2 shoes / 12 weeks atr post op

I have been doing exercises at PT for a week  in 2 shoes. Ride stationary bike, stretching, balance board, squat and calf raises on machine light resistance, hip strengthening with bands, as well as manual therapy on the tendon.   I also have been walking around the house and office with two shoes but wear the walking boot outside of that.  I am way too slow to go anywhere without the boot, my stride is short plus I don’t have any strength in my leg to keep correct balance and have a decent stride.  It feels ok to walk on it except in the morning it is really stiff and I can barely step with it, more or less shuffle until it warms up.

I feel the strength building in my leg but I still have a very tight tendon according to my PT. The tendon to the touch is feeling loose except right at the base of my heel where it is still tight and fat and they work on that manually.   I am  not looking at this as a negative just yet, it seems like it is better to be tight than loose feeling, meeting with the OS tomorrow for my follow up visit.   I have been able to dorsiflex 4-5 degrees actively and a few more passively.   I am pretty sure the OS didn’t want me to be upright on 2 shoes until the visit but according to my PT I was ready so we started a week early.

PT is pretty enjoyable for the most part, there is a good group of trainers and assistants who enjoy their jobs and keep up with all the happenings on the local teams so it is real easy to have conversation with them plus with my history of sports injuries there is always something to talk about.  I go at the end of the day so I can sneak in an upper body workout a few times a week since I suspended my gym membership, I dont have the time to do both although I would be up for getting back to the gym.  My PT is pretty new and has everything you can imagine but no Alter G treadmill, I asked the PT about this and they said other branches have one but it is something I assumed every new therapy place would have.  Pretty bummed about that as I have read a lot of blogs mentioning their usefulness.

I get pain in my leg only after being upright for too long say an hour plus straight but not too bad, I ice after PT and at night on and off before I go to bed as it swells by the end of the day.  Overall feel much better about this situation, I am still keeping June 14th 5k mud run on my calendar, I may walk it but I am pretty sure I wont have to sit it out.

8+Weeks Post Op

FWB, no crutches, removed a heel wedge (5 more to go) and starting the resistance band training in PT. Whole lotta action going on here! Not much else to say about it other than I am pretty happy with progress so far.  Measurable increased ROM and now starting with the resistance bands I can actually engage my calf muscle, well whats left of it but it feels good.  

Going crutchless is a great feeling.  I am pretty slow still but know I am getting better with it daily so it is just a matter of time before I am taking full strides consistently. 

I was using a cast sock for the last few weeks under the walking boot and just started wearing a compression sock as I noticed there is a lot more swelling again being on my feet more.  We will see how much that helps.   

I am going to try the stationary bike today I am looking forward to getting some cardio back in my routine.

Week 7 WBAT, started PT…now how to go crutchless?

I started weight bearing finally after 6 weeks of immobile NWB cast.  It is a freaky feeling to think that I can rerupture with one wrong move. I felt really vulnerable the first few days for sure.   There was a lot of pressure on my ankle joints, tendon, and my heel when I started WB.  I can put full weight on my leg but find it hard to believe I am cleared to walk without crutches.  

PT- went for initial visit  hoping to end up with a pretty female pt who I can look forward to massaging my tendon 3x a week but ended up with a pretty cool dude instead.  He really seems to know his stuff so I can settle for that!  Plus once I saw how up close and personal he got with my feet I think I might  feel bad if it was a chick.  

I have doc orders of active ROM and table stretches only for the next 6 weeks.  The PT is progressing I am on 4th visit and have much better ROM seems to be moving slowly though.  Basic day is heating, massage, ROM, hip exersizes, boot walking with crutches to correct gait, then ice.  Pretty basic boring activities that I can and do at home, all but the massage part.

I am still using 2 crutches for the majority of “walking”.  On one crutch, which I can do but with a lean, I am way too slow to do anything more than 20 feet.   One week after WBAT, the slight strain in the back of my leg tells me not to go 100% WB walking yet.  The pain is better every day but the wedges start coming out next week and feel that if I dont get to crutchless walking soon then removing a wedge might set me back pain wise. 

Is it just a momentum thing how does one walk without an ankle joint?   Walking with 1 crutch is possible right now for me but it is real awkward and slow, but at least I have use of one arm.  Hoping to be crutch free the end of this week with help of my PT.  Can someone ease my mind and get me motivated to go crutchless?  Did you have pain in tendon and still put weight on it or was it pain free transition?

ATR 4 week follow up visit… not as expected

Coming into the follow up visit wondering how it is going to be with a walking boot, man this was going to be good to be able to clean my leg daily and massage the soreness, even scratch an itch.  My appointment was 1 hour before the office closed on a Friday.  You could sense the urgency in the staff that they just couldn’t wait to get the hell out of there.  That made me nervous that they would rush me along.  Hate that feeling.  I had a list of questions again this time more focused on PT and ROM exercises. 

When the cast was removed I was surprised to see my leg doesn’t appear to have lost much size and felt good and strong when I put my leg on the table.  It was also pretty gross with dead skin buildup and cant see my ankle bones but other than that looks relatively ok.  The doctor came in and took a look and said it is healing good… and that I will need a cast for another 2 weeks, said very nonchalantly.  NO Way. I asked how he made that decision, last visit I was told I would get a walking cast.  His exact words were - “It is not as strong as I would like it.”  That knocked me off my ass and I really didn’t know what to say, so I just said ok that sucks.  How was it supposed to be strong just rotting in that cast, does he mean the tendon itself how can he tell that from just pushing on my foot, I didn’t have any pain when he did that… I didn’t think fast enough to actually ask him these questions directly, I was so caught off guard.

I did eventually ask about PT he said not to contact until after week 6 he wants to protect my tendon still.  I also said that I read a lot about early movement and PWB could be helpful for recovery but he said due to my complete rupture that is not his protocol and said this process has been a proven method and that they are taking care of me and not to worry. 

They were nice in delivering the information and I am not a doctor I have only read this stuff online.  But I cant help feeling like they are doing this just to put me on a shelf for another 2 weeks just to get me out of there for the weekend.   I stressed my concern but I also don’t want something to happen like a re-rupture. 

Since I was going to get a re-cast I asked if I could clean up my leg at least and they gave me a pile of gauze pads soaked in alcohol.  It did the job but it bugged me that they were going to just cast me back up without either cleaning my leg or suggesting this themselves.  It felt good to massage my leg and clean it and I was pretty bummed I wouldn’t be able to do this for another two weeks, on top of the fact that the doctor just told me it “wasn’t as strong as he would like it to be” ‘

So here I am in limbo again, everyone asks how I am doing, it sucks not being able to gauge my progress with some kind of ROM exercises or PT to measure improvement.  I am getting around on the hands free crutch pretty good now but I’m ready to start the next phase. 

ATR Post op - health and fitness

One of my first thoughts after the ATR was how am I going to stay in shape and not gain 50 lbs! I dont have a perfect system down and really want to open this up to suggestions and comments as my routine 4 weeks in is getting really stale.  I think the best thing I am doing is weiging myself daily so there is no way 10, let alone 50lbs can sneak up on me.

Diet: minimilize portions as much as possible and cut back on carbs, fats, sweets, sugar in general.
Typical day of meals: 7am protein shake, 10am lowfat greek yogurt, 12pm turkey and cheese sandwich with a fruit side, 3pm apple or almonds, 6pm chicken and vegetable dinner.
Pretty boring and was not easy over the holidays or when we had a mom staying with us to help out around the house making all sorts of baked goods!

Week 1-4 Exersize: Ab ripper workout from p90x mostly leg lifts and core twisting motions for a good 20 minutes every other day and on the alternate days a pushup and pullup routine, 20 minutes.   Also stretch whenever I get a chance on the floor to loosen up my back and hips from sitting so much.

Very simple and covers many of the upper body movements in just these 3 workouts.

Currently on week 5: I have completed one upperbody shoulders and arms P90x workout- about 45 mins long and an ab ripper x to get a full sweat going that I havent had in quite a while.  I plan to work these longer full workouts back into my routine probably once a week while doing the above workout as normal every other day. 

I have a fiberglass cast from toe to knee and dont really want to sweat too much in it but I tend to lean more to my fitness than worrying about a stinky leg.

Any other routines or suggestions on working fitness back in with ATR, or getting back to the gym tips?

ATR Post Op week 2 follow up visit

My follow up visit from surgery couldn’t come fast enough. I had to wait 16 days since my son was born at the 13 day mark. I was so curious to see my jacked up foot and ankle expecting it to be all purple and bloody, it felt like a balloon ready to burst out of the splint at least when it wasn’t elevated. Since the intense pain eventually subsided I was pretty confident I was healing up pretty well even though I spent a few days upright in the hospital and had quite a bit of pain towards the end of the day. I have even started a light upper body workout routine to try and keep some shape, doing pushups and pull-ups and core workouts and stretching throughout the day after the first week to relieve my back and hip stiffness.

Well I crutched into the follow up appointment and the nurse removed my cast and boom! Wait, no explosion, no bloody mess, no major bruising, looked just like it did two weeks ago. I was very disappointed in the lack of visual evidence of the major pain I had felt especially early on after surgery. Outside of the yellow iodine staining and the small incision on the back of my leg there wasn’t much to see. I remember sitting on the table and not knowing what to do with my vulnerable leg once the cast was off, can I set it down on the table should I leave it dangling??

The doctor came in and asked about the baby which caught me off guard, very impressed he remembered we were due. Looked at my foot, said ok throw another cast on it, and then see ya, on to the next patient. I was completely caught off guard I didn’t even get to my detailed question list which was on my phone! I was dying to find out how surgery went amongst so many other questions. I was really offended that he is not taking any time to reassure me that things were going well or at least explain how successful surgery was and how its healing and why it needs to be in a hard cast vs walking boot or anything. He was seriously like halfway out the door and I started with questions and he was just poking his head back in to reply to them with short answers, but after like the 5th question he pulled up a chair and started addressing me like the needy patient that I was! He realized I wasn’t going to stop any time soon.

Most of my questions were along the lines of returning to work and restrictions and getting a letter to get off medical leave, I asked if my workout routine would be ok, he laid out my restrictions and even mentioned I could go to the gym and do leg extensions if I wanted while also telling me I was in the protective phase and one fall could cause a re-rupture. I never thought to go that far as going to the gym yet, I don’t feel like crutching around people waiting for a machine. But, I was glad to hear I could be somewhat active.

I also asked his opinion on the hands-free crutch and he said he loves them and wished more people would use them. I still wonder why he never mentioned them before, I believe I first found out about them on a blog through this website. He must be getting paid more by knee scooter companies!

I didn’t have feeling in my toe still it hasn’t returned as he mentioned over the phone. “It will come back in time, was due to the splint cutting off a nerve but couldn’t have been from the surgery since all of the nerves for the toe run along the top of your foot” me – “ok I’ll buy that, but why hasn’t it returned now that the splint is off” OS- “oh it can take a while”

I asked about the timeline and what to expect next visit and even further down the line and he said they will make a decision to get a walking boot or recast after next visit. His original plan for me was 6-8 weeks in a hard cast NWB, then a walking boot for 6 weeks PWB then FWB as tolerated with heel wedges. But a walking boot at 4 weeks no way! that is great news. I have read a lot about early movement and the positives of this in my many online searches and feel like that would be my best approach since I don’t want my ankle joint to be unused for 6 weeks. I felt I made my surgeon decision out of urgency and didnt look into other options such as possible early movement or more active approach to healing which sounds more progrssive to me. So I was glad to hear we might be going to the boot and PT early.

I came home very hopeful of a quick recovery plus heading back to work so I can once again be a contributing member of society!

Post op- Week 2- house of pain

Fell asleep night one with completely numb leg and everything was great, all drugged up and finally on road to recovery.  I kind of  knew I had it coming so I took a Percocet and went to sleep, around 4am intense pain started creeping in and never let up for 3 days.  It was the most incredible unrelenting pain, I was miserable.  I had my wife call the doctor after about half a day, I was sure that something went wrong with surgery and they left several razor blades or needles in my leg after they stitched me up.  Seriously the only way can describe the pain is it felt like I had stepped onto a bear trap and was hung upside down from a tree by it. 

The doctor called back and upped my meds to Dilaudid which needed to be picked up in person being a controlled narcotic and cant prescribe over the phone.  Sent my out-of-town mom on the errand to run downtown Chicago as my pregnant wife and 2 year old were home but staying far away from me as possible so I wont curse them out.   Started taking this night 1 and nothing, didn’t touch the pain and didn’t make me drowsy enough to sleep through it like the Percocet did. 

Called doc trying to convince them that something was wrong, he said the pain is normal and to double dose and see if that works.  This kind of pain is normal! I wish they left me in the hospital so they can give me another nerve block! Doubling the dose didn’t work… so after 12 hours of experimenting with Dilaudid and overworking my liver I went back to Percocet doubling the dose and at least able to sleep during the peak of the drugged induced grogginess.  This went on literally 3 1/2 days taking 2 doses of Percocet every 4 hours, then it was tolerable and I was able to get up and sit on the couch, with leg propped up.  I iced religiously for the first 2 weeks, even waking my wife at night to refresh the bag. 

The rest of the week went ok with just taking meds at night to help sleep as I could never get comfortable.  Also I lost feeling in my big toe along the top side from knuckle to nail.  I informed the doctor and he said it is most likely the splint pinching something and it should be fine.  I lasted the 2 weeks but looking back I wish I went in right away to have the splint redone, I am certain the amount of pain I had and the numbness in my toe were due to too tight of a splint. 

Day 7 celebrated xmas with family out on the couch but able to enjoy it.

Day 13 Drove wife to hospital to give birth to our son on New Years Eve! The nurses there took care of all 3 of us so we stayed the extra day to get room service and fresh bags of ice.  Also this is where I figured that I need a shower stool and an adjustable showerhead to shower instead of taking a bath which was way inefficient! Had my brother set that up once I returned home.

Also side note- my mother came to town from Michigan to take care of us since my wife was so pregnant and expecting any minute. So Thanks again mom! I relied heavily on my mom and brother to help with everyday items such as shoveling snow and cooking dinner.  Was hard to accept the help but I was virtually useless outside of wearing out the remote. 

As far as the first 3 days go, I haven’t read of any accounts similar to mine.  Other post-ops I have read really either downplay the pain or were less painful can anybody relate to the incredible pain the first 3 days after surgery? 

ATR Surgery- Minimally invasive

After the eternity of waiting 3 days to even call an OS and spending every waking minute online researching ATR’s I finally made my appointment and met my doctor.  Since I had such a poor experience with the ER, see previous post, I decided to go with a different OS than they recommended one that serves the Chicago Bulls/Blackhawks and was able to see me right away. 

I meet the OS, he literally wrote protocol for diagnosing ATR with no need for costly MRI, that was pretty neat to hear that he is so passionately involved with ATRs, he was almost a little too excited it seemed to have an opportunity to cut me up and stitch my Achilles back together! but he went over 3 options: no surgery, minimally invasive (sexy incision), or old fashioned full incision.  I immediately said full incision but he explained all the possible complications and I started thinking about the mini as he says there were same amount of reruptures in both and really no drawbacks other than possible nerve damage in the mini vs incision complications with the full.  He informed me how NFL players are choosing both repairs depending on their OS and successfully back in the game, truly no one way better than the other.  I begged him for his favorable opinion one way or the other and he was split right down the middle, has performed the same amount of surgery techniques and hasn’t had any complications or reruptures with either. 

I needed to go home and really research for myself which way to go, he had no problem with that and we scheduled the surgery for the next afternoon.   He actually fit me in as my wife was due with our second child in 2 weeks to the day and he said I would need a full 2 weeks to recover from the surgery before I could be upright not elevating my leg. 

I researched and reached out to friends/family who were in the medical field and my dad who actually had the full incision surgery 15 years ago.  Although he hasn’t had any complications his shoes were very uncomfortable and had to modify to wear and he hasn’t been physically active other than golfing since due to knee problems, and I plan on getting back to sports.

Everything I found was either more positive doing the mini vs. the full incision and it just made more sense to go with the smaller incision as long as everything was lined up, otherwise we have the full incision as the fall back plan should he need to open it up more during surgery.  So I informed the OS minutes before surgery my decision to go with the mini.  I was already drugged up and nerve blocked by that point, woke up and leg was in a cast and I was in a different room around totally different people. “Hey how did my surgery go?!”

Nurse- I am sure it went well but I wasn’t there that team has already left for the night”   me: “huh what the….. well I have like 500 questions, first I was told I will need to elevate my leg after surgery and I’m laying here with my leg down on the hospital bed isn’t that what I’m not supposed to do?”

Given my post op instructions and  free to go home… dead leg and all

Anyone have same surgical/repair options given by OS? How did you make your decision on type of surgery?

ATR - ER Trip

ATR on 12/13/13.   Yup Friday the 13th.  I must have walked under a ladder, crossed path with a black cat, stepped on too many cracks…

Other basketball guys helped me to my car after the injury, by that time I really didn’t have much pain but couldn’t walk or move my foot properly, was hoping for the best still, possibly a sprain or strain… I called my wife (38 weeks pregnant) who just put our 2 year old daughter to bed to have her bring me crutches so I could drive myself to the ER. 

ER doctor confirmed ATR and took X-Ray to check for broken bones, told me I would get a splint and to call the orthopedic surgeon soon as possible.  Really that’s it? no rushing into surgery, no urgency at all, I have a foot that doesn’t work and I am supposed to just call someone else to fix it after the weekend, what do I do in the meantime, just let my tendon flop around??? I had really no clue this would happen.  Can I at least get some pain meds?? She got me a prescription of Norco and sent in a nurse to put on the splint.

Nurse walks in 20 minutes later, looks at my leg and diagnoses without looking at a file or anything, “sprained ankle” I’m here to wrap it up.  Me “You really think I would come to the ER for a sprained ankle?”  Doctor walks by and says “oh no he has ATR, need to put splint in downward position and wrap up until he can go to the surgeon.”  Thank God she walked by… so she gets this cast wet or whatever to set it up to put on my leg to form a splint and calls in two male nurses or really they could have been janitors for all I know and left them in charge of putting on my temporary splint, “ok lay on your stomach and point your toe upwards”  me- ” Owwww that hurts like hell, my leg is cramping up like crazy are you sure I should be doing this???” Janitor “yes hurry the cast is setting” Me “I don’t have a tendon how the hell am I supposed to do this” I flip around in major pain and hold my leg, I literally had to argue with these broom pushers telling them there has to be a better way to do this why couldn’t i just sit on the edge of the table and they put the splint on that way where my foot will naturally fall and “point down” seriously wanted to punch these guys they just looked at me like I was the biggest wimp. 

Somehow they manage to get the splint on and janitor 1 brings me a new set of crutches for my 6′-4” height not the 5”-4” ones I borrowed from my wife and tells me to have a good night.  I’ve got 2 sets of crutches a shoe, Jacket, and bunch of paperwork to carry and this guy gives me crutches, me “dude can I at least get a wheel chair out to my car in the snowy parking lot?”    janitor 1 “oh, sure”  he acts like he was doing me charity service…. $1700 total before insurance

Leading up to ATR- Why Me!?

Left leg ATR occurred playing basketball at the local rec center. 

History: I am a bit of a competitive guy and tend to go all out no matter the competition.  Being 31 I feel I am still in my prime and even better than in my 20’s playing college football since learning about nutrution and working that into my regiment of workouts including cardio, jump training, and weight resistance training every other day with one day off  per week.  I felt in top condition leading up to the ATR.  I have been doing the P90x 1 and 2 workouts at home and do other weight resistance training at a Gym.  I also recently found a new way to be competitive by doing “Mud Runs” I competed in several in the Chicago and Wisconsin area this last year and absolutely loved them even finishing in top position in one 4.5 mile race and 2nd place in a 5k. 

So back to the competitiveness, I should have been taking it easy and shooting jumpers and laying off on the defense knowing that I have been hurt several times playing basketball, either a sprained ankle, twisted knee, back pain…etc but I just dont have a slow gear when it gets competitive.  We were on the 5-6th game of the night and this one was going to end when they kicked us out so I was making sure to leave it all on the court.   I stole the ball and quickly turned to run upcourt and snap, pow, bang, somebody stomped the hell out of me from behind.  Some idiot just clobbered my leg!  who was this clutsy A-Hole!  turned around as I fell to the floor and nobody behind me.  Instantly remembered the same story as told by my father and co-worker about their ATR’s and knew what happened.  ATR would never cross my mind, I thought I had at least 10 more years before I would even have to think of that possibility, how could this happen to me, I was in great shape, stretch properly and was already warmed up? Still cant figure that one out.   My dad was in his late 40’s and coworker early 40s. 

oh by the way-  Wife 38 weeks pregnant (full term) and 2 year old at home.  Live in Chicago with all family back in Michigan, and I go and get myself seriously injured.   Definitley pissed at this point about all the conditioning and strength I will lose due to this injury, not to mention I was already signed up and paid for at least one race this year and very much looking forward to about 6 of them…