ems72’s AchillesBlog

After being warned that last week might be painful it actually wasn’t too bad.  I have found walking without a crutch quite hard on my hips though, especially as I couldn’t step past the boot with my good foot.  
Got to Orthotics today to discover that there’s still no reaction to the Thompson test so Charlie’s put me down to zero degrees and said I should try to manage without the crutches as much as possible.  He advised me to be quite ‘aggressive’ as apparently the tendon is strong enough and can take it.
Walking from his office to the entrance of the hospital was slow and quite difficult. I found that I could roll forward slightly which helped the hips, but by the time we were in the car my foot was aching. I have a feeling that this might be the hardest week so far - I haven’t needed to take painkillers for a couple of weeks now but I’ve got them on standby in case
I’m not back there for a couple of weeks now as he doesn’t think he’ll need to see me. I’m going to try really hard in the meantime to get moving properly.

So it was my third visit to Charlie at the Blackburn Orthotics Department today.  He has left my foot at the 15 degree angle but has put a much thinner wedge on the bottom of the boot - about an inch depth.

It’s nice to be closer to the floor, and so in line with my other foot but it’s definitely going to take some getting used to.  The other thicker wedge was curved at the front so that you could roll off it as you walked.  This one is just flat and comes out past my toes, so I can only step forward and then bring the good foot up to join it.

He also did the Thompson test again, and said there’s no movement yet but he expects to see something next week.

The wound is looking really good.  We’ve been using sudocrem on the actual wound site, as I was getting blisters as well and didn’t want to risk anything nasty.  I’m using E45 cream on the rest on my leg and foot to combat the dry skin - it’s just flaking off at the moment.

Apart from that I’m getting around much better - using just one crutch (as it helps to even out my hips somewhat) - so at least I feel a bit more self sufficient and can carry things.  I have another week off work and then I’m going to work from home.  Nice to have some time to myself though.

This week was quite difficult.  Changing the angle to 15 degrees made my ankle aches quite a bit, and I think I’m getting a water blister on the side of my heel where it’s rubbing inside the boot.  I have been exercising daily and making Rob rub cream into the wound site, which I know can’t be pleasant for him, but there’s no way I could reach down there.

By Tuesday though it was getting easier.  I’ve got the hang over sort of rolling on the boot wedge when I walk to put some weight on it, and although I’m generally slower now, I feel much more balanced.  I also resurrected some hobbies in the attempt to stop me from going out of my tiny little mind with boredom!  I’ve picked up crochet and knitting, which I can do semi-reclining in bed if I have to, and am working my way through a very complicated Fantasy series of books (Stephen Erikson if anyone’s interested - very, very good!).  It looks like we’re getting home made presents for Xmas.

Rob is still out of work and not always coping very well.  With me unable to chase our toddler around as well I think he’s starting to get a bit miffed, but to be honest it’s a good job he’s around at the moment.  When he does eventually find work, he may end up working and living in another part of the country during the week, and then things will get really interesting!

Had my second visit to Orthotics and Charlie is really happy with my progress.  Even I could see how much more movement there is in the ankle than there was last week.  I got to wash my leg again and when he wiped down the wound, some dead skin came away which frightened me but he said it was all good.  He’s left the boot angled at 15 degrees this week but now wants me to start putting as much weight as I can on it when I walk.  Next week he’s planning to maybe take away the wedge (which is actually a scary thought).

I asked when he thought I’d be walking and driving again - he reckons I’ll be walking for Xmas and driving in January as long as I do what I’m told and don’t do anything stupid.  I feel much more positive this week

I wasn’t sure what to do about work - Charlie reckons this week will be an easier week for me, but then if the angle changes again next week he thinks that could be quite difficult.  I’ve decided to take another two weeks off and play it by ear.

So back to Blackburn to see Charlie the Orthotics man.  He removed the boot, had a look at the ankle, which he said is healing really well, and then went off to collect a bucket of warm soapy water for me to dunk my foot into and wash.  That was so unexpected and an amazing thing to do!  I even got Rob to help cut my toe nails (this is what husbands are for after all lol) and then Charlie massaged cream into the foot and the wound site.

I tried moving my foot up and down, and he seemed pleased, but there’s not much movement there at all.  It’s not so much that it hurts, more that I feel like it’s not possible to move my foot where I want it to go.  He also changed the angle of the boot to 15 degrees and the difference was obvious as soon as he put the cage back on.

This week I’m allowed to remove the boot for 10-15 mins per day to practice pointing and stretching the foot and to apply cream to the wound to help stop the scar tissue from forming where it shouldn’t.  I also have to start putting some weight onto the foot - about 50% to start off with.

I’d decided to finally give in and get a sick note as I was really struggling with a laptop on one knee :)  I’m quite glad I did now.  I actually felt quite emotional today, and when Charlie was moving my foot I felt like crying - not from pain though.  I think this is just a lot harder than I thought it would be.  I’m starting to realise how long this could take and it’s really getting me down.

My first appointment at the fracture clinic after the operation was about 2 weeks after the op.  I had opened the letter, noted the date and saw the words "Fracture Clinic" and naturally assumed that it would be at Burnley hospital, where I saw the consultant before, and where I had the operation.  But no.

I arrived for my 4pm appt with 5 mins to spare, to be told that my appointment was at Blackburn hospital, which is a half an hour journey down the M65 motorway.  The receptionist rang the other hospital and they promised to wait for me, sop we got back into the car and set off.  It took us 45 mins to get there, through rush hour traffic :(  Rob dropped me at the door of Outpatients and went to park up while I went in to find the clinic.

After all that stress I was pleasantly surprised by how lovely the staff were.  Some had stayed longer than their shift to wait for me but they were all really understanding, and even apologised for making us come all the way from Burnley.  The cast was removed and I was pleased to see that actually the wound is about half the length I was told it might be.  My toes are still a bit numb and tingly, and my little toe hurts so some strange reason, but the ankle itself looks good.

The consultant popped in to see me and take a look and seemed pleased.  I am now handed over to a guy called Charlie from the Orthotics department.  He has fitted me with a Vacoped boot - it’s like an inner soft wrap which has air inside, and then a plastic cage around the outside.  It goes up to below my knee, and the angle of your foot is set by adjusting the cage.  Underneath the cage itself there’s what looks like a massive grey platform heel.

Charlie says that I now have to keep my foot elevated as much as possible.  I’ve been putting it up on the sofa next to me, but apparently it has to be even higher than that, which is going to make working on the laptop difficult.  I’m also not allowed to take this boot off, even in bed.  My initial impressions are that the angle is uncomfortable, as the cast must have been different, but also that it’s much heavier than the cast.  The wedge also makes things a bit more awkward - your foot’s now twice the size it was!  I have to invest in some more loose jogging pants as there’s no way my jeans will fit over this.

Also, in the previous boot, when standing I could rest the boot on the floor with my leg straight out in front of me.  It’s quite difficult to do that in this one.  Still I’ve been assured that using this boot provides a better treatment with better results than a normal cast would.  Charlie says there aren’t that many places using these boots yet, which is why while I’m in it I’ll have to visit him once per week at Blackburn hospital.  My physio can be done from Burnley though, so that’ll be easier.

The big day finally came!  I elected to have the operation at Burnley - just because it’s nearer and easier for people to get to (especially with Rob (my hubby) having two teenagers and a toddler to look after!).  We got there at 7.30am as requested but I was still sat in the waiting room with a number of other people until 11am because no beds were available.  The nurses kept having to ask us to come into different rooms, to fill out forms and speak to anaesthetists (spelling?) etc.  I finally got given a bed at 12pm and realised that I definately wouldn’t be in and out in one day, which had been a possibility.

Was finally wheeled down to the theatre at 1pm and apparently didn’t come out until 5pm!  I vaguely remember coming round and being sick (which always happens to me when I have a general anaesthetic) and then came round again at about 7pm to see Rob sat next to me waiting.  My foot was in a cast and up on pillows, but they used a nerve block so I couldn’t actually feel it at all.  It was a bit weird to be honest - I felt like my foot wasn’t there! Anyway they let me have something eat, and sent Rob home and that was that.

The day after my foot had started to tingle but wasn’t particularly painful for most of the day.  I was a bit miffed to discover I wasn’t allowed out of bed for 48 hours, which would be up at 5pm on the following day, the Saturday.  I actually cried when Rob told me that.  I think the worst thing about the bed rest was having to use the bed pans - some of the nurses were brilliant, others were plain awful.  That night the nerve block finally wore off, and by 10pm I was in agony.  I’d already had ibuprofen and paracetamol at tea time, but ended up having to have a morphine based painkiller to help me sleep.  It worked in that I slept for some of the night, but it had a really weird effect on me the morning after.  I woke up and felt strange, out-of-it.  I sat with my breakfast and felt like I wanted to just sit and cry.  I didn’t want to speak or do anything at all (not like me lol)  It took until after lunch for it to completely wear off but was a very strange reaction that I wasn’t expecting.  I stuck to the normal painkillers after that and made sure I took them regularly enough, but to be honest the pain never go tthat bad again.

I was finally allowed home on the Sunday, after a visit from the physios to check that I could use the crutches and get up and down stairs.  Of course I was an expert by now after using them for 6 weeks, so they discharged me really quickly with a pack of co-codamol to use at home just in case.

I had my pre-op assessment a week before the operation itself.

My consultant, still lovely, explained that from examining the MRI scan, he could see there was an 8 cm gap between the ends of my tendon, and so he thought he would have to use the tendon from my big toe to close the gap and strengthen it.  The risks of this are that I could get nerve damage along the foot where that tendon was originally, and it might affect the balance on that foot, as your toes help you balance.

I asked how big the wound was going to be, and he said that it would go from the bottom of my ankle to mid way up my calf (bit scary!).  At this point I sort of just want to get it over and done with.

The consultant said that if the operation is early in the morning I might be out the same day, but that it’s more likely I’ll be in until the day after.  So I’ve told work that I’ll be off sick on the Thursday and Friday (14th and 15th) but that I might be back on the Monday depending on how I get on afterwards.

I got the letter with the date of the operation on the mornng of my wedding - cool present eh?

It’s booked for the 14th October, which is further away than I thought it would be.  I was panicking about getting around today - there is no lift at the hotel where we’re getting married, and I hadn’t thought about how I would get down the aisle on crutches and carrying a bouquet of flowers!  In the end though it all worked out beautifully.

A friend of mine picked up my dress from the shop, and my crutches from me in the morning and then took them back to her house.  She covered the crutches in ribbons and bows to make them pretty for me :)  Then the photographer (who’s another friend) picked me up from the house, drove me to get the flowers, dress, crutches etc and got me to the hotel.  He was such a star - he delivered me to the bridal suite and then ran around like an idiot making sure that everything was sorted until my Mum arrived.

I had hair and makeup done at the hotel, but then when I was putting on the super suck-you-in-all-over underwear I realised that I could stand without pain on my foot.  Because of this, I actually walked down the aisle in bare feet, sat throughout the ceremony, and then put the boot on after signing the register!  In hindsight this might seem a bit dangerous, but I think I decided that I was having the op anyway so I might as well risk it.  I even stood for some of the photos so there are no crutches in sight, although my toddler did try to run away with the boot half way through the ceremony which was quite funny

There was only one very slight downside of having such a fantastic day - I obviously overdid the wandering around with the crutches at the reception, because by the end of the evening I had massive pain in the hollow my shoulder at the front and on the blade at the back.  Later in the week a doctor diagnosed this as a pulled muscle, apparently caused by swinging too far forward onto the crutches so that my arms were behind me and taking all my weight.  Oh well - a few more days sat on my bum doing nothing then!

Had my MRI scan - it wasn’t a pleasant experience.  The nurse who took me into the room and put me on the trolley to be wheeled into the machine, was really rough.  I wear glasses and am completely blind without them (no exaggeration) - I explained this to her but she was quite impatient when I couldn’t really see where I was supposed to be going.

Then they put like a cage around my feet to keep them still.  After wearing the boot for nearly four weeks I now wasn’t really capable of putting my foot in a 90 degree position, but she yanked it into place (almost making me leap off the table in pain) and then pulled it this way and that while she stuffed padding around it to keep it in place.  If my achilles had started to heal in any way it would have been completely wrecked.

The process itself wasn’t that bad.  It’s very, very loud and at some points the whole machine vibrates.  I had earphones on with Radio 2 being piped through, but to be honest I couldn’t really hear it over the noise of the MRI.  Hopefully this will tell the consultant whether he can just reattach the ends of the tendon, or whether he’ll need to transplant the tendon that runs down towards my big toe.  I’m hoping at this point for the former option!

I visited the Fracture Clinic for the first time and met the consultant, who examined me and confirmed that yes, it is an ACR. He ordered an MRI scan (to see how far apart the ends of the tendon are) and wants to do the operation asap. He was really nice - I’ve met consultant before who can be a bit abrupt and impersonal, but this guy was great!

Unfortunately (or not) I was getting married on the 25th September - only one month away! I managed to get him to agree that he wouldn’t do the op until after then, so that I wouldn’t be incapacitated at my own wedding. In the meantime he’s given me a boot to wear - it’s black and fastens with velcro, so I can take it off for baths and in bed. Not the sexiest wedding shoes but at least no-one will see it under the dress. I’ve also got crutches now and am told not to put any weight on that foot from now on.

I also now can’t get to work - I live in Burnley but work in Bradford some days which is a 1.5 hour drive away. Looks like I’ll be stuck at home with a laptop for the foreseeable future.