Welcome to managed health care!
July 15, 2008 by drahcir61
One of the reasons I was interested in this website was to hear about the “typical timelines” that people experience for surgery, post-op, PT, etc … it’s a long road so what should I expect? I noticed many people had their surgeries within a week, many within a few days after the injury. I was like, what the friggin’ happened to me? It took me 2 (long) weeks! Hmmm all I can surmise is that it’s alphabetical … see my last name begins near the end of the alphabet so I figure there must some sort of alphabetical process for scheduling achilles surgeries … yeah that must be it.
So I ruptured my achilles around 5pm on Wednesday, June 25th (’08) … a nice start to the summer. My wife was great helping me get home from the tennis court & getting the ice packs along with several pillows to elevate my leg. I knew I needed xrays & more than likely an MRI so we went to the ER (she drove despite my insistance that I’m actually a better driver when I’m in pain & in need of urgent care!).
Not much luck at the ER, no xrays & no MRI … those needed to be done at Kaiser (which was closed) so I came home with my ankle braced & wrapped. No big deal, I knew it wasn’t going to get any worse overnight plus after a few glasses of wine I’d be sleeping in the dog’s bed. I went to Kaiser the next day & got my xrays but they needed to schedule an appointment with my primary care doctor for further evaluation … so I waited another day.
The doc didn’t think it looked good so he wanted me to see the orthopedic specialist which is not part of Kaiser. Fortunately I got in to see him on Monday, June 1st (5 days after the injury) … he couldn’t tell anything from my xrays but did confirm that I had ruptured the tendon (the ‘ole squeezing on the calf muscle & the foot don’t move trick).
FYI, this is a large & very prominent Ortho group in Atlanta so I felt very comfortable visiting them (& still do). Nonetheless I checked the bio’s of all of their MD’s beforehand. This particular doctor was a specialist in hand/wrist injuries so when he confirmed my achilles was ruptured & told me that he would handle my surgery I had some reservations. Hand/wrist … ankle/achilles, kinda similar. I realize the ankle is connected to the shin bone which is connected to the thigh, the hip, spine, upper torso, eventually leading to the hand/wrist but seriously, did I really want a hand/wrist expert performing surgery on my achilles? I think not … unless he slept at a Holiday Inn Express last night.
Actually he was great & very professional … when I explained to him that I was hoping to resume a very high level of competitive tennis (wishful thinking) he immediately suggested having his colleague (a very skilled ankle/foot surgeon) perform the surgery. Now we’re talking, bro. Seriously though … managed care works both ways … health care professionals will manage your care but YOU have to be active in managing your care, as well. I knew what I wanted going in & wasn’t going to settle.
On we go … so all we needed next was an MRI but that had to be done at Kaiser. He writes up the referral & 2 days later I get my MRI (1 week after the injury). July 4th weekend so nothing is happening on Friday & I figured what the hell … honey let’s go to the pool. I didn’t have a cast yet & by now the swelling looked liked a case of elephantitis. Off with the bandages & dive right in … well not quite, I gingerly hopped down the pool stairs while holding the edge … but boy that water felt good once I was in (& what I’d give to be able to soak my leg right now!!!).
So the holiday weekend wasn’t a complete waste. Monday morning I got to see the foot/ankle specialist who surprisingly told me he didn’t need the MRI … he could tell from the xrays that the ligament was completely ruptured. Grrrrrrr … I waited 2 weeks for this? It wasn’t all bad, he got me in for surgery the next day … it took 2 weeks but I got the surgeon I wanted plus I was able to perfect the one-legged, doggy paddle in the pool.
I don’t remember much about the surgery … took a few deep breaths with this funny mask thing on my face & then I woke up with this 10 pound cast on my leg … I hate magic tricks. I also hate when they ask if you’re allergic to this or that … I’m allergic to needles. The intravenous in the hand was the worst part of the day … well until later that night.
FYI … I highly recommend the nerve block in the leg before surgery; I couldn’t feel my toes until 12 hours after surgery. I just wish they had told me to take the Percocet BEFORE the nerve block wore off. It’s now 3am … 12 hours after surgery & I wake up to feel my toes … hey I can feel a slight tingle, great. 15 minutes later I can feel the pain … not so great. Grab the damn Percocet!!! 10 minutes later the pain goes from a 9.0 to a 9.7 & I’m in agony! The things we learn … Percocet will kick-in about an hour after you take it … plan accordingly! lol
The good news is I only needed the Percocet for the first 2 or 3 days & then the pain was minimal. Interesting that I read the stuff is addictive & kids get off on it these days … I don’t get it. Maybe it was the pain but Percocet just made me sleepy. I never got any sort of “high” or weird feeling from it. Now wine … ok, wait … that’s another blog. Btw, no wine (or any alcohol) with Percocet … that combo can kill you. So I’m in a holding pattern until I get the first cast off in 9 days but who’s counting … I am!!! More good news … the Percocet is now out of my system which means the wine cellar is open for business once again.
Don’t look if you cringe easily but here are 2 pictures of the bruising & swelling 1 week after the injury … you can also see the indentation where the tendon is missing.
http://achillesblog.com/drahcir61/files/2008/07/achilles-rupture-bruising-1.jpg
http://achillesblog.com/drahcir61/files/2008/07/achilles-rupture-bruising-2.jpg
Well, sounds like your experience was almost identical to mine except…they told me to take the Percoset before I went to bed whether I needed it or not. Thank God! That was some good pain but like you I slept through most of it. I did have a headache for a few days after I quit taking it, however the wine made it go away. My biggest piece of advice with the wine….make sure you drink alot of water and eat a banana before you go to bed. I “accidentally” drank a bottle to myself one night and ended up with leg cramps. Its normal for me, always has been if I go past 2 glasses. BUT, leg cramps with ATR, NOT A GOOD COMBO!
If I had a picture of myself with the corkscrew in my mouth, wine bottle in front pocket of hoodie and stemmed glass hooked between my fingers on my crutches…..
Hang in there.
Cin Cin!!
Very interesting reading, and I must say enjoyable as well. The thing this site does it make us all into writers!!
Love the pictures. Have a look on my site under heading ‘bad leg’s’ and you will see my foot 2 weeks after rupture and that was when the swelling ‘reduced’.
I tried the wine, but as I am not much of a drinker my husband said I just went very very red, then I had to retire to my bed with a bad head, but it took my mind off my leg.
Good luck
Annie
Most foot and ankle doctors prefer 10-12 days after injury to do the surgery . my doctor who is an ortho and specializes in the ankle also preferred this timeline
im 11 days post injury when did my surgery.
Richard, you tell a good story!
I went to the ER right after I crumbled on the tennis court on April 26. They xrayed it but would not MRI it on the weekend, as it was not an emergency. (My life was in shambles, but it was not a “medical emergency”.) Not only would they not give me the MRI, they would not call in an orthopod to operate! Only later did I understand my expectations were wacko.
I never did have an MRI. The ortho resident in the ED, the ED doc and the Orthopod all did the Thompson test and said I had a full rupture, or if not full, pretty close to full.
Glad you got on with the surgery. I hope you are able to return to the pool before summer ends…it has been a wonderful physical and mental rehab for me.
I, too, asked about an MRI, and the three separate surgeons at Highland Hospital, Oaklalnd, agreed that there was no need - the Thompson test and the indentation, plus the fact that I could not stand up on my toes on the right foot, confirmed it. They don’t want to waste money on an MRI, for starters ($1000 or so vs. $200 or so for an X-Ray).
Secondly, all radiation is bad for you, to be avoided if poss.
Thirdly, so far as I have read, the surgeon wants the foot to have passed the worst of the swelling after the rupture so that it is easier to see inside. Your blue-yellowish foot was exactly like mine in the 12 days before my surgery.
This surgery has shot my whole summer, and my work, in the best season of the year to make money: I’m a driver/guide in San Francisco for tourists.
BAck to my older, bookish, more academic self, lying in bed reading WWII history books….plus movies and games.
Mary
Great post, Richard. If I had known about the nerve block, I think I would have requested it. I certainly will ask if I can use it if I have surgery down the road. The biggest problem I had the first couple of days was from the general. My body didn’t handle it well at all. I didn’t have this much of a problem 11 yrs ago when I had my gallbladder removed. Aging sucks.
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