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!

8 Comments so far

  1. normofthenorth on February 19th, 2014

    Brian, your “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” is just about EXACTLY the story I got when I did my first ATR in late 2001 — and I think it was perfectly justified by the best evidence we had back then. Judged by the best evidence we have NOW, I think it’s pretty outrageous. See my blogs, the 2007 and 2010 studies from New Zealand and Canada (”UWO”), the more recent evidence from Exeter in the UK, and the very recent meta-study from Montreal, all linked from my pages and elsewhere. ATRs are so surgically boring and non-life-threatening that otherwise-impressive surgeons can get away with falling decades behind on the literature.

    Anyhoo, surgery still works, so it’s not as if you’ve gotten ineffective care — just surgery without informed consent.

    Check out bit.ly/UWOProtocol for a very successful schedule for ATR rehab (post-op or non-op). If your doc wants you to go slower, challenge him, because there are no benefits according to the evidence. (We used to think there were, and he may still think so.) The Exeter people are getting results at least as good — and ZERO re-ruptures in a couple of HUNDRED post-op patients, last I read! — with a slightly FASTER protocol, so we may not have found the optimum rehab speed yet!

  2. brian2332 on February 19th, 2014

    Thanks for all the input Norm. I for whatever reason never considered the non-surgery route. Only reason being is I saw two close friends of mine in the last 3 years tear it, and they both opted for surgery, and had good recoveries. Does that mean it’s full proof? No way. I just was going off what the doctor told me, and what I’d seen with my own two eyes. Depending on how this goes for me, I could be very upset that I didn’t opt to research the non surgical route a lot more. Thanks for the protocol info also, I’m going to bring it to my next therapy session and see how close I’m going to be on that timeline, and then make adjustments from there.

    Incision question for anybody that reads this: had my stitches out on 2-14, today was the first day that I’ve had any bleeding at all including when the stitches were taken out. Reason to worry? The incision is scabbing over and healing, and is slightly dry, and I’m not sure if the boot just rubbed on the incision a little to cause the few drops of blood on my ice pack or not. Doc seemed to think that the incision was awesome as mentioned before, and did mention it might have a little discharge.

  3. normofthenorth on February 19th, 2014

    Brian, “for the same price”, you might as well “own” your decision to get the op. Regrets are generally useless and often destructive.

    Most op incisions ooze a bit for the first few days, so most OSs put post-op patients in a splint for a week or so, then a boot. Less messy. If your boot is upsetting your incision, Make It Stop!!

  4. normofthenorth on February 19th, 2014

    I’ve slowly figured out that about 90% of what surgeons say to patients is pure BS. My first ATR was the nastiest and messiest that my OS had ever seen — and my Aortic (heart) valve was as well. They want us out the door, doing the right thing, feeling good, and being impressed with our care and our surgeon. No lie detector in sight, end of story!

  5. brian2332 on February 20th, 2014

    I looked at the protocol Norm, and I’m curious the definition of PWB. I understand what it stands for, but is this walking with crutches, and applying some weight on the boot? Just curious because everybody seems to have a different idea of what it is. Also, just curious…..I’m now 16 days removed from surgery, where would you be if you were in my shoes? Some PWB, I’m assuming from the protocol? Thanks.

    [WORDPRESS HASHCASH] The poster sent us ‘0 which is not a hashcash value.

  6. TVS on February 25th, 2014

    Day 14 Post Op

    I have 3 wedges in my boot and can walk unassisted. Walking in the boot is so awkward and tough cause it makes my bad leg 5 inches taller than my good leg.

    Leg and tendon feel great today. when I get up from sleeping and put my foot down I do feel tingling in my heel but that goes away quickly

    I did my PT today
    http://m.youtube.com/watch?v=WVYwTQCmMiE
    Seated non weighted calf raises.
    Elastic band heel raises. Down and Up

    Follow my recovery

    http://achillesblog.com/mbots/2-months-outquick-recovery/comment-page-6/#comment-297

    Scroll down

  7. brian2332 on February 25th, 2014

    When was the first day you attempted to walk without crutches and just use the boot? I’m just wondering if I should speed things up slightly…..I have heard from my PT and the doc that the first 4-6 weeks are crucial for the tendon to heal.

    [WORDPRESS HASHCASH] The poster sent us ‘0 which is not a hashcash value.

  8. normofthenorth on February 25th, 2014

    bit.ly/UWOProtocol. Exeter too - probably both with better results than your OS. Read, learn, follow.

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