The Second Follow-up visit. Boots
My second post-op visit to see the doctor was at about 4 weeks. The nurse took my cast off, and it felt great to let my leg breathe.
I knew that my calf muscle had been atrophying, but I was still surprised to see it so puny. The skin was loose around the muscle! So it looks like I have a lot of rehab ahead of me.
I saw the surgeon this time, and he cleared me to ditch the crutches and start walking in the CAM boot. When not walking, I can take the boot off and move the foot as much as I want. I can shower and finally wash the foot that hasn’t been washed in over a month.
I’ll be doing physical therapy at around 5 to 6 week mark. The scrip says:
“PT 2-3x week / 8 weeks,
ROM, Strengthening, modalities, evaluate & treat”
He said that I should do some exercises while I am home as well. Here is a good literature (pdf document) with illustrations for home exercises: Home Program For Ankle Exercises
He also mentioned that from what he recalls, my surgery was fairly routine and there wasn’t any other damage. He trimmed off the damaged ends, put sutures on both ends and tied them together. In addition, he wraps more absorbing sutures around the reattached tendon for added support.
He does 3 to 4 achilles tendon surgeries a month, and that’s the bulk of the ATR surgeries at that particular hospital.
So the follow-up was fairly brief, with minimal examination as I didn’t complain of any pain or other complications. In fact, I don’t even think he laid eyes on my heel, which I think is bizarre come to think of it.
But who knows, maybe it’s all like that.
After the surgeon left, an orthodist (sp?) came in and fitted me with a boot. She showed me how to put on and take off the boot, along with some helpful tips like: When indoors, wear an indoor shoe on the other foot so that it feels more level.
Here is what the boot looks like:
I don’t see any model number on the boot, but looking at their website, I think it’s MaxTrax Air Walker made by DJ Ortho. It looks like they also make the Aircasts. Not sure why they brand them under two different names though. It has a single air pump in the front that inflates the air bladder in the padding for more support.
Some others on this site were fitted with half-length boots that come up to middle of your calf, not all the way up to just-below your knee. I’ve heard that it is better for lessening calf atrophy, but it doesn’t provide as much protection. Dave (http://achillesblog.com/daveleft) re-ruptured his achilles while wearing this type of boot. He was fitted with a full length (up to his knees) boot the second time around.
I don’t feel comfortable walking in the boot yet, but it’s better than fumbling with crutches. I limp around, but it should get better as I get more and more comfortable with bearing weight on my left foot.
So I drove home, parked the car in the garage, took my crutches out and put them in a dark corner. Hopefully I’ll never need them ever.
Michael,
Is your toe pointed down in the cast, or fairly flat? How bad is your pain on a 1 - 10 scale?
Are you staying in bed for a few days. or what are your plans? It’s going to be hard with thee kids running arond, although two are teenages, and one is 4! I am 54.
Mike
Mike -
Right now, 26 hours post surgery I am pain free, 0. I am in a splint, top and bottom of foot extending halfway up my lower leg all held in place by what looks like 2 miles of Ace bandages. My foot is pointed down and only my toes can move. The doctor doesn’t use a cast at first so that it’s easier for him to check the incision. As you may know, the major potential complication for this surgery is infection. There is very limited blood flow to this area.
I am 58, with a daughter in college and one teenage son at home. My wife is a trooper and has gotten used to my sports injuries. I landed in the hospital 4 years ago after a bicycling accident. 3 broken ribs, broken shoulder blade and a puctured lung. My bike helmet saved my life.
I just came back from my first walk with the crutches. Walked a few blocks for about twenty minutes. Downhill is easier than uphill. All in all, it was a pretty good workout.
Again, ggod luck and feel free to ask more questions. After all, I’m a 26 hour veteran.
Michael
My Dr. does casts only, or at least that is what he just said when I called I did call and request a splint.
How is the swelling with your leg down on crutches? If I can get around without too much swelling I can actually live my life pretty well. I also have a trolley that someone let me use.
Do you keep it elevated most of the day?
Last question how was the pain compared to the accident, when it happened? Mine has been very mild but I do have a pretty high tolerance for pain.
Mike R
Mike R - sorry about your injury…you can check out my status report after during week one @ http://achillesblog.com/brendan/2008/03/07/
The first 3 days post op is when I experienced the most pain (probably never higher than a 6)…I took vicodin for the first 4 days…and was off it by the 5th day. I also elevated pretty much all the time for 2 weeks straight. Now, in my 4th week post op, I can keep it down and there isn’t any throbbing. I think Doc Ross mentioned…slow and steady wins the race…and that is fitting for my first few weeks.
Mike R -
If you are going to be in a cast after surgery, just make sure to elevate your leg as much as you can (above the level of your heart). It gets quite uncomfortable if your ankle swells and your leg is in a cast. I spent about 70-80% of my time in bed the first two weeks. When not in bed, I was on my desk slouching and making sure that my leg was elevated above the level of my heart.
I couldn’t be on crutches for too long, as my foot started to turn puple.. When I laid down, it turned to normal color.
i have a question to all of you
my 2nd post op is in 2 weeks and my surgeon gave me the option of putting my foot/leg into a boot or an aircast
has someone tried both?
which one would you recommend?
is one lighter than the other?
thanks
Nancy - I was in a splint for 2 weeks, a cast for 1 week, and an Aircast for 2 weeks after that, all NWB. Then after 5 weeks I’m 50% WB in the Aircast. I have not tried a boot. I think the Aircast is good…seems relatively light. Maybe they could show you both so you could compare on the spot and make a decision? Not sure of the pros and cons.
John
Nancy - here’s a discussion on another forum: http://www.marfell.me.uk/nuke/modules.php?name=Forums&file=viewtopic&t=705
thanks guys
my friend lent me her aircast so i’ll try it
and maybe try the boot at the hospital if they have one so i compare
thanks for the link brendan, i’ve been reading for at least one hour
i think i’ve never read so much in my life
same thing for using my laptop
it’s going to be hard to go back to work without checking this site!
Advice on slight movements - Hey! Dr. said while I “air” out the incision area once a day while my splint is off he wants me to move foot “slightly.” I don’t want to overdue it, but I also want to make sure I’m moving it enought to benefit. I’m 2 weeks post op. Advice on movement pls? thx!
Kristen - At 2 weeks I would keep the movements to a minimum. Flex your foot down a bit until you feel resistance, hold for a couple of seconds and then flex your foot up and hold for a couple of seconds. You could also try the same with lateral movements. The movements should be slow and controlled, just enough movement to keep the ankle from getting too stiff while it is immobile. If you feel pain when doing the movements, you’re probably doing too much. This advice is just from my experience and not medically based, so take at your own risk. Perhaps Doc Ross may have more information.
Kristin..
I agree with Tom…start some range of motion, a good idea would be the alphabet exercise. Spell each letter of the alphabet as though your big toe was the pen. this will give you a finite amount of time doing something and take you through all the motions. Remember no sharp pain you should feel some mild pulling/strectching. Slow and steady wins the race with this injury.
Let me know if you have any more questions.
Doc Ross
I am 4 weeks post-op and just got into my Cam Walker boot….I am 33/m in good physical condition. Does anyone know how long it takes to be full weight bearing in the boot so I can get off the crutches? The heel seems to be the most sore of anywhere. I am only supposed to be in the boot 2 weeks before I start PT. Thanks,
Brent
Brent Galyon -
It really depends on your doctor’s protocol. There is really no set time. As you can see from everyone’s experiences, it really varies. Good luck with your recovery, and keep us posted.
Hi all - I am 3 weeks post-surgery and just found this site! Total rupture - tendon retrenched way up in to the calf - 5″ incision, etc.
I have been casted in inflection (toes down) since surgery and see the doc next Thirsday. At the last visit (one week post-op) he mentioned he would be recasting me in “neutral” position for another 2-3 weeks. I am going nuts with the non-weight bearing thing and want to talk the doc into putting me in a boot. Anyone out there have to “negotiate” this with the doctor? Any ammunition I can use?
Ed
HI all - just discovered site, so still need to put info on blog, but since I just had my 2nd follow-up yesterday, I thought I would chime in. I was playing in a tennis tournament out of town Memorial weekend when this happened. *When I get the chance, I’ll read how other’s injuries happened - I’m curious how many are NOT sports related based on what I’ve been hearing.
My doc took the original 2 wk old cast off, removed the staples and put me in a new fiberglass cast. From what he’s saying, I expect to be in a cast for 3 months(!!!) which seems a bit long compared to the other things I’m reading. He also did the long arched cut rather than orthoscopic surgery, which according to him allows for a better repair.
So, I’m a bit concerned about atrophy with it being so fixed for such a long time, but he said he’s never had one he’s repaired break again.
As of yesterday, he’s approved a light weight load on it, such as standing or balancing, but no walking on it, yet. My next appointment is in 4 wks.
This looks like a great resource, so glad to see you all here.
Sheila
Sheila,
sorry to hear about our injury. I did mine playing tennis too. Warmed up after a tough first set then pow after coming in behind a serve. Happened in mid March. After you read what is on the blogs I think you will find that 3 months in the cast is very long. I was in 3 weeks and then in a boot - NWB and crutches for a few weeks. After 3 months was doing great, almost walking normal then slipped a little coming up the stairs and did it again above where he repaired it. I am now almost a month past the second surgery and looking to get out of the cast soon - at least by 7-10. Read up what others have done and make your decision. The longer in the cast, the longer your recovery will be.
Has anyone re-injured the achilles tendon during the post op recovery time? I am at 7 weeks post op and was put in an orthopedic “sock” yesterday. Today I turned the microwave oven on and it immediately made an explosive sound — sounded like a gunshot. I must have moved backward suddenly. The surgery site hurt badly and a raised area developed and turned blueish. I am so worried that I will have to have surgery again. My initial injury was from a bottle breaking and a piece of glass sliced my tendon in half.
Hey Catherine, Daveleft and Chipintn are both re-ruptures. Check out their blogs. I suggest calling your surgeon and scheduling an appt., so you can find out where you are. Though I’m not a doctor, if you can move your foot around, you are probably ok.
I’m 3 days in after total rupture being treated non surgically. Totally depressed and struggling with the enormity of the recovery period
I just discovered this blog searching for more information on how long it takes for a completely ruptured achilles tendon to grow scar tissue after surgery. I had a complete rupture of my rt. AT on June 29th playing frisbee. I heard a “pop” and felt like a hardball had hit my calf! My son in law who is a cardiologist almost immediately diagnosed my injury as a ruptured AT. I had surgery on July 3rd, was fitted with a plaster splint for 13 days and am currently 18 days post op. I was fitted with a Aircast pneumatic boot on Day 13 post op. When I was examined at Day 13, my surgeon informed me that he did plastic surgery on my incision. It looked very nice. I have been incrementally putting more weight on my boot walking around my condo with a single crutch. My son in law said it would take around six weeks for the repaired tendon to “scar” over but cautioned me to be patient with PT, etc. I am 64, and in good physical condition and a very good immune system. At least thats what I have been told. (I recovered form a broken ankle (compound fracture) in three weeks.) I am hoping that this will speed up my recovery. Like others, I have experienced a slight heel pain when walking around in the Aircast boot. I am particularly frustrated because I just bought a new Nissan 350Z convertible, 6 speed, 306 HP….and its just sitting there waiting to get a ticket! BTW, I stopped taking percocet (750 mg) on Day 10 due to no pain whatsoever. Good luck to everyone on a speedy and complete AT recovery!!