Making Progress

Posted on April 10th, 2011 by billb44

Got the cast removed on Thursday.  Dr says things look great and that since my foot is already at the angle the he wants that I can do the first month of PT at home since it will just be some light stretching.  I’ll be in boot for up to 4 months.  Good news is that I”m full weight bearing and weaning off of crutches.  Today was first day almost completely without them.  I still keep them around when I’m out of the boot since I can’t push off at all yet.

This is painfully slow but for the first time, I feel as if I’m making some progress.

3 Comments »

First Post Op Visit

Posted on March 13th, 2011 by billb44

Got the first look at the cut.  Doctor wasn’t kidding about having to slice me more than he normally does to get at scar tissue.  Cut is about 7 inches long.  Good thing my wife digs scars.  Wound is healing well and staples were taken out.  Then the bad news…got the cast instead of boot.  Doc tried to do reading on rehab protocol for 2- month-old injuries and largest sample was about 5 cases.  He is looking to be conservative, knowing that I will push myself to get back to active too fast.

Wasn’t happy Monday night but Tuesday morning when I tripped on dog bone in living room, he was my hero.  Cast took the brunt of fall and although ankle was sore, no pressure on injury.

Cast was able to set foot at 90 degrees so off to a decent start but now 4 weeks before next chance at boot.  Learning to enjoy little things like trip to grocery store and rides from friends at work.

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Off the Couch

Posted on March 3rd, 2011 by billb44

On Wedneday (8 days after surgery) I was able to go into work.  Most of the morning was a customer meeting and the afternoon relaxed as well.  I’ve turned my office into a bit of a lounge using my guest chairs as chair and leg rest rather than my desk.  This way I can still relax while on the computer or phone.

Officemates like that they can hear the creak of my crutches long before I get to their desks.

Felt good to get out of the house and back into the real world.  Took it easy working from home today and other than being a bit tired, doing great.  I’ll be back in tomorrow with then the weekend to spend on the couch.  First post op visit is Monday afternoone

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Dumb Marine

Posted on February 27th, 2011 by billb44

The Marines taught me a lot when I was young but apparantly knowing when you are hurt itn’t one of them.

On the day of Christmas Eve, my family and I were enjoying one of the last couple of days on a great western carribean cruise.  My kids and I were participating in an Amazing Race type event on the ship where families are given clues that lead them to stations on the ship where they answer ships trivia questions or perform activities such as climbing the rock wall, playing a hole of miniture golf or in my case shooting as many basketball free throws in a minute.  While crouching to shoot, I was hit in the achilles by a ball that was being thrown back to me.  I immediately lost the power to push off of that foot and needless to say didn’t make any more shots.  Thinking that it was just a deep bruise, I hobbled along with the kids for the rest of the race. 

Against the better judgement of the smart one in my marriage, my wife, I simply iced the leg and didn’t see the ship’s doctor.  I continued to hobble around the ship and it was a week before I could see my GP at home.  When I saw him, the ankle was pretty swollen and looked like a bad strain or twist.  He tested to see if I could push with my foot and said at least I was lucky that I hadn’t torn the achilles.  He suggested continued rest and ice.

At 6 weeks with everyone in my office and my wife telling my I was nuts for thinking that my leg would get better, I went back to the GP.  He couldn’t believe that it wasn’t better and recommended that I seek some physical therapy.  To be safe, he set up an appointment with an orthopaedic surgeon to make sure that I didn’t hurt anything while doing PT. 

It was day 29 after my injury when I saw the ortho and he was shocked that I was walking without aid when he saw that I had ruptured my AT.  MRIs confirmed his concern that the tendon had retracted with a gap of about 5cm.  On day 30, he had me in surgery.  He found that I had years of damage to the tendon and that he had to make a v-cut in the tendon to lengthen it enough to come back together.  He said that it was one of the trickier surgeries that he has had to do and he cut me open more than he likes to so that he could clear the scar tissue that had formed.

After a night in the hospital, I was sent home with the foot in a brace with instructions to stay on my back and elevate the foot for a minimum of 23 hours a day for five days.  I’m now on day 3 and I’m pretty bored.  I’ve been able to get some papers written for a masters degree that I’m working on and a lot of paperwork for my job but staying still is not my thing.  On Monday, I need to schedule my first follow up appointment around day 10 when he will take out my staples and either cast or boot me.  He has said both so I’m not sure what direction he will take.  He projects a tough rehab given the time that I had between the injury and surgery. 

Luckily, the pain hasn’t been as bad as I anticipated.  I’m still on pain meds but I’m weaning myself down off of them.  The uncertainty about what will happen next, when I get back to work, when I can resume traveling for my job and will I get back to running is my biggest challenge right now.  I run a sales team so I can sit a desk most of the time that I’m in my office when I’m not traveling to customer sites or meetings.  We have important customers coming in this week that I want to be there so see but my office won’t let me back in without the doctor’s permission.  I need to work out how much I can work from home or do I need to file for short term disability. 

I’m conflicted with trying to determine the breaking point between pushing myself to a speedy recovery and driving myself to the point of reinjury.  Luckily for these first 5 days, my wife stressed to the doctor the importance of writing clear, straight forward rules and he set me on my back for that period.  Now I want to know what to do on day 6.

Sorry for the long post…three days on my back with uncertainty has me ready to explode.

5 Comments »

  • ATR Timeline

    • Name: billb44
      Location: Cheshire
      Injured during: Basketball
      Which Leg: R
      Status: NWB

      666 wks  5 days Post-ATR
      658 wks  1 day
         Since start of treatment

    • billb44 has completed the grueling 26.2 ATR miles to full recovery!
      Goal: 365 days from the surgery date.
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    • Recent Comments

    • normofthenorth | May 11th, 2011 | 12:13 am

      Sue, you should start a blog page of your own, so we don’t have to keep meeting in the alleys behind other people’s houses! ;-) And if you install the ATR Timeline Widget, we’ll also get a quick update on your dates, which leg, where you are, etc.

      Yes, fire that PT!

      Your “weight bear only on my toes not through the heel” sounds weird to me. Without a boot, you would ONLY be able to bear weight on your heel. With a boot, its rigidity allows you to bear weight on your toes, by transferring the stress your AT would normally bear, to your shin. But your heel should be just as capable of WB as your toes. What many of us started doing around 2 weeks post-whatever, PWB, is “rehearsing” our gait, but (a) in the boot and (b) with the crutches still taking most of our weight when the injured leg is doing the walking.

      Slip-ons could be scary, or not. Many of us loved wearing Crocs when we first got into 2 shoes, because the squishy gel was so friendly to our sensitive soles and heel-bottoms. People with wounds also have to be careful not to rub them the wrong way, with their shoes. And while you’re in the boot, building up your other

      [...]
    • Sue Brooks | May 10th, 2011 | 4:39 am

      I ruptured my achilles on the 3rd Feb playing netball for the first time in 2 years. Went to a physiotherapist the next morning who told me it was a torn muscle. I then spent 8 weeks exercising and limping before going to my doctor who diagnosed a ruptured achilles immediately. Then came an ultrasound and MRI. Diagnosis of a 4.7cm injured area…. Surgey on my 56th birthday the 27th April. It is day 13 and just had bandages removed this morning. Wound is healing well and my black adjustable boot has been adjusted closer to a right angle and I am allowed to flex my foot within that boundary ( pointed to nearly normal) and weight bear only on my toes not through the heel! Crutches and partial weight bearing for the next 4 weeks is the plan. But then I need a built up shoe. Am I right in thinking I need a pair of flats that are firmly attached to my foot not slip ons? Coping well with it all as the end is now in sight… after a small amount of time spent cursing my ex physio!

    • normofthenorth | April 12th, 2011 | 9:45 pm

      I hope your “up to 4 months” ends up like those “save up to 75% off” sales in some stores!

      Your Doc’s right that there are no big studies on long-delayed ATR surgery, but all the big studies that HAVE been done (mostly on “normal” ATRs) show that slow conservative immobilization is neutral (aka useless) or negative (aka harmful). Many or most surgeons still over-immobilize (and over-NWB), because it’s so easy to imagine that longer babying will be helpful, even if the evidence consistently shows the opposite. Harrumph!!

      At least at FWB, you can carry stuff around, even if your choice of footwear is way limited! I don’t suppose you were lucky enough to get a HINGED boot? Either way, make sure your uninjured side is “built up” as high as your boot side, so you don’t destroy your hips and knees and spine walking off-kilter for “up to 4 months”.

    • lsjoberg | March 13th, 2011 | 8:30 pm

      great news on the 90 degrees! besides being able to take the boot off to do basic ROM with your ankle, there shouldn’t be much difference between the cast and boot for the next couple of weeks anyway. just try to enjoy the downtime and keep reminding yourself that you’ll be back on your feet in time for summer…

    • gailbuddy | March 13th, 2011 | 7:37 pm

      Looking forward to you posting a pic of that scar when you get the cast off. If you are set at 90, that is great. It took two casts to get my foot to 90 so you are already ahead. Can’t get the doc to go for the boot at 4 weeks total? We all have different time lines and you are on your way now. I think my hardest days mentally were getting used to moving around with the cast and doing day to day stuff. Just rest and elevate as much as possible. If you keep the swelling down that will pay off in the end. Good luck and keep us posted!

    • gailbuddy | March 4th, 2011 | 2:37 pm

      The sound of the crutch IS a dead give away gimp is a comin! The real world feels good even if it is work I bet.
      Monday you will probably get your stitches out(if you have them) and a first look at your doc’s handiwork. It’s kinda exciting in the AT world. You have to take your jollies where you can get them at your stage.
      Let us know what happens and what your doc’s protocol is!
      Have a great weekend warming the couch!

    • billb44 | March 1st, 2011 | 9:51 pm

      Thanks for the advice. I’m making a run at going into the office. I have one co-worker to drive me in and another to give me a ride home. They have a wheelchair in the office if I find that I need it. I think a single day will be alright for this week. I’m actually get a lot done sitting at home.

      I’m hoping for a boot. I have my 1st post op visit on Monday. My Dr said that he makes the call at that visit based on what he sees. The study supports the boot but as norm mentioned their subjects were fresh ATRs.

    • Andy1000 | March 1st, 2011 | 12:25 pm

      Hi there,

      I concur 100% with norm. I was in a boot FWB with five wedges at week 2 there is absolutely no pressure on the tendon in that situation. All of your body weight is taken up through the heel, you still have to be uber careful though if you fall forwards or slip off the kerb there is still a chance you could re-rupture your AT. The other thing to watch for as well as the swelling is the incision opening up and becoming infected. I had to have a second op to remove an unwanted suture which has set me back about three weeks. The main thing is be patient, you are going to take around 12 months to get back to normal. You may be walking after about three months but you wont have a calf muscle so you’ll walk with a pronounced limp. The strength returns slowly week by week. I am just over 6 months from surgery and am probably about two weeks away from doing a quality single heel lift. Mind you if I lost a couple of stone that might help!!!

      All the best mate — Andy

    • normofthenorth | February 28th, 2011 | 2:56 pm

      Fight for a boot! “Neutral” isn’t necessary or relevant — the best boots can hinge and lock into a fixed non-neutral angle, and all the simpler boots can accommodate hard-rubber heel wedges that do exactly the same thing, for the first few weeks. My fave protocol — bit.ly/UWOProtocol — uses 2cm of heel wedge for the first 6 weeks, then neutral. It also gets you exercising and into PT and PWB at 2 weeks, gets you FWB walking at 4 weeks, and gets you out of the boot (”weaning”) at 8 weeks. I don’t think there’s much excuse to go slower, given their excellent results (with and without surgery, though their patients were all admittedly “fresh” ATRs).

      Returning to work is up to you and your employer (and your wife, if she’s doing the driving!). Many people travel while booted, or even on crutches. The main accommodation is usually sitting and elevating a lot, until you get the swelling under control. That part of the schedule is hugely variable among individuals — I personally posted a blog page with a title like “This swelling is getting OLD!” Post-op patients have to think about not “angering” their healing incision, lest things

      [...]
    • lsjoberg | February 27th, 2011 | 9:20 pm

      sorry to hear you’ve joined the club, and best of luck. I was able to work from home for 2 weeks after my surgery, and then took 2 weeks of vacation before returning to work at 4 weeks in a boot. by the time I went back to work I was able to get around in just the boot without the crutches, much to my ortho’s disappointment. if the need had presented itself, I could have worked out of the office those first 4 weeks with the crutches, although my wife would have needed to drive me (I ruptured the right achilles).

      according to my ortho, the biggest driver for boot or cast is whether or not your foot will go to “neutral” at the first follow-up - mine did, and so I was able to go straight to the boot. my brother, on the other hand, ruptured his achilles a couple of years ago and was in a series of casts for 8 weeks before finally moving into a boot.

      it will sound absurd, but enjoy the down time for the next couple of weeks. you’ll be back on your feet before you know it.

    • Mr WordPress | February 27th, 2011 | 1:11 pm

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