Archive for July, 2010

Jul 28 2010

From ATR day to 6 days post-op.

Published by elsurfer under Uncategorized

I ruptured my right Achilles playing basketball on the night of July 7th.

My Background: I have been on the road to basketball league comeback at the age 40 and had been playing for about a month before the injury occurred. I hadn’t played competitively in two years and thought it’d be great to get back into shape. I’m a stocky 220 lbs. 5′10″ looking to get down to 200 lbs.  Active in a lot of outdoor sports (now I’ve crossed a few high impact sports off my list).

The Injury: The night previous, I had done a 7 mile mountain bike ride that may have contributed to the achilles tightness, but I never felt any tightness, fatigue or soreness in that area leading up to the injury.  Having done nothing spectacular (no dunks) to contribute to the tear, I was warmed up, felt no tightness, playing well for about an 1.5 hours before it snapped. I came down after someone had rebounded the ball and I turned to go up the court in the other direction. I heard a dull pop or thud as if someone landed or kicked the back of my shoe. No one was near me and I went down. It didn’t hurt, just swollen and tightness in my shoe from the swelling.

The ER: I went to the ER that night straight from the court, where they splinted me, prescribed some pain meds, put me on crutches and referred me to an orthopedist. On the pain meter, I was about a 3/10, not painful enough to take any meds. ER trips are expensive on the insurance companies, I’m guessing at least 2K when the EOB comes out. But when you don’t know what the heck you just did to yourself at 8pm at night, the ER is the only sense of security you’re gonna get. Knowing what I know now, I wouldn’t go again, but if this is your first time…

The Ortho: I got to the orthepedist the next day and of course the two PAs (Physician’s Assistant) recommended surgery. (Ironically there was another guy there for the same injury from tennis).  There was an obvious gap and the Thompson test was conclusive of a complete tear/rupture. The ortho gave me a boot to keep it stable until my appointment for surgery which was scheduled two weeks later. The boot would also be used Post-Op or during rehab I was told.

The two weeks leading up the surgery was uneventful, the pain and swelling somewhat subsided and I had no problems sleeping. I could actually drive and gimp around in the boot they gave me. It would only hurt if I actually tried to put any pressure or the ankle turned a certain way, it was very manageable and I couldn’t wait to get the surgery over with.

Surgery day: July 21st (two weeks after the initial injury): I met the Dr doing the surgery for the very first time right. He had just gotten done with another ankle procedure before he met me.. He looked at my chart, then the achilles and confirmed the full rupture. He also spent about 5 minutes with me talking about how it happened, the mechanics of the injury and procedure to fix. He said that they would incision, clean out the “junk” (probably meaning clots, loose material), then sewing/suturing the tendon back together. He said that it would probably heal in 6 weeks and then I could rehab. “Wow” I think to myself “only 6 weeks?”, which has been contrary to the 10-12 weeks I’ve been reading and hearing about.

Pre-op: IV hooked up, anti-biotics dripped in. Here’s the most interesting part. The anesthesiologist came to do what I call the Jedi nerve trick to numb my leg. I was on my stomach and he put some kind of pulsing electrical probe in behind my knee to locate the proximity of the nerve that controls feeling of everything below the knee. The ticking of the probe would cause my foot to twitch… tick tick tick, twitch twitch twitch - spot found. He then put in some medication behind the knee and numbed it much like the dentist does to your jaw before drilling. This numbing would last about 24 or 36 hour after the operation I was told.

Operation: They rolled me into surgery where I could hear some rock music playing, the last thing I remember seeing and hearing was 5 people or so in the operating room and someone saying “Dr. loves his rock music”. That’s my kind of Doc. Next thing I know I’m being woken from a deep sleep and very groggy, but not in much pain at all - my leg is numb. I can’t feel or move my toes (from the nerve numbing). My leg from the knee down is in a splint (vs. a hard cast) with toes pointing slightly downward as to not put any tension on the tendon. If you were to look at the right leg, the toes are at about the 2 o’clock position.if the leg were at the 6 oclcok position.

My wife drives me home and I sleep pretty much the rest of the day, waking up in the evening conscious enough to email my co-workers and tell them everything went fine. I go back to work the next days (Thursday and Friday). I’m allowed to work from home so I didn’t lose much time. I’ve been told to pre-manage the pain so I did end up taking 1 or 2 Norco’s the night after surgery and the day after, but I really don’t think I needed them at all.

Post-op: So here I am 6 days post op in a splint. No pain at all. ( I did have some aching in my heel because it seemed all the weight seemed to be focused there when the leg was resting). There is also swelling and aching when I stand up right for too long so I’m trying to keep it raised. The splint is loosening up a little bit - not sure if it’s my leg atrophying (shrinking) or the guaze from the splint is naturally loosening up or possibly the swelling going down. I was told to NWB on the leg and have been struggling to find a good wheel chair for work. Crutches really suck. Let me say it again. Crutches really suck. One more time, Crutches really suck. Instead, I found a friend that had a prostheic from his micro-fracture ankle surgery a few years back. I must say after you learn to balance, this thing works well, and I don’t think I’ll need a wheel chair or these damn crutches any longer.  My armpits are extremely thankful.  I go in for a follow up in another 9 or 10 days.

The device:

http://lousarcade.com/anticrutch.jpg

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