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…