Week 8-wedge question

So, if anyone read my experience with the PA at my doctors office at my 6 week check-up, you could most likely pick up on my disappointment of how slow they are dragging me through rehab. Well, the latest installment is…..nobody knows when I should take a wedge out of the boot! At my 6 week check up, I asked the PA when I take the first wedge out. The PA was already upset/surprised that I was FWB when I came into see him, and then he told me that he couldn’t tell me when to take a wedge out, that it was PT’s job to tell me when to do that….wtf. So at my first PT appointment after that 6 week check up, I ask my therapist when to take the first wedge out, and they say it’s not in the protocol, and the doc should have told me when. Soooo, I decided about a week ago to take a wedge out of my boot, and much to my surprise there was only two wedges, if you want to call the heel piece an actual "wedge". I was under the impression and so was the doctor that there was 3 wedges in the boot. Frustrating. Anybody else have any experience with just the two pieces that I have pictured here? They were basically glued together, and I pulled out the bigger, bottom wedge first, and now just basically have the heel/wedge piece in my boot.  Feels really good though, I’m contemplating trying to walk around in shoes in my house over the next week or so.

6 Week Post-OP appointment

Went to my 6 week post-op yesterday, was greeted by a look of wtf, when the PA came into my room and looked around for my crutches and didn’t see any. He then asked where they were, and I told him that I was moving along a little ahead of the schedule given to me by the doctor. He asked how long I’d been
FWB, and I told him I started FWB about 2 weeks ago. He seemed shocked, then almost stand-offish about me talking to him about the protocol I was following. Then told me that they don’t always approve people to walk FWB in the boot at 6 weeks, but he was going to approve me since I was having no issues with it. I then asked him about the wedges in the boot, and he said that physical therapy would decide when I remove them, and when I asked physical therapy, they said it was based on the doctors protocol. So once again, glad that everyone in this office is so clear on what the “protocol” is. Then the PA told me that my protocol is on the aggressive side of things in the Achilles recovery world. Kind of made me laugh a little. He then scheduled me another appointment for 4-21-14, and told me to bring shoes to that appointment. If I ride with his protocol, I’ll be in shoes by the 11 week post-op mark. Glad that his physical therapy starts stepping it up a little, or I would quit attending, and take physical therapy into my own hands, and avoid the 20.00 co pay I get hit with every time.

Here’s the pic!

One month out picture of incision...

One month mark after surgery…..

So, as I talked about earlier my Doc had me slated for being in the boot NWB until March 16th, after having surgery on Feb 4th. After looking around and talking to some of the other ATR victims on here, I decided to speed up my recovery. On 2-23, I started some PWB, and was still using crutches for the most part. After feeling more comfortable with the process, I ditched the crutches on 3-1, and am getting around without any crutches. Only bad part to this whole scenario is that my physical therapist refuses to budge of the original protocol that the doctor sent over, so I’m basically doing more aggressive stretching and exercises on my own. Today marked my 3rd week of seeing the physical therapist, and now I will start going twice a week. I’m using bands at home for resistance for some of the ROM exercises, and then not using any at therapy. Frustrating, but I’m happy to be crutch less at the moment, and other then the soreness on the sides of my calves from putting weight on the leg. My therapist did say that next week I will begin with some more "aggressive" PT, and told me that I would be a little more interested with what we are scheduled to do. Frustrating. From what I’ve seen from several studies, staying in a boot for as long as I was going to be asked to do so seems very dated. Oh well. Here’s a pic of my incision at the one month after surgery mark.

Achilles incision 5 days after stitches

Incision 5 days after stitches out

Here is the incision as I talked about earlier. Not sure if it’s worth worrying about or not. I know that they told me to expect some discharge, but I thought it was strange that I didn’t see anything for the first few days after the stitches were taken out.

Hoopin ain’t easy…..surgery, recovery, first therapy session.

Another basketball ATR to go along with all the other stories I’ve read on here:

So I’m 37 years old, and have been playing pick up basketball on my lunch break for about the last 12 years. The game is half court 4 on 4, winners stay, and it has been a very competitive game that usually has several ex college basketball players and or good high school players. I ruptured the Achilles on 1-29-14 during the first game of the day, and did it while coming off a curl cut to the middle of the lane. I’m left handed, and went to plant with my right foot, and boom…. it sounded like somebody threw the ball off the brick wall underneath the hoop! I knew immediately what had happened. 3 years ago, my best friend did the same thing, and then a week after he did his, my cousin ruptured his, both playing basketball. I limped off to the sideline, with no real pain, and got immediately in to my family doctor no more then 40 minutes after it happened. My Doc confirmed it, and made my appointment for the next day to visit with an ortho doc who he classified as specializing in Achilles tears. I met with the Ortho Doc on 1-30-14, and he confirmed it as well, and set up my surgery for 2-4-14. We talked briefly about non surgery, and he told me that he wouldn’t recommend that route for anybody under the age of 55, unless somebody has had complications from surgery in the past. The doctor then put me in my boot, and said "I’ll see you for surgery on Tuesday."

Upon showing up for surgery on 2-4-14, I was actually pretty nervous. I had never had any type of procedure in my life, and the closest I’ve came to general anesthesia was having my wisdom teeth out when I was in my teens with some local anesthesia. Upon meeting with the anesthesiologist he told me that he highly recommends the local block from the knee down (which I did), and before I could get too worried about anything, they gave me some meds that mellowed me out in seconds. While going to the operation room, I didn’t make it to a countdown or anything, I was out! When I regained consciousness, which seemed like 5 minutes later, I had a nurse feeding me ice chips and telling me that everything went great. About 20-30 minutes after waking up, the staff got me out of bed to meet with the therapist so they could show me the "proper" way to use crutches. About 40 minutes later, I was dressed and wheeled to the car for my wife to take me home, no pain, no discomfort, and in nothing but a splint wrapped in an ACE bandage.

24 hours post surgery- This is where the real fun began! When my block wore off, which was about 24 hours post surgery, I felt some unbelievable burning, and pressure on the back of the leg. I took my Norco as soon as I felt pain, but it was too late. I did a steady cycle of Advil and Norco for the first 24 hours post surgery, as this was some pretty extreme pain. I was elevated basically all day with ice on the back of the splint, and only got up to either go to the bathroom, or go to the front door to look outside. I am lucky in the home care area, as my wife is a registered nurse, and has been awesome with helping me with any issues. Here’s a little bit of advice for the first few days post surgery: start taking a stool softner, and or get some prune juice. The constipation that followed for the 3-4 days post surgery wasn’t far behind the pain I was feeling from the incision. Also, get a knee scooter. Once you feel like getting up and moving around, the scooter is far more stable then crutching exclusively, and you can actually carry food or drink on it. It has been a life saver for me also with my kids (ages 6 and 2) running around. Last advice for the being laid up period: EAT CLEAN. It will help with movements, and this can also be a point for people who have been struggling with diet to make a wholesale change. I did nothing as far as work or leave the house for the first 7 days post surgery. Kept it elevated, and iced. I feel lucky in that sense that I was able to do so. Watched A LOT of DVR, thank God for my movie channels and also the large amount of college hoops that was on over this period also!

2-11-14- Back to work!
I’m very lucky to have a desk job…..never thought I’d say that, but I was back at work 7 days post surgery and was able to elevate some at work, and even though I worked less hours then usual, getting out of the house was awesome! Crutching around with just the splint on was very maddening at times, but I was very careful, and didn’t push the limits at all. I was off the pain killers 3 days post surgery, and am only taking ibuprofen in the AM and the PM at this point to help with swelling. I was getting burned out pre injury, and it was nice to WANT to be at work for a change.

2-14-14- Valentines Day! And my first follow up appointment. (10 days after surgery.)
Was very excited for this day, not only because Doc had told my wife post surgery that he was planning on putting me in the boot, but I was going to get to see the incision for the first time. So, when the nurse removed the splint and I saw the incision…..my first thought was, that looks horrible. To my surprise, the nurse said it looked great. Then the PA came in and checked it out, and he literally was in awe of "how good it looked." I obviously thought everybody was over-doing it with the compliments, but then the Doc came in and he was impressed with it as well. Made me wonder aloud if they expected it to look horrible. Doc then had the nurse remove the stitches, and put me straight into the boot. What I took from the convo with the Doc: He doesn’t want me walking in boot too early, stated that the Achilles can get stretched out too easily. Gave me the green light to shower, and get the incision wet, just not to submerge it into a bath. Talked about how important the first 4-6 weeks are for the tendon to heal from the surgery, and stressed this to me. I think he was worried that I was going to be entirely too aggressive with it. My next appointment to meet with him was scheduled for 3-17-14, so I basically have 30 days in the boot with crutches, and not being able to walk in the boot. I was hoping for a quicker timeline for walking in the boot, but we will see how therapy goes. Best part of the day, went to the movies with my wife after the appointment, and felt way more comfortable in public with the boot as opposed to the splint!

2-17-14-Started Physical Therapy.
Not much to say here, talked with the therapist, did some very, very light stretching, and then ice and hooked up to a machine to send electrical currents through the foot. Looks like I’ll be once a week to therapy for the next month, and will then be doing twice a week.

Sorry if I was a little lengthy with this, tried to spew out the last few weeks of my life and get into words what a mess it’s been. I’m so thankful for this site, and being able to see other people dealing with the same issues has gotten me through some sleepless nights already. I hope moving forward I can have the same effect on some other people that were as devastated as I was initially to understand the process a little better. I’m gunning for golf season, and hope to be back into shoes in May so my game doesn’t suffer! Good luck everyone!