Jun 15 2014

boredoutofmymind

Boot Day

Posted at 8:37 pm under Uncategorized

This past week I transitioned from the “splint/miles of ace bandage” to a donjoy mc walker.  From reading other posts and information on the Achilles site and marathon you soon realize how important milestones are.  Probably the mental aspect of the milestones are more important than the physical ones in some regards.  I had been waiting to get out the splint for the 3weeks that followed my first post-op appointment with my surgeon.

Bootday finally arrives and I was excited.  I checked in with the desk and was put in the usual room.  I waited for half an hour.  Surgeon finally came in and gave me the scoop on what was going to happen next.  Basically, get the boot set a 20 degrees and maintain for 1 week.  Then 10 degrees, the week after, then 0 degrees and put weight on it, and try walking.  Another milestone to look forward to, walking again and PT.

The surgeon then tells me I can start taking off the bandages and that a nurse will be in to help me out.  I unraveled the  ace bandage to find this thick white gauze type stuff that I could not find the start or end of.  Instead of making a mess by tearing at it I waited and waited for a nurse to come in in and give me hand.  Finally I grew tired of waiting, opened a draw and wala, a pair of scissors.  I cut the remaining menace off and waited some more.  The surgeon returned and gave me the thumbs up no infection and the incision looked good.  We went over what I could and could not do, the best part of which was permission to wash my leg.  Goodbye trash bag/ace/tape contraption that I made for taking showers.

The surgeon then left and the nurse with the boot arrived.  She had trouble with it and when she had it set where she thought it should be, she put it on my foot/lower leg.  I had some qualms about it since she had it set to flex to an acute angle between my foot and leg.  This was opposite of what the surgeon had told me a few minutes prior about the boot holding my ankle at 20 degrees.  I kinda questioned this and did not get a satisfactory response.  Then the nurse told me to try it out by standing on my ATR leg. To this I said no, the doc told me no walking for 2 more weeks.  She went and checked and came back with the same answer he had given me minutes before.  Not impressed with the nurse.  Anyhow I scoot out and make it home, talk to the wife and she checks out the boot and gets it set up properly.  The boot has negative and positive markings and the nurse had set it to the reciprocal of what it should have been set at.  BE YOUR OWN ADVOCATE.

Not really fond of the boot and am looking into the vacocast.  I have not really figured out the best combination of strap location and tightness yet .  However the boot has given me the confidence to get on the bike trainer.  Nice to get some cardio in.

So now I have a week and a half to FWB status.  This coincides with a trip involving plane travel.  I have not figured out the best way to handle this trip.  Take my wheels and check them at the gate.  Leave the wheels at home and use wheelchair service to get around the airport and just take my crutches.  I know I will not be setting any speed records transiting from terminal to terminal.  Not sure what the best plan of attack is for this trip.  Bring the wheels as insurance or just bring the crutches and htfu.

4 responses so far

4 Responses to “Boot Day”

  1. vegasjoeyon 15 Jun 2014 at 11:44 pm 1

    I’m ess aggressve plan. I have two risers in my boot at the heel, I take one out after 2 weeks and at 4 weeks I see the doctor again then I go to full weight bearing but I stay in the boot. I hate sleeping in the thing. What a pain. I find it helps to loosen the straps for sleeping.

  2. hillieon 16 Jun 2014 at 12:39 am 2

    Hi Boomm

    After my atr diagnosis and during early recovery, I didn’t need to fly and I wasn’t a surgical case. However, there has been considerable posting on the blog about flying soon after surgery, and the risk of DVT/blood clots (apparently can apply, but less so, with non-op cases too, due to poor circulation).

    Others who see your post will pick this up and advise you better but you might just want to check with your doctor about taking aspirin or something to help with the blood circulation - or put off the flight for a while if you can…

  3. boredoutofmymindon 16 Jun 2014 at 10:34 am 3

    I checked with the surgeon on flying at my 4 week post op appointment and he gave me the green light for air travel.

  4. normofthenorthon 16 Jun 2014 at 12:32 pm 4

    I think I had your exact boot for ATR #1 and I dug it out of storage at around 7 weeks into ATR #2. (My non-op surgeon prefered the AirCast because we were following the UWO protocol, and that study used AirCasts, so I used it at first.)

    Vaco users mostly love it, but — barring incompetent nurses or bad fit or adjustment — I don’t think the Donjoy-vs-Vaco decision will make much difference. I added some padding and such to make mine work better. Be your own advocate AND your own “stationary engineer”! Most protocols spend some time at a fixed angle before letting the boot hinge. The key adjustment when it hinges is the angle where it stops your ankle from dorsi-flexing. That angle, along with the prior fixed angles, should progress in a steady and comfy manner, to neutral (or a bit beyond, in some protocols, though I hated the feeling).
    And I think that any angle change should be done at bedtime, followed by a night in the boot, to let the AT and calf stretch NWB before you load it up.

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