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Casted… again.

Well, I had my two week post-op visit yesterday.  And despite all my hopes and prayers, I was re-casted.  On the bright side, the incision looked great(I tried to post a picture of it, but couldn’t figure out how to get it done with my iPad). I guess I had kind of gotten my hopes up in the days before my appointment that I might be able to return to some level of normalcy, even though I knew in my head that I would still be NWB for at least an additional two weeks.

Ugh… It’s so frustrating.  I’m generally a very ‘glass is half full’ type person but this whole ATR thing is giving those rose colored glasses a slightly darker tint!  It’s irritating on so many levels. There is a multitude of big picture things that I can’t do, like work/drive, which are problematic.  Especially since I had just started at my current practice and was working to build a good client base and all I can think is that the base that I had invested so much time in building is slowly fading away as I sit on my couch.  Then there are the small things like carrying a drink from the kitchen to the couch or showering that can really throw a wrench into the works.  Even going to the bathroom is a chore and god forbid I drop something!  But it’s in these little things that I’ve been able to find my small ‘victories’ by figuring out a method or system to get these previously simple tasks done. And I guess that’s been key for me getting up each morning and facing the day, knowing that there is probably something new I can figure out how to do or how to do better.  In terms of the big picture stuff, for me it’s a matter of realizing all the little picture stuff that I still can’t do that help to put it in perspective.

At least this time I was conscious at the time of casting so I was able to pick the color for my cast!

Alternative Therapy Questions

Has anyone had any experience with PRP (platelet-rich plasma) or IRAP injections in the treatment of their Achilles injuries?  I ask because I was joking around with one of my colleagues who is big into equine surgery and we figured since they are both currently used options for horses, there might be some human usage as well.

Anyways, feel free to comment if you’ve had any experience with either therapy or perhaps anything else different or progressive.  I get my stitches out on Monday and I want as many ideas as I can get for recovery!

Time to Cut

So, I had surgery last Monday, 11-19-12.

Overall, it went pretty well. It was a standard out-patient procedure. My admission nurse was awesome! As dumb as it sounds, the part I was most nervous about was the placement of the IV cathedar. She talked me through it and to be honest I didn’t even notice. The worst part of the whole morning was just the waiting. I was there at 815a but was schedules to be the second patient on the table. I guess it could have been worse.  My parents were both in town so they both able to hang out. Which for my mother meant nervous chatter and for my father meant getting out his laptop and knocking out some e-mails! But it was good none-the-less.

At about 1045a, the anesthesiologist came in to go over ‘a few things’. Once that was done she ducked out of the room and came back shortly after with a syringe of ’sedation’(or midazolam for anyone medically inclined). As soon as she gave that, I urged my parents to go. I’m glad I did cause the next minute or two consisted of me musing out loud about what animals must be going through when we anesthetize them.  The last thing I remember is going through a doorway mid-sentence. Then nothing…

I guess it was about an hour or so later and I was waking up. It was certainly much less sudden than going to sleep. I think I was in and out of it a few times.  Unfortunately, my recovery nurse (who was not the same awesome admissions nurse) was in no mood for any humor.  Which was problematic cause from what  I remember I was hilarious.  After a little while, we had the pain managed and I was discharged and sent home.

In the week since surgery, the level of discomfort has steadily decreased.  Accordingly, so has the amount of pain medications that I’ve been taking.  I have been keeping the leg elevated as much as I can.  The first few days, I could feel it swell when I got up to go to the bathroom.  However, over this weekend that swelling while standing has greatly improved and I’ve even managed to haveit he leg down quite a bit more.  There have been a couple rough nights as its been an adjustment to sleeping with my legs elevated.  Also, I’m not sure of the cause (maybe a side effect of the drugs, either pain or anticoagulant) but I’m having some weird vivid dreams. Last night, I dreamed that my cast fell off and I couldn’t find it… It was so real that when I woke up, I had to reach down to check and see if it was still there!

Anyways things seem to be progressing well. Two steps forward, one step back!  I am in a wedding this coming weekend… Not sure if I am going to be able to do it by then or not.  I guess the next few days will tell!

Surgical Consult

I met with the new foot and ankle surgical specialist on 11-13-12, two days after my “incident”.  It was a pretty straight forward visit. The PA came in first and removed the cast splint. Then he did the same exam that had been done by the PAs before in the ER.  He got the same results- basically my calf was no longer attached to my heel.  He explained the process of what all would happen during the visit that day and left to get the Doctor.

I think my experience with the doctor was pretty similar to what most people have gone through. But I felt like the most important part was the fact that the discussion revolved around me.  He explained the issues of surgical vs non-surgical treatments, recovery, rehab, management and future return to activity.  We both came to the conclusion that surgery would be the best option for me as I’m on the young side and want to return to a fairly high level of activity when all is said and done.

This was also the first time that anyone really took a look at my MRI to say anything other than ‘yup, it’s ruptured’. The Doc explained to me that my tear was higher up the tendon (closer to the calf muscle) and that while he thought surgery was still possible, it was going to be a little bit tougher.  It was also going to make it necessary for him to have a plan A and plan B in regards to his approach. And lastly it was going to make him want to tend towards the conservative side with time periods for my recovery.

Thus far in the whole experience, I hadn’t felt at all nauseous. But when we began to discuss that I would be NWB for 4-6 weeks and 100% NOT going to be able to work for a minimum of 2 weeks but more likely 4 weeks due to the nature of my work, I needed to lay down.  From reading the blogs on here I had certainly read and understood what I was looking to in the future, but it hits hard when it’s told to you and in terms of your life.  Once I picked myself back up a little, I was told that I would be sent home in a raised heel boot and could schedule the surgery for either that Friday or the next Monday depending on what my insurance would approve.

I was switched off of Asprin and onto Xarelto (which is apparently the newest ‘go to’ anti-coagulant for orthopedic surgeons). I was also given an Rx for a lot more Percocet. I was taking 1 tab about every 4-5 hours to keep the pain under control. And over the next week or so before my surgery, I would occasionally skip a dose if I wasn’t gonna be moving around too much.  That seemed to work out pretty well for me.

We scheduled the surgery for Monday, 11-19-12.  And over the week, sorted out all the details that needed to be in place for my future care.  I was very lucky that my family has pretty flexible work schedules/employers so they are able to basically come live with me until I’m more or less under my own power. It’s absolutely essential.  The week after the initial diagnosis can be extremely depressing when you start to think about stuff that you’re missing out on and just the shear amount of simple things that you can’t do while on crutches. Sure, I could get around a little on the crutches but it was painful and I couldn’t carry anything. I do suggest wearing hooded sweatshirts with the front pockets on the belly. It’s just enough to give you a little feeling of independence.

More to come about the surgery tomorrow.

My Story- Same tune, different song

Reading the stories of other has helped me so much through the initial injury, diagnosis, and now surgery. Thanks to all those who participate.

My backstory: I’m a recent veterinary school graduate and had just moved about three hours away from my family (and most all my friends) for my first job. It was great living here over the end of the summer, as it is a beach town and is pretty packed up until Labor Day.  Since then, it had gotten a little boring.  But there were some great bright spots that came with having less people around.  I could fish, bike, kayak and do a bunch of other outdoor activities with ease.  Only issue was that these were all individual pursuits and I felt like I needed to get back into some sort of team sport/activity. It turned out my hospital sponsored a flag football team that played in a league in the local college town. And after some coaxing from my boss I decided to join.

My injury 11-11-12: 2nd half of the last game of the season before playoffs. I didn’t initially appreciate how serious flag football could be for some people, but over the weeks it sank in. Anyways, I was on defense waiting for the snap so I could rush the quarterback. Their center snapped the ball to the QB, then I (and everyone on the field and sidelines) heard my snap.  It was such a hollow, rubbery sound.  My first thought was that I had been hit in the back of the leg with a ball throw from the sidelines and I remember looking around for it as I fell to the ground…  Nothing and no one else within 15 yards.  That’s when I felt the back of my calf and came to my own medical conclusion… Ruptured Achilles’ Tendon.

ER Visit: My visit was honestly a mixed bag. I was seen immediately by an intake nurse and then by a PA before being transferred to inpatient care for an MRI. I didn’t have to wait long. It seemed like as soon as I had changed into the hospital gown, I was off to the radiology department.  It was about a 30 minute scan and when I was being rolled back to my room I asked the tech what she saw on the scan. She told me she wasn’t allowed to interpret them but that there was definitely a ’suspicious gap’ where my tendon should have been.  I got back to my room and then the waiting started. The on-call surgeon was in a trauma surgery and I was behind one other consult. It was about 1.5 hours before the surgeon’s PA was able to come see me. He told me the surgeon might not make it in to see me, and in the 5 minutes he was examining my leg he got two pages for incoming traumas and the hospital went onto a lockdown code because one of the traumas was a gang related gunshot wound. Luckily for me it was a pretty cut and dry diagnosis. Complete rupture.  I was put in a cast splint and given an appointment in two days with the foot and ankle specialist.

I had been offered pain meds all day, and declined them the whole time. I guess I have a pretty high tolerance for pain and was riding high on adrenaline.  But by the time I left the hospital with my pain med prescription in hand, I was in a pretty high amount of pain.

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