Achilles Tendon Rupture Recovery

I am able to put a bit of weight on my cast leg when I am standing, but I can’t walk on it yet. The PA told me to limit the weight bearing to about 20-30 lbs.So I got the bathroom scale out, stood on it with the cast leg on the scale and my good leg on the bathroom floor. I started out with most of my weight on the good leg, and I gradually put weight on the cast leg until I put about 20 lbs on the scale.So, now I have a good sense of what 20 - 30 lbs is like. It feels awkward when I put weight on the cast leg, so I am going to take it real slow.I do feel tightness in my heel, probably due to the neutral position of my foot. Comparing notes to other’s recovery protocol, it seems like I am on a bit of a fast track, and I am wondering if I should have had my toes pointed down a bit more.Hopefully the tightness will go away in a few days. Luckily the foot isn’t swelling up. I still elevate the leg most of the time, but it turns purple when I stand around. It returns to normal color when I elevate the leg again. I should have asked if I am still supposed to elevate my leg all the time, but I have a feeling that I am supposed to.My calf muscle is getting smaller and smaller, and my thigh cramps up a bit every once in a while. I’ve started to eat more bananas to alleviate cramping.

I went into see the doctor today, it’s been 2 weeks, 1 day since the surgery.

The nurse removed the cast, and I finally got to see my left heel, stitches and all. Here is a nice picture of it:

It was a relief to have the cast off since I was able to scratch regions around the incision. It’s been bugging me for a couple of days.

The nurse removed the stitches, and it was painful, but manageable. This is how it looked:

Overall my heel looked good, and luckily there was no infection in the incision area.

I waited a few more minutes and the physician’s assistant walked in. I was hoping to see the surgeon, but he was busy. The PA recommended 3 more weeks of cast in neutral position (90 degrees) allowing for about 20 - 30 lbs of weight bearing.

This is my new cast. I don’t think it’s quite 90 degrees, but close enough.

After that, I’ll be moving into a CAM boot with steadily increasing weight bearing until it’s full weight bearing with the brace in the 2 week time frame.

Normal shoes at 8 week mark.

I asked the PA about early weight bearing protocol, and he advised against it. He didn’t give me any concrete reasons why, admitting that the rupture rates are not any worse according to some reviews.

I also asked if I could go into a CAM boot right away, but he recommended that I don’t since people get tempted to take the boot off and if you get sloppy, you might hurt yourself while you have the boot off. As for the cast, it’s on for good, and from the doctors’ perspective, they can be sure that I won’t be hopping around without the boot.

I thought about it some more and decided that I didn’t feel comfortable with the strength of my achilles tendon now anyway, so I asked that I be put in a cast for 2 weeks, and then I’ll move into a CAM boot. The PA said that was a good compromise, and the nurse put on another fiberglass cast on me.

I also asked the assistant if I could see the doctor, but he said that the surgeon was in surgery, and if I really wanted to see him then I would have to wait for a while. I did see the surgeon walking around before, and he did see a few other patients, but I suppose the timing didn’t work out.

I’ll make sure that I see the doctor next time.

I guess this doctor’s recovery protocol is moderately conservative, and I am not in a cast for too long. I am happy with partial weight bearing for now.

Earlier, my friend advised me to get a copy of the Operative Report and Discharge Summary, so I asked for it. The PA said that there was no discharge summary since it was an outpatient surgery, and he was happy to make a copy of the Operative Report for me. After a couple of minutes, he handed me a copy of the Operative Report, and he also filled out my temporary handicap permit form that I brought with me.

Overall I was happy with the visit since the incision is healing nicely, and I am at the partial weight bearing stage. Two more weeks in a cast, and then I should be able to slowly walk in the CAM boot.

Apparently Krackow suture is the type of suturing that they used. I’ll have to look it up to learn a little more about it.

I drove to the Orthopedic center for my appointment with the Knee Orthopedic Surgeon to go over my MRI results on my knee.

I had initially thought that it was a meniscus tear, but it appears that I have articular cartilage damage of about 1 cm wide. The cartilage will probably not heal on its own. Physical therapy will help, but it probably won’t fix the problem. I’ll have to do a bit of research for a few months, and also get a second opinion, but I’ll probably opt for surgery in about 6-8 months after my achilles tendon has mostly recovered.

It’s going to be a long and tough road to recovery, but it’ll be well worth the hard work and commitment. I can’t imagine my life not being able to ski, run, and play basketball.

I am really looking forward to getting back on the court and on the slopes next year.

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I woke up with a moderate itch in the region around my surgically repaired achilles, which I can’t scratch because of the cast.

Also, I usually wake up with a bit of swelling around my ankle, which goes away after an hour or so. I keep my leg elevated with a pillow in the bed, but I toss and turn, and I can’t be as vigilent when I am asleep.

I haven’t come across any posts about itches, except for someone mentioning that his recovery process was going well and that he’s had no swelling, itching, etc. So I am inferring that itch in the wound area must not be a good thing. I’ll post more when I find more info.

I am going to see another orthopedic surgeon today to go over my MRI results on my right knee. (FYI, I have ATR on my left leg). There might be some meniscus (cartilege) tear, and I want to find out if this is what’s causing the pain when I put all my weight on it. It’s not great for hopping around. And “No” I am not going to have an operation on my right knee, unless that’s the absolute best thing for me to do, and it’ll be after my left leg heals. There is no way I am going to have casts on both of my legs.

My calf muscle on my left leg is atrophying due to the immobility. It’s not a pretty sight, and I don’t think there is a way to exercise it without putting strain on my achilles heel. The proponent for agressive recovery protocol gives the reason that you don’t want your leg to lose too much muscle mass. It’s depends on the person and how fully the person has recovered from the ATR.

The key is determining how much the achilles has recovered and how much strain it can withstand without any damage. I think Kelly has some insight into this. You can checkout Kelly’s comments here.

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For more information on Achilles Tendon Rupture, go to: http://achillesblog.com
My Achillesblog is: http://achillesblog.com/dennis

5 seconds is how long I can stand on just the crutches.  Feet not touching the ground.

I am looking forward to being able to walk without crutches, and I am still waiting to find out if I can get the iWalkFree crutch through my insurance.

I was able to get a shower chair through my insurance (I paid 20% of the cost of the chair). If your leg is in a cast, a shower chair is a must-have item. There were these benches that can be placed partially on the bathroom floor and partially in the bath tub. I wanted to get that, but my insurance wouldn’t cover it since it’s not technically a “shower chair”.

I have a follow-up appointment with the surgeon on Tuesday.