Alright…I’m back in the saddle after a crappy day…the ups and downs are really incredible when you think about them.
Surgery Report - Ortho said the surgery went fine, no complications. Used fiberwire to reattach tendon, and then 2 layers of dissolvable stitches to close the wound, and an outer layer of removable sutures..which came out today. It was nice getting that split off so I could finally take a look….here’s what I saw:
Three things to note - (1) the incision was made on the inside of my leg, much farther off center than I thought. The doc said he does this as some people scar’s just don’t heal well and if it’s on the back of the leg, it can be irritating to skiing and snowboarding boots…good on him, didn’t tell him about my snowboarding..but appreciated the thought! (2) Had I known the incision was there, it would have answered my concerns about the feeling I’ve had for the past 10 days that my splint was digging into me…turns out it was the guaze pulling on the stiches a little! (3) Had I known, I probably would have been more comfortable resting my elevated leg directly on pillow, calf down. As it stands I’ve been either resting it to one side or the other, as I read somewhere that direct pressure on the incision can inhibit healing a little.
Here’s a shot of the incision…I was so relieved that it looked good. The yellowish is just a little internal bleeding that should go away in teh weeks to come.
Here’s a real close up…sorry, if you don’t like the details!
So, I crutch over to the casting area, which was a bit suprising because my foot was total exposed. I would think that if we are so concerned about a re-rup at this point, they would wheel you. Regardless, I made it fine, but the foot definitely felt a little floppy. I’ve broken my arm before, and I remember wanting them to put the cast back on after it came off because the arm felt so limp and lame. On the flip side, it was nice to give it some air and let the skin breath, even if it was for 10 minutes. I asked the cast tech for a wash, which he did with rubbing alcohol. He said they don’t recommened cleaning with any soap at this point, I think because they cast it so quickly and you wouldn’t want any suds building up while your skin rubs up against that cast (are you getting the image of a washing machine with suds pouring out of the lid!) Regardless, the wash felt great. He put on some tape:
For the cast, he pushed up on the ball of my foot and did so until it felt uncomfortable. We didn’t make it to 90…but we weren’t going for that with this first one. It was a little sore, and awkward, but I could tell the AT was attached and that was an awesome feeling. The tech said that the fiber wire is extremely strong, and would take a lot to break it (let’s not try though, OK?) He casted it up…had to go with pink for the gals in my life (wife, 2 kids, and dog):
Alright, so looking forward - The ortho doc initially said cast for 4 weeks. I explained about my research, in a real unthreatening way, and that early mobilisation feels right to me. He was a little concerned as he had a patient that took this approach and was in a boot after 4 weeks, was at the gym pushing to hard and stretched the tendon at the repair site. It eventually healed, no true re-rup, but the tendon was not as tight as the doc would have liked. I said I wouldn’t be that guy, and we agreed that 2 weeks in a cast, NWB, and revisit. If after two weeks he and I are feeling good, we’ll move to a boot, still NWB, but at least allow me to start moving the joint around. So a really great conversation, and a big thanks to everyone on this board for giving me the tools/knowledge needed to have that discussion with my doc. I echo the comment someone made about being your own doctor…you really have to….and it helps to have a doc that is willing to work with his patients on a case by case basis. I’m so happy with the decision I made to switch surgeons initially!
So in the next two weeks, got the OK to wiggle the toes, do the leg lifts (no extra weights), and get back to work. The cast won’t give as much with the swelling, so it will still be ice and elevation as much as possible.
I printed out the temporary handicapped parking permit application before I went in and had the doc sign it…you can find any states application here: http://arthritis.about.com/od/driving/a/handicapparking.htm
Wow..what a relief…I still can’t belief the tricks my mind was playing on me during those first 10 days….everything was going fine in there even though I was feeling all this nasty stuff…damn!
A good milestone….here’s to the next steps (well..not quite yet literally)….