The path is the goal..

Well here we go - I am sure you all know the feeling I have when saying that. And I will admit it is comforting to know I am not the only one. Thanks to all of you in this community for sharing your experiences and being a part of this, it can be quite the “virtual” safe haven at times.

Also a quick thank you to the founders of this, I will surely do my best to support this site any way I can.

I am on here to share my experience with you guys in the hope of getting any valuable feedback I can from those who have been through this before me, and to genuinely join people on the journey back to full health that can understand what I am going through.

So here are the details:

12/12/18 (Evening) - Complete rupture of right AT playing basketball

12/22/18 (Late Morning) - Surgery

12/28/18 (Afternoon) - Fiberglass splint removed, placed in walking boot with 3 heal wedges (approximately 1.5 inches total height).

Surgeon - NWB until 1/5/19 (two week mark) then progress to WBAT in boot - approximately 25% per week. Full weight bearing in boot by week 6. Shoes by week 8-10 with the heel wedge.

About me:

I am a 30 year old male that has played basketball my whole life, from 5 years old to playing overseas professionally for a short period. I am and always have been in pretty good physical condition and this injury came out of nowhere. I was simply shooting around at the local gym for about 10 min after having done a leg workout when I planted my right leg behind me to push off for a driving layup and felt the infamous “kick/shot”. My calf completely coiled up and I immediately knew what happened. It was heartbreaking.

I had never felt any achilles discomfort prior to the injury, but I have had multiple injuries to the ankle and the big toe of that foot in the past. Either way, these seem to be “freak” injuries and I don’t care to know if any of that had any effect as I am in the here now and (hopefully) on the road to recovery!

I am on day 8 post-op and feeling okay aside from one side effect that I will end this post with as I am hoping someone here can chime in or has some advice. On day 6 I went into have my splint removed and my leg looked great. Sure it was skinny, amazing how quickly it atrophies right, but I had nearly no swelling at all and the incision looked good. I was excited as I had expected to see a lot more swelling/bruising, but was hard pressed to find any at all!

I am now in this uncomfortable franken boot from Kaiser (Surgeon is great. Kaiser sucks in general, but I digress), BUT I have the Vacoped coming in this Thursday, 1/3. CAN’T WAIT for that. I’ve heard enough from you all here to know it’s going to be refreshing to wear, to say the least.

My surgeon is quite progressive and wants me on an early weight bearing and early ROM protocol. His views line up almost exactly with what I was hoping for after doing hours and hours of research following my injury, so I am happy about that.

Now to the one issue I have faced - I was a given a lower leg nerve block that was intended to last 1-3 days. I am currently on day 8 and my leg is still numb. I have most of my motor sensation - I can control the muscles, wiggle my toes, move my ankle etc. But my sensory nerves are all out of wack. The leg feels like it does when you fall asleep on your hand - pressure with tingling or pins and needles sensation.

I am somewhere between extremely concerned and not sure what to think because I have no control. My surgeon said this happens sometime, albeit not too common, and that traditionally it will wear off within days or weeks (but could possibly take a few months). I am also in direct email contact with the anesthesiologist, and his last response to me was as follows:

“Hi Paul-

I’m glad you came in today and that Dr. Fogelson checked on your healing. Nerve injury from nerve block is thankfully exceedingly rare, especially with the use of ultrasound. During your nerve block, we had no issues with hitting a nerve, which sometimes may happen during a block and cause transient nerve damage. If we hit a nerve, we would know immediately as it would cause sharp electrical pain down your leg and you’d yell. Additionally, the way your nerve block set up and how it started to wear off (albeit slowly), I am confident that this this block will wear off. It’s just a matter of time. This isn’t scientific, but drink plenty of fluids to flush the local anesthesia medication out of your system and try to move around if you can. I know this can be concerning, but you’re recovering well. Hope it keeps wearing off over the weekend. Keep me posted. ”

Has anyone here had a nerve block done? If so, when did it wear off? Also, any complications? Has anyone heard of a nerve block not wearing off for this long? I am hoping for the best because I have that choice. I had the choice to be positive since the day of my injury and I am fighting as hard as I can to maintain that. That is what I can control, and I will do that.

I truly hope to make some connections on this blog, you people are amazing, both those who have recovered and those still fighting. This is tough. And you guys are even tougher. I will be too. Thanks for your time!

Please comment, introduce yourself to me, ask any questions you may have, and please please offer any advice you feel necessary. I am not a master, and I am open to learning always. Hence beginnersmind, because a master’s mind has no empty space for new knowledge, it knows it all.

One love, Paul.

12 Responses to “The path is the goal..”

  1. I did feel the nerve block when I had my right foot surgery (bone spur removal) in 2017 and it wore off in about 3 days. This time around (left foot bone spur removal 8/2018) if I had a nerve block I didn’t ever feel it. The only difference for me was that I am now on a vegan diet. My diet change did have a BIG affect on how long hydrocodone stayed in my system. I was having nausea for it for 2 weeks after I stopped taking it. I had no problems like that for my right foot. So different people can definitely react differently to the various drugs that go into your system during and after surgery.

    I’m with Kaiser as well (southern California) and am quite pleased with my doctor and actually didn’t like the boot I got from them this time (a grey one, a lot of plastic). My doc thought it was a better boot but I preferred the old black one I got in 2017 since it didn’t have any hard plastic on the outside that would stab and scratch my other leg - LOL! And the black boot was all fabric so it breathed much better. It was more comfortable :) But I also insisted that they give me something different to wear at night since I could NOT sleep with either full boot. So I got a plantar fasciatis splint for use at night. You can see pictures of everything I’ve used and follow both of my foot surgery journeys if you check out achillesblog.com/cserpent.

    Sorry you had to join us on this journey but you found a good place for support here!

  2. Hi cserpent! Thank you for replying. I read through much of your blog, you are so strong and positive to go through this (or rather the bone spur removal) twice.

    Noticed you comment that you got that small bump figured out, crazy to think it was a bone fragment that didn’t get washed away. I suppose, just like my nerve block not wearing off, that anything can happen when having surgery.

    It is interesting you mentioned the hydrocodone, last Monday I felt the very first indication that the block began to wear off in that I was able to very slightly move my toes. With that came some pain so that day I took a few of the Norco’s they prescribed me. After that day the block stopped wearing off, it was still just my toes that could move. Do you think the Norco’s I took that day could have an effect on the block and make it last longer?

    My biggest concern is that I am on day 9 and still numb. I can’t seem to find anyone on here, or anywhere online really, of somebody having a nerve block last this long. It is really starting to worry me. I emailed the anesthesiologist again this morning so I hope to receive some answers.

    I believe I have the black boot you are talking about. It is mostly soft fabric and does breathe well. The problem I have is the heel lifts. They are all the same shape and size, they do not cascade into a “ramp” so to speak so they are all stacked directly under my heel. Feels like there is a ball digging straight into my heel rather than the wedges contouring to my heal and part of the foot. I agree, sleeping feels impossible in it.

    Anyway, let me know if you have any feedback on my block not wearing off.

    P.S. I lived in SD for 7 years. Went to school there. Favorite city in the world. I dream to be back there. I am in the Inland Empire now.

  3. Hi Paul,

    My nerve block lasted a long time as well. It seemed like it was at least week before I felt anything. I’m currently at week 12 and I’m still numb right around the outside of my ankle. For the first few weeks, it was most of my foot, then just the outside down to my pinky toe. The numbed area gradually receded over time, but not before I had a range of strange sensations that kept me up at night for several weeks. I was very concerned (more like panicked), and I couldn’t get any relief from the nerve pain outside of hydorcodone, which I refused to take. I was told that the nerve that runs along the tendon was probably damaged during surgery and it grows back at 2mm a month.

    My suggestion is to wait a few weeks to see if the numbed area gets smaller over time. It probably will.

  4. Hey kamueller - good to know! Not that you still have numbness of course but that the majority of it wore off.

    Can you share where they gave you the nerve block?
    For me they performed the local anesthetic above the knee so that I was numb from the knee down. Like you, my surgeon explained that the Sural Nerve that runs along the achilles tendon can get irritated from injury and/or surgery and cause these symptoms on the lateral half of the foot. Good thing is, he assured me that it did not have any damage and he physically examined the nerve during surgery to see that it was in tact and healthy. In fact I have more sensation on that area than the rest of the leg.

    My numbness at this time is strictly from the nerve block, so from my knee down to my toes is numb.
    Did you have something similar done? Did it take a week to get the knee and leg sensation back or was it just your foot?

    Good news is I got an email response from the anesthesiologist this morning and he assured me again that it is nothing serious. He spoke to my surgeon this morning and they both feel I am recovering very well and that it is likely my metabolism is just taking longer than most to metabolize the drugs from the nerve block and rid of them.

    P.S. I read through most/all of your blogs. Good stuff.

  5. Well that stinks that they didn’t give you sloping heel lifts! I did get sloping heel lifts with this newer boot (and the doc and techs were so excited that they had this “new” boot - LOL! they were a bit bummed when I told them I liked the other one better - hahahaha!) but they were still very uncomfortable. I was also given some heel lifts for my transition to shoes (these were made out of wool I think) and I got a bunch of different sizes so I used those in my boot and then in my shoes. From what I hear about the vacoped you will be more comfortable in that. I don’t know if your heel lifts can be cut but if so then see if you can modify them yourself - LOL! I even used some pretty solid packing material (like a styrofoam but more solid) to fashion heel lifts for my croc so I could use it when I showered. If you didn’t have a vacoped on the way I would mail you the lifts that came with my boot :)

    I doubt the norco slowed down the wearing off of the nerve block. I do recommend doing some gentle massage. Once the incision is all healed you can do more vigorous massage. Since you can’t move the foot much yet the massage will help get some blood moving around. I had some residual numbness on the back of my heel that lasted over a year. It’s mostly gone now (on my right foot) though it still feels like the surface skin is a bit numb in one spot but below that it isn’t. It’s hard to describe - LOL!

    And my only motivating factor for doing this twice is because I know how good my right foot feels since I had the surgery!

    So keep positive, do any ROM exercises you’re allowed, rest, elevate and ice (if they didn’t tell you then ice behind the knee while in the boot). Swelling slows healing so you want to minimize the swelling as much as possible.

  6. Hey Paul! Welcome! Although no one is super excited to be a member of this club we’re glad you found us. Listen to cserpent….keep positive, do the exercises you can, ice and elevate. I also second the gentle massage. This has helped me a lot. Not only to break up the scar tissue of the incision but I think it’s bringing back the feeling in the parts of my foot that are still numb. There are times when I think that certain parts of the heel might just stay numb, and I’m okay with that. But I think over time most of it will recede.

    I also think you should get better (sloped) heel lifts if you can. That seems like it would make a big difference. Mine were three stacked, kind of cloth/wool material and sloped. It made it easier to remove one every three weeks. I wish I could send you mine, but they’re kind of icky at this point.

    I’m not a doctor, but I don’t think you have anything to worry about with the nerve block. I think eventually it will wear off…just be patient. You’re just that one special person!! Hang in there and stay strong.

  7. cserpent - you are so kind, if I didn’t have the vacoped coming I would totally accept the offer. I’ll take a rain check for a future favor though, LOL!

    That’s funny, you tell them. So did you go back to using the black boot from your first surgery afterall?

    I will definitely use those suggestions once I transition to shoes (hopefully they give me great heel lifts and I won’t have to improvise too much).

    junebug - Hi and thank you! Glad I found you guys as well. I read through most of your blog, you and cserpent had the same Haglund’s procedure done huh? It’s great you have each other to talk to about it.

    I am all ears, I have already done some gentle massage since I read cserpents comment earlier and it feels good. It has already helped get the blood flowing, let’s see if it helps the numbness.

    As for the sloped heels, luckily with the vacoped I won’t need any heel lifts at all. My surgeon already instructed me to lock it at 25 degrees at the 2 week mark which is the day after it arrives and drop 5 degrees per week until I am neutral at week 6. So I am looking forward to that very much.

    Thanks for the offer to send the sloped lifts though, you two are so kind :)

    Chatting with you guys has made my day! I have been yearning to discuss things with people who can understand what I am saying/asking and why.

    Well, here is to hoping the rest of the numbness in your heel recedes :)

    Staying strong guys, you do the same. Happy New Year to you both!

  8. beginnersmind19: The block itself wore off after three days, so I started feeling the pain from the surgery. But the numbness lasted a long time. The block went in at the knee like yours. The numbness ran all the way down my leg to my pinkie toe. I don’t know how long the numbness lasted in my leg, as it was just along the area where the nerve ran. I noticed it the most in my foot as I was only able to wiggle four out of five toes. So there were times in the first couple of weeks that I ran my hand down my leg and felt numbness, but the lack of sensation in my toe really freaked me out. I was still freaked out at my 6 week post op. Major numbness and the shooting sensations that had me googling nerve damage and nerve pain meds. But, over the next few weeks, the affected area has subsided and I no longer have any pain from it. So wait a few weeks. My doctor told me it would improve, and it did. The nerve regrowth is just really slow, as it everything it seems with this injury.

  9. kamueler: interesting and sorry you had to deal with that. It seems like I am in the same boat and it’s freaking me out too. I can move everything, but my entire leg, foot, and toes are numb in general. Some pins and needles feeling in the toes and sole of foot. I began getting the shooting sensations the last few nights and it sucks. It wakes me up in pain every single time.

    Since your doctor said it will wear off and mine said the same, I will take solace in your experience, hoping it will wear off just the same for me.

    So if I understood you correctly, you still had numbness at your 6 week post op and it took a few more weeks after that to wear off??

    Did the numbness affect your rehabilitation at all? I am supposed to begin toe curls and light ROM at week 3 but I am afraid with the numbness I won’t know how much I am pushing it and if the tendon/leg is getting overworked..

    I don’t feel pain or touch, haven’t since the surgery, I am simply numb. It’s crazy.

  10. If I still had the black boot I would have started using it - LOL! However I donated it to a group that recycles used or new discarded medical items in both the US and in other parts of the world. It only took me a year to find someone to donate all my things too (except the knee scooter). Silly me I figured it would be at least a year, if not more, before I had the surgery on my left foot. Wrong! I even donated my even ups - oh yeah - if you don’t have even ups order those for when you start walking in the boot. You want the good leg to be at the same height as the boot leg so you don’t give yourself hip issues as well. I doubt you have small feet or I would send my even ups to you. I have size 7 womens feet :) When I ordered them again for the left foot surgery amazon sent 2 pair … and I only need one out of the pair.

    I do hope the numbness goes away sooner rather than later! I do recall shooting pains just under my ankle with my right foot. My doc said that was the nerve healing. Haven’t had that withh my left foot but it is providing many other challenges so I’m happy not having nerve pain to deal with as well.

  11. At 6 weeks, the numbness was the entire outside of my foot and across the front. I had the pins and needles and random shooting pains. As the weeks passed, the pain subsided and the area of numbness decreased. Now at 12 weeks, I’m still numb around my ankle bone.

    It hasn’t affected my rehab at all. It feels odd (like there’s extra scar tissue in there), but I’m still gaining strength and flexibility every day. Both my plantar flexion and dorsiflexion are close to normal.I can balance on my bad leg for at least 20 seconds and I can weakly do double leg toe raises.

    Just keep the ROM exercises light in the first few weeks. Just move it around as much as it allows. The numbness will most likely will have subsided by then, but even if it hasn’t, just keep it light. Unfortunately, this injury requires patience and time. As much as I wanted to push it (and I dd as much as I could), I was forced to realize that it just takes time. I made new goals each week, like be able to move a certain way or go up the stairs, or whatever. So keep your weekly goals small so you can focus on the incremental progress. Plus, the early weightbearing will make a huge difference.

  12. serpent - don’t worry, I think this process will make us all a bit silly and that’s okay. I am sure there is some urge inside to get rid of all those things once we are feeling well again, even if just for the sentimental value of moving on!

    I got the even-ups as well, going to use a shoe that along with the even-up, will “even” me up as closely as possible.

    kamueller - Looks like these nerve issues are part of the game with this injury. The surgeon just messaged me saying he cannot predict accurately when it will wear off but could take 6-8 weeks or longer sometimes. Since you experienced similar I am going to expect that to happen but we will see.

    Appreciate the sound advice, I understand this is going to be a slow and long process and I am just fine with that. I don’t care to get back in a certain time frame or rush anything, I just want to get it right and ask all the questions I can to avoid missing something critical.

    Weekly goals it is, great idea :)

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