Chris’s double achilles blogg

It is over 6 months since my last post and 1 year since the ATR so I thought I would do a final post.

Since last December I have been dancing regularly. This has been ok up to a point. There are some moves which require a push off from the injured leg which are more difficult. I have found I tend to do more than I should and a couple of days later my calf gets stiff and painful. So I should really space out the dances and do less but it’s too easy to get carried away.

I have been building up my walking and last month I did a week’s hiking in the Alps. I had no problems at all with the Achilles, only with my knees which is a different issue and not related to the AT. I use walking sticks most of the time and I think this helps a lot.

I still have a hard lump at the base of the Achilles and the calf muscle is much smaller than my good leg. I have probably not done as many targetted exercises as I should do (eg heel lifts) as I do more general stuff like walking and cycling etc.

I still have a bend in my spine. Now, I cannot be certain of this, but I only noticed this last December after I had been going around with one decent leg for 6 months and I wonder if this is related to the ATR. Anyway it does seem to be permanent.

This is all now and I am signing off.

At the end of October my wife and I treated ourselves to a couple of days at a Health Spa in Bournemouth. At the time I could not walk without pain so took the crutches just in case. These were useful as while my wife was busy with retail therapy I was independent and able to walk around the town and along the prom quite well. The hotel had a pool and a hydrotherapy suite. I found the best thing for the Achilles was to walk in waist deep water. But really the best thing about the weekend was the aromatherapy massage . .  bliss.

I had been exercising on my exercise bike each day more or less and in November took my road bike for a ride. This was a great success. I have been out a few times since and can now go up some minor hills but I have more work to do to get back to my old fitness.

I have had 3 more physiotherapy sessions and Sue said I will have reached a milestone if I can do a heel raise on only my bad leg. I still cannot really do this -  at least not without some help. But when I mentioned dancing she said it would be good therapy. So I have now been twice. It is modern jive which is a slow type of jive mainly and it makes you push off with your toes. I found that my bad leg was getting tired halfway through the dance and I found that if I  waited until later in the number before I asked someone to dance then it was not so bad. The second time I found that it was my knee which was the limiting factor, not the Achilles or calf muscle, so I need to get on the bike a bit more. Still, I never thought I would be dancing this side of Christmas.

Yesterday, (and this is 4 months post op) I went on a 6 mile walk with friends and had no problems at all! I was ready to call it a day but not because of my Achilles, just generally tired but no limp and no pain.

My ankle still gets swollen at the end of each day but I detect that as the calf muscle is improving the swelling is not quite as bad as it was. The site of the operation is still very thick and quite numb and I suspect this may be permanent.

However, I have noticed one strange thing - if I sit with my legs outstretched before me and, without any additional help, make both feet point as near to my body as possible, I find I can angle the bad foot more than the good foot! I assume that this means the bad tendon is longer than the good tendon. Anybody else notice this?

Overall I am very pleased with progress but need to get out on the golf course. Perhaps this will be in the next blogg.

16th November

Well, it’s now 11 weeks since my second operation and overall I am quite pleased. A typical day for me runs something like this:-

I drag myself out of bed. I usually have back pain (long standing problem) and of course a stiff AT.  Before getting dressed I do my exercises. These take 15 - 20 minutes and comprise:

• stretching AT
• heel lifts
• back stretching exercises
• tummy exercises using my cruncher 

After breakfast I do 5 minutes on my exercise bike to warm up my leg muscles and then walk the dog, a distance of about a mile. I keep the heel lift orthotics in my walking boots and I take my telescopic walking sticks. These are useful when negotiating slippery downhill stretches and going uphill. Sometimes I use them on the flat to help with walking with  a normal gait. I find I tend to walk with a limp when sometimes I do not need to. I think this is mainly  because my calf muscles in my bad leg are considerably weaker than my good leg but it is also partly a mental condition - I have not walked normally for over 4 months now. I still sometimes have a pain low down in the AT but it is bearable and mostly I am pain free. I am very concious of the need to be careful when negotiating hazards such as slippery stiles as a slip could be disasterous.

During the day I may go out in the car. I have been driving short local journeys for 2 weeks now so have some very welcome independence. I am still reluctant to take long journeys as having ruptured my AT twice the last thing I need is another rupture when braking hard. If I do not go out I usually make myself useful doing DIY around the house, or maybe even clean the oven (unlikely though). Generally, I feel I am more help to my wife Elaine now as I can do the shopping, walk the dog, or do some cooking.

I try to repeat the stetching and heel lifts a few times during the day. Unless I have been sitting with my feet up I find that my leg gets swollen later in the day. I find that an occasional massage helps reduce the swelling.  My Physio says that the calf muscle acts as a pump and until it recovers the leg will continue to swell up. At around 4 pm I walk the dog again.

Last weekend we visited our daughter Caroline who presented us with a third grandchild - a daughter, Martha. This was a very pleasant experience but I mention it because I forgot to take my anti-inflammatory pills which I take daily to help with arthritis. I noticed that my AT became stiffer and it was not so easy to walk. What I am not sure of is - do these pills assist in my rehab, or by preventing pain are they allowing me to do too much? Who knows? I need to take them anyway as I get bad stiffness in my joints, especially the back and knees.

A few weeks ago I calculated that I was about to run out of outpatients insurance cover so I agreed with my physiotherapist Sue that I would self administer my rehab for a while. I was not entirely happy about doing this but I could always go back to her anytime if necessary. I have since decided to see her every couple of weeks as I think I need to know how I should progress in order to keep moving up a level.

At the last physio I mentioned to Sue that my leg was very stiff in the mornings and she showed me a picture of a type of sock that can be purchased (at vast expense) which attempts to keep the foot at right angles to the leg. Back home I managed to find a way of doing this with the bits and pieces I had. I used a couple of straps with velcro which I put on at bed time. It was pretty successful - I was definitely less stiff when I got out of bed, but I found it tended to slip off during the night so have to use some sticking plaster to prevent this. I wonder if anyone has purchased the sock - it has a piece of elastic streching from the toe to the top of the sock. I have tried to insert a photo at this point but not sure if it has worked.

23rd November

I have had another physio session. This time Sue gave me a wobble board to use - to strengthen my ankles. My leg feels stronger and I have no pain when walking but still have a slight limp. I still am nowhere near lifting myself up on my toes using my bad leg only. Sue says this will be  a major breakthrough when I can do this. Perhaps this is when I will feel safe to go back to dancing which I was enjoying so much before this happened. Must remember to ask Sue if I could try some gentle dancing before this stage.  I have now dispensed with the walking sticks and the orthotics. I tried extending my walk by a small amount the other day and realised how unfit I am. But it could be my age - I turned 63 ealier this month.

I think that is all for know so until next time - BYE!

Chris

 

Today is 7 weeks since my operation on August 28th. By this, I mean my second operation and all future posts will be reference to the second op. I expect my rehab to be somewhat more than a year from this date since there is more trauma and healing will be slower than most. Let’s say  October 2009 - wow, this sounds a long way off!

Yesterday I had my first physio post op 2. Sue said my leg was more swollen and tight than after op 1but I was expecting this. She gave me ultra sound and some quite painful massage. There is much work to be done to get the swelling down and she recommended that my wife Elaine helps by  massaging it. I felt that despite the consultant’s advice that I take it easy for a couple of weeks, Sue wanted to get things moving straight away. She asked me to rise up on my toes. I found it difficult not to just use my good leg and could only put 10% on my bad leg. I also needed to hold onto to something to keep my balance. She told me to stop using the crutches as I can be FWB now and if necessary only use one to warn people that I am fragile. I need to start walking normally by taking short strides and pushing with my toes on my bad leg. I really have to concentrate to do this, I have not walked normally for 15 weeks and I have forgotten how. There were a couple of other exercises intended to stretch the AT.

I mentioned to Sue that Elaine and I wre planning a break and had booked a couple of nights at a Spa Hotel at the end of October. Sue said that using the pool will give me good hydro therapy and suggested some exercises.

This morning my leg was really tight, much tighter than yesterday. Perhaps this was the result of the physio and my attempts at walking. It took a lot of work to get it going. I have been in more pain today as I have been trying to walk.

Inspired by another blogg I took some photos of my ankles and legs. It might help if I can see the swelling go down. I was quite shocked to see the difference between the two legs. I will try to take photos each month.

I managed to do a bit in the garden and even some housework this morning to keep mobile. This pleased Elaine when she got in - this is quite a rare event for me to volunteer to do housework. But Elaine has been great over all these months  and now I can move around I want to help her as much as possible. I am also doing most of the cooking these days. I choose a couple of new meals each week and Elaine buys the ingredients.

I was really pleased to get some feedback from people who had read my account of the first 3 months. I am beginning to feel part a community. I would like to hear if anyone else has ruptured their AT twice. It is going to take quite some time to read everyone’s bloggs but I am sure there are some interesting stories there.

What I really would like to know now is 1) when can I expect to be able to drive? 2) has anybody had two ruptures like me?

This post covers my initial injury on 1st July, my second injury on August 20th through to today. I hope to keep you posted on future developments.

1/7/08

This was the day of my injury and the start of my ‘different’ life (at least for the next year). I ruptured my achilles tendon playing tennis with friends in my village. It was Wimbledon week and my lady friends Jo and Jan both suggested I join the weekly lady’s “Crap Tennis” session. After a knock up I felt my calf muscles were stiff so tried some stretching. Someone suggested playing  a game. It crossed my mind that I should have done some warming up and I felt some apprehension, but not sure why. I found my game was not up to much -  it was at least 5 years since I last played. Sliced forehands were best and sent the ball curving away into the RH corner. Topspin shots very hit and miss. Serves embarrasingly bad. Threw ball up and it went all over the place so were embarassing. Seems like I was losing control of my hands. Then in 3rd game the ball was just out of reach to my right. Set off after it and immediately felt a snap and collapsed to the ground. Not much pain but knew immediately what it was and felt a sense of despair. Got carried off the court and felt a bit faint. Probably shock. When I recovered from that I was driven home by Jo who gave me encouraging words of hope. Spent rest of evening lying on sofa with ice pack hoping for the best.

 

2/7/08

Examined my options. I phoned the surgery and asked how to get referral for private treatment. Was told I needed to go to the local hospital. Trapsed off to Trowbridge hosipital, waited for an hour then was told my GP must refer me. Heck! Got cross with surgery and made an appointment for later today. Saw Dr Mathews who confirmed a rupture, and gave me the referral I needed. I could not get an appointment today at Bath Clinic so opted for the Ridgeway at Wroughton. Saw Mr. Foy in the afternoon and had scan. Was told the injury was bad and achilles was torn and shredded where it meets the muscle. Not encouraging. Operation arranged for next day.

 

3/7/08

Had an early breakfast then no food after 7.30 am. Arrived at Ridgeway at 11 am and was shown my private room. All very comfortable. Nurses popping in and out to get me ready and do some tests. Was wheeled to the operating theatre, had a general anaesthetic and Mr Foy operated about 4 pm. Woke up in private room with leg in half conventional plaster. Overnight stay.

 

4/7/08

Had some pain in night which was helped with morphine and codeine. Later a physiotherapist gave me instructions on negotiating stairs with crutches and recommended some exercises to keep leg muscles working (from this point I religiously did these every morning even though they were very boring, but worthwhile). Made the most of my accommodation and stayed till after lunch.

 

5/7/08

I borrowed a special waterproof bag for my leg and with the aid of a plastic chair was able to take a shower. I can get up and down stairs OK but find it easier to get up the stairs on my bottom. I cannot do much to help on the house, I cannot carry anything. Elaine has to do most things.

 

14/7/08

Today my half plaster was replaced by a full fibreglass plaster. Mr Foy was not available and had left instructions for the nurse. The nurse was not sure what was meant by the ‘neutral position’ so she assumed it was with foot relaxed. I have my foot pointing down so I cannot put weight on it but I don’t suppose that is a good idea anyway. Later I discovered that ‘neutral position’ means 90 degrees.

 

17/7/08

I had been unhappy about the angle of my foot. Mr Foy was on holiday so I saw Mr Fogg who checked orientation of the foot. Mr Foy had asked for it to be put in neutral position and I wondered whether this should have been at 90 degrees. Mr Fogg said it should be ok and there was an advantage in tendon being compressed. He also said I had one chance to get this healed and must not damage it. I thought about this carefully.

12/8/08

I am doing these daily exercises. a) Sitting up on my bed I lift each leg 200 times b) lying on back I do 100 cycles each leg c)  50 crunches d) usual 15 half pressups to flex my back. Got up stairs on my bottom. Elaine doing all work such as mowing lawn, walking dog, cooking, shopping, driving. I decided to continuing working whenever I can so I spend time sitting in the lounge with my IBM laptop on my knees (or occasionally watching Olympics on TV!).

 

14/8/08

Today my plaster was removed. I had borrowed a leg brace from my friend Ric but  Mr Foy said it was not necessary to use it as any movement would be limited by pain. (This proved to be crucial later) I felt it would provide some protection but decided to manage without.

 

18/8/08

First day of physio. Sue gave me 3 exercises. a) pulling on foot with a strap b) standing up and putting foot behind to stretch c) lifting up on toes (this seemed difficult). Started to feel really good that I could now make progress. I was walking without a crutch although slowly and gradually stretching the achilles. Sue said she could bend foot almost as much as the good one, and much better than she could with my friend Ric at this stage. (Ric had ruptured his Achilles the previous year)

 

17/8/08

Now I am walking around slowly with one crutch and feeling pleased with progress.

 

20/8/08

Disaster! After disagreement with my wife Elaine (not related to this condition) I lost my temper in our house, forgot all about my delicate condition and stormed out. I immediately had the same reaction as I had on the tennis court - a terrible sharp pain in my achilles - and immediately felt a  sense of dread.  I had done exactly what Mr Fogg had warned against - not to rupture it agan!. I tried to rest it, hoping against hope that it was only scar tissue or something minor. Went out in the evening with friends to celebrate Jo’s birthday and that helped take it off my mind.

 

21/8/08

Felt dreadful today and sick with worry. Saw physio Sue at end of day and she ran some tests. She thought there was damage as a) she could feel an indentation in Achilles that was not there before b) there was no reaction when she gripped my calf muscle c) I could not stand up on toes at all. So it does not bode well.

 

23/8/08

Still feeling in shock and panicked. I keep seeing images of me in a temper and feel scared that a proper repair will not now be possible. I had a dream that my leg was fine and I was walking about without any problem. Then I woke up to face the reality of the situation. I feel very cross with myself, and Elaine. I know that I did the damage myself but cannot accept that it had nothing to do with her. But she is probably right - I should control my temper.

 

24/8/08

Met daughter Susie and boyfriend Chris in the New Forest and it helped me take my mind off the situation. Susie talked about her new job which started this week and she was very enthusiastic which pleased me.

 

25/8/08

Today I decide to do something useful to improve my mood. I cleaned some kitchen cupboards which pleased Elaine. First time they had been cleaned in years.

 

26/8/08

Back to work with IBM (at home) and that helped my mental state. Foot still swollen but perhaps not quite as bad but it still fells very different to prior to last accident. Cannot lift my foot.  I could easily panic again and have to force myself to think of other things. Dreading the appointment with the consultant tomorrow.

 

27/8/08

Had bad night lying awake thinking of what news today would bring. Elaine took me to Great Western Hospital Swindon as it was quicker to get a scan there than at the Ridgeway. Had scan at 0850 and radiologist confirmed my worst fears - the achilles had torn in same place as before. Had a long wait until my next appointment with Mr. Foy. Elaine buzzed into Swindon to do some retail therapy. I could do with some therapy of my own!  I decided to hang around at the hospital. I read a paper, talked to a friendly nurse and slept for a while in a chair. Had a second breakfast to past the time. Saw Mr Foy at 1200 and he confirmed the need for a 2nd operation as before. He thought it incredible that the only person who had ever asked whether they could rerupture their achilles had in fact done exactly that. I decided not to mention that the use of Ric’s leg brace would have prevented this accident. I would have liked some reassurance that something can be done but left not knowing what my chances are. He said he hoped I would be operated on tomorrow.
When home I began to feel better as at least I knew what had to be done and was not just waiting for news. However it all came back when Elaine suggested it was not caused by me walking in a fit of temper. (This got me wound up again and slept in guest room!). My friend Mick  phoned to ask how I was. Also spoke to Caroline and Susie who sounded more sympathetic than Elaine wich helped. Good to know that people care.

 

28/8/08

Felt slightly uneasy about going through this operation for the second time. It all feels so unncessary. Although it was a long wait in my rooom - there so many people coming to see to me - nurses, meal service, blood pressure, pain killers etc that time goes quite quickly. It is all very comfortable in a private hospital. Did some work on laptop in afternoon. Had the operation at about 4 pm. Mr Foy came to see how I was afterwards this time. He said it had gone well although he had to take some tissue from somewhere else (do not know where!) and inclined the foot more so that he could make the repair.
Found I could not eat any food as my mouth was so dry, unlike last time when I devoured 2 rounds of sandwiches. Probably due to the tube put in my throat. Spent a relaxing evening watching TV in my private room attended by nice nurses. At least there are compensations!

 

29/8/08

Slept much better than last time. I had been given some morphine at about 10 pm last night and this seems to have lasted all night.
Had good cooked breakfast and cooked lunch then Elaine came to take me home.
I did not feel that lively for the rest of the day so took it easy in the evening.

 

30/8/08

Apart from a couple of codeine I did not take any more painkillers after this point, which really surprised me.

 

Had one of the few sunny and warm days this summer so sat in garden and read. Jo came round with a computer magazine as a gift in the afternoon. Ric and Jan came round in evening and we played cards. Elaine who professed to know nothing about cards  nearly won! It really cheers me up to have people round.

 

31/8/08

Weather turned bad again. Did not go out. Felt grim. At least I am not missing a good summer!

 

1/9/08

Tried some work on laptop but not much to do. Spent about 2 hours researching and buying 2 pairs of shoelaces online. That shows you how desperate I am! Again I did not go out. I cannot see how I am going to survive this. I can only take one day at a time. I cannot make any plans for the future. The day when I get back to where I was 2 weeks ago seems a long way in the future. I also feel much less certain that this will be successful now. I still feel angry with Elaine for making me lose my temper and cross that she cannot take any blame whatsoever. I am having to put these thoughts to one side as it only starts another argument if I bring it up.

 

2/9/08

I am trying to arrange evenings out with friends to help with my boredom.This evening I am going to the Wilts Astronomical Society meeting in the village pavilion with Tony and Simon so I have something to look forward to. Logged onto IBM laptop but not a lot to do again. I do not feel very productive which does not suit me. I am sure that when my IBM project comes to an end I shall be leaving IBM and then what? Food and fuel prices have gone up and house prices gone down and  I know it is going to be more difficult. The society meeting in the evening was on the Hubble Space Telescope. Very interesting and worthwhile.

 

8/9/08

Back to the Ridgeway and had plaster changed for a fibreglass version. This time Mr Foy was there and my foot was made to set at as near to 90 degrees as possible. This will be on for another 4 weeks

 

 24/9/08

I am finding I need to get out of the house each day otherwise I get frustrated. Today I had a chance to go with Elaine to look at new curtains. Even this would have been preferable to staying at home, but did not go which was a mistake. I really miss doing the things I enjoy like walking, cycling, golf. I did not enjoy Strictly Come Dancing so much on TV last week because I do not knjow when or if I will be able to go dancing again. I am finding it more and more difficult to do all my exercises as they are so boring. But they do help I think. I wake up and feel my calf muscle stretching on its own as if it is saying “I want to work!”. I am thinking of buying some elastic things to help with execising thigh muscles. I also looked at exercise bikes for auction on ebay.

 

30/9/08

Tonight I went with a group of friends to a local folk night for the first time. It was quite a surprise when we asked to sing something but fortunately Jo volunteered and her effort was well received. My effort to keep occupied paid off as we had a good time.

 

9/10/08

Plaster came off today. Hooray! The nurse got to work with her circular saw but I was more relaxed this time. When it came off I saw this thin looking leg with no muscles. I put on both shoes with wedges in to lift the heel.  I explained to Mr. Foy that due to the second operation I have used up a lot of my out-patient allowance from my insurance company and would only attend another appointment with him if it was really necessary. He was happy about this, so we said goodbye and he said he hopes he will not see me again. I really hope this is true this time.

 

14/10/08

My whole ankle if feeling very stiff and tight but each day I find that it is feeling a bit easier. I am trying to walk as normal as possible with the aid of 2 crutches. I find it difficult to remember to put the opposite crutch forward to the leg that is going forward. When I do this it feels like normal walking. I am not trying to lift the heel yet, I will wait until Sue the physio tells me it is ok to do this. I am however using my green piece of dynaband to exercise my quads and this feels good. I have also been trying to buy an exercise bike on ebay but have been outbid twice. I am using my leg brace for additional support when I am doing jobs around the house, as a precaution against an accident. I do not find it very comfortable to walk in this so prefer to manage without. I wonder how my rehab would have been if I had used it like so many others have.