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. 

7 Responses to “ATR 4 week follow up visit… not as expected”

  1. Murray - I know it suks when you read about so many others who have got into shoes quick or out of the casts but I really would encourage you not to worry. I have trouble with casts and convinced my doc to let me get a boot after one week. The evidence is there for early weight bearing and motion but from what I have read, given good PT you will still have a good result. One study I read (linked to my page under further reading - Xplora) said the real difference was in quality of life in the early stage and there was little difference in results after 2 years. I know this early stage is on your mind at the moment but in real terms this is the shortest phase of recovery. Try to be patient and think of the end game. The hard work will be starting soon. The anit spam word was optimism. Sometimes it is very appropriate.

  2. Your post brings back memories. I remember feeling anxious about getting out of the cast and into a walking boot. My queries fell on deaf ears too. Sounds like you are keeping in shape and making the best of the situation. Two more weeks and you can start WB–while not optimal compared to some of the people around here, I have a feeling you will make up time on the other end. Hang in there.

  3. That is disappointing! For what it’s worth, even though I was in a boot from day of surgery, I wasn’t supposed to WB for much of that.

  4. Ohhh I’ve been where you are and I felt the same way you do. I agree with Stuart 100%.

    I am a rerupture, so I didn’t really have a leg to stand on (pardon my pun) when I balked at having to be in a cast for 6 weeks post op. So 6 weeks in a cast, and 5 weeks in a boot. I don’t think any of this impacted my recovery. I’m 6 months post op now, I’m running at 62% of my bodyweight (I’m up to 6 miles & 7.5 mph) and can do a single heel lift. In many aspects I am much better off than before my injury.

    Everyone heals differently, but I found the most important thing about this recovery (for me) is grit and attitude.

    I think they don’t wash the leg when they change casts, is because it was sterilized from surgery. I finally asked if i could wash my leg when I went for my 2nd cast change, and the nurse wouldn’t touch it, she gave me a towel and a bucket with water.

    My defiance was walking in my cast.

    Sometimes it takes a huge storm to clear the sky and then the sun comes out. Your sunny day will come soon.

    Take care!!!!

  5. Hi beardedmurray, it really is disappointing when you don’t progress as you expect to isn’t it? Especially when it seems to be a very quick decision by the doctor and they don’t explain what it’s based on. And of course since he mentioned you’d be in the boot last time he saw you, it’s a real knock when you have to wait longer than you expected.

    Hopefully these two weeks will pass quickly for you anyway and your tendon will feel strong once it comes to putting weight through it in the boot. Good luck for your next appointment!

  6. 6 Week visit yesterday and received a walking boot finally… it is really heavy and bulky but so glad to be able to start washing the layers of dead skin off!
    It is stationary with heel wedges. I am to leave the wedges in place for 2 weeks then remove one every 3 days. I am WBAT and have not been able to T yet. Feels very awkward trying to put weight on the foot with a boot on, a lot of tightness in the tendon area along with pain in heel/foot/calf. Very timid to try it so far. Seeing PT for first time tonight as well so hope they can help me thorough it. Any advice on first few days WBAT with a walking boot?

  7. @Bearded: I was a nervous Nelly when I first got in the boot. I think that is totally normal and to be expected. I think the best thing to do is just gradually start putting more and more weight on the boot–you can use two crutches at first and then drop down to one. (I skipped the one but I think you are suppose to use the crutch on your good side.) Make sure that your foot is securely fastened into the boot–that’s my best suggestion. Once you relax and get the hang of it, you won’t be looking back. Hope that PT helps you sort it out. Good luck!

Leave a Reply

To prove you're a person (not a spam script), type the security word shown in the picture.
Anti-Spam Image

Powered by WP Hashcash