7 Weeks Post-Op: Thankful for Good PT!

June 29, 2013

This week marked 7 weeks since my surgery and the difference between today and a week ago is astounding to me! Last weekend, I was in the boot, on two crutches, PWB, no driving, no walking. In the past 7 days, I’ve ditched the crutches completely, gotten clearance to drive again (yippee!), taken several steps on my own two feet (without the boot or crutches!), and gone FWB full-time. I feel so much more independent and functional. When I am out and about my surgeon wants me to keep the boot for a bit longer, but he gave me medical clearance to drive so that was huge. (I just remove the boot while driving.) A week ago I was also still crawling up the stairs on my hands and knees (I am lame - never mastered going up the stairs on crutches!), but now I am walking up the stairs on my own power.

I started physical therapy three weeks ago (going twice a week) and that has made such a huge difference. Each session is about 90 minutes, starting with massage, manipulation of the tendon to increase ROM, ultrasound of the incision, stationary bike (without boot), stretching and weight bearing exercises, and then icing. Each session I am able to do more - my ROM increases, I am able to put more weight on the leg, my RPM on the bike increases, etc.

I was fortunate that my daughter and my husband had already undergone physical therapy for other injuries so we were familiar with this PT practice and I knew that was where I wanted to rehab. In fact, I called them the day of the injury and my therapist has been advising me from the beginning. He is very focused on getting me back to my previous activity level (running competitively, doing high intensity classes at my gym, hiking, etc.), which is obviously exactly what I want.

My therapist did advise me to ice my leg several times a day for the next few days. The increase in weight bearing and the walking have definitely increased the swelling and the soreness. Icing makes a huge difference. The first 15 minutes in the morning are also a challenge - so stiff. I try to take it very slowing, though, and things eventually loosen up.

My next big hurdle is a trip I have planned for ten days from now - flying with my two kids from California to the midwest and then driving 3 hours to two separate family reunions. I feel confident I can handle the traveling and the trip itself - the only thing I am worried about is the driving. At this point, I’m not sure I will be to handle that much driving. Yesterday I realized that driving with the injured foot is basically like doing constant stretching exercises - fine for 15 minutes but tiring after a while. There is no way I could drive for 3 hours right now. We’ll see how it feels in another week. Whether to make the trip or not will definitely be a game day decision.

How it all began…

June 23, 2013

I am a 39 year old (40 in a few months) woman - played sports my whole life, very active, two young kids, one busy husband, owner of a demanding marketing business. But - for the last 8 weeks I have operated from the comfort of my couch, with my right leg elevated, iced and splinted/casted/booted.  No walking, no driving. It’s been a long, humbling journey. I am 8 weeks in on this journey, but I should probably start a the beginning - when I heard that horrible SNAP!

April 26 I was doing a group fitness class at my gym - the same class I had done probably a couple hundred times before. We were in the middle of a 90 second interval - doing some kind of jumping, sliding, kicking move. Then it felt as though the woman next to me had kicked me - I even looked at her like "What the hell?!?!" and she looked at me with shock and asked "What was that?!?!". She had heard the snap too. I immediately fell to the floor and knew exactly what had happened. (I had just watched Kobe Bryant rupture his Achilles two weeks earlier).

Fortunately my friend was in the class with me and drove me to the ER where they confirmed what I already knew. In hindsight, I know that ER visit was probably not necessary, but I would still recommend going to someone who is in doubt - they were able to put a nice splint on my leg and immobilize it really well and they also gave me pain meds. It was a Friday morning and I knew I wouldn’t be seeing a doctor for a few days, so I’m glad I went.

Fast forward… got an MRI on Sunday, saw a surgeon on Tuesday, scheduled surgery for the following Wednesday (May 8). That was followed by  8 days in a splint, 3 weeks in a cast, and now 4-6 weeks in a boot. A few things I learned during those first few weeks:

  • Surgery: I was adamant about not having surgery. I have had two c-sections, but no surgery other than that and I had never been under anesthesia before. I was terrified of surgery. My surgeon - who came highly recommended and whom I have been very happy with - told me that I would have to wear a full leg cast for several months if I didn’t have my tendon surgically repaired. I knew that would not be a good option for me so I chose surgery. I now know that there are lots of people who go the non-surgical route (without the full leg cast!) but I would probably still choose surgery. Just my personal choice.
  • Pain Management: I feel lucky that my pain was very minimal, even after surgery. I do not handle pain meds very well and only had to take two doses of a fairly low-power med (Ultram, I believe?) immediately after surgery. I had Percocet but never used it. I stuck with Ibuprofen and thenTylenol. I mention this because everyone told me how much pain I would be in and that just wasn’t the case for me. I credit this to lots of icing, elevating and just good luck. (And maybe a high pain tolerance.)
  • Ice Packs: I am so glad that the day of my injury my husband immediately bought me a great ice pack specifically designed for ankles (it is in a sleeve with a velcro wrap). At first it was too painful to actually wrap the pack around my ankle - I just laid it on top, but the past few weeks I have been using the velcro and really wrapping it and it is awesome. I only wish I had gotten two - it is so crushing when you realize you forgot to put the ice pack back in the freezer! Also, I am now icing my knee at times because of the strain caused by the boot (that’s another story). So my advice - invest in good ice packs early on because you will be using them for months.
  • Set up a good spot: My spot from day one has been on the couch. I have a stack of pillows I use for elevating and I keep everything I need on the table in front of me - magzines, remotes, chargers, laptop, water bottles, meds, etc. One of my best purchases? Baby wipes! The first couple weeks I used the wipes for everything: cleaning up when I spilled food (inevitable when you basically laying on the couch!), cleaning my hands, but most importantly - cleaning my toes and whatever other part of my leg I could get to. Once my cast came off I used the wipes to clean the whole leg - loved it.
  • Showering: Fortunately for me, my husband immediately identified a great shower plan for me. We have a shower stall with a door and he put a folding chair in the shower and one outside. I would sit inside with my injured leg propped on the chair outside. I then use a handheld shower head to bathe - it is AWESOME. I am sure you can buy a handheld shower head at Home Depot for not much $$$ - it is a great investment. It allowed me to shower without worrying about getting the cast wet and it is still great for me now because I can quickly and easily shampoo, etc. Highly recommend it!
  • Getting around: Around day three it hit me that since all of our first floor is wood flooring, I could use my wheeled office chair to get around - it was such a revelation! I cooked dinner from my office chair, did laundry from it, carried my coffee cup and meals around on my office chair, etc… I still used my crutches whenever possible but the chair was such a lifesaver when I needed to have my hands free.
  • Mechanics: Over the past two months I have learned to really keep an eye on how I am using my body - the slightest turn of the leg while crutching can tweak your knee… slumping while using crutches can hurt your back… putting too much weight on your hands while crutching stresses your wrists… I have really tried to use as normal a motion as possible for whatever I am doing to avoid hurting other body parts. I still have some knee pain (caused by partial weight bearing while in the boot), but I think I would have been in much worse shape if I hadn’t really focused on my movements. Also, when using crutches you can get a pretty good ab workout if you use them properly - upright, squeezed in to your sides!
  • Work: I have been so grateful that except for a couple groggy days right after surgery, I could continue working this entire time. I do marketing consulting and except for one project that I had to subcontract out, I have been able to do all of my work from my laptop on my couch. This has been great not only because I have continued to make money, but it has given me something to do all day, every day. I am so, so grateful for that and I really feel for people with this injury who can not work from home. That would be rough. My only advice would be to find yourself some projects you can do online (blogging? organizing family photos? anything!) and do it. Also - online shopping is the best! :)
  • Depression: This can be a very depressing injury. I think probably everyone who has suffered a significant injury like this will experience bad days now and then. For me, the important thing was focusing on each day, one day at a time. Also I learned the hardway that being stuck in your house for too many days is not good for you! I know now to call a friend and ask for a ride or a visit if I’ve been home a day or two. I also accept help when it is offered, which did not come easily in the beginning. I also try to remember that this is an injury that WILL get better - unlike a disease that may not. It could be worse. My mind is still strong and my body will be strong again one day too!
  • Children: As I mentioned, I have two young kids (7 and 9). This injury has been rough on them. Not only could I not do the usual things for them (tuck them in, go on field trips, take them to the park) but I suddenly needed THEIR help. It’s a shock to kids to have their parent be powerless. But - they are surviving and they’ve actually learned a LOT of new skills - everything from taking care of the garbage, to walking the dog, to putting away laundry and helping cook dinner. All stuff that they probably should have been helping with before but I was too Type A to make them do - so it really has been a win win! If you have young kids, just try to be patient with them. They don’t understand the injury and it really rocks their world. They’ll come around eventually and they’ll end up being your biggest cheerleaders!

So that is my two cents about this injury overall - I hope it is helpful to someone. I am so grateful for everyone’s posts - they are such a great source of information and support. I will post more later about where I am in the recovery process now.