I am lucky enough to have my employer cover a majority of my healthcare. My wife and I are on a Kaiser HMO plan where about $100 or so comes out of my paycheck a month to cover the both of us.
My achilles surgery cost me $250.
My surgeon had scheduled my surgery for Monday, 3 days after the injury. After paying and checking in at Kaiser I waited in the hospital surgery room for a while before being called in to change into the surgery gown. I was then put on a gurney and hung out with the nurse, who was doing her routine checks, in a curtained area. A young dude came over and told me he was the resident surgeon on duty. He had to be about 25 years old or so. He walked me through what was going to happen after I was rolled into the operating room.
Then the operating podiatrist came over and introduced himself, Jason Neufeld, DPM. He is in his mid 30’s. I had lots of questions for him and he answered quickly and confidently. It really made me feel comfortable. Below are a few questions I paraphrased from our conversation.
How many achilles tendon ruptures have you repaired?
I have repaired 100’s of achilles ruptures over the past few years.
How many re-ruptures have occurred out of those you have performed surgery on?
None, that I am aware of. I follow and keep in contact with all of my patients until they have fully recovered from the injury.
[After giving Dr. Neufeld a brief background about who I am, what I do and what my active life is like] What is your recommended recovery and rehabilitation timeline?
With surgery, we keep the patient in a cast for 2-3 weeks and when the cast is removed the patient is given a walking boot. The stitches are removed when the cast is removed. The walking boot is in a fixed position with your toes pointed down similar to the cast. Patients will still need to use crutches for the first month or so after surgery and shouldn’t put any weight on their recovering leg. After that we slowly ease patients into allowing weight on their recovering leg in the boot with the toes still pointed downward. Depending on how that goes, we adjust the boot a few times until the foot is moved towards a position where it’s flat on the ground. Patients are in the boot in a fixed position for about 6 weeks total. Afterwards we keep the boot on, but allow patients to move their foot and increase their range of motion until we feel they are ready to remove the boot.
Each patient is different so this timetable is not in stone and will be adjusted depending on physical therapy and feedback from our appointments.
Do you have experience with the VACOcast boot? Do you recommend it?
I have had a few patients use the VACOcast. They all showed great results from using it, but a majority of our patients don’t use it. The reason they don’t use it is because it is quite expensive and not covered by Kaiser. The bottom line is you should recover just fine regardless of the type of boot you use. Recovery results depend on how well you follow our rehabilitation process.
I asked more questions about the procedure itself including how long it took, what are the anesthesia options, how long it takes to wake up from the anesthesia, etc. I also asked about rehab and physical therapy which I’ll cover in another post.
What I was most satisfied with was the doctor’s overview of his recommended recovery path. That was the rehab plan that I had been reading about. It was exactly what I want to do.
I decided to take local anesthesia instead of general anesthesia. I just wanted to be out, then wake up when it was over. Both do that, but local anesthesia allows you to breathe on your own. General anesthesia requires a tube down your throat to help you breathe which can get complicated with this type of surgery since you are laying on your stomach.
They rolled me in to the operating room and asked what kind of music I wanted to have playing. I told them I’d rather have the surgeon have his favorite music playing–he’s the one who I want comfortable.
My drugs were kicking in and I was getting drowsy. I remember was Dr. Neufeld doing what they called a, “Timeout.” They went around and each person in the operating room took a turn, giving a status update. After the last person gave their status, I asked if I could give mine. I wished them good luck and asked them to bring their, “A-game.”
Then I asked if they had seen Rookie of the Year. “I want to come out of this surgery with a laser left footed (soccer) shot. Hook me up, boss!” That’s the last thing I remember.