duke’s AchillesBlog

Just another AchillesBlog.com weblog

    • duke has completed the grueling 26.2 ATR miles to full recovery!
      Goal: 365 days from the surgery date.
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    September 2011
    M T W T F S S
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  • ATR Timeline

    • Name: duke
      Location: Pennsylvania
      Injured during: basketball
      Which Leg: R
      Status: 2-Shoes

      567 wks  3 days Post-ATR
      566 wks  6 days
         Since start of treatment

Archive for September, 2011

post-operative day #7 — shiny new ‘bike’ (rolling knee walker)

Posted by duke on 26th September 2011

My rolling knee walker arrived at the medical supply store.  They had to special order one for me.  The standard size they carried only adjusted to fit someone who was 5’10” (at 6’3” and change that wasn’t going to fit).  Fortunately, my wife had asked about the height when we dropped off the prescription.  I went to the store and I have to admit it was a little like getting a new bike.  My hands were getting sore from the crutches and I was looking forward to setting them aside a bit  There in the store, in the midst of bedside commodes, shower chairs, and power recliners was my new mode of transportation.

Fresh out of the packaging (complete with plastic still on the wheels) was my cherry red rolling knee walker.  Handbrakes and basket included.  I hopped on and the fit was good.  It was loaded into the car and I was off to roll around the house.  We have hardwood floors, my wife wasn’t interested in my idea of pulling all the rugs up to help reduce the drag.  I settled for cruising around and putting things in my new basket.

As silly as it was, having more freedom of  movement and being able to give my hands a break from the crutches boosted my spirits.  My insurance company is covering part of the rental fee and I am a big fan of the rolling knee walker.  As long as you are on level ground it beats crutches by a mile.

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Day 0 — Trip to the OR

Posted by duke on 26th September 2011

After a weekend with my foot up, my wife drove me to same day surgery at 6:15am.  I signed in and took a seat.  By 7am I was in the pre-operative holding area, I met with the anesthesiologist and signed my anesthesia consent.

There was a moment of comedy while I was on my stomach for the peripheral nerve block.  I was prepped and the anesthesiologist was ready.  The nurse asked if I was starting to feel more relaxed (from the sedatives), I felt no different and this led to a discussion between the two nurses that amounted to “did you give the meds” “no I thought you gave the meds” “I didn’t give anything yet”.  Bottom line was a little bit of light sedation and then a lot of pressure as the block was given.

The CRNA (nurse anesthetist) introduced himself to me, we had some small talk about his kids.  After another dose of sedative to relax me…I woke up in the recovery area with oxygen via face mask.  I vaguely remember the surgeon assuring me that everything went great with the surgery.  I snoozed a bit, my wife came back to see me.  I found out that the surgeon was able to simply stitch my tendon together–no release from the calf, no tendon transfer.  The surgeon’s physician assistant came by to give me my discharge instructions.  Post-operative visit would be thee following Friday and she recommended I try to stay home until then, keep my leg up and get my recovery started properly.

I was sent home with a wrap to ice my leg through the splint (it is a small cooler that circulates ice water through a wrap I put on my splint).  My instructions were to keep my leg elevated and continuous cooling for the next 72 hours.  The nerve block was great but I had to pay close attention to my foot whenever I got up to make sure I didn’t bump into things.    Heeding the anesthesiolgist’s advice, I took a dose of pain medication before going to sleep (even though my nerve block was in full effect).   By 2:30 am the block was wearing off and I was reaching for more medicine…

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first week after surgery

Posted by duke on 25th September 2011

I spent the first day after my surgery with my leg up with the ice wrap running continuously.  I used several doses of pain medications to keep the surgical site quiet.   I was keenly aware of my incision and had some soreness in my tendon whenever I was upright for more than 10 seconds or so.  My wife took care of me, getting me what I needed and helping to make sure I was getting around safely.  A neighbor brought us extra ice (as our icemaker wasn’t doing well keeping up with the sudden heavy demand).   It started to sink in about just how different things are going to be over the next several months.

As all of you know, that first week is one full of adjustments.  The fact that you can’t just hop up to get what you need when the mood strikes you.  The pain/discomfort when the leg is down.  Getting accustomed to maneuvering with crutches.  A lot of sports radio, DVR, books from the library and hulu as I passed the time.

A great deal of the time feeling good, optimistic about recovery and thinking philosophically about my situation relative to others.  At others, feeling trapped by my splint, struggling to find a position of comfort and wondering if I ever fully recover.  I spent a lot of time scanning through blogs on this site, reading stories of people who made it through just what I am going through.  This gave me a lot of comfort knowing that others were sharing a similar experience.

I don’t know the attribution, but I do believe that with these kinds of situations— shared pain is half the pain, and shared glory is double the victory.

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surgical consult

Posted by duke on 23rd September 2011

I had a formal consult with the foot and ankle specialist the day after my injury.  The resident came in first, examined me and sent me off for an x-ray to see if I had calcification in my tendon (none seen, a good thing).  He reviewed a bit about operative versus non-operative management.  He talked to me about something called a “wheel a-bout” (a rolling knee walker) that I could use while I was recovering.  “The older ladies who break their ankles love zooming around on these things.“  Quite comforting.

I met with the orthopedic surgeon.  We discussed operative versus non-operative options in detail including the risks of re-rupture and the operative risks (including infection and clots).  He went over more recent data supporting a non-operative approach.  He told me he might need to do a release to free up extra tendon from my calf and could possibly need to do a tendon transfer from my big toe as well.  After weighing the issues,  I opted for surgery and was scheduled for the following Monday.

He gave me a copy of his rehab protocol (which is fairly similar to this one:  http://www.mcworthopaedics.com/pdf/mark-richards-achilles-tendon-protocol.pdf).  I asked when he thought I could drive again (4 to 6 weeks) and whether he thought I might be able to return to work the week after the surgery (he thought it was possible if I could keep my foot up).  He reassured me with some anecdotes about some of the patients he had successfully treated in my age range.  I had a new splint put on and I was out the door.

That left me with a weekend to surf the web, prop my foot up and continue to debate with myself about whether the surgical approach was the best one for me.

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“Dad you’re too old to be playing basketball”

Posted by duke on 22nd September 2011

I am 35 years old, fairly active, with (what was) Achilles tendonosis on the right.  The issue was chronic dating back to marathon training a few years ago.  I had actually seen an orthopedic surgeon about the pain in my Achilles 1 ½ years ago and he offered me a surgery for pain management.  The key question I asked at the time was whether or not it would alter my risk for rupture, he said no.  I opted against surgery and gradually increased my exercise.

Pain free for over a year and back to playing basketball, running, and lifting weights with careful warm-up each time.  That changed while playing pick-up basketball on a Thursday.  The injury came during the second game of the evening.  I made a quick cut to get open and you all know the story from there.

I felt/heard a pop and felt a searing pain in my Achilles as I crumpled to the floor.  One of the guys I was playing with said my words were “this one isn’t good.”  I limped off the court with no power at all.  Fortunately one of the players happened to be an orthopedic surgeon.  He confirmed what I suspected, Achilles tendon rupture.

With my right leg involved I didn’t feel safe to drive and thankfully a couple of the guys playing drove me home.  Having tendonosis I had prepared myself that rupture might happen at some point. The reality was difficult to face.  The lengthy rehab and the questions about whether or not I would return to my prior activities.  I told (and am telling myself) that it is better to happen now rather than 20 years from now and that my fitness level is as good as it has been in four or five years.

My wife and I explained the injury to my daughter and 6 year old son.  His response, “Dad, you’re too old to be playing basketball.”

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