What not to do…

Nothing in this message is considered to be medical advice.  All topics and suggestions are NOT from a doctor, and do not replace the advice of your medical provider.

So, here I am, 2.5 weeks out of surgery thinking it’s about time I contribute to the Achilles blog.  I’m hoping I can help the next guy (or gal) out there to find an easier path and learn from some of the mistakes I’ve made.  So, to get started, here’s are some things to avoid once you think you’ve ruptured your Achilles:

  • Stop thinking how you are going to be able to walk in 2-3 weeks.  If it’s ruptured you’ll be Non-Weight Bearing (NWB) for 4 weeks post-op if your lucky;
  • Driving is not possible;
  • Get used to being called names.  So far I’ve been called a pirate, long john silver, gimpy, crippled, and special.  Be prepared to be humble;
  • If you need to get places, plan on not being on your crutches or knee-walker for over 15 minutes.  It is possible to go out for meals because you can put your foot up when your seated, but shopping is not a  good idea;
  • The knee walker is a good idea for the house.  I’ve been able to do much more with the knee-walker and only wish i rented it (from a local medical supply store) earlier;
  • Don’t feel sorry for yourself.  Granted, the injury sucks because your out for months, but life must go on and it’s doable with this injury;
  • Eat healthy and be sure to not each too much salt.  After surgery, eating salt would make my toes larger!
  • Be ready to see a smaller leg.  After 3 weeks of being off my foot, mine is about half the size.  A shrunken appendage is a very awkward feeling.
  • Don’t forget to keep your leg up.  The office, dinner table, meetings, TV, sleeping, ironing, cooking, driving, lounging, and observing can all be done with the leg up;
  • Forget grocery shopping. Delivery is OK, but the produce is questionable.  I’ve been purchasing packaged produce and finding better quality;
  • Don’t be difficult with your significant other, family or friends.  Your going to need their help and it will only make you look more desperate if your being a jerk;
  • Don’t keep talking about your devastating injury.  People get tired of hearing about it quick.

If anyone’s reading this far, I guess they might be interested in my story.  i ruptured my Achilles 3.5 weeks ago playing basketball.  So far, no accident with the NWB!  There have been plenty of close calls with the crutches, but I’ve stayed away from landing on my bad foot.  I’m hoping to get the boot 4 weeks post op.  Luckily, I’ve been fortunate to have a very helpful wife and mother to help with driving and advising how to deal with this injury.

I’ll continue to update with some other findings which come my way for dealing with an Achilles rupture after surgery.  To anyone reading this who has the same fate, keep truckin’, be smart, and take it easy.

13 Responses to “What not to do…”

  1. As you already said (twice!), shopping is the WORST!! To me, it always seemed way harder than it should have, and (at ~21 wks) it STILL does!

    Check out my blog page for a fairly fast rehab protocol that was proven in scientific studies to produce good results, with and without surgery. It calls for PWB at TWO weeks, and WB “as tolerated” starting at FOUR weeks. That usually means “goodbye crutches” by five weeks.

    Take a copy of the protocol (or even the study summary with the good results) to your 4-wk appointment to make sure you’re not immobilized or NWB longer than necessary, or longer than optimal!

    And of course, when you’re “here”, you can keep talking about your devastating injury as much as you like! :-)

  2. While not part of the usual rehab program, I wouldn’t say NWB for four weeks and a badly atrophied calf are inevitable. Faster rehabs are possible, although the advisability of such a program for common use isn’t yet clear.

    Doug

  3. I’m thinking about trying out one of those Hover Rounds at Costco. There’s a chance it could be fun. Still waiting for those handicap tags, which will be huge when it comes to going out. The wife asked the doctor for that, good idea.

    I contacted 2 DPMs, 1 Orthopedic surgeon, and 2 sport doctors to find the fastest rehab protocol. I went with a DPM, even though they have 4 years less residency, because he seemed to be the most aggressive. The current plan is to go to physical therapy in 4 weeks when starting with the boot. So far, no complications with swelling on last 2 post op visits. I’m ok with the additional NWB, but wish I could have found the 10 day post op PWB plan. I think it’s difficult to find a physician to take this risk.

    A cast is very effective at keeping injury secure. If I were to get in a car accident, my leg we be completely unharmed.

  4. You’ve chosen a “theme” for this page that doesn’t show your home town (or the weeks and days since ATR & “op”). Where are you? (I’m guessing the US, if nobody made a convincing case for skipping the surgery.)

    For a quick laugh, check out http://www.en.wikipedia.org/wiki/DPM ! I’m going with “Doctor of Podiatric Medicine”, though a bunch of the others produce funnier results. :-)

    Check out http://www.achillesblog.com/normofthenorth/the-non-surgical-protocol-ive-been-following/ for the UWO protocol I followed, with PWB starting at 2 weeks, and WBAT at 4.

    This protocol produced excellent results with and without surgery, and there are several indications that even faster can produce good results after surgery — including Doug’s personal experience. So I don’t think there’s any advantage from going slower, and there are obvious disadvantages, some of them clinical (and lots of them personal!).

    The studies I found — including a fascinating one on a new super-aggressive super-strong Japanese surgery — are all linked and discussed at http://www.achillesblog.com/normofthenorth/2010/03/08/a-more-complete-review-of-the-options-surgical-vs-non-operative/ , fyi.

  5. All excellent points! I would add…
    - Focus on what you CAN do and not on what you can’t.
    - If your injury is to the left leg start driving (automatic) when you are off pain meds.
    -Exercise anyway possble. Upper body with weights or bands, Core work.
    -Get outside for some fresh air…BREATH
    - Remember that this is a temporary condition, we WILL get better. (even if it’s not as fast as we would like)

  6. That’s the problem, isn’t it, finding a doctor who will go along with a more aggressive protocol that doesn’t leave you locked in a cast for weeks with increasing muscle atrophy. My doctor’s protocol wasn’t particularly aggressive, but, necessity being the mother of invention, I pushed as fast as I dared on my own. I was lucky to be in a removable splint after surgery that gave me some options. Could lots of people do what I did? I suspect so, but I can’t prove it.

    Good luck,

    Doug

  7. Bio-
    Great post! I do think that it is good to take Dennis’ outlook that this is an injury that requires 1 year for full recovery, but:
    My two cents’ worth: my surgeon was actually more aggressive than my PT. At the surgeon’s suggestion, I was PWB after 2 weeks and got rid of the crutches a week later. I started PT at 6 weeks and my PT thought I was starting too soon. More than once, my surgeon (I am an anesthesiologist, so I tend to see my surgeon in passing more than I see him officially) told me that he wished that my PT was moving me along faster. That said, I was back to playing my sport (Ultimate Frisbee) indoors at 6 months and outdoors at 8 months. Yesterday, I wore cleats for the first time since my ATR and it felt great.
    Cheers, Ron

  8. Casts and boots are pretty identical in function for the first few weeks, when the boot should be 24/7 anyway. The boot still has a few advantages, like the ease of solving pressure points and such. Only one disadvantage — that you could take it off and screw things up.

    BTW, I’ve got a comment above “waiting for moderation” because it includes some links — mostly to my protocol and my blog page of annotated links to ATR-rehab studies. PLEASE approve it, Bio!!

  9. Thanks for the posts everyone! I’m very anxious but also content with the PWB in 4 weeks. I’m optimistic the recovery will be smooth at the 4 week mark. Although it has been debilitating, I have been able to do many things. In the spirit of notsorad’s response, here’s what I’ve able to accomplish:

    - work. I’ve been able to go back into work with a week off after surgery;
    - going to restaurants. No problem, but I was quick to get to and from the table;
    - baking pizza
    - carrying things, with a satchel;

    Once I got the knee walker, I could do so much more;
    - bring coffee to my wife (to wake her up to take me to work);
    - cook, BBQ, make my lunch;
    - clean carpets after our dogs;
    - go to the mailbox and show off my new wheels to the neighbors!

    I’m not trying to sell one of these things, but renting has made a big difference for me. I had only crutches for 2 weeks and getting one of these made life much easier. http://www.specialtymedicalsupply.com/files/images/ambulatory/TLC-X_PRD.jpg

    Cheers, Matt

  10. Bio, I still see “Your comment is awaiting moderation.” on my comment of 4:27 PM yesterday. I think that means nobody can see it but you and me. To fix that, one way is to go to “Dashboard” at the top of the page here. From there, you should see your total # of comments, and a breakdown of comments Approved and Pending and Spam. I think you’ll see that 1 is Pending.

    If you click on that, you should be able to select it and choose from Approve, Mark as Spam, and Delete. (If somebody’s got a better way, please share!)

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