Days leading up to the surgery

On Crutches

My ATR (Achilles Tendon Rupture) injury occurred on a Friday night. It’s probably the worst time to have this happen since it was impossible to get operated on right away. If I were lucky, the surgeon could squeeze me in on Monday. I wanted the surgery done as quickly as possible since it seemed like common sense that I would have the best chance of full recovery if the problem was fixed right away.

The Physician’s Assistant called me Sunday saying that they might be able to squeeze me in on Monday for the surgery.
The surgeon is a foot and ankle specialist so I am hoping that I am in good hands. No food/drink past midnight, and I’ll get a call early tomorrow morning.

I talked to a friend in the medical profession. He told me to make sure that the surgeon is board certified. I looked up the surgeon’s credentials through Google. Yep, looks like he is board certified, and he is a clinical assistant professor. However, does this mean that he’s going to use me as a teaching material for his surgical residents..? I should ask my friends about that at some point.

Reminder: Make sure that your surgeon is board certified.

It all seems like such a crap shoot. I wonder if there is a better way to select a surgeon. I am able to do more extensive research on buying a television set than selecting a surgeon who will operate on me. I’ve visited a few physician review sites, and either they are pay-sites or they are free sites with nothing more than the doctors’ office addresses. Here is a review of one of them that I’ve used. The link is here.

Short answer is that it was waste of my money and time.

Luckily there wasn’t much swelling or pain in my leg, and I elevated my leg as much as I could. Even though I knew that the chances of complications from the surgery is very, very small, I went to bed on Sunday night nervous, wishing that I had setup a will beforehand.


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24 Responses to “Days leading up to the surgery”

  1. I need surgery for a partially torn Achilles tendon that was originally misdiagnosed. My greatest fear about the surgery is how bad the pain would be and for about how long would it last. I have had problems with pain in the past for even minor surgery.

    I would greatly appreciate it if someone could tell me about their experience with this. I really need to have the surgery done because I work in a profession that requires standing most of the time. I am having too much pain while I’m on my feet to allow things to continue the way they are going. I’m in a boot and still having a lot of pain while standing.

  2. Sheri,

    My experience was 24-48 hours. But don’t be afraid to supplement your narcotic painkiller with plain old Advil. My life improved siginifcantly when I discovered this. And keep the foot elevated. Knee above hear, foot above knee. I am just 3 weeks past surgery, so the memory is fresh.

  3. Sheri-
    I will assume that since you are in a boot and have a partial tear, you have some control over the timing of the surgery (sounds like you suffered the tear some time ago). I am an anesthesiologist and I would strongly suggest that you tell your surgeon of your pain issues after previous surgeries and ask for a referral to a pain specialist before the surgery. There are several strategies for treating postoperative pain, some of which go beyond what is routinely done. Now, pain specialists can have a variety of backgrounds, so I would suggest one who is also an anesthesiologist. By having a pain consult beforehand, a plan can be made and, hopefully, you won’t have to hear things like “well, we’ve given you all that the doctor ordered”. Let us know how things turn out. Ron

  4. Thank you for your replies. I will ask about a pain specialist. Unfortunately I’m at the mercy of my husband’s travel schedule for work and will probably have to have surgery within the next two weeks or wait until late summer or fall. We recently moved and don’t have any relatives or close friends in town.

  5. I ruptured it on Saturday playing tennis, actually an aerobic tennis clinic. I am 50 and play tennis and/or do aerobic exercise 6 days a week. I do not like not being able to do stuff and move around. I fear the next few months may be dreadful. I am guessing swimming may be a start as well as more weighlifting. So I have my surgery Thursday and had my MRI today. We will review the MRI on Wednesday and I guess Thursday will be the first day of the rest of my life!!!

  6. Having my surgery tomorrow, 9:30AM. It will be 9 days after my injury, longer than I’d like but my initial diagnosis did not indicate the severity of the injury. Got second opinion on Thursday and surgery scheduled following the weekend. Expect to be in pain for a few days but have had surgery before so baring complications know what to expect. And as peteco said, Advil is remarkably effective.

  7. I ruptured my achilles June 6th.  Misdiagnosed as calf contusion initially.  Was confirmed as full rupture June 14.  Ortho recommended cast/ non-operative treatment.  I explained that I am very active.  I have been in cast for 2 weeks.  I am now feeling like I made a mistake to not go for surgery.  My ortho keeps telling me to wait and see if this route works.  I am afraid of not having confidence to return to my highly active lifestyle and activities.  This doc does not want to operate bc he treats all of his ruptures non op.  I cannot get into another ortho until next week- that makes 5 Weeks after ATR.  Has anybody waited this long for surgery?  How were the results?  Has anyone gone non surgical and return to explosive activities?

  8. I have, Frustrated Coach, as have the vast majority of non-op (& op) patients who post here. Once your AT heals (by magic biology in either case), the risks of rerupturing it are virtually nil. Rupturing the other side is way more likely, but not worth skipping beloved activities for most of us.
    Check out the 2010 UWO study (& protocol) on the studies page of this site for the good-news evidence for skipping the surgery. Casts can work, but they’re Old School. Boots work better in several ways. Old-school non-op treatment (aka “conservative casting”) produced 2nd-rate results including much higher rerupture rates (<~15 weeks) than surgery. UWO and other modern fast boot-based protocols have demonstrated excellent strength and ROM and rerupture rates around 3% (vs. 15% or more for Old School), statistically indistinguishable from post-op.
    Good luck, and start a blog here!

  9. A lot of old posts above recommend Advil (=ibuprofen) or other NSAIDs. I’ve read several places that NSAIDs are bad for tendon healing and contraindicated for ATRs. Many Docs recommend Tylenol (acetominophen) instead.

  10. My doc is the exact opposite - recommends surgery in most all cases. Had surgery two weeks ago. Stitches out, leg feel fine most all of the time, in a plaster cast for three weeks. Then another plaster cast and on to boot.

    Getting around on crutches well, (left leg, driving is not a problem) and just plan to listen to the doc and play the long game.

    Ryan Howard, Philadelphia first baseman just came back to his team yesterday after tearing on 10/07/11. Sure hope mine doesn’t take that long to heal. Surgery works for me!

  11. I ruptured my Achilles with a confirmed complete break just this Thursday (after doing step ups in the cross fit gym at. 6am. An ambulance ride and much morphine later - I’ve been sent home in a cast to go back to see the surgeon tomorrow morning and be prepared with an empty stomach in case a theatre space opens. The pain has been tolerable since and my husband has been amazing - however I suffering from the most horrific full leg cramps every single night. They are so horrible I wake up screaming in agony. Has anyone else also experienced this and have any recommendations on things that can help avoid the cramps and relieve them at the time?

  12. Many of us had less serious cramps. For bad ones, there are anti-spasmodic drugs, OTC and prescription. Get help.

  13. Surgery doesn’t usually cure cramping, and extreme cramps could hurt your repair, so make sure your OS knows.

  14. I had a full ATR rupture Easter Sunday playing in a 40 and over basketball league. I had surgery on the following Wednesday. Since I am in the medical device industry, I talked with my Anesthesiologist about having an Arrow nerve block and then inserting a pain pump post surgery. The best thing I could have done! I didn’t have much pain post 24 hours since my foot was still nerve blocked and then the pain pump lasted through Sunday. I only took about 4 pain meds the whole time then one muscle relaxant after the block went away. The only thing you have to prepare yourself for is for the first 36 hours your foot will be completely numb an immobile. It feels like your paralyzed but it wears off. In addition, less Anesthetic gas is used since you have a nerve block. You are asleep but you don’t get that nauseous feeling that you get sometimes.

  15. Well folks I would like to say I’m on my way…. Alas that is not quite the case… My injury has developed over a period of months now and no one has a good explanation as to why!! Over the previous two years I had cortisone injections in my left heal… It was like a miracle!! Took the pain away in a matter of days however, and little did I know it was the worst thing I could have done!! Second was last Sept. Fast forward to January 29th… I was getting ready for a trip to Mexico and the pain came back…. By the time I left for my trip I was limping!! Made and appointment with sports med. Doc.
    Two days prior to my appt. I stumbled a bit at work and popped something…. The doc said I ruptured a small tendon that connects behind the knee to the achilles and not to worry… Ultrasound showed some calcification of the achilles but no tear… A boot and PT for a month…(quite the fashion statement if I do say so) I kept complaining that it felt so weak and like it was going to give way at any moment but doc. Said to follow protocol… I obeyed…. Two week follow up… Little improvement… One month follow up…. No improvement…. So she orders an MRI, which shows a small tear in the mid achilles… And refers me to a doctor who does a fancy new procedure called TENEX…. We discuss this and I am informed it is a minor procedure quick recovery and back to normal in 3 months tops!!! SIGN ME UP THEN!!!! I was told they would call me that Monday to schedule it… I am out of the boot at this point as well and simply went to take the garbage out the day before Easter… BOOM… It was like someone ran over the back of my leg…. Now… I have had a baby… This pain was as bad as any labor pain (kind funny as I was in my Jammie’s in the middle of the street paralyzed!!! Looking back anyway) … Needless to say the Doc. Did another ultrasound and said he saw no change… That I must have strained my calf because it had been in the boot so long and was definitely smaller than the other leg….negative with Thompson squeeze as well as all other cutaneous tests…. He refuses to do TENEX and orders PT for one month… Said I had to rehab my calf before he would consider further treatment… I comply once again… One month back in the boot with Weekly PT… It gets a wee bit better but I cannot do a couple of the exercises without being in pain… I go back to the Doc. And beg to move forward with treatment… I insist that until the achilles heals I am not going to get anywhere with my PT… Meanwhile… The rest of me is going to pot!! My hips hurt, I am gaining weight and the inactivity is killing me!! He agrees to do the procedure he also wants me back out of the boot to give my calf a little more exercise… TENEX supposed to be 5/27/14…. EXCEPT…. day before treatment…(saga I know but it’s already been a long road) I walked over a small pebble and readjusted my step just enough that once again the bringing and tearing was felt… Pain and bruising all over my ankle….
    I went in the next day for my “treatment” knowing full well it was not going to happen… Yep…. He says…” My, what did you do to this over the weekend… There are huge changes… You have a really big tear here” “it’s hanging on by a thread” …”what’s odd to me Mrs. Hay, is your physical exam shows no indication of a tear… Thompson testing etc all negative….you are quite an enigma” … Time for a surgical consult and another MRI… Saw the first surgeon on Friday…. He said he had never had a patient present like me… That the achilles clearly shows a full rupture on the MRI but the physical exam does not indicate it….
    So here I sit… Wallowing in a wee bit of self pity… Frustrated as HECK…. Waiting for my second appt with another surgeon on Monday… I swear if he uses the word enigma I may lop his head off!! Lol…. I can move my foot and am not in to much pain right now…maybe a 2 out of 10 when I walk on it… Trying to find the humor in all of this… Oh and did I mention I own two business’ and have a very active 12 year old…(and a 40 year old..lol). Two months off of work is not an option…. I am hoping to have surgery next week… And with lots of help a trade show over the weekend with tons of help… Have a chair all set for this girl… Yep… I’ll be that one… Drooling in the corner with Purple toes writhing in pain… It is nice to know you are all here… If I can figure out how to get the blog thing started I will update you all as it’s obvious I have a lot to say!!

  16. Everything I have read suggests it is better to have the surgery as soon as possible after the injury. After wasting time with a couple of unnecessary imaging and follow-up appointments, my surgery is scheduled for THREE WEEKS after my initial Achilles rupture. Is this too late? Should I be concerned that my ortho surgeon isn’t pushing for a quicker surgery?

  17. Whether you go non-op or op you should be in a cast/brace right now and non-weight bearing. You should be on bed rest. If your tendon is immobilized it is already starting to heal. That is how they do it without an operation. They set it in a boot/cast/splint and let the body do it’s thing while you sit back and rest.

  18. On June 22 I jumped off the couch and to avoid our new puppy I over extended my leg then “POP”. I hit the ground in pain that topped having my children. Went to a CNP she said ankle sprain. X-ray was negative crutches and elevation and ice. Went back a week later in horrible pain, knew it was ruptured and she gave me a referral to Podiatry with a snarky comment of..It will heal before you are even seen just a sprain. By sheer luck Podiatry got me in, one look a few tests and he said complete rupture, low to the heel I cannot believe you have been walking around like this.
    Surgery is tomorrow July 2 and I am absolutely terrified. I have been reading recovery stories and am mortified. I almost talked myself out of it but being a Homeschool Mom and we are a very active family surgery seems the best option. I was only under Anesthesia once for wisdom teeth and woke up in the middle of it. I don’t know if I am more fearful of the Surgery itself or the aftermath as I have read so many horror stories. I will NOT sleep tonight. I have been in a boot for 3 days so at least I can hobble/pace until noon tomorrow. So happy I found this site however…I am already getting depressed and I haven’t even started. :(

  19. Dixie - there are also a great number of very good stories to read. You wil have time to do that. If you tendon has pulled off the bone then surgery would be the only option. Not sure if that is what you meant by ‘low to the heel’. Tendons do not reattach to bone on their own. It would be good not to have your scar on the very back of the tendon as they tend to rub on shoes and irritate. Maybe you could put a polite request in for them to cut on the side. There are a great many positives people take out of this injury but they will be there for you to discover on your journey. Not sure what a CNP is but I take it you are in the USA. I guess you will not be going back there in a hurry. Cheer up. Lots of great people here to help you through.

  20. Thank you so very much xplora. Certified Nurse Practioner..CNP. You are correct I will find a new Primary..hahha
    He talked of the Surgery with smaller incisions but said the fear was to low so he would have to do the larger one. Thank you for that info he is a very nice man so I will definitely mention that. I am a Cyclist so anything to avoid my cycling shoes irritating the scar would be great.
    The horror stories I read from another site, so that is why I was so relieved to see this one. In just the last little bit I have read positive much more hopeful posts so it has put my mind at ease somewhat.
    I know it will be a long road to recovery but like you said I think some positives may come of it. Your kind words helped, thank you again!

  21. Hi All
    My user name is etb2000.
    Have never created a blog before so this will be new ground for me.
    Two and half years ago I had surgery to remove a heel spur
    (left heel - right side of heel)
    Long story short my achilles has been badly inflamed
    and painful since the op.
    After different types of treatment I am now going
    in for my second Op tomorrow week (Tues 28th July 2015)
    The achilles is to be detached from the heel,
    heel to be ‘cleanned and tidyed’ then achilles to be repinned.
    I am 50 years old. Up until the first surgery I was running twice a day
    for 5 days a week and once a day for the other two days.
    I covered approximately 80+ miles per week.
    My 10k times were sub 35 minutes.
    My one mile race time was 5 minutes.
    I now jog 10 minute miles for a couple of days per week.
    Up to 25 miles in total for the week.
    Its time I was ‘healed’ (sorry..!!)
    etb2000

  22. Hi All…was walking in my backyard, took a step and heard what sounded like a .22 cal pistol went off. Next thing I know I’m on the ground. Wife took me to VA ER, x-ray showed nothing. Was scheduled with Ortho appointment who send me for MRI. Great pictures I was told..acute ATR, this was on the 20th of May,15. I am scheduled for surgery the 26th of August. Long wait as the VA had to outsource the surgery with a foot and ankle specialist. Been lots of pain and although I am not looking forward to the surgery, I know the healing won’t begin until surgery is over. I am diabetic so I am concerned about infection. Add to that my age (67) just adds to the concern. Anyone out there that can speak from experience with similar stats?

  23. Hi All,
    If you are interested in learning about ATR recovery and physical therapy tips, as well as some advice for staying positive and active after surgery, please check out our Injury Resource Center. We try to provide you with as much information as possible to alleviate some of your pre-op concerns.

  24. Was playing basketball on Thursday night, January 12th, and I heard a pop when pushing off my left foot and felt like someone dropped a weight on the back of my heel.

    Was in a lot of pain and I could barely walk. Went to a Podiatrist at an Orthopedic Center the next day, they took an Xray and he told me that it is an Achilles tear.

    I have an MRI scheduled for this week and they scheduled surgery for Jan 23rd. The Doctor explained that he prefers to wait at least two weeks before surgery because it gives the ends of the tendons time to heal. He said right now the ends are stringy, like a mop. It’s apparently easier for the surgeon to let those ends heal and then re-attach the tendons. Otherwise, they have to re-attach them one “string” at a time. Curious if anyone else went this route.

    They did give me a boot with inserts and crutches. Also having trouble understanding how often I should keep it elevated or iced, and how much I can lean on the hurt leg (if I can lean on it at all).

    What did everyone else do from the injury leading up to the surgery?

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