Hi - I know it’s been a while since I posted and I promise to do so and update everyone on my PT progress.  But in the meantime, can anyone out there recommend a good pair of sneakers?  I’m ditching the boot and going “2-shoes” next week and wanted to treat myself to a pair of sneaks that are conducive to supporting our ankles and the area around the Achilles. 

I keep hearing New Balance is a great sneaker, but not sure which model to get…

Any and all suggestions are appreciated!  Thanks!

UPDATE 4/3/09 :  I asked my PT about what to look for in a pair of sneakers for our recovery.  She said to look for “motion control, stability and a rocker bottom as well as arch support.”  It’s important to know how high or low your arches are because that can make all the difference in the world. 

I went to a New Balance store yesterday on a lunch break to get fitted.  I took my old shoes off and walked (limped) around the store.  They told me I had low arches and I over-pronate a little.  For more on that go here:  http://www.runnersworld.com/article/0,7120,s6-240-319-327-7727-0,00.html

I tried on a bunch of pairs, but the most comfortable one for me was the Saucony Progrid Stabil CS.  It retails for about $115, but when you’re an ATRer and can’t compromise support and comfort, I believe it’s money well spent.

I thought this day would never come!  Doc changed the angle on my boot to neutral (90 degrees) and cleared me to full weight bear.  To shed the crutches and finally hobble around the apartment (albeit gingerly and sloth-like) is a huge milestone - both mentally and, of course, physically!  And to think that only 8 days ago I was NWB and miserable…

I also got a scrip for PT today.  2-3x/week for 6 weeks.  Luckily, the PT clinic is located downstairs in my work building.  Talk about super convenient!  My first appointment (and my first day back at work) is next Wednesday, March 18.  I’m actually a little nervous about going back to work seeing as my brain probably atrophied more than my calf muscle over the last 6 weeks.  

The first steps feel really, really, really weird.  I’ll get up out of the chair and gently place the ball of my foot on the ground.  Meanwhile, I’ll gradually place weight on the heel until my weight is evenly distributed among both feet.  There’s a slight “pins-and-needles” sensation when all the weight is on the heel, which totally freaked me out (I am assuming this is normal?) but it goes away pretty quickly once you start moving.  Yesterday, I was still using one crutch to get around, but then I graduated up to a cane.  I can maneuver around without it, but it’s probably safer to have something there for support and balance.  I can’t stand up for more than 5 minutes at a time without my calf muscle barking at me due to fatigue.  Simple and mundane daily activities such as brushing my teeth can become rather tiresome because my calf muscle is so weak.  Oh well - I’ll get there eventually.  I’m just happy to be on my own two feet again!  And my wife is happy that she doesn’t have to wait on me hand and foot (no pun intended) anymore!

So to recap:

Jan. 23:  Ruptured right Achilles tendon playing indoor soccer

Jan. 29:  Surgery (spinal anesthesia, outpatient, fiberglass splint/cast)

Feb. 13:  NWB in a CAM Walker (105 degrees and splint/cast removed)

March 4:  PWB

March 11:  FWB (90 degrees/neutral)

March 18:  PT begins and I return to work

March 25:  Next post-op doctor visit

April/May:  Two shoes!

THIS GUY!

I’m 5 weeks post-op and my doc just cleared me to 20 lbs. PWB!!  It doesn’t sound like much, but it’s really a huge “step” in the right direction.  

My last doc visit was 3 weeks ago, when he put me in the CAM walker at 105 degrees and NWB.  I’m still at 105 degrees, but at least now I can bear some weight.  He said to come back in exactly one week, at which time he’ll change the angle of the CAM to neutral (90 degrees).  

He was “marveled” by the way my wound healed and how well my leg/foot looked overall.  He administered the Thompson Test and I passed with flying colors.  I noticed some scar tissue building up around the tendon, but that’s perfectly normal.  The new tendon is considerably thicker than the one on my good foot due to the scar tissue.

I was also surprised to hear him say I’ll be starting “light” physical therapy in only ONE week!  That was out of the blue.   He said he’d write a scrip for outpatient PT next week, and that would ramp up to more serious PT in about 4 weeks.  I’m thinking the “light” PT will consist of basic ROM exercises and nothing too crazy.  We shall see…

I’d been getting a little stir crazy, anxious and impatient over the last week or so (I can only tolerate so much daytime TV).  I’m not sure how I would have handled any “bad” news from the doc today - it may have sent me over the edge!  But luckily I got some great news, and I’m well on my way to recovery.  Slow and steady wins this race!

So I’ve been NWB for about 3 weeks post-op now.  For those of you who are a bit ahead of me in the game, what did it feel like to take those first steps?  Were you scared?  Hesitant?  Fearful of a re-rupture?  Excited?  Frustrated?  I’d love to hear your experience!

I ask because I keep having this recurring vision of myself walking normally again.  Everyday I wake up, I reach for my crutches and try to not lose my balance as I stand up on one leg.  My biggest fear is falling over on my crutches and having to brace my fall on my bad leg.  I just can’t wait for the day to wake up, yawn, stretch, rub my eyes and plant my two feet firmly on the ground to walk again.  I know it’s a long haul, but I’m not exactly the most patient person in the world. 

(Note:  1 week post-op was February 6th, 2009)

For the most part, the constant pain has completely subsided.  The only pain I feel is when I get up to walk around on my crutches.  It’s like a race against the clock.  If I’m up and about for more than about 30 seconds, the blood starts rushing towards the wound and throbs for a good 5 minutes after I’ve sat down again to elevate my leg.  The pain alone is deterrent enough to make me squirm and not break the seal!

My doctor is extremely cautious about having my wound heal properly without any complications, so he ordered me to lay prone (on my stomach) with my foot in the air as much as possible.  This facilitates blood flow to an area of the body that doesn’t otherwise get much blood.  The first step in the recovery process is to have the incision wound heal as quickly as possible.

I had my first post-op visit to the doctor this morning.  He removed the plastic cast to have a look at how the wound was healing.  Everything looked great and he said the “architecture” of my calf muscle, tendon and foot all appeared back to pre-injury.  He placed me back in my plastic cast and said to come back in exactly one week, at which time he’d fit me for a Cam Walker.  Darth Vader ain’t got nothin’ on me.  

I’m getting used to walking around in crutches, but it’s a pain in the arse if you want to carry anything in your hands.  Sponge baths (administered by my lovely wife) are a fringe benefit to an otherwise crappy situation!

Note:  The date of this post is Feb. 16, but my surgery took place on January 29.  Better late than never!

So today (January 29, 2009) marks my “ground zero,” if you will.  Everything associated with my recovery from ATR will be measured as a period of time from today.  

My doc told me to show up at the hospital at 6AM.  When I got there, I changed into gowns and waited on a bed in the pre-surgery waiting area.  A few nurses came by to see me, take my heart rate and blood pressure, etc.  Then the ortho resident came by.  He asked me which leg they were operating on.  I couldn’t help but think, “you don’t know by now?!”  But it turns out that his question was standard protocol.  At least 5 different people will ask you which leg (right or left) they are operating on today.  It’s not a laughing matter (think airport security and that sign about not joking about carrying a bomb)!  Then the anesthesiologist came by.  He thoroughly explained the sequence of events for administering the I.V. and which drugs they’d give me while I was in the operating room.  Then the surgeon came by.  He marked up my leg with a Sharpie pen.  

I entered the O.R. at 7:30AM.  They inserted the I.V. and administered the spinal tap.  The damn resident screwed it up at least twice, so they brought in the attending anesthesiologist who finally got it right.  They flipped me on my stomach and then I was face-to-face with the residents for the duration of the surgery.  The anti-anxiety drug they gave me (Versed) did wonders.  I felt like I was in a bar putting down a few beers and chatting it up with people I just met.  I was completely oblivious to the surgery being performed a few feet away.  

The surgery ended at 9:30AM.  They flipped me over to my back.  I couldn’t feel a thing below my waist.  Not even my twig and berries.  If you’re a guy, this is the scariest feeling in the world.  The nurses told me it would take about 6-8 hours for the pain block to wear off and by then I’d regain control and movement of my legs.  They said they wouldn’t discharge me until I could control my bladder.  I just had to sit there and wait and wait and wait until I could pee in a cup.

Finally, around 4:30PM, I pee’d and they let me go home.  I was in a huge plastic cast with gauze and ace bandage wrapped around it (not a molded cast).  There was a vacuum drain inserted into the wound that served to drain any excess blood or discharge from the surgery (I know - disgusting!).  I had to go back to see the doc the very next day.  At that time, he removed the drain (ripped it right out of the wound, but surprisingly, it didn’t hurt) and gave me a new dressing (same cast).  

When we left the hospital, I sat in the front seat (big mistake - you should sit in back and elevate your leg) and the pain just RUSHED to the wound.  It took 30 mins to get home, but it was the longest 30 mins when your leg is throbbing and all you can think about is Willy Wonka & the Vicodin Factory.  :)  I popped two vikes when I got home and that made me really drowsy.  

If you’re wondering, the pain I felt in the couple days post-op was never as bad as either the day the injury occurred or the days leading up to surgery.  Of course, I didn’t have the luxury of having vicodin pre-surgery, so don’t quote me on that.  I only took vikes AND advil for 3 days post-op (vikes for the pain and advil to reduce swelling at the wound), then switched over to just advil for 4 more days post-op before my first post-op appointment.   

Getting sleep was another story.  It wasn’t so much the pain that kept me from dozing off as it was the cumbersome cast and the elevation of the foot on two pillows.  That definitely took some time to get used to. 

Well, the worst of it is over.  I suffered the injury.  I had the surgery.  I still have to go through physical therapy, but I will be uber-motivated to get through that after sitting on the lazy-boy for 2 straight months!  

I honestly think that for someone as averse to hospitals and doctors and the sight of blood as me can get through this, anyone can.  

The “S” Word.  No, not that 4-letter word once shunned by the late, great George Carlin.  I’m talking about a dreaded 7-letter word that I’d even cringe at making in a game of Scrabble:  S-U-R-G-E-R-Y.  

The doc presented me with two options, only one of which (given my age and physical activity) was viable.  I could either put it in a molded cast for about 8-12 weeks, plantarflexed so that the two torn ends of the tendon could heal themselves.  Or I could opt for surgery, which would have a dramatically shorter recovery time and a much smaller chance of a re-rupture (9.8% vs. 1.4%) [Trust me:  this is not something you ever want to go through again!  Surgery is a no-brainer!]

To say that I was a nervous wreck the day and night before surgery would be a huge understatement.  I had so many questions and fears to overcome, yet only about 15 hours to mentally prepare myself for what would be the scariest day of my life.  My surgeon was very open and honest with me.  He fully explained the procedure and told me exactly what to expect.  I asked question after question, yet his answers whizzed by my ears as I couldn’t help but think, “Is this really happening?  I’m actually going to have surgery tomorrow?  I’m going to lose complete control of my faculties and put my trust into the hands of a surgeon I just met a few hours ago?”  Well, not complete control of my faculties…

It went from bad to worse.  My surgeon strongly recommended that I undergo spinal anesthesia (lumbar puncture) rather than general anesthesia.  That would entail me being completely awake for surgery.  WTF?!  Awake?! That’s nonsense!!  But after hearing about the complications and risks associated with general, not to mention that rolling me over on my stomach (I had to be in the prone position for surgery) as dead weight would be extremely difficult for the surgical team, I reluctantly agreed to it.  I figured I might as well make this as easy for the surgeon as possible.  As for the overwhelming anxiety associated with being awake in the operating room?  Nothing the anesthesiologist can’t handle:  a little midazolam (Versed) would do the trick.  

I didn’t sleep a wink that night.  My first words when I “woke up” that morning was, sure enough, a 4-letter word.  George Carlin would be proud.

I’d just turned 33 years young earlier that week on January 19.  As the birthday wishes poured in via phone, text, email and facebook wall messages, they all served as constant reminders as to how old I really was.  Thirty-f’n-three!  I was halfway to collecting Social Security!  Remarkably, I didn’t feel a day over twenty-three.  I was exercising regularly and playing indoor soccer once a week; I’d never so much as broken a bone in my body.  So how did this injury find me?  Me - of all people?!  

The injury occurred on a Friday night.  It’s probably the absolute worst time to happen.  No orthopedic surgeon’s office is open on the weekend, and I wasn’t about to check into an emergency room.  I had no other option but to just pop Advil like candy and R.I.C.E. it til I could get an appointment to see the doctor on Monday.  

I woke up Saturday morning with less pain than Friday night, so that was somewhat encouraging.  Getting to bed was difficult because the pain was still throbbing.  I would literally count down the hours til I could safely take my next dose of Advil.  

Sunday morning’s pain was nearly as bad as Friday night.  I was growing more and more disheartened as time went on and yearned for a conclusive diagnosis.  I called around on Monday morning for an appointment with an orthopedic surgeon.  Luckily, I found one who’d see me later that afternoon.   

I gradually started telling friends and family what had happened, describing the circumstances surrounding the injury, but not quite certain the extent to which I’d been injured.  People assured me that I’d recover quickly, given the fact that I was young and in relative good health.  Ironically, these same people callously reminded me of how OLD I was not even a week ago!  Funny how that worked out…

So it turns out I turned 33-years old earlier that week on January 19.  Happy f’n birthday, Eric.

A common misconception of an ATR (Achilles Tendon Rupture) is that some other cruel being inflicted this gruesome, horrid injury upon you.  It’s unthinkable that the thickest and strongest tendon in the human body could just snap like a frayed rubber band on its own.  I had to pin this on someone or something for my own peace of mind.  

A couple months ago, my good friend floated the idea of joining a co-ed indoor soccer league.  Without hesitation, I agreed to join.  Although I’m not an athlete by any means, I make a concerted effort to maintain my physical fitness by going to the gym 2-3 times per week.  I usually hit the treadmill or ellyptical machine, and if I’m in the mood, I’ll work in some weight training as well.  The bottom line is that while my body may have been aerobically conditioned, it was by no means ready to meet the physical demands of indoor soccer:  intermittent sprinting and quick bursts of movement.  

I collapsed to the ground.  Moments earlier, I sprinted full speed to chase down the ball in a corner, all the while being marked by a girl slightly larger than me in stature.  I juked her to my right, came back to my left, and swore she tripped me by swiping at the back of my right leg.  I tried to get up on my own power.  Not happening - so I just sat there clutching my right leg.  The girl defending me at the time conceded, “I’m sorry.”  I had my guilty culprit, but I had no idea the extent of my injury.  People started to crowd around me and I had murmurs of “sprained ankle” or “broken leg.”  I immediately ruled those two out.  Although I’ve had numerous bouts with the former, I’ve never experienced the latter (knock on wood), yet I knew it wasn’t broken.  The funny thing is, neither of the two things typically associated with an ATR occurred: a loud “pop” sound or the coiling of the calf muscle up into your knee.  I was confused and eager to seek a diagnosis.

Two of my teammates propped me up as I gingerly attempted to bear weight on the foot.  Not happening - it felt like my heel went completely numb and I was walking in stilleto heels.  Coincidentally, my wife (a doctor!) was dining with a girlfriend a few blocks away.  She arrived on the scene and a few minutes later we were in a cab heading home.  I elevated my leg across her lap and that’s when it hit me.  The pain was simply unbearable.  It was throbbing as I looked out the window and spotted the GW Bridge off in the distance along the West Side Highway.  ”Jesus, we’re not even close to home,” I thought.  I couldn’t wait to pop a few advil and get some ice on this.  

When we got home, I limped over to the couch and elevated and iced my leg.  It hurt so much that I started laughing uncontrollably.  My wife is a pediatrician, not an orthopedist, so she scrambled to find any information on the web to diagnose me.  She came across a site that mentioned the “Thompson Test.”  Lying on my stomach with my knees bent and my legs perpendicular to the ground, she proceeded to squeeze my left (good) calf.  My toes involuntarily wiggled.  Then she squeezed my right (bad) calf.  The toes stood still, unfazed by my wife’s coaxing.  This was not good.  My achilles tendon was torn, and my hopes to recover using the R.I.C.E. method were dashed.

Over the next couple days, I absorbed the ribbing my friends gave me when I told tales of a girl kicking me in the back of the leg.  ”A girl did this to you?!  HAHAHAHA!!!”  Then I told my orthopedist, and he laughed at me, too.  Yet he’d heard this before; every orthopedist has.  He routinely dismissed the theory that I’d been kicked in the back of the leg.  Alas, I’d done this to myself.