May 09 2013

Non surgery on the NHS

Published by bambam at 7:54 am under Uncategorized

Hi there,
I’m a 41 year old male and I’m 12 weeks post ATR on the non surgery route. I’ll tell my story on my next post.
But for now I’m very keen to hear the recovery experiences of everyone, especially the UK NHS non surgery recovery stories.

7 Responses to “Non surgery on the NHS”

  1. bambamon 09 May 2013 at 8:33 am

    Right as promised here’s my story.
    I was diagnosed with a full AT rupture on my left leg on 17th feb 2013 at Sunderland Royal Hospital in the UK. A similar story to others in the UK on our NHS actually.
    I ruptured it playing squash and although I’ve never done it before (so didn’t know what it felt like) the position of the pain when it snapped immediately made me think it was my AT.
    I turned up at Accident & Emergency 2 hours after (as an ambulance wouldn’t take me because I was still conscious!) and waited for 4 hours with no pain relief to see the consultant on call. (I was climbing the walls by this stage).
    The consultant came in and did a quick Thompson test and said “yep, that’s an Achilles Tendon rupture. We’ll book you an appointment tomorrow to see an orthopaedic consultant. They’ll ultrasound it and tell you if it’s a full or partial rupture.”
    I was then sent on my way with under arm crutches that were set at different heights and told to take pain killers.
    Next day i was seen by the consultant’s registrar who did the Thompson test again (ouuuuch!) and confirmed it was a full rupture of my AT. He said that as I had ruptured it so far up (virtually where the calf muscle joins the tendon) that surgery would be difficult “as it’s very hard to stitch muscle to the tendon” he said. He then went on to outline my treatment plan as 12 weeks of NWB with crutches and foot in a plaster cast. Toes pointing slightly down for 4 weeks then another cast with toes at 45degrees for 4 weeks then finally at 90 degrees for another 4 weeks. He then went and consulted with his boss (the consultant) and he concurred. I had the first cast fitted and was sent on my way.
    I then started reading all the info on the web and started getting myself worried about
    a) why they didn’t operate
    and b) was my foot at the correct angle to allow a full repair.
    Anyway I managed to get another appointment to see the consultant (2weeks after) to put my fears to him. The plaster cast was removed and the consultant asked my concerns. When I told him about the angle of my foot he said it was fine and not to worry. When I told him I understood why they couldn’t operate his exact words were “it’s not the fact it can’t be operated on, it’s just that the position of your rupture tends to heal better without surgery.”
    I thought as he’s the expert he must know what he’s talking about. My foot was re-cast and I was told to come back in 2 weeks.
    I returned on the 18th March 2013 to have the cast number 1 (4 weeks in) removed and my rupture assessed. My consultant was so happy with my progress (no pain and decent flex) that he was fitting a ‘moon boot’ and he’d see me in two months time! He then put me in the care of the NHS physiotherapists. I saw a physio that day (4 weeks post rupture) and she gave me 3 exercises to do every 2 hours (toes pointed down and then up x10 and circular motions clockwise and anti-clockwise x5) with the boot off. She also told me that I needed to start putting weight on my boot but still needed crutches although she did give me elbow crutches.
    I then didn’t get another physio appointment for another 3 weeks (7 weeks post rupture).
    I was astounded. They got me in, asked me how I was, asked what exercises I was doing and said “great, that’s it then, keep doing those 3 times per day. Book another appointment and we’ll see you in 8 weeks!!”
    That’s why now reading about the UWO studies I’m worried I’m not being active enough.
    I do hobble around without the crutches (doing little jobs at home) but my good leg aches after a while.
    I’m terrified of a re-rupture because my AT isn’t strong enough.
    Anybody else had non op treatment on the NHS?
    Thanks, Chris.

  2. micah1on 09 May 2013 at 9:20 am

    Hi Bambam, I am also UK NHS Non op. We perhaps can’t compare treatment completely as my ATR was about 4-5 cm up from the heel and I only know my treatment so far. click on my blog to read it all. Our NHS trust do 2 weeks equinous cast, 4 weeks boot then 2 shoes (and the boot got binned, no transition) .However I didn’t see a physio till I went into shoes and the advice prior to that was “weight bear as tolerated”. I don’t think you ever stop worrying, I’m doing the “is my treatment too fast/am I doing too much” worrying.

    Its difficult in the UK as you are stuck with your local hospital, it seems equally tricky in the US as its seems you have to shop around blindly when you often don’t know what you are shopping for.

    I’m sure there will be plenty more advice to follow when more experienced members log on here. Remember that most sufferers DON’T re rupture what ever treatment they have recieved, but I understand that we all want to reduce our risks. Best of luck.

  3. arielviton 09 May 2013 at 10:03 am

    I have a different case and cannot compare but I also went through that phase filled with fear of a re-rupture. It very slowly goes away. In fact, even at this late stage, it still crosses my mind. But one thing I would remind you, as maybe all your attention is on the ATR leg: take care of the good leg, too. I realized this when I got a plantar on my good leg. I’ve been overloading it perhaps. From then on, I gave the same focus on stretches and exercises on my good leg.

  4. Ripraproaron 09 May 2013 at 12:40 pm

    Hi bambam
    Uk here went NHS , decided Togo private 3 days after, to be honest I’ve got less than NHS , my private consultant is the same person doing NHS , so why have I got less, NHS pt started earlier, so my view its the OS how good he or she is and how eductated they are on ATR, if you look at hillie blog her NHS treatment appears light years ahead of mine even down to the boot so many advocate on here,
    Good luck bb
    Rgds RRR

  5. normofthenorthon 09 May 2013 at 3:15 pm

    There is a whole page filled with years of UK experiences too. And Bambam posted that story somewhere else a bit ago, and it got some responses and Q&A there. UK, US, NZ, Canada… Every region seems to have a different approach, and very few patients seem to get full info and optimal evidence-based ATR care. (Thank Heaven that our Docs are perfect when they treat our OTHER ailments, right? ;-) )

  6. bambamon 11 May 2013 at 4:52 am

    Thanks for your comments everyone. RRR I can’t seem to find hillies blog or yours. Are they still active?

    [WORDPRESS HASHCASH] The poster sent us ‘0 which is not a hashcash value.

  7. bambamon 11 May 2013 at 4:55 am

    Thanks a lot. You seem to be doing amazing. An inspiration for us all.

    [WORDPRESS HASHCASH] The poster sent us ‘0 which is not a hashcash value.

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