I’ve been meaning to write this for awhile, but once I got back to work, things have been moving so quickly that I haven’t carved out the time to fully write this out. My quick statistic: 29 year old male, I’d say I’m in generally good shape. Before the injury I was doing Crossfit twice a week, playing basketball once every week or two, and yoga the weeks I was too sore from Crossfit or basketball for a third workout. I’ve been married for 11 months, and before the wedding was in the best shape of my life, so not that far removed from a more rigorous schedule. I usually run a half-marathon once a year and a few 10ks. I’ve run one full marathon – best/worst day of my life. So, in general, active.
The day before the injury: My name “bad timing joe” comes from the fact that the day before the injury, my wife and I signed to purchase a house and close in 4 weeks. A very exciting time for us, but I quickly found out how fast things can change.
After writing the entire post, I want to summarize for people that are just looking to skim and get a perspective on healing time and protocol:
ATR Rupture: April 19
Surgery: April 30
First Follow-up: May 6 - removed hard cast, put into removable splint for showering purposes)
Second follow-up: May 13 – removed splint, removed staples, put into walking boot at 15 degree inflection. Told to “toe tap” to get the feeling of swinging my leg with the crutches for May 13-May 20. From May 20-third follow-up I was told to put 25% of my weight on my boot.
Third follow-up: May 28 (today) will update after this appointment
So here is my story:
The day of the injury: I think I jinxed myself. The morning of the injury (a Saturday), I was feeling pretty good and thought it would be fun to get together with friends and play basketball. I had actually stopped working out for a week because I had some lingering knee pain from Crossfit, but I did stretches/squats in the morning and a few lunges to see that everything felt good. Before I left the house I told myself, “I just cannot get hurt right now. That’d be the worst timing I could imagine.” – So yes, completely jinxed myself. When at the gym, I stretched extra (20-30 minutes of stretching) for the very fact I didn’t want to get hurt.
The injury: First game of the day, five minutes into the game. I went to make a quick move, thought someone kicked my heal extremely hard, and instantly fell down. When I looked around and saw no one was around me, I knew something very bad had just happened. I tried to convince myself it was just a sprain and the fact I could walk on my heal made me think it was “ok” and I just needed rest. The first thing I said as I was being helped off the court, “this can’t be happening right now.”
The prognosis: After consulting WebMD and 3-4 other websites, I knew it was a torn Achilles. The “pop” feeling like I was kicked in the ankle, and even the lack of pain all pointed to it. I was so upset with myself. Luckily I live close to a very good orthopedic center, so after calling my sister-in-law (a physical therapist) to get her opinion, I went into the center.
This is where things got a little interesting. I finally saw the doctor and he confirmed it was a complete rupture just based on feel. He was the former head of the local University’s orthopedics program, so I felt like he knew what he was talking about. He told me, “There are two ways to treat this. You can do it non-surgical and it’d require 2 months in a hard cast for the summer and a higher likelihood of re-rupture, or you can do it the right way and have surgery.” – I told him I preferred non-surgical (I’m on a high-deductible plan, and I work for a healthcare company that is focused on reducing waste in the healthcare system), but he told me, “That’s the wrong decision. You need to see a surgeon. We have the best in the country right here.”
Meeting with the surgeon: I met with the surgeon 5 days later. He was a bit more open to non-surgical, but highly recommended surgery based on my level of activity. We reviewed the MRI together and he noted a complete tear and showed me the gap. It seemed like a small gap, but I don’t MRIs. He quoted a “30-40% more likely to re-rupture in the first year” statistic, and he reiterated the longer healing time. Given I wanted to get it done and enjoy the summer, I opted for surgery.
Surgery Day (12 days post injury): I wanted surgery to happen sooner, but my surgeon was completely booked. He’s been doing the surgery for 20 years and had great reviews. The local orthopedics center manages all of the Minnesota sports teams, so I wanted to stick with him, but I was a little frustrated by the timing.
Overall, the day of the surgery flew by. My surgery was scheduled for 7:30am, and I was out of the hospital by 11am. I don’t know how long I was out. No pain when I woke up. I was prescribed Norco for the pain and told to take it before the pain started, but that the nerve block would last 12-24 hours. I slept most of the day, but our hockey team was in the playoffs Game 7 that night, so I got myself downstairs to watch the game. We won, made the day feel that much better. I started taking the Norco around 10pm to “Get ahead of it.”
1-day post surgery: Worst pain of my life.
I set an alarm for 4am so that I would wake up and take my next dose of Norco. I didn’t make it that far. The pain woke me up at 1am. Hard to describe it as anything more than feeling like a knife was cutting directly into my heal. I quickly popped 2 more pills with little benefit. I was awake from 1am-7am with the worst pain of my life. Looking back, I wish I would have started taking Ibuprofen right away for the swelling. The entire day is a blur looking back, but I was popping as many pills as was allowed and just trying to sleep the pain away. Norco (which is similar to vicodin I think) definitely made no impact for me. For future surgeries (hopefully I have none) I will demand Percocet or something stronger.
I’ll just try to summarize each of the weeks after surgery:
Week 1 (0 – 7 days post surgery). I was told I could shower and move around to get food, but to keep it elevated at all times after that. I was probably too active. I was staying at my parents house because my wife had to work, and went home on Saturday. I was so ready to get out of the house that we stopped for lunch and bought a fan for the new house at Menards. I was definitely moving around without it elevated for a good 3-4 hours. I stopped taking vicodin 4 days post surgery. It was doing nothing for me.
First follow-up: 7 days post surgery:
Was told everything was healing really well. Swelling was low. My hard cast was taken off (it was more of a splint) and a new removable split was put on. I was told I could take the splint off to shower but to keep it on other than that. No driving, lots of elevation, and rest were still required. I started working the Monday after surgery (surgery was on a Wednesday), because I can work from home from my computer. Was good to keep my mind off of my lack of mobility.
Week 2 (7-14 days):
Uneventful. I was able to shower without a bag on my foot which was nice. Other than that, a lot of sitting with the foot elevated as much as I could. I left the house a few times with my wife for dinners, church, and other 1-2 hour excursions.
Second follow-up (14 days post surgery):
Was told everything looked really good. The doctor tested if I could push down at all, which I could. A tech removed the staples, and I was fitting for a CAM walking boot. They angled it at 15 degrees. I was told I could take it off for showering and sleeping, as long I wasn’t a “violent sleeper” and would kick or jump up in my sleep. Luckily I am not.
I was told to adhere to the following protocol:
Week 3 (14-21 days): Very light touching down of my toe as I’m walking with crutches. “light tap” to get the movement of walking in. I followed this pretty closely. I had some bleeding from the incision. I don’t know if it’s because they took the staples out too early or if this is just normal from an injury. It only lasted a day or two.
Week 4 (21-28 days): 25% of my body weight while walking with crutches. I started out at 25% and was pretty good at following this. At first it felt uncomfortable, but I quickly got the hang of it. We were moving into our new hours at day 25, so I was anxious to be able to put more weight on it. I definitely started to push the limits, occasionally walking without my crutches for very short distances, standing in place without my crutches, even helping to move a table (mostly forcing the weight onto my non ART leg and using my arms). I’m hopeful that I haven’t pushed things too fast too quickly. It just feels good not to walk with crutches. I’ve put very light weight on my barefoot (again, just to steady myself, no real weight). It definitely feels good to put a little weight and to feel that the Achilles is actually working.
Third follow-up is today (28 days post surgery). I will write another blog post after my follow-up today. I just didn’t want to wait any longer.
Overall, I’m feeling very hopeful for my recovery. Everything seems to be going great. While I don’t necessarily feel the “surgery is the only way” advice I was given was right, I’m glad I went with one of the best orthopedic centers and a surgeon that knows what he’s doing (at least I think he does).
Cheers,
Joe
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