3rd post op appointment and physio - bye bye cast

July 4th, 2010

After 11 ½ excruciating weeks my cast was finally removed on Thursday 29 June . I’ve put the date in bold because it was such a momentous day and the end of much frustration.

In the end I never did get an aircast boot due to a mix up at the hospital (???). Following Norm and Mikes advice I tried a little gentle pester power (phone calls, faxes, etc) to get my cast removed sooner but had my 10 ½ week appointment cancelled (fog at the airport this time) and ended up waiting the surgeons originally prescribed time.
At the appointment, my cast was cut off, surgeon did the Thompson test to see if the tendon had healed and I was left to go on my merry way with a referral note for physio (no heel lifts which was a surprise). My poor calf was non-existent and I had a lot of dead skin underneath my foot but everything seemed OK.

I dropped by at the physio dept and met a physio I know. Although I didn’t have an appointment she kindly asked me to come back in half an hour and took me through a few exercises. One of the benefits of living on a small island is that you know just about everybody. Apparently my scar looks good and my leg/ankle had decent ROM and strength considering the amount of time I was stuck in a cast.

My calf is still so weak that I still need to use crutches to walk ‘properly’ and stop me from learning bad habits during my rehab. I asked my physio whether I could make as good a recovery as people following more modern protocols. She thought that I should be able to catch up eventually if I worked hard although she may have just been saying that to put me at ease. I haven’t read of anyone else on here having surgery and then wearing a cast for so long and don’t fancy being the test case!

Anyway, things are a lot more positive now that I’m getting physio. My tendon feels good and my calf strength is returning quite quickly. I hope to throw the crutches away on Thursday this week and get the all clear to start driving.

I’m wearing a pair of crocs (which I bought after reading gunners page) and these are perfect for avoiding any rubbing against the scar.  I’m doing as much walking as I can and so far I’ve had no pain whatsoever. Also I’m rubbing plenty of scar oil/cream in my incision which doesn’t look too bad.

If any new ATR sufferers are reading this, make sure you get on an early weight bearing protocol and try to get a boot so that you don’t have to suffer the indignity of wearing a cast for 3 months. You really need to do this at the start of your treatment as it’s very difficult to change things later on (as I’ve learned the hard way). I would even say go and buy your own boot as soon as you can so you don’t have to rely on what the hospital has in at the time.

2nd post op appointment

May 26th, 2010

I finally had my second post op appointment today 7 1/2 weeks after surgery, this time with the surgeon who operated on my achilles (not the resident surgeon).

I asked if I could start weight bearing but he told me he would prefer me to stay NWB.  When I enquired about wearing a boot he said he would have given me a boot but there were none at the ortho clinic (d’oh).

My foot was moved to neutral and I was re-casted.  I’ll be given a boot at my next appointment in two weeks and will then begin weight bearing.

While I had the chance I rubbed some moisturiser into my incision scar and noticed how bumpy my achilles was near the heel.  This must be the tendon scar tissue which felt quite significant and I’m hoping will reduce with physiotherapy.

Hello everybody!

May 21st, 2010

Hi All

I’ve been reading this excellent website for three or four weeks and, after recently posting on the UK ATR blog, thought it was high time I bored everyone with my own Achilles blog.

I ruptured my right Achilles seven weeks ago playing football (soccer). The game was 10 minutes old when I tried to play an exquisite through ball with my left foot while ‘pirouetting’ on my right foot. As I did this my heel stuck in the boggy pitch and I was bumped by an opponent from behind and then … BANG … my Achilles went. Although I’d warmed up well my legs felt fatigued from a long barefoot run I’d done the day before on sand and, with hindsight, was probably a factor in my injury.

I visited the local A&E and they arranged for surgery the next day. I live on the island of Uist in the Western Isles of Scotland and had my surgery on the neighbouring island of Lewis at the Isles Hospital for surgery. I found out that the surgeon was a locum covering for the resident which made me a little nervous but the nurses told me he was very good. He carried out an open surgery and described the repair as having to tie horsehairs together. Rather devastatingly he advised that I probably shouldn’t return to football and wasn’t sure whether I’d be able to run again. My hope is that he was just being ultra cautious and that I could amaze him with a fantastic recovery.

I left hospital in a cumbersome below the knee plaster of Paris cast with my foot in equinous position and instructions to keep my foot elevated. My rehabilitation is being looked after at an ortho clinic on my own island which the resident Isles Hospital surgeon visits fortnightly to see out-patients.

After two and half long weeks I attended an ortho clinic with the resident Isles hospital surgeon. My stitches were removed and my cast was replaced with a hard cast with my foot remaining in equinous position. The surgeon thought my incision was healing well although I was shocked that it was about 10” long. I was also shocked by the level of calf atrophy I’d suffered. I was told that I would probably be in a series of casts for a total of about 12 weeks. I asked whether I could use a boot instead of wearing casts but my surgeon advised that boots weren’t suitable for this type of injury.

I was due to see the surgeon at an ortho clinic last week at 6½ weeks but the clinic was cancelled due to a plane mechanical fault. The joys of living on island!

I’ve had a few days back at work the last few weeks although as my work involves visiting construction sites what I can practically do has been reduced significantly. I’ve been doing my hip and thigh physio exercises every day which has at least help me feel like I’m being proactive in my recovery but I will be insisting(!) on beginning weight bearing at my next ortho clinic visit.

My experience to date:

3 April
Rupture Achilles

4 April Easter Sunday
Travel to Isle of Lewis. Open surgery of Achilles performed

15 April
Original post-op appointment had to be rearranged to as surgeon flight was cancelled due volcanic ash

22 April
First post op appointment

20 May
Scheduled second post op appointment cancelled

26 May
Due to have my cast replaced and hope to be PWB