Weeks 8-10 Boot off, Flight home, PT begins

Hello,

Sorry for the delay. I think I was typing so much I ran out of time! I think I should add, before I go back and finish the story: Yes, I am back in a boot, but no, I didn’t re-rupture! Something else maybe PT related, but thank goodness, NOT a re-rupture…

8-10 Weeks

Anyway. After getting really used to the new angle, and no crutches, I was zipping about all over the place, feeling great. September 14th, 8 weeks to the day after the rupture, I had my final appointment with the Ortho Specialist in Swindon. It was a day of mixed emotions, as I was elated to finally get the boot off, but afraid to hear it hadn’t healed properly. As far as I was concerned, the non-surgical method seemed like nothing more than ‘magic’. Was my tendon really capable of healing and fusing itself ? This was my first appt with the specialist at all, as I’d only seen nurses and technicians before. Anyway, they had me take it off, I held my breath as the poking and stretching and rotating began, then the doctor said: "Well done, you’ve fixed it". My range of motion was a 4 out of 5, which was awesome, but my calf muscle was 80% wasted. Oof. Well, I knew it was just the beginning of the next, and longest phase: Physical Therapy. Then I was ushered to a PT who repeated the pushing, and rotating and stretching (still really uneasy on those, convinced it was going to rip in two, without the boot). But, it was fine. Then they had me walk up and down the office. It was pretty easy, I was amazed. The gave me a silicone heel cup, and a tube bandage and sent me packing. My ‘beloved’ boot was taken away. I felt the urge to ask if I could keep it, just in case. But my optimism/superstition made me hold my tongue. "If I don’t have it. I won’t need it.."  and then it was gone.

I was given a few sheets of notes/exercises to do: Stationary bicycle-As tolerated. Elliptical -As tolerated. Swimming- as much as I like. Then there were the stretches, so many stretches! Am I right, people?  Rotating the ankle and side to side , round and round side stepping and towel stretches etc. 3 sets, 3 times a day. I made a spreadsheet, and I was so diligent!  Walking got a bit easier, but was harder than with the boot. I staying in England another 10 days, did all my exercises, and got in a bunch of swimming. Walking got better, but still got tired pretty quickly. But I could feel the flutter of my calf muscle in there somewhere, and it was getting stronger! Then on the 26th of September,  with my fledgeling calf muscle flapping in the wind, I flew back to California. A few days later at 10 weeks,  I had my first appointment with Kaiser. Which was classic Kaiser. I went all the way there for them to say, yes, you need PT, so you need to make an appt for that.

Then almost immediately I flew to NY for 5 days, where I did a bunch of walking, probably 3-5 miles a day. Slow going though, with some pain and swelling afterwards. Then back to California again, and my first PT appt. Examination, range of motion tests and walking tests. Everything looked great, except for that calf. But I knew that already. So my prescription was as follows: calf raises (as many as you can, as often as you can). Continued Elliptical, Bicycle, walking, side to side weight bearing, and rubber band stretches ‘window-washers’ and then a seated band stretch with crossed leg (that one hurt!). Also said I don’t need the cup or support stocking. I really wish he had been more specific with the how many how much. I like detailed instructions, this felt like a bit of a free for all.

A lesson in pain tolerance.

So off I went and did all those, plus some swimming. Then I went to Hawaii. I think this is where I may have overdone it. I walked a lot. In flip flops. I climbed in and out of the ocean on a steep bank with very soft sand, a lot. I went snorkeling, I walked some more. I went to the gym, cycled and ‘elipticized’. My ankle was clicking, my sole was sore, my tendon was stiff, my ankle swollen, but I kept going, I was sure this was all ‘part of the healing, part of the PT, and part of powering through’. Somehow I thought it was better to wear flip flops than sneakers, as I didn’t want to coddle my tendon, and let it shrink back. I think I might have been wrong there.

I came back to California, and had my 2nd PT appt. He saw me and immediately said "Are you limping?”. Yeah, I was limping. He didn’t seem bothered and had me go through a session in the office. This time it was the treadmill on full incline, side-stepping, and balancing on a half ball, and then bouncing the leg press at 50lbs with only my bad leg. I have to say this one seemed outrageous to me. It felt dangerous. But I did it. Doc knows best, right?

2 days later, I got a terrible, stabbing, boiling pain in the sole of my heel. I couldn’t walk on it, and it lasted all day. I still thought it was acceptable, I iced it, took some ibuprofen and elevated it. Most of the pain went away. But numbness replaced it. I couldn’t feel my heel at all or the sole of my heel.  So, I contacted my original Ortho doc at Kaiser, she thinks I may have damaged or trapped a nerve, or damages my plantar muscle, anyway some sort of damage was done,  and she had me go straight in and get fitted for….. a boot!. I couldn’t believe it. But thank goodness, it wasn’t the tendon.

So here I am, 16 weeks since the rupture, and back in a boot. But it’s OK. It’s just a small step backwards, it’s starting to feel better each day, and soon I’ll be back on track. I guess the lesson here is that I confused that fine line between ‘pushing it’ and ‘breaking it’.

So now we’re up to date, and I’ll keep you posted. I’m really hoping the ankle/sole isn’t going to get in the way of healing! I am planning on taking that acting course again next year!

Thanks for reading!

-Catherine

Almost 17 weeks…back in a boot.

Hello fellow rupturees!

I am just now starting a blog, my rupture was almost 17 weeks ago. During the first few weeks (those soul destroying, NWB, totally frustrating first few weeks!), I visited this site many times. It proved to be such a great resource for information and more importantly, for my morale. I just didn’t have the wherewithal to post. I am almost 17 weeks post-injury, and thought I would share my story now, and hope it is of use to those who are going through the same thing. I guess I’ll give you the details, in segments, as the treatment happened, then bring you up to the current date.

Warning: I’m not really a ‘just the facts’ kind of  person, so this might be a bit long…

Day of Injury to Week 3.

I completely ruptured my left tendon whilst skipping in an acting class in London on July 20th 2011. I thought someone had kicked me in the heel. I heard the bang. I fell to the floor. As I lay there, surrounded by my classmates, I thought: "It’s fine, I sprained my ankle, it’s fine, but WHAT was that noise?". I stood up, and my foot was kind of flapping about, but, again, really just thought it was sprained.

I rested and iced it in the lobby, then after a couple of hours, after the school officials insisted, I walked to the hospital, using crutches from the props department. I had no idea how to use crutches, so I ‘walked’, shuffling and dragging to A and E.  It took me an hour to go four blocks.

The nurse gave me the Thompson test. I failed. Then it was on to a doctor, then to an Orthopedic specialist, who told me I needed to have surgery. Bad news. I may mention now, that I had quit my job of 13 years in the US to follow my dreams and traveled to London to take the Shakespeare Summer course at RADA. This happened on the second day. So, seeing as I was out of the program, and having family in Wiltshire, I requested that I transfer to their local hospital in Swindon for treatment. I ended up having a solid cast put on in the equinus position, left the hospital, and I arrived at Swindon A and E that night. They removed the cast, performed a physical exam, followed by an ultrasound. Because my tendon actually overlapped when I pressed my foot downwards, they chose a conservative, non-surgical treatment.

I was fitted in a Vacoped boot at 30˚, non weight bearing for 3 weeks. This was the hardest time. I was told I couldn’t fly, so was going to have to remain in the UK for the duration. Crutches were very hard to get used to, had to go up and down the stairs on my behind. Couldn’t shower. Going to the bathroom was it’s own special challenge, but I figured out a way of balancing and turning ‘just so’ in order to navigate various cramped English restrooms. My upper body got super strong, and my right leg seemed like a rugby players’! I’m sure you can relate. Putting all the pressure on my right leg made me terrified of rupturing that one, too. Sleeping in the boot had it’s obvious disadvantages, and I couldn’t get a good night’s sleep. Getting used to the boot was a process. I eventually figured out how to adjust the vacuum and straps to ‘comfortable’ positions. I felt very uneasy whenever I took the boot off to wash my foot or change the liner, I could see the bruising and swelling, and the gap where my tendon used to be. I was always happy to be safely back in the boot. This was also the time when I realized the severity of an ATR, and the long road ahead. But as I got used to the boot, (and asking for help!), I decided to just take one day at a time,  and I felt better. I think that following the NWB to the letter is essential at this stage, and luckily I was able to do just that. I also kept a written diary, so that I could see my progress and celebrate the tiny victories, such as figuring out how to go down a step to get into the garden, and washing my hair in the sink etc.

Weeks 3-6, First adjustment.

On August 10th, 23 days after the rupture, I had my first check up. I was very nervous. Not knowing what to expect, only that they were going to adjust the boot’s angle.I imagined the tendon tearing as I put my foot back in the adjusted boot…. They took off the boot, adjusted it to 15˚, then put it back on. It was a strange sensation, and I was apprehensive to put any weight on it. I was told I could bear ’some weight, as tolerated’. That was frustrating, as you can’t be sure if you are overdoing it. I recommend writing a list of questions for the technician, as I found the appointments happened so fast, and then you were back home wondering what you can and cannot do. I just let my body dictate how much I was able to do, and when. I began by gingerly putting weight on my toes, and rolling forward. If I felt a sting or a twinge in the tendon, I would stop. After a couple of days, I was able to gently walk a few feet with crutches and both feet. A bit of swelling and tingling in my toes would occur if I did too much, so I knew to take it a bit easier. This continued for the first 2 weeks of this stage. I was able to walk short distances, but nothing major. Still elevated my leg as often as possible. During the 6th week, I was walking on crutches in the rain, and one of my crutches slipped, I was forced to put my foot down hard, it was painful, but thankfully more scary than harmful- no damage. Be careful out there!

Weeks 6-8 Final Adjustment.

August 31st. My boot was adjusted to 0˚. This was the most difficult adjustment, as it feels like a huge difference. My foot was now at a right-angle, and I really felt the pull. Initially, I still needed crutches as I was nervous about putting full weight on my foot. I was pretty sore for the first 2 days, then after about 3 days, I began walking without crutches. What a great feeling! I got better and better at walking and my morale was high! I still got tired pretty quickly, but was elated to be mobile! I knew that it was only a matter of weeks before the boot came off, and I could fly back home!

Weeks 8-10 Boot off, Flight home, PT begins .-Coming Soon. Thanks for reading!