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Archive for March 2nd, 2009

2nd Dr. Visit-got the boot!

Friday, Feb. 27 I had my 2nd Dr. visit at 4 weeks and 1 day post op.  Here is a quick rundown of how it went-It’s a bit long but wanted to share some details that may be helpful to others just starting on the journey.  First of all, thanks only to this website, I was prepared at my first Dr. visit and had already lobbied for getting a boot at my 2nd visit because the original plan was to have me in two casts with my foot at different angles for 2 weeks in each cast after being in a splint for the first 2 weeks for a total of 6 weeks in a cast.  This all seemed like over kill and way too slow of a process after reading this blog.  So at my first visit, after requesting a boot, I was talked into a fiberglass cast for 2 weeks and was told that I may be able to get a boot on the next visit.  After suffering through those two long weeks with great discomfort, I was determined to not go home in another cast.

When I arrived for the 2nd visit they first cut the old cast off which is a non-event, a bit of noise and dust, unless a sharp blade that looks like it could chew a giant hole in your leg happens to freak you out.  To reassure me, the tech demonstrates that it will not hurt you pushing his finger against the blade while he grins as my 9 year old son looks on in disbelief.  I was prepared for a small calf muscle and it did not disappoint–very pathetic looking.  The wound looked pretty good once I cleaned it up.  

The Dr. says I can have a boot but it needs to be plantar flexion (toes pointing down 15 degrees) for 2 more weeks.  I groan and start to explain other methods of treatment that allow weight bearing by using a walking boot at 90 degrees with a heel lift but she does not go for it at all saying something about too many variables.  She does say I can start range of motion up and down with my foot as much as I want and says to come back in 1  1/2 weeks instead of 2 (I guess to make me calm down and be more compliant).  It’s really interesting to read all the different treatment protocols on this site.  What seems to make the most sense to me is the walking boot as soon as possible with heal wedges so you can bear weight but not stretch the tendon too far too fast as long as the patient knows the risks and is willing to take them.  This method does seem to carry more risk as a boot can be removed and a patient could then do something to cause a re-rupture.  However, it seems that the patient should have more say in what they are willing to take on for risk vs. the Dr. giving only one option (3 splint/casts for 6 weeks).  So I agreed to 1 1/2 more weeks of crutches non-weight bearing with the boot.  I’m trying to look on the bright side–all of the crutching my way around is at least helping build a bit more upper body strength.

Getting the boot after 2 weeks in a splint and 2 more weeks in a cast was a great improvement.  Getting my leg out in the air resting is excellent, getting to shower again (sitting down to reduce risk), putting on a sock, putting lotion on all that dry skin and being able to move my foot a bit is a huge step forward.  It finally feels like some real progress.  As for getting around better, I met a guy in the lobby on my way out and he has a knee caddy (4 wheeled cart you rest your knee on and power it with your good leg) and he tells me I can rent one from the clinic for just $25 a week.  Wow, and to think that no one in the clinic even thought to offer such a service.  It kind of boggles my mind that as patients we are not given more options, choices of treatment, tools available, etc.   Especially when I think of how much this event is costing me.  My first bill so far is something like $8,500+ and I have a $3,000 deductible so I’m paying a lot out of my own pocket and as a consumer it seems we might get a bit more service.  Now don’t get me wrong, I am super amazed at the great medical care we enjoy in America but there seems to still be more room for improvement in the options for care after you leave the clinic.

It really makes me appreciate this blog and all the people who are willing to share their stories.  It has helped immensely!!