Askeladden’s AchillesBlog

Ok, not really, but I’ve been running! Two runs so far, alternating running and walking. Both about 4 miles. I start out walking, then run for a bit, emphasizing flats, walk up hils and run flat and down. I probably run 2/3 of the way. I stop when the burning sensation sets in.

I think the biggest thing this does is help me trust my leg more, and worry about stray dogs and angry cabdrivers less…I know I can make a quick dash for it if I need to!

Today, walking my daughter to the bus, uphill, I showed her that I can now walk limp free in my Merrell barefoot shoes. Wahay! Of course, I limp like a chicken when actually barefoot, but whatever.

One-legged heelraises are also on the horizon. I still rely a bit on my arms, but can do it if pressed. It feels great to walk down stairs and actually have my foot support my weight on the ball as opposed to heel.

Today, I’m taking it easy to left the leg rest. Tomorrow, I think I’ll take up parcour…

Happy heeling…

OK, it’s been nearly two months since my last confession…I’m still alive and my foot is still attached. It’s working pretty well, too.

This summer has been great. First we spent two weeks in Europe. I wasn’t quite ready to spend three days walking around London, climbing St. Paul’s and schlepping from museum to museum, but getting to know my limitations was good. What I hadn’t expected was that my heel would be so sore. I felt a bit older than I really am as I occupied the disabled and elderly seats wherever I could. At least my family didn’t complain that I was taking them out on yet another death march. I was the one complaining about that. “Are we there yet?”

Given travel and a crzy travel schedule post vacation, I wasn’t being too diligent about doing my exercises and became frustrated about my progress. Well, duh! Since that rather basic realization, I have been doing well. My limp is slowly disappearing and my vision of Kevin Spacey in the Usual Suspects as he limps then slowly walks more normally is the image in my head. Kaizer Soze, that’s me.

I found a great way to train up my tendon, but am not holding my breath on widespread adoption. Rollerskiing. Yup, that’s the ticket for me. It allows me to move my foot as I would in a normal stride, but with slightly less weight and no impact. And I get a good upper body workout, to boot. The only challenge is that my shape is not exactly stellar. Three days of moderate rollerskiing and I’m ready for a looong nap. Tomorrow will be a day off, with only mild heel lifts.

Nope, I’m not there yet, but getting close. I can almost lift my weight, but expect it will take another two weeks before I can do it for real. I feel a bit like the Aflac duck in rehab, exercising to the theme from Rocky while lifting only the lowest weight. Obscure reference, but I love that ad.

Reading the new posts and seeing the new folks is a great reminder of the journey we’re all on. While yesterday was the first day I felt pretty normal, I have a long way before that is really the case. That big lump above the tear that gets sore when I overdo it, the slight limp that gets worse late in the day, and the odd feeling as I try to extend my foot as far as I can are daily reminders that I’m only at mile 8.

Thanks again everyone for posting!

I think it has been about three weeks since I posted, so figured I should give a little peep.

Since getting out of the boot around May 21, I have limped my way through days, weeks, airports and hotels and am happy to report that all is well. My limp is still prominent, but I’m no longer moving at a snail’s pace. I was in Chicago walking down LaSalle Street during rush hour late may and felt I was causing serious congestion due to my pace. Now, I’m failry speedy although my step length is far from equal. I would estimate the difference at max speed is 75% of full length for the bad foot.

I saw my surgeon this week, and he cleared me of any restrictions. I think he has sensed that I push myself about as much as is sensible and that I won’t go too far beyond what is right. He told me the bump in my achilles about 1.5 inches above the rupture site s likely due to the suture where it grabs the tendon. Keep massaging it and it should disappear, he said. Fine by me.

I have been rubbing vitamin E on the wound for the last four weeks and it looks pretty good. I should see if it actually spells something in morse code -.-.–.-.

At work my advisor gave me my annual review today and she told me one of my strengths was my left calf. I tore the right one. Funny gal. While I’m feeling pretty good, I’m a bit frustrated that the calf is still so weak. I try to walk and bike regularly - I did a 1.5 hour ride clipped into the pedals last weekend and will attempt 2 tomorrow - but the calf is still a limp, wet noodle.

Patience, I know.

On the positive side, Kobe had surgery one day after me and he’s about 9 days behind me in getting out of the boot. perhaps I should getting ready if he can’t make it for the start of the season…

OK, maybe not.

I am quite amazed at the huge variation between people, doctors, recovery times and experience. I have talked to my doctor once since my surgery and I will likely not see him again. He is totally confident in my recovery and my own ability to manage it. No word of PT or to be careful about specific activities. He said cycling is good and that I should walk a lot, and that is what I’m trying to do. I really don’t feel any restriction now other than seeming older than I think I am. My time in the cast was about 2 weeks, and the boot 3 weeks. My foot still swells up without a compression sock, and turns all sorts of colors when I get out of bed, but besides the time in the cast, I have had an easy run of it. Reading many of the posts, I feel I am lucky that it has been so relatively easy.

My doc strongly feels recovery is faster with the operative route, and he said he was aware of the UWO study. Yet he insists non-op is for older folks who have the time to heal. While he may have read the study, I’m not convinced he believes it, but then again - he is a surgeon.

I’m not complaining, though. My foot feels good (much better than it looks…) and I’m experiencing progress, albeit slow. I’m off to Europe on vacation on Sunday, with many miles of walking ahead of me. I have a coterie of compression socks and sleeves for my calf and a strategy for getting around.

The only thing that bothers me is that the only things I have spent money on lately are compression undergarments…

Heal well, everyone.

So, ever since I came back from the last trip, I have only used the boot twice - both times because I wanted exercise and build up a sweat. All other times, m walking around barefoot or in two shoes outdoor. I walked my daughter to the bus this morning, and almost kept up with her. I still feel like I’m hobbling, but try to focus on making a natural stride.

The last two days I also spent time on my bike trainer, clipped into the pedals. No issues with the foot - it feels great. More an issue with endurance or patience. Mobility seems good and there is no pain. I do two-legged heel lifts at the kitchen counter using my arms to offload the weight, I try to feel pressure under the ball of my foot while walking. So when am I officially in two shoes?

OK, so I’m just puttering around at home, but still! I did go for a half mile walk with two shoes and one crutch - up the hill and back down again. Felt good. I don’t have any strength to actually walk with the bad foot, but I use the crutch to offload the weight so the foot can at least simulate the motion. I have also been doing my ROM exercises, some light rubber band work while I’m also trying to feel some more pressure under the ball of my foot as I walk, not just the heel. Keeping it on the safe side of any pain, though, and trying to keep any swelling at bay.

I have noticed that the five days traveling did wonders for my foot, so motion is good, I just need to err on the side of caution. RyanB’s schedule looks pretty accurate for how I’m progressing. I purposefully didn’t check his schedule the last week so as to not push myself beyond what feels right, but the progress is very similar. I feel like I’ll be ready to ditch the boot at the next visit. In walking in two shoes right now, my thinking is that I need to work on all the stabilizer muscles as well, and am actually more interested in that than actually stressing the tendon much at all. If I go out to do errands, I’ll use the boot for sure. The strength will come, however slowly.

The foot feels good, although definitely a bit tired today. Might try the bike trainer tomorrow, with no resistance. I think I can, I think I can…

So, I’ve been in the boot for a week now, and life is definitely looking up. I’m slowly getting the hang of walking with the boot and crutches in a manner that resembles normal walking. Hope to get a hang of it before I ditch the crutches.

I find myself glancing at Ryanb’s blog and having to remind myself it’s not a race…but his progress is certainly something to aspire to! Had a good mile and a half walk today and noticing great progress from day to day. ROM is improving and strength is slowly returning as well - at least now I feel I could crush a bug if I had to. Last week, not so much…the lack of muscle and the obviously visible tibia was freaking me out.

I find myself spending more and more of my time without the boot. If I am going to be up and about or leave the house, I put it on, but otherwise I hobble around barefoot, being very careful. I have some of the technicolor fireworks in my foot in the morning after waking up. My daughter wondered why my foot was purple! The compression socks i bought take care of it. And they feel good too!

Come Saturday, I get on a plane for the first time. I’m figuring that the compression socks, lots of water and a first class seat will make it ok (international trip for work). And I’ll get up and walk about. The walking I have been doing is giving me the stamina I need. At least I hope so!

So, all in all a good week. I might be able to walk without the crutches inside (withe the boot) by the end of the week. It’s not a race…;-)

Spent the last four days in Copenhagen on business. Suit and boot looked snazzy together. I left with one crutch to help me through airports. In the end, it was a bit of a nuisance, but it did help me with the sympathy vote in security and immigration lines. Last night after arriving back home again, the foot was quite swollen, but I had been drinking copious amounts of water and hence running to the bathroom every 30 minutes or so, so no issue with DVT. Compression sock helped, as well.

There are a lot of cobblestones in Copenhagen. The boot does not like cobblestones, so I found myself walking in traffic more often than not. I found myself moving around forgetting to use the crutch, and feeling like a bit of a fraud, so I left the crutch at the hotel, and hobbled around as best I could. By the time I was ready to come back, I was perfectly comfortable without the crutch. I also spent time with the exercise bike and equipment while at the hotel, which felt great. Yup, I’m back in the travel saddle!

And this evening, I walked down the street and back up again in two shoes, and one crutch. It was an old mans walk, but it felt great to be out of the boot, and since I have a rigid boot, it feels good to put a little pressure on the tendon while walking. Not a lot, but enough to feel the blood flowing and the muscles activating.

The doctor said he would likely have me ditch the boot at the next visit, which will be on the 28th. Seems about right. While the foot feels much more stable now, I need to get some strength back, and some exercises and careful walking in shoes should help. A friend who tore his AT some years ago told me he spent hours walking on the beach. Sounds like good advice, though I’m too far away from the beach for that to be a daily activity.

So - all in all a good week! I have the last scene from “The usual suspects” in my head, when Kevin Spacey walks away with a limp that magically vanishes as he walks down the street. I like that image.

It does sort of feel like that - I’m finally off on the the high seas of recovery. My cast came off and the stitches came out today, and it was nice to get reacquainted with my foot, although my calf was a sorry sight, all sunken and flabby.

I met with the Physician’s Assistant today, and she walked me through where I am and what to expect. It was music to my ears as she was encouraging early motion and exercises. I was prepared to make a case for an early mobilization protocol, but there was no need - she told me to feel my way through PWB to FWB over the next 4-6 weeks and gave me exercises to do.

The PA had been in my surgery and mentioned how well it had gone. "So it was a pretty clean rupture, then" I said, to which she responded "oh no, we had to do some braiding - it was pretty torn up." Oh well. It feels good and isn’t swollen, so I won’t complain, although that image of the frayed rope is coming back…

The scar "looked great" she said, although for me pretty much every scar looks absolutely wretched. Occupational hazard I guess if that’s what you do for a living.When I asked about wearing the boot at night she said I didn’t need to unless I was a violent sleeper or had to get up a lot. That surprised me a bit, and I’m not entirely sure what I’ll do. It still feels rather fragile to me, but then having that boot on doesn’t exactly make for a pleasant night’s sleep. Opinions welcome.

After coming home, I found I could walk around with a single crutch and the boot indoors without any pain. I take the boot off and keep the leg elevated as often as I can, although looking at that flaccid calf muscle makes me sad. Those fibers had been bulked up through miles and miles of running, cycling, cross-country skiing and skijumping. Boohoo.

Finally, I will attempt to attach an image of the scar. This is likely the only audience that will actually appreciate the picture. My family, friends and colleagues are threatening to put me on the spam list if I send them more.

Onwards!

Well, not really even limping. Getting by is more like it, but my blog is up and running!

I’m not the kind of person who would normally have a blog, but the benefit I have received in the last few weeks from reading entries on Achillesblog more than makes up for any hesitancy to share my ramblings.  It’s good to know I’m not alone, and that ATR it’s a rather well-trodden path, albeit the footsteps may seem odd for someone unaware that we are all limping.

My rupture happened like so many I have read, an innocent pick up soccer game in the gym with my daughter and some of her class mates on a Sunday afternoon. Less than two minutes in, an attempted quick turn and POP, down I went. I had no sensation of pain, or  of anyone kicking me, just the sensation that this wasn’t good. I was quite certain it was my Achilles and a fellow parent and doctor did a quick Thompson test and showed me what I feared.

I was loaded into a car and driven around the block to the ER, and 3 hours later I was none the wiser. The PA felt the Thompson test was inconclusive, gave me a splint, a prescription for Oxycodone in spite of me saying there was no pain, and told me to call the orthopedist in the morning. The next day after some rather humorous time on the phone with the scheduling person who had reviewed the ER notes which incorrectly said it was my left leg that was injured, asked me if this was true. I told her no, it was the right foot. She asked which foot my splint was on. "Right foot." Without skipping a beat she said, "well no wonder you are having a hard time walking. The left tendon is ruptured and the splint is on the wrong foot!"

Later that day I saw a sports medicine doctor who said it was a tear, but unsure if it was complete. He told me the option of surgery or non-surgery, without pushing hard for either, although after hearing me say I wanted to return to being active, he suggested surgery, gave me an Air Walker boot and referred me to a surgeon.

In the shower the next morning, my already overactive mind was fixating on the image of the hero, suspended off the edge of a cliff by a badly frayed rope, barely holding him and about to snap. The image of my straining tendon and the expectation of a final, even louder pop made me woozy and it was only by luck that I made it out of the shower onto my bed to lie down again to avoid fainting. Deep breaths. Don’t think about climbing and stay off that leg.

Later that day the surgeon didn’t take long to ascertain it was a complete rupture and again, say there were two choices. Like his colleague, no hard sale, but the bias was clearly there - surgery for young and active, non-surgery for old fogies and smokers. We scheduled surgery for the Friday, first thing in the morning. Once I decided, I felt a little bit like I was buying a car - signatures, initials, handshakes.

That evening, I felt pretty good about having surgery. The idea that the tendon ends would be reattached was comforting, and as is likely often the case all my Google searches seemed to confirm my choice. I had a lot of work to do before surgery, however so I put my head down, leg up and got back to work.

I was first on the docket for surgery on the Friday, so stumbled out of bed around 4:45 am and took a cab to the hospital. My wife needed to get our daughter to school, so she would come and pick me up. At the hospital, I was entered into the system, had my insurance checked, prepaid, etc. etc. and sent to the pre-op area where I was given a gown and some oversized wetwipes to clean my body, and I was off. A horde of anesthesiologists, nurses and the surgeon filed by, more hands were shaken. I asked the surgeon if he had practiced his Krackow technique to which he flinched a bit and said he had just talked to his students about that - perhaps I should do the surgery?  I was finally wheeled into the OR and given a general. Lights out.

When the lights came back on, my throat was raw from the breathing tube, but otherwise I felt good. I had a splint wrapped with an ace bandage on my leg and a kind nurse watching over me. The surgeon came by to say everything went well - it was a complete rupture and four sutures were put in keeping it together again. He had cast the foot at a neutral 90 degree angle and everything looks good. I could take a shower in two days, just don’t soak the wound, and keep the dressing clean. My wife arrived and the nurse offered to give me some fresh 4×4 dressings which we declined - we have a stash at home.

Two days post surgery I was itching for a shower, and started to unwrap the bandage. As it unwrapped, it became obvious the bandage was embedded in the plaster, and either they had done a bad job or the splint was not meant to come off. I re-applied the bandage and decided to call the clinic in the morning - the shower could wait.

After leaving my message with the clinic in the morning I received a phone call in the afternoon asking if I had taken the bandage off yet. No, I said to which she replied good - you should leave it on. It’s sterile now, and it should stay that way. You can wrap the cast if you want to shower.

So here I am, just over two weeks post op with a smelly but completely pain free foot, waiting to remove the cast. I have hopped around on a funky-looking crutch called the OnlyOne crutch which allows me to use both arms, walk up and down stairs and have a fairly normal existence.

Every day I have delved deeper and deeper into studies and experiences from folks on this blog, and am coming to both a new understanding as well as a whole new host of worries. These worries come in a variety of flavors - regarding my tendon, my cast, my surgeon, my rehab - and my interim conclusion, which seems to jive with many on achillesblog, is that there really is no standard approach to this, and it is absolutely incumbent on the patient to put together all the pieces.

While I have none of the knowledge or technical skill of a surgeon to make the incision, stay away from nerves, protect the sheath, clean up the tendon endings, minimize trauma, I do have deep knowledge of my own body, what feels right to me and how I want to be involved in the recovery. In the next 6-9 months and beyond, it will be incumbent on me to manage whose direction and insight to listen to and when to insist that my insight should take precedence. It will never be obvious, but I hope I will be able to know when to listen and defer and when to speak up. All the information and insight on this site is a huge help for me in making sure I manage my treatment in the best way, and I am grateful to all the time people spend sharing what they have learned so we all can be better prepared and have better outcomes in the end.

The cast comes off on Tuesday - I will come armed with questions regarding the surgery, the rehab protocol, which boot I should use, etc. and with everyone’s help, I will be on my way through limping to running and playing with my daughter again.

Happy recovery - more to come…