Entries from November 2008 ↓

I never finished my drafted post for the 2 week post-op. This means that around that time, I returned to somewhat normal functionality, got busy at work and no longer had time to blog.

The theme of weeks 2-6 seems to me: This is really getting old, are we their yet? Not there yet. I am done with the excitement and drama and now have a long slog of extreme inconvenience and thinning patience of my support crew (wife, Grandparents, and so forth). According to the cruelly honest Achilles marathon widget, I am at mile 2 of 26.

It strikes me now how sorely our story tellers miss this aspect of injury. Sure super tough hero or heroine can keep going with three bullet wounds and a crab pincered onto her ear while loaded with adrenaline … but can she stay sane through 6 months of recovery? Or … hero gets injured in that dramatic initial chase … must suffer the indignity of supporting role for the rest of the movie. There be drama there - I wish I had more heroic examples to follow from our cultural icons. However, I suppose the telling of such a story probably switches your audience from block buster to a dusty English Majors bookshelf.

At two weeks post op (purple cast)

I finally got to see my foot. I’ve never gone 3 weeks without seeing my foot before. Stitches came out, and we switch from a split to a cast. I chose purple.

I now understand the different between a splint and a cast. The splint had support around the back and sides, but had no plaster in front (just tape) to allow for considerable swelling.

Back at work, up to speed, simply highly annoyed with how long it takes to move anywhere.

At four weeks post op (black cast)

I’d heard of some people getting boots at 4 weeks and was irrationally hopeful. The leg feels great most of the time. When they cranked me up to 90 degrees, I decided I really didn’t want the book after all. I suspect the purpose of the 2 week cycle is entirely psychological: Let’s ensure that our patients remain careful and cognizant of their injury by giving a painful yet harmless reminder of their fragile state every two weeks.

Boot next time? I hope so.

How do I describe my injured calf when I saw it out of the cast? Soft - but how to express the floppinesss? Jello? Water balloon? Both too firm. It reminded me a bit of a cows udder after a good milking. Flop flop sway.

This post is all about things I attempted to do the week after surgery, and how it went. I hope to provide as concrete a picture of the post-op recovery as I can. 

From what I’ve seen, experiences vary wildly. One poster described not much pain post-op. I had a lot of pain … but it seems to drop off rapidly over the first week. 

Things I tried to do the day of surgery

Before surgery, I was in total denial. I actually got some work done - that worked great.

I eschewed offers of transportation and took the bus to the hospital. That didn’t work well. It was raining, I slipped on slick walkway outside the hospital and landed on my bad leg. I finally got to say 8 when they ask, “on a scale of 1 to 10, how much does it hurt?”. Hopefully, I’ll be more careful after surgery. 

The surgery was on Halloween. I had general anesthesia, most of the day is vague, and I can’t tell you how the surgery went. I’m fairly certain it was an open surgery in the correct leg. I left the hospital 2 hours later than they expected I would … so I think anesthesia recovery did not go well. 

I tried to answer the door for trick or treating. This didn’t go well. I could not manage to get off the couch to open the door. I fell asleep. Drowsiness is a side affect of narcotics.

I sent my kids trick or treating with the grandparents. That worked great … quite the haul.   

Things I tried to do a 1-2 days after the surgery (lots of swelling, on Narcotics)

Time off the couch before swelling and pain were intolerable: 5 minutes, 30 minutes by day 2. 

Pain (1-10) : 7, with oxycodone

Surgery + 1 day: Doing nothing worked well.

Sign a check: Nope, I couldn’t quite figure out how to sign a check. I kept getting the numbers mixed up. 

Dishes: I tried to do dishes on day 2. This did not work well at all, it really really hurt.

Sleeping: Did not work well, there was no comfortable place to put my foot. I moved to the couch so my wife could sleep.  

Things I tried to do 3-4 days after surger (off the narcotics)

Time off the couch before swelling and pain were intolerable: 20 minutes, 45 minutes by day 4. 

Pain (1-10) : 3, with tylenol

Stopped taking narcotic paing killers for Tylenol. That worked great. I have no idea why people take narcotics for fun. Oxycodone was good for the pain, but otherwise, a misery of muddled mentation. It gave me headaches. What kind of pain killer has head-aches as a side effect? 

At surgery + 4 days I took a bus, just to get outside. I actually went to the gym and did a very light upper body workout. After 5 days on the couch, that felt great.  I had to leave my leg up for 30 minutes at a coffee shop before I could get on the bus and go back home.  

At surgery + 4 days, I voted. 51% of the country thinks that went just fine. I had plenty of couch / internet time to research the issues. 

Things I tried to do at 5-6 days (no painkillers)

Time off the couch before swelling and pain were intolerable: 1-3 hours (once a day).  

Pain (1-10) : not much if I keep the leg elevated. 5 after 30 minutes without leg elevation.

I tried to work. I have a desk job, and theoretically don’t need me foot. Working did not work well at all. I was too tired and uncomfortable to be effective. However, I’m out of sick time, so I don’t have much choice. Well, there is always a choice - but I don’t like options such as cancelling my Christmas vacation or unpaid leave. For next week, the best choice appears to be, my life shall be working and sleeping - sleeping enough that I can make it through an 8 hour work day.   

Things I tried to do at 7-8 days

I’m getting close to the level of functionality at had pre-op. I don’t crash in the middle of the day, pain is still much worse than pre-op.  Its the weekend, so I’m not trying to do much. 

I am leaving the house, seeking destinations suitable to my knee walker (lots of smooth walking surfaces).  This works fine, although I need about 10 minutes of leg elevation each hour to keep up the activity. 

Starting with some comments vaguely related to this blog posting

(Note - I just woke up from post surgical haze — about a week of post surgical haze. More on that later, now I’ll finish my post on getting around.)

(Note 2 - I’d really love to here other peoples experiences with other crutch alternatives. The One-crutch,
I walk free, and so forth Getting around seems to be the main challenge with one good leg).

The weekend before halloween, my neighorhood businesses open up for trick or treating. There is nothing more delightful for the kids. It’s a parenting experience I treasure - and I couldn’t imagine doing it on crutches. This was 4 days post rupture. We ran out and rented a knee walker just so I could go. I managed 1.6 miles that day, some carrying a 26 pound bumblebee. So, I love me knee walker.

After 2 weeks on the knee walker, here’s all I know about it.

Summary of the knee walker experience

Crutches? Anything but crutches! I love my knee walker! After a few days on crutches I was desperate. I had know idea how inconvenient crutches were. Let’s point out the obvious: you can’t carry much with each hand on one crutch. (Yeah - I figured out the trick of hanging a satchel over a shoulder). Absolutely impossible for the daddy of two busy children.

However, don’t throw out the crutches. There are many places you simply cannot go on a device with tiny wheels. The back yard, the beach, poorly maintained sidewalks. I crutch around periodically to give me right knee (bad) and left ankle (good side) a break.

What about other devices? I know little of other alternatives. One-crutch, I walk free look interesting, but I haven’t found any informative reviews of these, and don’t want to shell out the cash to find out that it won’t work for me. I wanted to try before buying, the local medical equipment stores only carried the knee walker. So, that’s what I have.

Great stuff about the knee walker

I just went trick or treating with the kids! 20 blocks. Not easy, but possible. (early - our neighborhood business do a Halloween walk the weekend before)

Carrying things! I have a free hand (+ basket) for kids, dishes, coffee, and the like. When I’m daring, I have two hands free.

Walking with the kids! My favorite thing to do. I still can’t keep up with the four year old, but it’s a fairer race now. I’ve decided to just cheat and go to places where walking is easy (the zoo, the Locks.)

Warnings about the knee walker

It works great indoors and on very smooth surfaces, but is not an off-road vehicle. Hills and even slight inclines are frightening. You are on one leg or on tiny wheels with very little breaking power. Tt tends to slide off to one side. Any flaw in a sidewalk can send you over the top. A 1″ pebble outside my house got me last week.

It is not a scooter nor a skateboard. Don’t lean all your weight on the knee walker and push it along, even if you see me doing it. This is tempting - but I’ve spilled off the walker several times this way (pebble, table leg, sidewalk crack). If you actually “walk” with it, you have much more control. By this, I mean you take your weight of the walker while you move the walker forward. You keep as little weight on the walker as possible. If the walker flips or spins downhill you are still standing.

The super safe method of using it is like this (I do this on any questionable terrain)

1. start with nothing moving
2. move the good leg forward while walker is still not moving
3. shift weight off the walker onto good leg and “walk” forward: push the walker forward with your knee just barely resting on it.

This feels just like walking.. (However, I’m a slow learner, despite 3 tumbles in a week, I still scoot and coast. I’m practicing those judo rolls … )

Limitations / Complications

Very tricky to get up and down stairs: In the basement, I leave a rolling office style chair or my crutches near the stairs.

Did I mention hills? Ascending a hill gives you much time to contemplate high school physics, friction, force, intertia, but hopefully not corialis effects. I occassionally navigate two steep blocks in my neighborhood or to work. This is extremely unpleasant. For getting to work, I’ve found A map of seattle accessible routes - it has all the buildings in downtown with public elevators. I go well out of my way to find wheelchair routes.

Weird pains the first week. These aren’t as bad as with crutches (or hopping), but I’m had weird pains in butt and hips the first week. Keeping it stable requires use of muscles I don’t use much. No problems after I learned how to use it, except a sore right knee. I’m thinking of getting kneepads to create a flat surface from knee to splint.

Miscellaneous other mobility tips

Best when combined with a claw … I keep a 3′ claw / grabber thingy hanging off the front of my knee walker. This allows me to clear toys and clothes out of the way (the 2 year old is very tidy, the 4 year old is not). The claw saves me lots of hops, squats and other awkward one -legged maneuvers. We had to get 2 more (cheap ones) for the kids, though.

How do you get kids (2yrs / 4yrs ) to listen to you from a distance, so that you don’t have to hop 30 yards accross a playground to keep big brother from dragging little brother through the dirt under the slide? Getting a 2 year olds attention is especially hard when you can’t just run over and pick him up. This worked for a week: “Hey, Kepler, I think I hear a Zebra in your jammy drawer! Come look at the Zebra in your jammy drawer!”. Now, I try silliness: I scoot on my butt like a crab in the direction I want him to go. What will I do when these tricks wear off?

Hopping. With the knee walker, my left leg is much less tired, and I have plenty of energy for a short fast hop when needed. I have two very roudy spirited kids, and I sometimes need to get to them fast. ( If I had a legal department, they’d want me tell you that I strongly recommend against one legged hopping while in recovery. Therefore, I strongly recommend against hopping as a mobility solution. Hire a nanny to chase the kids with all the money you save from having your surgery in at a medical tourism resort Cuba / India / Mexico. If you can’t afford a nanny, keep your kids on a tether and indoors at all times, well away from anything that might tempt them to run around and squeal with delight. There, you are warned against hopping. )

Scoot on butt: I unpacked all the groceries today on my butt. I chase the kids to bed on my butt. They think it’s even funnier than hopping.

Insurance? It was pretty easy to convince my doctor to write a scrip for the knee walker. Now we’ll see if I can get my insurance to pay for some of it. I’m renting it, but it’s not horribly cheap.

Thoughts only peripherially related to this post

You really can get anything on Highway-99. (except books). For the last 6 years, we’ve been laughing at a silly quaint shop with a wheelchair hanging over the front door a ways up the road on Aurora Ave ( Highway 99 has many names ). It’s an effective gimmick … when I needed mobility assistance I knew where they were. They have knee walkers for loan and I got some instant gratification.

Anyway we’ve often attempted to come up with something we can’t find on Highway 99. I’m pretty sure I can get everything I need Highway 99 ror achilles tendon rupture recovery,: Groceries (and delivery services), a hospital, crutches (or walkers), and enough pawn shops that I’m certain I could get anything else. I could even get a cat to keep me company. There was an all night diner to eat at after a late night in the E-R the first night. The only think I can’t get on 99 is a good fiction book to read while resting my swollen calf.

Stuff I’d like to know from others

How do you manage busses? I manage them awkwardly.

Experiences with other ways to solve mobility problems?

Is there a normal bookstore on Highway 99 (in King County)? There are several a few blocks off 99. is a Christian bookstore, but they wouldn’t carry Ursala LeGuin or Kage Baker.