Dumb Marine

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 Responses to “Dumb Marine”

  1. Hi, this is a comment.
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  2. 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.

  3. 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 go far south. That sometimes means extra down-time, but often just means extra care, wraps, ointments, slippery surfaces, etc.

  4. 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

  5. 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.

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