One Week - Two Week Post OP

Early in the week, I got the call from the Surgeon’s office to set up my appointment for Thursday, Oct 21st. That first week went by amazingly fast! I kicked the drugs by day 4. I have to give myself an injection of blood thinners - yikes! But it is getting much easier although my technique has a bit to be desired. It’s a good thing the bruises heal fairly quickly or I would be running out of room on my tummy. I chose this location since it is convenient (I had tried my thigh and missed the fatty area and stuck myself in the muscle - just a bit more painful!). Word spread quickly of my injury and “confinement” and we were overwhelmed with the response of friends, family, and neighbors. I have a group of 8 gals that I meet with and they arranged dinner for us for two weeks straight. So everyday I would have a dinner delivery, coffee delivery and a visit if not once but twice a day for the first week! It was really amazing and I as well as my husband are eternally grateful for that. Kevin felt confident to leave me to my own devices during the day after getting the kids up, and out the door to school. I also have a babysitter that we kept on for one day per week when my daughter started Grade 1. She also has a part time job elsewhere and was able to switch her shifts in order to be able to pick my kids up from school and take them to any after school events. I have developed a great routine at home as well. Even though longing to try and get up the stairs to have a shower I resigned myself to hanging my head over the sink to wash my hair and giving myself a good ole’ sponge bath.

Thursday arrived and I was finally going to have my first foray into the outdoor world since coming home from the hospital. I was soooo excited! The first order of business was to try to get into the minivan. It is definitely higher than my brother’s car. Since the passenger door to the minivan didn’t open very wide, we tried to get me into the back seat. We used the transfer board to make the bridge but is was pretty steep. I got about 2/3 of the way up and then the board slipped and I came crashing down into the seat but not without smashing my left foot onto the ground. The pain reverberated right up my achillies. Man did it smart! We then tried the front seat again and was able to make it and we were on our way. At the hospital, they cut off my plaster half-slab casts. I was not expecting the gruesome scene that lay before me. They had stapled my incisions. I counted about 11 in each leg. The Doctor looked at them and said they looked great. Yeah right. I told him about the leg smashing incident and he checked it but couldn’t see much movement as my legs were rather swollen he didn’t seem to think I did any damage as he thought I would really have had to wrench my foot up to do injury. They decided it was still too early to take the staples out so they fitted me with a pair of Aircasts with 3 lifts each and sent me on my way with an appointment date in another week.

Two Week - Post OP Check

Once again, the next week went very quickly. I had at least one visitor every day bringing me my much craved coffee or someone bringing us dinner. I didn’t do anything stupid on my own either. I good friend and PT dropped by when he heard and gave me a great layman’s description of what the surgeon did and why it was so important not to activate the tendon. He also assured my that I could actually stand in my boot (carefully that is) and briefly and he encouraged me to try it a couple of times a day. This he said would help to keep my foot muscles from cramping and stiffening. Before I knew it, Thursday was here and off we went to the clinic again to get my staples out. I was pretty apprehensive about this procedure and for good reason too. It kinda hurt! Once all the staples were removed the nurse put tapes on the incisions and they felt better. I was to keep these on for 10 days. They also suggested to sleep without the boots and let the incisions breath. One thing I was concerned about was actually how on earth did I rupture both? My research online suggested that my taking an antibiotics of the flouroquinoline family increased your chances for tendon rupture (namely the achillies). Now I did have an ongoing sinus infection late last fall and into January 2010 and took two antibiotics. After pulling my prescription records from the pharmacy it showed that I did not take one of these. I asked the surgeon why he thought I did both. He told me he thought it was just plain bad luck. He said the tendons were healthy, they had minimal shredding and they went together very well. So I guess I can get over the why and just get on with the what now. He told me that in one week I could start putting 25% weight on my legs. I asked him who he might suggest I do that. He replied with that he had absolutely no idea. He basically said I had to be ultra cautious and then some. I could also take out one wedge at the next one week mark and can take another on with each consecutive week until I see him next. Also, after two weeks of 25% weight, I could up it to 50%. So armed with all my new found knowledge (or lack of) I was released until Nov 25th for my next appointment.

Here is a pic of my incisions after the staples were removed;

Frankensteinish

Frankensteinish

8 Responses to “One Week - Two Week Post OP”

  1. Hi Cheryl - Well, now I am caught up with all you have written (and looking forward to more!). Maybe you can write an article for you local paper - I am sure people would find it fascinating and educational! Anyway, your attitude is great and that is a large part of it all. Sounds like you have a great immediate family (those kids are sweet at that age!) and a trooper husband. This story should put my husband in his place - he has been much better help the second time around but yours had no way out!

    It is amazing what one can do when there is no choice. You are making a great go of it all. And you do find out what great friends you have. Guaranteed you will have an opportunity to repay it to someone within a year or two and you will be happy to do so knowing how helpful it was to you. That is a big part of the silver lining in these situations. There is good in almost everything.

    TAKE CARE and keep blogging. We are eagerly awaiting more!

  2. I can’t offer any advice or anything, I’ll leave that to Norm and Gerry. But I’ve been wondering how you were getting on. Your husband and friends sound like real stars and you seem really positive.
    Keep blogging, I’m rooting for you

  3. A couple of thoughts though more useful in the very beginning but worth considering. The Knee-walkers are great and for you it might aid in the Partial Weight Bearing area as you could have one leg completely NWB and the other pushing a little bit (but you have to be very careful to push flat footed. This might be riskier than nothing so talk to PT about it). The other suggestion is, don’t forget crawling. I was shameless crawling upstairs and around to get to where I wanted without bearing weight. So, while not ‘elegant’ it gets the job done, especially if you are dying for an upstairs shower!

  4. Unlike Norm, I have to say that I’m at a loss for words about how you can do this 25% weight bearing business with two surgical repairs. Crutches don’t seem like a particularly good idea because it would be very easy to lose your balance and end being 100% weight bearing on one leg or the other, plus when you stop moving with crutches your weight has to be primarily on one leg. You might be able to do it with crutches but I would still be very concerned about balance. I don’t know, nor can I imagine how difficult it would be to get around with a boot on each foot. I know I wouldn’t want to try it with the Don-Joy MC Walker boot I had, but I don’t know if the air-cast boot or Vacoped would really be any better. I think what you need to do is find a really good PT and see what suggestions he/she might offer about how you start being PWB on either foot. Good luck and let us know what you do.

  5. What about using the back of a sofa, so that most of the weight goes through your hands. Or some kind of harness system (like kids have the jolly jumper!). Actually, my calf raises started as an isometric push into a wall (lying down) and graduated to a seated calf raise, which you could add more weight to by putting something heavy across your legs (e.g. dumbells, or a powerbag)

  6. Gerry gives me credit for having a plan to get you PWB, Cheryl, but I don’t! Get Kevin to install a chain hoist on a track that runs along the ceiling!! :-) Using crutches generally DEPENDS on being FWB on one leg, period! Your weight shifts from the two crutches to the one leg, and back. If and when your TWO booted legs together can bear your weight, you’ll be able to do a modified crutch-walk — two crutches bear the weight while BOTH legs swing forward and “plant”, then roll forward onto the crutches again. Until then, you’re looking for little exercise fixes like Bronny’s, or a chin-up bar, or a good strong walker. I’m not sure that any of them would work well for transportation, just for short exercise sessions.

    Getting slid or dumped into the deep end of a pool could still be fun, as long as you can get out. Swimming and also walking in chest-high (and gradually shallower) water. Do you have the upper-body strength to hoist yourself out of a pool and spin onto your bum? It’s pretty routine for most guys, but many women don’t have that kind of arm strength. If not, you could get hauled out.

    Now that you’re 4 weeks post-op, you could reasonably be proceeding toward walking in the boots. My fave protocol (from the just-published UWO study) starts PWB at 2 wks, and “WBAT” (as tolerated) at 4 weeks. For most of us, the main challenge was getting the bottom of our foot (esp. the heel) to bear the weight without hurting. Being gradual helped for most of us — but that’s EXACTLY where you’re short of options. When you can split your weight — and a bit of extra pressure from “landing” — on your two booted feet, you can move from the wheelchair to crutches.

    Rolling forward on two AirCast boots while crutching shouldn’t put any tension on your ATs, PROVIDED (a) that you’ve got the boots fairly snug, especially near the top, (b) you ALWAYS make sure you’ve got that extra plastic “L” mounted in the front of the boots, inside the Velcro straps! and (c) you “give yourself over” to the boots. That means that you leave your legs essentially relaxed and limp inside the boots, and the stiffness of the boot — NOT your ankle/AT/calf! — holds your toes down while your weight rolls forward. The boot will transfer all that force to the fronts of your shins, which should be able to handle it just fine. Same trick when you get up to FWB, and starting to walk without the crutches — which I’d have you trying soon, starting in a protected place (like between two long tables, type thing).

    If you’ve already started standing and moving slowly on two booted feet, then it sounds like your heels aren’t complaining much, so you may have the “as tolerated” part of FWBAT licked already. As I’ve said, moving to FWB is huge for the REST of us, but for you, it should be. . . huger!

    EVENTUALLY and GRADUALLY, your ATs and calves will naturally tend to “pitch in” and take some of the load off your shins, as they get stronger and more confident. (Then we can all start worrying about your special challenges when moving from TWO boots to “2 shoes”!!)

    Keep progressing, and please keep catching up with the great reports!

  7. wow i feel for you ! i can,t immagine this hell you must be going throu . it makes 1 achilles rupture a breeze

  8. Hi Cheryl,

    You certainly have found yourself in a tough situation! It amazes me you have been able to get around at all. I guess, like the rest of us, you have found ways to do what you need to do, only more so.

    When I wrote my long blog note last year about my rehab, I split the rehab into four parts. The first, wound healing, you seem to have accomplished. The next two, flexibility and strength, you can work on while lying down. Those can be as simple as a towel around the ball of the foot, pulling up with your arms to gain flexibility, and pushing down (using your arms to provide resistance) with your calf to gain strength. The fourth and trickier part is keeping the rest of your body in shape. Swimming would be great, if you can find a way to do it. In my blog, I describe an exercise where I did a “pelvic tilt” sort of exercise, lying on my back, digging in a heel, and lifting my butt off the bed. This gives a fair workout to the upper leg muscles.

    While simply getting around is, obviously, important, you will get better faster if you can do more than that, and do some things aimed specifically at ankle flexibility and calf strength. With some imagination, you may find all sorts of ways to work on flexibility and strength in your unique situation.

    Maybe this is all obvious to you, but I thought I would write in case it might help.

    Good luck,

    Doug

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