How it all began…
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.
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Calimama,
Agree with everything you said! Having small kids adds quite a different element to this recovery! I have a 9, 8, and almost 2 year old and it definitely rocked their world! I feel like I have learned to accept things done not just the way I would do them, such as my husband folding t shirts inside out (?what?!). At this point I’m just happy to be getting help with the laundry! So hopefully we all learn something about ourselves out of this!
Also, I made some homemade ice packs that I love just with gallon ziplock bags with 1 part rubbing alcohol and 3 parts water. They freeze but still stay pliable. And you can eat them as a mommy slushie when the kids are getting on your nerves! KIDDING!! I double bag them in 2 ziplocks and put them in a pillow case so you can wrap it around your leg. Easy and cheap!
Good luck to you!
Sorry to hear about your injury. You’ve made some great points. I especially agree about it being a great learning experience for kids. My children are older but they have never really had to do much around the house–but now they at least know how to do some things. Best of luck with the rest of your recovery!
Great post and very informative. A must read for anyone who is just starting on this journey. Good luck. You already know that every day is movement towards normalcy. Once you start PT (if you havnt already) you will really enjoy the feeling fo being able to move your foot and start weight bearing and weight bearing exercises. Geeting that calf muscle back is the biggest challenge.
2 main things, with the rant at the end:
If your injured-side knee is complaining about PWB, you must be doing something wrong, IMHO. PWB should be way easier than the FWB you’ve been doing for the past few decades, and I assume you didn’t have to ice your knee very often then. Are you hyperextending your knee in the boot? Make sure you roll over the boot sole, heel to toe, feet more-or-less parallel, pushing your knee forward to get that roll. RyanB has a video of good boot-walking on his blog page. FWB boot-walking shouldn’t cause any knee problems either, and should be about as fast and comfortable and normal-looking as the walking you did a few months ago.
BTW, I’m with you 100% on the office-chair trick, but I’m sorry how long you’ve been forced to use it, when you should have been walking around with your hands full for the past month or so.
It’s nice that you still respect your “highly recommended” surgeon after he gave you malpractice-level misinformation about your options when getting your “informed consent” for surgery. And it’s nice that you think you would have made the same choice if he’d told you the truth instead of a load of BS. It’s possible that Americans — though often more critical and skeptical of experts and authority than many of Earth’s humans — treat their physicians even more like Gods than the rest of us do. It kind of makes “informed consent” into a joke when all you get is BS.
About “a full leg cast for several months”: You now know that the full-leg cast part is pure malpractice-level BS. But you may not realize that for a non-op ATR patient, even going as slow as your “expert” is NOW taking you, is associated with inferior clinical outcomes because it is TOO SLOW for optimum results!! You’ll probably do OK with that old-fashioned slow protocol, but only because you got the surgery. In other words, the non-op approach generally requires a FASTER recovery than post-op, in order to get the best results. And it usually uses only boots, no casts, partly so you can start PT at ~2 weeks in. This guy may be great with a scalpel (or not), but he obviously EITHER doesn’t read and understand the published evidence, or he really needs to keep his O.R. full and doesn’t care about telling his vulnerable patients the truth. If there’s a third option, I can’t think of what it might be.
bit.ly/UWOProtocol shows one fast modern protocol that produced excellent results, and it would have gotten you walking FWB at 4 weeks in, while you were still casted. And Hillie and Suddsy have just posted British near-identical protocols using the Vaco boot that seem to have produced even LOWER rerupture rates (with and without surgery) while chopping about two MORE weeks off the transition to FWB without crutches. Hillie’s goes to FWB at TWO WEEKS in (op or non-op), and Suddsy’s goes to “FWB as tolerated” at the same point, which might add a few more days. Of course, your @#$%& was just imprixoning you in a NWB cast when the luckiest Brits were walking around without crutches at two weeks in — with or without surgery!! (I wonder how dumb or dishonest the NON-recommended surgeons are in your part of the world!)
Just imagine what chopping a month off your couch-lounging would do in the Depression and Children (and Showering) categories!!
Good luck and good healing! You’ve certainly paid your dues with the long slow rehab so far.
Norm - appreciate the comments and the intent with which they were delivered (I think), but please understand that you do not know all the details and extenuating circumstances of my injury, treatment or rehab. I think this is a great forum for offering support to each other and advice (when solicited), but I think some of your comments may have, unintentionally, fallen into more of a judgmental, non-helpful category.
I completely support those who pursue a non-operative route. I also support those of us who seek a surgical repair. What I don’t support is forcing that debate into a post that was merely meant to be helpful to others who may find themselves facing the same challenges.
Without getting into all of the details of my medical history, I can tell you that my tendon was recoiling at a rate that was not conducive to a normal non-operative repair protocol and my healthy tendon displayed a tightness that indicated healing of the injured tendon would be challenging. I share this not to continue the debate with you but just to show others that everyone’s case is different and at the end of the day, one must decide - in concert with one’s physician - what is the best, most reasonable choice for one’s own injury.
Thanks for this great post, Calimama! Mine are 8 and 10, and I’m looking for the same bright side about getting them to put their own laundry away.
As far as the ex-post-factor second-guessing about our choices between surgery and non-surgery…this reminds me so much of the Great Debate among pregnant women: take pain medication during childbirth, or not? People got so passionate about it. What really matters are the results.
Great idea on the office chair. Happy Healing.
Hi calimama
Norm doesn’t mean to offend, he’s one of the most helpful people you will meet, and because he cares he gets mad about docs giving wrong advice which they often do, I’m not saying your doc does, so when I read norms mail to you I understand where your coming from, you will both get along just great.
Norm sorry to speak about you but I can’t help putting my tuppence worth in, we are part of a great community
Sorry, thanks, etc. Calimama, I wish there was good evidence to suggest that Medical Science can predict which ATRs will respond best to which kind of care. There’s virtually none, and some good evidence to the contrary! The latest non-specific evidence is so contrary to what most Docs learned in Med School that it’s still giving the system indigestion.
I really am happy that you’re happy with your care, and I hope you stay happy. But care and information given by Docs to ATR patients seems almost random to me, and I’m frustrated by that. Your Doc’s recommendation for non-op ATR care — if he meant it, and wasn’t just trying to direct you away from it — was ridiculously counter to all the evidence on the subject, regardless of the specifics of your leg, tendon, and injury. My $0.02, of course, and totally academic to your recovery now. Happy to focus on that with you.