Archive for August, 2010

Aug 28 2010

5.5 weeks post op walking - Vids.

Published by elsurfer under Uncategorized

Two days out of a neutral cast. I realize I have some foot alignment and balance issues. Also need to work on the stamina. Those will come with time and PT. However I’m staying in my boot (no crutches) when I go out. Some Atrophy notes - I’m right leg dominant. Left non ATR’d calf is at 18.5″, Right ATR’d is now at 16″ circumference. Guessing I lost about 3″ around, however it’s not too noticeable.

Feel free to comment.

8 responses so far

Aug 26 2010

Cast-rophobia - My cast didn’t make it to 6 weeks post-op and died a horrible death.

Published by elsurfer under Uncategorized

Cast-rophobia (cast anxiety) was very real (to me anyways) . I don’t know what caused it or maybe it was just the power of suggestion. (Stop reading if I’m going to jinx any cast worry on you!). I generally have a high tolerance for pain and uncomfortability, but I never experienced anything like this before.

We were posting in another thread comparing time lines about how long our casts would be on. Someone mentioned "castrophobia" and I didn’t think anything of it because my first 5 weeks in a splint/cast were uneventful. However the 2nd and last cast was put on a little tighter, but I thought it’d loosen a bit as my leg atrophied more and the compress underneath the fiberglass would "break in" like in the first cast.

At this point, I believe the catalyst for the behavior was when I rode the stationary bike last weekend. I’m thinking the activity "woke" my foot up. Now, subconsciously, I’m wanting move my foot around, rotate my ankle, crack / flex the toes, scratch - the usual things you do with your foot that you take for granted. I’m not a jittery person (like those types that do the nervous leg shaking), so this comes as a surprise to me.

I’ve been unusually busy, work stressed and somewhat sleep deprived this week which made the symptoms worse.

Oh the symptoms - where do I start… I think the feeling of inescapable confinement was the worse. My ATR’d foot also felt hot, stuffy and started to itch inside the cast. No amount of ice packs would make it go away. This lead to restlessness and irritability - you can ask my wife… I started feeling this on Tuesday night 8/24, so I decided to move my cast removal appointment on 8/31 up to Thursday (8/26 soonest appointment) knowing I would be demanding for my cast to be removed early. The symptoms got worse on Wednesday night. I tried a lot of things to get my mind off the uncomfortableness - went to the grocery store, bank and gas station at midnight, chewed gum. I was hoping to tire myself out so that I could crash quickly, but when I got home  the anxiety got worse and I couldn’t sleep. 12 hours to the appointment seemed like an eternity.  I reckon some Xanax  or left over pain pills might  have helped but I needed to be awake and alert for the next day.

As a lot of you guys stated here, I own my leg and it’s well being.  This reminder gave me the push to do the needful.  Mr. cast didn’t make it past 2 a.m.  The Dremel tool would have made too much noise that time of night so off it came with tin snips and into the trash in two pieces.  I slept like a baby.

Woke up rested, put my boot on NWB, got to work,  gave a presentation to my V.P. and went to the Dr’s office.

The Aftermath: I go into the Dr’s office, and told the medical aid what happened and why.  She was not happy and gave me the evil stink eye.  They put me on a patient bed, leg raised on a pillow, boot off waiting for the Dr. to chew me out.  Might I add, the amount of hard, dry,  flaking skin is incredible.  I need to grab a pumice stone when I get home tonight and start grinding away…  The Dr. comes by, and I give him my explanation.  He checks my leg for healing and asks about what kind of pain I’m in and I say "none, my leg feels great other than the episode".  He says he’s seen crazier and worse things and totally understood my reasons.   I ask a few more questions about PT, washing the wound, weight bearing and my next appointment.

What next:  NWB boot for 5 days, then WB and PT.  But I’m already PWB/FWB much sooner than that.  I come back and see the same Dr. in three weeks.

Back to work, I can scratch and shower, life is good.

3 responses so far

Aug 24 2010

Almost 5 weeks post op - PWB vs FWB Qs.

Published by elsurfer under Uncategorized

I’m still a bit unsure about how people are defining PWB and FWB.

I’m supposed to be NWB in this cast, however I’m able to stand and gimp around the house and office in the cast pretty easily without the aid of a crutch. Most of the weight when gimping, of course, is on the heal with a very slight roll towards the toe. Does that count as FWB, even though I can’t flexion either way?

When the cast comes off, and I get into a non hinged boot, the same will apply. I’m pretty confident that I won’t be needing crutches. The boot will probably allow a slight bit more dorsiflexion than the cast would. Would that be considered FWB? If that’s the case then I will have had zero PWB time.

Out of the boot and in rehab however, I know will be a completely different story.

I did 30 minutes on a stationary recumbent bike today with no tightness or soreness or anything. Probably could have gone much longer, but stationaries bore me to tears. This is at 4 weeks 6 days post op.

I am getting a bit of cast-o-phobia. It gets tight and hot in there. Raising the foot loosens it up and makes things feel better, but I want this darn thing off.

9 responses so far

Aug 18 2010

2nd Cast for two more weeks.

Published by elsurfer under Uncategorized

Post Op Status:
2 weeks splint - done
2 weeks cast 20 deg plantar flexion - done
2 weeks cast Neutral/0 deg - in progress

I got my 1st cast off today and was able to really move the foot around a bit. I was asked to really dorsi-flex the ankle position so they could put me in a neutral position cast. I did so and took the 10-15 minutes to massage, stretch, wriggle, rub, repeat on the leg. It was nice to get some sensation back, but stretching the tendon and calf was a lot tougher than I ever imagined. The swelling had gone down so much more than the last visit so I felt better about the tingles - nerve damage was a concern for me, but I was told that was normal due to swelling and lack of sensation in the cast.

My ROM was pretty good (not sure how scientific this is),but in a sitting position  I put both feet together toes pointed forward and they were equal.  Pulled both toes backwards towards the my body, and the ATR’d foot was about 1-2 inches less than the good one.  There’s just no strength behind it and now locked in neutral…

When it came time for the PA to see me, I was not successful in convincing him into putting me into my boot (NWB) instead of the cast. Apparently they did this for two people last week who pleaded and begged, got their way, and ended up falling (for whatever reason) and re-ruptured. Of course, I could have absolutely demanded it, but by the way my stretching went and the two "cases" that went wrong I opted to just wait it out and follow their program.

So I’ve got 13 more days ( I tried to up my appt.) in this cast and again I hope it loosens up a bit so I can do more flexing in there. Then it’s on to rehab.

The scar still looks like @$$, but overall I think I’m doing well.

7 responses so far

Aug 16 2010

Signs of life (calf movement) 3.5 weeks post op.

Published by elsurfer under Uncategorized

The swelling in my leg has gone down enough that there is a bit of play in the cast. In addition I’ve been semi-good about doing the suggested isometric exercises (leg lifts, toe movements, curls, etc) which I believe is keeping a lot of the muscles in the entire leg and around the calf active. The atrophy I’ve been noticing hasn’t gotten any worse.

I can move my foot and toes within the cast to the point of flexing the calf muscle - Hurray!. So, I’m kinda adding "calf stiffening" to my exercise list.  Although I’m feeling a few small strains and pulls in the upper calf - probably because they haven’t been used in a long while.

This was a very nice feeling because for a while I was questioning whether or not the AT was actually fixed or somehow I messed it up and it became detached. I know.. I know…

So now that I can tighten the calf, I can definitely feel where the repaired part of the tendon is pulling. It’s TIGHT, kinda like a knot in a muscle that needs to be stretched out slowly. I hope others here can confirm that this is how it’s supposed to feel.  I’m also wondering if it feels tight because of adhesion?

This Weds I go in for a checkup and neutral position cast or boot, but I think I’m progressing quite nicely.

2 responses so far

Aug 13 2010

Hands Free Crutch

Published by elsurfer under Uncategorized

Okay, I actually borrowed mine from a friend, but here’s where you can get one:

It’s smaller than a roll-around and I’ve been using it for 2 or 3 weeks now.

No crutches
I can actually go and down stairs with it (with the aid of handrail)
Hands free

strapping on and off all the time to sit for long periods of time
From the front it looks like you’re missing a leg
Pirate Jokes and stares.

Getting used to it:
Learning to balance on it, I only fell once the first day, but once I got it the height adjusted, it was a piece of cake.

although I hope to be done with it in the next couple of weeks. I will probably need real crutches when I get to PWB.

3 responses so far

Aug 08 2010

Excercise the leg in a cast?

Published by elsurfer under Uncategorized

Any cyclists out there that had/have this injury? I’m almost 3 weeks post op and wondering if a recumbent bike in a cast is good idea. I hopped on the one I have at home and went really light for a about a minute or two and didn’t feel any stretching or pull on the calf or Achilles. The thigh is starting to atrophy and I’m losing muscle mass all over the place. Wondering if this is a good idea aside from the potential stink/sweat in the cast and maybe swelling.

4 responses so far

Aug 03 2010

My Protocol - 2 weeks post op.

Published by elsurfer under Uncategorized

Thanks Norm for answering my question earlier about split vs. cast. The question was answered definitively for me at my two week follow-up this afternoon.

They cut my splint off and the PA visually checked it out and said all was okay. To my surprise, they didn’t do another Thompson test nor did they try to flex anything.

All the blood came rushing down and the parts of my foot that were splinted swelled up like the Goodyear blimp. Those parts also felt tingly as if they were asleep. I could not get very much sensation due to the swelling (I think). I also didn’t get a chance to massage them as they were about to pull the stitches and PUT ME IN A CAST!

So my protocol is:
2 wks in a splint, toes point slightly down. (completed)
2 wks in a cast, same toe position (in progress)
2 wks in a cast, foot in neutral/perpendicular position.
After that, walking boot and rehab.
And I’m to keep my foot elevated a lot more than I’m currently doing.

I think the cast is probably for the best for me, I’d be to agressive with a boot and end up pulling something unnecessarily.

I’m going to read here more and compare notes with other blogs to kill time. yeeesh!

3 responses so far

Aug 02 2010

Post-Op: Cast vs. splint?

Published by elsurfer under Uncategorized

Can anyone tell me why they would elect to put me in a splint vs. a hard cast? Or if this splint comes off, will they put me in a cast?

One response so far

Aug 02 2010

36 hours to my 2 week surgery follow up.

Published by elsurfer under Uncategorized

Believe me, I’m counting each and every hour. This splint has loosened up. 3 reasons - 1) The calf has shrunk, 2) the wraps have loosened. 3) The swelling has gone down. Probably all of the above, but the loose splint makes me nervous. I can flex my foot upwards in there and just don’t feel a whole lot of "stiffness" in the splint. It keeps the angle stable but I had a couple of close calls. Losing my balance and putting weight on the foot - I felt the stretch but don’t recall feeling or hearing any popping (hoping for the best). And of course closing doors behind me banging into the bottom of my foot. I don’t think I’m doing any harm in flexing my toes and a little bit of flexing my foot (really lightly) within a looser splint. I can pretty much tell that the calf has atrophied, I can’t make it hard by pointing my toes. Anyways these are just some random thoughts. I’ll got to bed, stop thinking, dive into work until my appt on Tuesday afternoon. I’m assuming they’ll pull stitches and put me in my boot that I got and wore pre-surgery with some wedges. If you were to ask me right now, I feel like I’d be back to normal walking within a month or so. I’m just not feeling any pain or soreness, but I’m sure that’ll change when I get to PWB and FWB. I really have no idea what to expect.

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