Nov 18 2010
Bored, bored, bored
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.
Thanks for the detailed catch-up! I didn’t even know we could “post-date” a blog entry!
Your situation sounds like good news and bad, ems. Tearing an AT is always bad news, of course, and leaving it untreated is too. But that’s bygones! Now your leg is repaired, and you’re into exercise and PT (”orthotics”?) earlier than many patients.
On another blog — Barbara’s, IIRC — I posted a link to a new study showing that people who get your surgery — with the re-purposed big-toe tendon — generally never miss the tendon AT ALL! So that’s also good news.
Also, you’ve also gotten into the VacoCast, the fave boot of maybe every single person here who’s tried it! It has a number of nice features: It’s waterproof, so you could use it in a swimming pool if you have one available. (EVERYBODY who’s tried “hydrotherapy” and swimming during ATR recovery has RAVED!) And it can be set to “hinge”, which can be very useful when you’re facing the transition from the boot to 2 shoes. Basically, your ankle will be able to flex downwards normally, while still being protected from flexing upwards into the danger zone. Not yet, but when the time comes.
As you’re starting PWB and standing and walking, you should do SOMETHING to make sure that your right foot is “elevated” as far above the floor as your left, in that big boot with the platform under it. Otherwise, you’re “training” your whole body to stand and walk off-kilter. That puts a bunch of important joints at risk of injury, as well as making you learn bad habits that may be hard to un-learn later — not to mention making standing and walking more difficult.
Some of us improvised with footbeds inside big clunky shoes or boots, some went to shoemakers to get something made up out of an old shoe, some of us strapped “cast shoes” onto the outside of some old footwear. The Vaco people sell an “equalizer”, similar to a “cast shoe”, IIRC, which might be the simplest solution. The method isn’t important, as long as you get your hips straightened out.
The next adjustment of your boot angle, from 15 degrees to zero or “neutral” may or may not be difficult, I hope not! But it will also change that alignment, by lowering your left leg.
One other suggestion: If your water blister is really from rubbing inside the boot, you should be able to do something to keep it from rubbing. If you’re comfy enough with your leg to put on socks, that should help a lot. At the extreme, double socks should let the two socks rub against each other and leave your skin alone. If not, maybe some kind of bandage (plaster)? You may be tempted to loosen the boot, but it might be better to tighten it instead, either with the straps or by adding some padding. Also, tightening the very top of the boot, where it hits the top of your calf, may help it follow your foot around obediently when you roll over it, so you get less rubbing.
I’ll be surprised if it takes you ’til Christmas to be walking without any sticks. Good luck and good healing!
Thanks Norm
I can’t really tell much difference in the movement of my big toe at all at the moment, so hopefully the study is right and it won’t affect me much. My little toe is extremely sore though which has made me wonder what on earth they did to it during the op!
Swimming would be wonderful. I’m assuming that people take off the inside bit and just wear the plastic cage? I’m feeling really fat and unfit in general - the diet I was on before all of this went out of the window, so once I am back up and about I was planning to swim anyway. Seems like the safest exercise I could do.
I have been wearing a high heeled boot on my good foot (the advanatge of being female!) to try to even out the hips a little. The guy from the Orthotic dept said he may take off the wedge next week so it might be lower then anyway.
Anyway - wearing a sock is a really good idea, thank you
And the orthotics seems to be just geared around using the vacoped. He’s already talked about physio therapy and that I’ll be passed onto a different PT department back in sunny Burnley.
I noticed, belatedly, that you said you’d done it twice! That’s really scary! Was it better or worse the second time around?
Ditch the diet word! I’m a dietitian and I’ve found that one of the main enemies of successful weight loss is see- sawing between being on a diet and being off a diet. It’s very tempting to use food to cheer yourself up, or to stave off boredom, but you won’t burn it off so easily as you’re not so active at the moment. Try to practice ‘mindful eating’- think before eating something, are you hungry or just bored? Put smaller portions on your plate, it’ll be too much hassle to hobble around for a second helping.
But above all, don’t see foods as bad or good, it’s what you eat 90%
of the time that matters. Your main priority is to get back on your own two feet and keep your sanity.
You sound like you’re having a hard time of it at the moment, use this blog, it does really help.
Fingers crossed for you
EMS, the online video of the Vaco in the swimming pool shows the whole thing going in and coming out. Then the guy sits at the edge of the pool, takes off the boot, removes the liner, wrings it out (MAYBE towels off his leg and the boot frame??), reinserts the liner, puts the boot back on, and walks away!
BTW, for AirCast users, I think the same approach would work pretty well. The AC liner is held together with little Velcro “tabs” that might not survive many of those trips, but mine survived one perfectly, when I washed the liner out by hand and wrung it out in a big “shammy cloth” as hard as I could.
Later in your recovery, you could presumably leave the boot by the side of the pool and jump into the deep end, or carefully heel-walk down the ladder. The deeper the water, the less weight there is on your vulnerable leg.
Yes, I tore both ATs, at 8 year intervals. After the first healed, I returned to competitive volleyball at almost 60 y.o.. I actually got MORE aggressive and competitive. Mostly playing with 30-somethings, I switched from 6-on-6 court volleyball to 4-on-4 on the same full-size court. And I added beach volleyball, mostly 4-on-4, but sometimes 3-on-3 and even a fair amount of 2-on-2! It was the 4-on-4 court ball that finally popped my other AT. (Unlike the first time, I knew EXACTLY what I’d done right away!)
In my case (and for quite a few others who blog here), the second one was MUCH easier. Partly knowing what to expect and having faith that there’d be a good outcome, partly remembering the “tips and tricks” of how to survive without two good strong legs, including the crutches NWB stuff. And in my case, I got talked out of surgery the second time by my fancy sports-med Ortho Surgeon! So I skipped the delay before treatment, the hospital time, the wound, the bleeding, the sedatives, the scar, the attachments, the pain-killers, ALL the time off work (I mostly work at this computer), and virtually all of the pain. (My first surgery went perfectly, so there were no surgical complications to skip.)
In addition, he put me on the UWO Protocol, which was roughly twice as fast as what my first surgeon did, so I was off crutches and carrying things around in my hands in what seemed like no time at all, less than 5 weeks after the injury!
I always knew that there was a risk that I’d “do” the other leg, and I accepted that risk in return for the chance to return to my fave sport. I had 7 great years at it (often playing 2x/week) before the second ATR, and I consider it a great bargain, wouldn’t change a thing — except maybe skipping the FIRST surgery and going faster on that rehab, but the UWO study hadn’t been done yet. . .
I’m not sure that high-heeled boots would be my choice for your other foot. If they make you do that short “mincing” “high-heeled walk” that women often do in high-heeled shoes, it will slow down your walking, and probably also give you less exercise. I don’t think it’s important to match the plantar-flexion angle in your two ankles, just the general height, so your hips are straight and your “good” foot and leg aren’t compensating in some weird gimp-walking way. You should encourage your booted leg to stride normally, striking the heel first with your toe pointed straight ahead, then rolling straight over it on that rounded “platform”. The boot should transfer all the force (of holding you up on the ball of your injured foot at the end of your stride) through the shank of the boot, to the front of your shin. Once I got used to my boot, I was walking quite fast — faster than most of my able-bodies friends, in fact, and maybe faster than I walk in shoes!
It’s ironic (but not really surprising) that every big transition — from NWB on crutches to FWB without, then from FWB in the boot to FWB in 2 shoes — initially makes us walk slower! And in each case, we should free to “backslide” when it’s appropriate, e.g. to use the crutches again, or the boot again, when heading out to scary places — even though we’ve given them up when walking around the house and in other safer places.
BTW, I have no idea about your little toe. If you think it may be something about how the boot fits, try to fix that! It’s natural that lots of things get rearranged, and sometimes even nicked or scraped, during invasive surgery like yours, so that might be what happened, and it might take some time to heal. If you haven’t complained about it to your Doc, definitely do that ASAP.
Hi ems72, I noticed that you had surgery the same day as i. It is of particular interest to me how you and others in the UK are being treated by the NHS and the protocols being followed. I am English but now live in Canada(dual nationality) and knowing that i could have been treated in either country i find myself reading the UK posts and making comparisons.
I smiled when you wrote about wearing the high heeled boot on the good foot to even things out a little. I too decided to do the same but with a Sorel boot. This is similar in style to a wellington boot and is what some of the folks wear here when the snow falls. I just did it from the get go(12 days post op, beginning of PWB) as it made sense to me that my stance be level. Also the fact that there is a foot of snow where i live it again made sense!
Glad to see that you are putting some weight on your leg. The more you do it(stopping if painful) the better. The rolling of the foot technique was in the back of my mind as i first started weight bearing and i still think about it as i am walking without crutches.
I am looking forward to swimming too as it is something i do regularly. I think it would be a great form of exercise for recovery of an ATR but first i need clearance from my surgeon who i see for the second time post op next week.
Good luck with your recovery and i will check in on your posts as time goes by.
Paul
“it’ll be too much hassle to hobble around for a second helping.”
LOL
“walking for Xmas and driving in January”
theres a great target .
timeswise , were not far off either .
probably no help to you but ,
i played facebook po ker a lot (its free) and you van chat with the other people playing …..
Wow - thanks for all the feedback and advice guys! I didn’t realise that many people would take the time to read and comment.
I’ll be visiting all your blogs to see how you’re getting on.
btw re diets… after being obese for over 20 years, I don’t really mean diet when I say it - I mean eating sensibly as opposed to resorting to chocolate every time I get down. I’m an emotional eater, and find myself in front of the fridge when I’m sad, stressed, angry or frustrated. I was using the Slimming World plan before I injured myself, which involves lots of cooking things from scratch - I really enjoyed it and it definitely works. I’ve just struggled to stand in the kitchen for long periods, and cooking’s been a bit of a pain to do. Anyway - I’m going to make a real effort to keep myself busy and not succumb to snacking throughout the day!