August 5 2015 - Eleven Weeks Post-op

August 5, 2015

Well the time really does pass quickly.  We returned on Monday from 2 weeks of vacation out West, and today marks 11 weeks to the day since my ATR surgery.

While we were gone I did not go to PT, but I did go to the gym each day the first week and I progressed through most of my PT exercises.  I did standing balance on each leg, leg raises in four planes of motion, massage and Theraband resistance with the assistance of my wife, toe presses on a leg press machine, and eccentric strengthening on a leg press machine - pressing down with both toes and then back to neutral under resistance with just my repaired leg.  Also, I did at least 3 sets of 10 of two footed calf raises every day.

Most all of my activities were fine.  I wore mid-height hiking boots with a heel lift for extra support.  My gait is pretty normal but I walk pretty slow, some steps feel perfectly fine, others make my repair site feel like someone is squeezing it with pliers.  Range of motion is the same in both ankles, which is great.  The biggest problem I have had is with walking down stairs, but we are starting to work on that specifically in PT.

I went back to PT on Tuesday morning, the morning after my flight home.  I was excited to show my therapist how strong I had gotten and how I could do two legged calf raises with ease.  That was a mistake - never gloat to your physical therapist.  He proceeded to kick my butt for an hour, even having me walk around on my tiptoes with resistance bands, which really hurt a lot.  It helped to have him work with me on my stepping and I think before long I will be fine walking down stairs much better.

I continue to drive with absolutely no problem.  I got another set of boots - side zip lightweight mid-height black boots from Under Armour, they work great!  I added a 1 cm heel lift to my right boot. They are “Men’s UA Valsetz RTS Side-Zip Tactical Boots.” Extremely comfortable, lightweight, and supportive.

Men's UA Valsetz RTS Side-Zip Tactical Boots

My scar is healed and gives me very little trouble.  Around the house I still don’t go barefoot, I use light shoes with a heel lift to remove some of the stress from my Achilles.  I took walks up to about a mile on vacation and plan to continue walking as much as I can.   Being out of the boot, I feel my strength and muscle tone returning.  The hardest thing for me now is my balance, it is taking a while to come back.  I bought a stability pad to help me work on my balance at home, and will be doing some one-legged exercises in my spare time too.

Next appointment with the OS is next week - looking forward to that.  Will concentrate on improving strength and balance before my next OS visit.


July 19 2015 Take me out to the ball game in two shoes.

July 20, 2015

I had tickets to yesterday’s baseball game, Washington Nationals vs LA Dodgers, and I just had to go. The Washington Nationals are my adopted team, and the LA Dodgers are the team that I grew up with in Los Angeles so this was a must see. Since my injury I have attended two games, both when I was PWB in the boot with crutches, and I switched out my seats for ADA “handicapped” seats and everything worked out okay. Yesterday I decided to use my regular seats, which are all the way down right on the field in the 3B corner, meaning I have a loooong set of concrete stairs to go down and up to get to the seats. To top it off, yesterday was a heat warning day in Washington DC - high heat and extreme humidity with heat index values in the 100’s. If you have never been to the Washington DC area in the dog days of summer, the place is absolutely miserable. It is built in a swamp and it just swelters, and yesterday was predicted to be the hottest day of the year so far.

So with that background, I decided that it just was not practical to wear my walking boot - it would get uncomfortable, be difficult on the stairs, and also be difficult in terms of people stepping over me to get in and out of the row. I wanted to sit in my seats, not in the ADA section. Since I am at 8.5 weeks post-op and doing well in PT I decided to give it a go in two shoes.

I bought a special pair of shoes just for this purpose. My background is military and law enforcement and I am kind of a nut for tactical gear. A company out in California called 5.11 Tactical makes great equipment and gives me a veterans discount, so I chose them in selecting a protective boot to wean in to out of my Aircast boot. After looking through their selection I decided that I wanted the following qualities in my boot:

- 8 inch height for ankle protection
- lightweight and breathable
- stiff shank to prevent excessive dorsi-flexion
- ability to accommodate a 10mm heel wedge
- comfortable enough fit around my scar
- side zip for easy on and off

I selected the ATAC Sage 8 Inch CST Boot because it had all of those qualities in addition to a composite safety toe (CST) to protect my foot if someone stepped on me. The boots are very comfortable and I took them to my OS appointment and my surgeon really liked them and thought they would be a fine boot to transition into as I moved to two shoes, providing lots of ankle protection and support.

So I am still not driving, my friend picked me up and off we drove to Nationals Park in Washington DC, just south of the US Capitol. We had a parking space right next to the park and I had no problem whatsoever walking in my new boots! I walked a little bit slowly just out of caution, and I was very careful to avoid situations like curbs which would potentially put me into excessive dorsiflexion, but I did just fine. Once inside the concourse I walked all the way to the far side to get to my favorite sandwich stand, over to my seats, down the stairs - no problems at all. Sitting in the seats I was very glad I didn’t have the Aircast boot on as people stepped over me to get to their seats.

After the game I came home and iced my ankle but I really did not have any pain or swelling - I was very pleased as I had worried about both of those issues but neither materialized.

I consider the whole outing a great success, except for the fact that my adopted hometown team lost to my boyhood hometown team :( I hope this info is useful for anyone transitioning to two shoes. I am going to stay in the Aircast boot for most day to day activity for a couple of more weeks, as my OS had ordered, but it is nice to know I have this option and I am going to use the boots as I start driving again next week.

5.11 boots!