Chip’s Achilles Recovery

Flew to PHX from TN for a quick trip - no problems on the plane. Having the handicap card for parking is a big plus and the wheelchair to get from the ticket counter to the gate and from the gate to baggage claim was a must. Too far to walk or to be on crutches.  I speak at conventions for a living and was on stage for 75 minutes - no crutches, in the boot and felt fine after it. I am doing the basic ROM exercises and have a follow up appt with the Doc on the 21st. I want to start PT as soon as he will let me.

I am three weeks past my operation on Monday and have been in the boot since Thursday. I have been walking without crutches and doing the basic ROM exercises after the first 24 hours. It was sore the first day and it as been much better the last 24 hours. I read an article about Dr. Myerson - Rehabilitation after Achilles tendon surgery - who pioneered a different recovery protocol. Here is the link to the page - http://footandankle.mdmercy.com/conditions/achilles_tendon_probs/acute_achl_tendonrupture.html

Following the tendon repair no walking on the foot is permitted for ten days. Then walking is begun in a removable boot. There were some treatments used many years ago that relied upon a leg cast. This led to tremendous weakness and atrophy of muscle that was often permanent. Approximately fifteen years ago, with a treatment pioneered by Dr. Myerson, the recovery after surgery for repairing the Achilles tendon changed dramatically, leading to maximum restoration of tendon healing and rapid return of strength. Instead of a cast, a removable boot is worn and instead of using crutches, walking is commenced very rapidly after surgery. Therapy and exercises are begun soon after surgery. This therapy process is critical in the recovery after tendon rupture, and without a carefully monitored program, full recovery is never possible. This treatment has made a huge difference in the recovery process for both recreational and professional athletes.

 This makes sense to me - the longer in a hard cast the longer it will take to recover. I will be patient and take it slow, but if I am having no pain walking in the boot without crutches - isn’t that a good thing that will speed my recovery? I was curious what others have experienced. Also - here is a link advance rehab in the water that can be done - full videos with a PT. I would like to do this when ready.

http://www.hydroworx.com/rehab-and-performance-applications/sub-section.aspx?sectionId=1&subsectionId=5

Got the splint cast off this am - stiches out and it looks good. I have three flights in the next two weeks - two cross country and was concerned if I was in a hard cast the natural swelling would be very uncomfortable. I have the boot on now with the promise to wear it consistently. Having read some recent posts here about people doing a rerupture by walking up the stairs - I will take it slowly. I look forward to taking a shower and giving the leg a proper cleaning. It is amazing how much smaller the leg looks after only a few weeks. I will do some simple exercises to rotate the ankle and slowly build strength.

Complete rupture of Achilles tendon - Surgeon: Dr. Cletus McMahon

General Anesthesia - Blood loss minimal -

Operative Note - The patient was placed in a the supine position where he underwent general anesthesia. He was then placed in the prone position. The left lower extremity was prepped and draped from the knee to the toes. A posteromedial incision was made over the posterior aspect of the ankle and carried through skin and subcutaneous tissue. He had complete ruture of the Achilles tendon approx. 4 cm proximal to the insertion into calcaneus. The edges were freshened without difficulty and repaired with a figure-of-8 Bunnell suture using number 2 FiberWire. This gave an excellent repair. The ankle was taken through a range of motion, and the repair was quite stable. It was then taken covered with TissueMend and secured with interrupted 2-0 Vicryl. The wouldn was irragated with saline and the subcutaneous tissue was closed with interrupted 3-0 Vicryl and the skin with a runnint 4-0 nylon suture, and the wound was covered with Telfa, 4 x 4’s and the left lover extremity was placed ina plaster splint with the ankle plantar flexed. The patient was then taken to the recovery room in satisfactory condition, good vascular flow to the left foot.

My daughter found a nice recource called BrokenBeauties.com - I just got in nice pads to make the crutches more comfortable - very nice. I ordered a special cover to make it easy to take a shower and cover the cast - works great.  Much better than a garbage bag and the tape I used the last time I had a cast.

I had my first visit with the Doc at 10 days post op - I have a “open” hard cast on that iswrapped in bandage - at an angle pointed down. Very quick visit - no pain so no infection. I thought they were going to change it but they did not.

I go back this week to get this off and I think he said a hard cast for a few weeks. I know I was told no weight bearing on it now, but it feels very good.  I now longer have to elevate and I can do toe raises easily with it when sitting down. I have been testing it and have no pain when I move slowly on it without the crutches. I know patience is important AND how quick has anyone gone into a removable boot? What have others been doing? I would appreciate what you did from 2 weeks post op to 4-5 weeks?

 How quick has someone been in a walking boot?

Thanks for all your posts gentlemen - do women ever have this injury? I had a good first night - getting your leg up with plenty of pillows is crucial, especially one supporting your thigh. I am a veteran at this from several leg casts in the past.  Having those additional pads on the crutches are a big plus - much better.  Had to pee about 330am - used the crutches to get to the bathroom - mistake - putting my leg down that fast is very painful. I took the “tupperware pee cup” from the hospital and will use that at night in the future.

How long have people been icing - is it effective through this splint cast?

How much time are you elevating the first week -pretty much full time? With March Madness not a bad time to be laid up.

How many days until you went in to exercise?

Has anyone gotten on an airplane close to surgery? I have a trip April 6 - I am thinking I will be fine.

Just got back home - 24 hours after surgery - last night was the toughest I have ever had. Felt pretty good directly after surgery - had a little food and hit the button on the morphine drip quite often. Word of advice - if you are sleepy go to sleep regardless of what time it is. I was out of surgery at about 530pm and watched a movie in a haze. I was sleepy but figured I would stay up until normal bed time about 11pm.  For some reason every time I fell asleep I would wake myself up with a snore - went on for three hours -then got the chills and then got hot……and then my jaw locked up. It has happened once before after a dental procedure where my mouth was wedged open.  Must have happened because of being of the position of my mouth when they kept me under the anesthesia. I can still only open my mouth about the width of my thumb. Needless to say I ate very little.

I finally got a little sleep and the surgeon came in at 6am - I vaguely remember the visit and did not realize he discharged me. I had a “23 hour” visit I wanted to take advantage of. I was wipped out. From there the PT came in to teach me how to “use the crutches”. I put my foot down for the first time below my heart - yes that is an intense pain. I walked for a few moments with the crutches and then in the reclining chair. It seemed like everyone was trying to get me out of there and I felt in no shape to go.  Very little empathy. I wanted to try and sleep. With three kids at home under 10 I new that might be a little less relaxing. My wife got a hold of the floor manager in the hospital and things changed quickly.  Linda was very nice and totally changed the energy of the staff. When I did pre-registration I was told my ins. company (I have an HSA) had OK’ed up to a 3 day stay. I really wanted to stay tonight but do feel much better now. I slept most of the day. I found out that since my surgeon discharged me there was “no medical reason to stay.” An administrator told that the “ospital was not a place for recovery.” That surprised me. I ended up staying the 23 hours. I hope this first night home is a peaceful one.

Great to find this site and look forward to learning and sharing in our recovery. I ruptured mine playing tennis on March 5th. I am in great shape - was warmed up, into the second set and decided to come in behind a serve….took that first step and dropped like a sack of potatoes. I had no idea what had happened at first. I remember hearing and feeling the pop. I went to the emergency room (a mistake - did not need to go in hindsight) and they really did nothing. I gave them the name of the orthepedic surgeon who had screwed my 5th metataursal back together in my left foot about 18 months ago. Dr. McMahon in Oak Ridge TN - great guy and surgeon. I was hoping it was not ruptured since I could move my foot pretty well and actually walk, but I was wrong. I speak for a living and have two events this week and then surgery on Monday the 17th. The only good news is that it is my left leg again so at least I can drive.

I have a question on the surgery - I read about Dr. Myerson at Union Memorial Hospital - it is from 1994 but talks about a different technique - http://findarticles.com/p/articles/mi_m1272/is_n2593_v123/ai_15826313 - they describe it here - is this standard procedure now?

The new treatment program is a two-step process, he explains. “First, patients with ruptured Achilles tendons undergo surgery where the damaged, fibrous tissue in the Achilles tendon is removed and then a new method of suturing is used where a series of single locking-loop stitches secure tendon ends to bone by tying the sutures to a staple or screw. Other suture methods consist of a series of simple, interrupted sutures that do not offer a secure fixation of tendon to bone.”

 Is this standard now?

What about after the surgery - he talks about instead of a cast - a boot and …read below - here is the link I took it from. http://footandankle.mdmercy.com/conditions/achilles_tendon_probs/acute_achl_tendonrupture.html

Rehabilitation after Achilles tendon surgery

Following the tendon repair no walking on the foot is permitted for ten days. Then walking is begun in a removable boot. There were some treatments used many years ago that relied upon a leg cast. This led to tremendous weakness and atrophy of muscle that was often permanent. Approximately fifteen years ago, with a treatment pioneered by Dr. Myerson, the recovery after surgery for repairing the Achilles tendon changed dramatically, leading to maximum restoration of tendon healing and rapid return of strength. Instead of a cast, a removable boot is worn and instead of using crutches, walking is commenced very rapidly after surgery. Therapy and exercises are begun soon after surgery. This therapy process is critical in the recovery after tendon rupture, and without a carefully monitored program, full recovery is never possible. This treatment has made a huge difference in the recovery process for both recreational and professional athletes.

What did you do after your surgery?