minutes later I had an ice pack strapped to my ankle and an associate Personal Trainer was trying to make me feel good about his own partial rupture that he walked around Europe on for two weeks. There was no change in the aspect of the muscle so there was no reason to suspect it wasn’t just a partial rupture, except the profile of the ankle was wrong, as if the tendon were missing.

With some help from both trainers we made it down the stairs where I was to sit for another half-hour until my wife came in for her own session, then things happened quickly.

My wife arrived for her session at 4:15, we had to go back to my office to get my OHIP card and wallet (the office is in the same block). Because of security I couldn’t send my wife so I had to do it myself. At 4:45 we’re at a local walk-in clinic where the receptionist looks at us, the crowd in the waiting room and the clock and says “we close at 6 and we’ve got enough patients to last until 7. If you’ve got what you say you’ve got we’d just be sending you up to St Michaels anyway so go now.”

5pm on a Friday in a hospital in downtown Toronto, that didn’t sound like fun.

Timeline

5:05 pm enter the emergency of St Michael’s hospital

5:07 pm interview with the triage nurse

5:09 pm interview with the admitting nurse

5:20 pm meet with the nurse practitioner overseeing the non-trauma soft-tissue clinic

5:30 pm nurse practitioner confirms diagnosis of a full Achilles rupture

5:40 pm splint applied

5:45 pm crutches and training provided

5:55 pm nurse practitioner sends us on our way with

• prescription for Tylenol 3 with codeine
• appointment for an ultrasound in the imaging clinic for 8:30 the next morning
• appointment at the fracture clinic for 8:30 the Monday morning
• preliminary schedule for appointment with the surgical admitting nurse
• preliminary schedule for appointment with the pre-operative analysis unit
• preliminary schedule for surgery to take place 7 days later on Friday the 13th.

6:20 pm stop at the local Pharmaplus to fill the prescription

7:20 pm leave the Pharmaplus with the prescription finally filled

7:30 pm home, drugged and Swiss Chalet on its way - not that the drugs were much use.

Yes, I spent less than an hour in a downtown hospital in Canada’s largest city on a Friday night something Shona Holmes should maybe have tried. I spent more time in the pharmacy.

Pre-operation

May 2007 - March 2009

I joined the gym. It was done mostly because I was missing the feeling of actually doing something, of moving stuff around, of actually putting an effort into things. The personal training sessions were purchased for two reasons: firstly I didn’t know a thing about free weights or weight machines, every bit of effort I’ve put out has been practical - tossing boxes of computer cables ten feet in the air or catching hay bales from a baler that had a broken scale; secondly out of spite, if I was going to join the gym by god I was going to get something out of it!

I’ll admit to a few things here: I’ve grown older; I’ve gained weight; I’ve become sedentary; I’m lazy.

Working weights isn’t all that bad, and doesn’t stress me out much. Doing low-impact cardio isn’t much of a challenge since I put about 5000 km of commuting meterage on my bike every year and top that up as close to 10000 with charity rides and rides with my LBS.

Impact though, that started bringing some challenges. First it was heel pain, mostly in the bottom of my foot, and always associated with the stair climbing or other running exercises. Being that I had been prone to heel spurs as  a teenager and that I haven’t slacked in my milk consumption since I wrote it off.

Then came the tendinitis. Both Achilles tendons started exhibiting tendinitis. At first it was mild and only on weekend mornings when I’d spent 10 hours or so in bed but it got worse. Eventually it flared up after sitting in a chair for two or three hours and it was bad enough that I had to wake up and perform stretches before I got out of bed so that I could actually walk. This did make me nervous, but not so much that I looked for a doctor.

Eventually something in my life changed, and I still don’t know what it was, but the tendinitis faded and disappeared leaving behind some tenderness but no swelling to speak of so I forgot it. Things actually were going pretty well in the gym too. I’d maxed out the machines and had to move all my exercises to free weights and I’d graduated up through personal trainers until I got a provincial boxing champion contender (retired).

Our workouts started to focus on a more martial aspect even throwing in some glove and foot work exercises to keep things interesting, but the heel pain started coming back too, not often, not too bad and it wasn’t accompanied by tendinitis so I didn’t worry so much.

Probably not the smartest thing to do.

What I’m doing

I’m cheating. I’m beginning my posts most of the way after everything is done, sort of celebratory for having had the surgeon tell me that he doesn’t want to see me in unless I need a tune-up. He felt good enough about my sanity and his work that he simply laughed when I suggested my first action was to pogo in the first mosh pit I came across.

At least this time he didn’t pause and then ask me how old I was before telling me I couldn’t do stuff. “Continue on with your life, it’ll just get better from here.”

What’s Different

I’ve read many of the posts on achillesblog and what I’ve read has for the most part given me heart and really helped me understand what I could expect in the way of suggestions, surgery, recovery even pain but I didn’t come back post surgery because there was nothing here that I could find to help me.

I didn’t have a rupture, I avulsed.

The Achilles tendon in my right leg literally peeled away from the calcaneous, I was lucky in that I didn’t fracture, but it was a bit of a surprise to the surgeon and the main reason why I didn’t come back here - there really isn’t much out there on my particular problem.

What I am doing

Hopefully I’m filling a void and giving those few people who will suffer this particular malady a place to get a little hope. I also hope to increase my capabilities in writing and perhaps spur me on to more challenges to help me recover to the point where I forget this happened.

Hopefully.

But thanks

Because there was a lot I did gain from this site and from those users who put their stories up here. Hope certainly was the one greatest thing but I was also able to shift my fear, change it into an enervated curiosity and let me see the experience not as a sign of age or decrepitude but a challenge and something to learn from and the folks on this site certainly helped in that regard.

Thank-you