firemedic1’s AchillesBlog

“You’ll Roll In and then Walk Out.”

Well, the time has come for my 2nd post op.  I went in and the doctor evaluated my leg again.  Asked me how things were going and how I felt.  It was pretty short and fairly uneventful.  I was given clearance to turn in my knee scooter and was advised that I would be FWB in the boot from here on out.  My doc told me that I will be wearing my walking boot 100% of the time and after about a week that I could start going without the boot while at home.  She also adjusted the angle of my boot from 15 degrees to 5 degrees.  Lastly we spoke about what would happen at my next appointment which was scheduled a month away.  She said that I’d need to bring a left shoe because I’d be losing the boot that day and back into two shoes!  And she said isn’t sure if I’ll need formal physical therapy yet but I do know that I want PT and I will be requesting it for at least a month.

That’s it…after our meeting, I gently walked out under my own power.  It was a wonderful feeling.  I didn’t waste any time driving back to the medical supply place and returning the knee scooter so I wouldn’t be tempted into using it anymore.  That actually isn’t a temptation at all…I’m rather glad to be rid of it.  I was thankful for it’s usefulness but loathed lugging it around everywhere I went AND having to explain why I had it to everyone!

Happy healing all!!

I had my first post op appointment approx 2 weeks after my surgery date.  If you read my last blog, you’ll recall that I had a spill on my “death mobile”…I mean, knee scooter!  Oops!  I haven’t had any pain or lasting effects from my fall and I’ve been very much looking forward to getting my stitches removed.  During my appointment after my fall I received an ankle wrap which has gotten loose from time to time.  It wasn’t a big deal for me to unwrap and rewrap my foot in order for the ACE bandage to stay nice and tidy.  I was also able to unwrap my foot in order to clean my leg and foot for the first time since my surgery.  That was a nice feeling.  I used baby wipes as to not contaminate my incision and I didn’t do much to clean around the stitches, I just left it alone.

Goodbye Stitches!

My appointment went well and was pretty uneventful.  The doctor palpated my tendon and confirmed that it was still attached and said it felt good.  She did some small ROM exercises with me and advised that I would do some dorsiflexsion of my foot but keep it minimal as to not stretch the tendon while it was still in the healing phase.  She removed the stitches, which I expected to hurt a bit, but I hardly felt it.  After she removed the stitches I spent a few moments gently scratching/itching my incision site.  She looked at me strangely and asked if everything was okay and I said I was great and it just felt good to itch my leg a bit.

Toward the end of the appointment, which was pretty short, the doctor advised that I would remain NWB for another 3 weeks, until the next appointment.  I’d have to say that I wasn’t entirely pleased with the 3 weeks which was 1 week past the minimum time frame she had initially told me on surgery day, but what really could I do?  I chocked it up to my accident 1 week post op.  And right before I left, she told me that I’d be losing the knee walker after the next appointment.  As this was pleasant news to my ears, I was a little concerned because I didn’t feel like I’d be ready.  On top of that, she said that I’d roll into the appointment and at the end I’d be WALKING OUT!  This was a shocking turn that I hadn’t expected and I did not believe that I could be walking in 3 weeks.  Again, it was pleasant news that excited me and I want nothing more than for that to be true and to walk out of the appointment in 3 weeks under my own power on my two feet.  I know I’ll be weak but weakness is only temporary and strength will come back over time.

Preparations for my first steps…

I’ve been sitting around being pretty sedate after my injury and even more so after my surgery.  I can literally feel that I’m more exhausted now doing menial things than I ever had been in the past.  I determined that it was time for me to get back into the gym.  Aside from that, I know that increased bloodflow always helps with the healing process and nothing gets the blood moving more than exercising!

I got back to the gym and had to improvise some things in order to get the job done.  I began with using the row machine.  I was able to successfully row by putting my good foot in the foot strap and resting my injured foot on top of the foot rest area.  I was able to row only using one leg and having the injured one doing nothing.  It was tough at first and I didn’t row very far or very long as my cardio was shot, but things have improved over the past couple weeks.   I also have been using the Airdyne bicycle and using my arms and good leg to get my workout.  I, again, just let my injured leg sit on the peg below the handlebars, doing nothing.  Finally, I’m able to utilize some free weights here and there.  Its more difficult to get and use heavy weights while NWB but I was still able to get the flat bench close enough to the weight rack to use dumbbells and again, get a good workout in.  So, I’m proof, this injury is no excuse to not workout and continue to be somewhat active.  It just takes a bit of motivation.  I hate not being able to do the job I love and my motivation to get back to work is the reason I refuse to stay sedate.  The faster I heal, the faster I can come back to work.  And that’s my desire at this point.

So Monday was supposed to be a great day. I was going back to work 7 days post op. The surgery went well and I had been 7 days pain free. I was in a splint and had been mobile using a knee walker.

Hi Ho Hi Ho…It’s off to work I go!

The day started off well, I checked into work and they lined out what I’d be doing and how to log my hours. I work as a firefighter/paramedic so I haven’t had a time sheet for years! It was new to me…haha. My light duty job would be as a paramedic instructor for our dept medic program. Not bad…beats pushing papers. It’s M-F which is like torture…I’ve been used to working 24 hr shifts with 48 hrs off between shifts (BTW..it’s awesome.).

Anyway, I was directed to go sit in the class and observe and be expected to get right after it the following day.  3 hrs after getting there, IT happened. Murphy and his damn law showed up! I guess the ATR wasn’t enough!  I was to include insult to said injury as well.

Murphy…is that you??

I was moving across the parking lot and hit a dip/crack/perfect storm which jarred my knee walker handles one way while my body went the other way.

**TIME OUT**

OS: You will stay NWB for at least 4-6 weeks.
Me: You got it! Zero weight.

**TIME IN**

I suddenly find myself falling forward with the walker between my legs and involuntarily thrusting my 7 day old surgically repaired leg toward the ground to break my fall. I remember thinking, as I fell in what seemed like slow motion, NO NO NO NO NO NO!!!!

Murphy: Yes. *maniacal laugh*

I crashed to the ground and felt my foot damn near touch my shin!  Well, that’s what it felt like in my head.  I knew instantly I’d screwed up and screwed up Huge!  All I knew is that I needed to get to my Dr right away.  I called the Ortho right away and demanded (kindly, by explaining my predicament) that I speak to my OS’s tech right away.  I was able to get to her and explain what happened.  She made me an appt for the next day as my OS was currently in surgery for the day.  The rest of the day was choked full of fear and regret and anger and fear and more fear.  Did I mention that there was some modicum of fear?   As for the pain…Nothing hurt, but it didn’t hurt before the surgery either so I could’t be certain that I hadn’t reinjured my AT.  I could move my foot and I could feel my calf activate with movement of my foot too so I assumed it was good sign.  Still the fear persisted.

Pre-post op #1

At the appt, my splint was cut off and I viewed my leg for the first time in over a week.  It looked…like I’d had surgery. Still didn’t hurt, wasn’t swollen. Dr did her thing and politely, as if ribbing me, told me she wouldn’t have expected anything like this from me and thought that I’d be more coordinated….Har har.  I relayed that I felt the same way.  She touched and poked and prodded and stated that the tendon was still intact and that I’d be fine.  Still I was leery. Happy!  But leery.  They fitted me for a boot set at 15° plantar flexion and told me to come back next week to get the stitches removed.  She told me to keep it dry and I can now take the boot off and begin moving my foot gradually.  With that, I was released and I left.

As soon as I got home I removed the boot and decided that I wasn’t ready for 15° after my fall and that I’d rather stay plantar flexed at 22.5° instead.  I readjusted it myself to 22.5° and now feel much better.  I feel that if I did stretch things out a bit when I fell that 22.5° would be better for letting things settle down in hopes that I don’t heal long.  Feels good.

But wait…there’s more!

Lastly, as if this weren’t long enough, I decided to order a VACOcast pro!

I found one on eBay and won the auction at far below retail.  I can’t wait to get it and try it out and ditch this Frankenstein-esque boot!

Moral: please be careful guys! Don’t fall and tread lightly on your knee walkers and crutches! That was a day of woe that I hope K never have to relive!

As The Week Ends

The rest of the week went pretty smoothly.  I rested for the most part and kept my leg elevated.  I continued to use my medication cocktail of Men’s One-A-Day, Norco, Potassium, and stool softener.  I’d have to reiterate that when taking some type of opioid pain killer that you also take a stool softener.  Opioids can and will cause severe constipation and it’s best to get out ahead of it before it’s a problem.

I did manage to pick up a cast cover to aid with taking a shower.  I’m not much for taking baths so I took showers and the cast cover did the trick.

I also didn’t bother to get a shower chair as I was able to get in and out of the shower with ease by sitting on the edge of the tub and swinging my legs inside and then standing up.  It was a bit tedious but not as tedious as trying to maneuver a chair in and out of my tub on a regular basis.  I was also able to stand up easily using one leg, so if you’re someone who isn’t able to do that for whatever reason then I’d suggest taking a bath or using a shower seat.  Keep in mind that if you choose to shower and go without a seat then you will be doing it balancing on one leg.  Again, that’s something that wasn’t tough for me because my able leg was easily up to the task.  That may not be the case for everyone.  Just be smart and use common sense.  There’s no rewards here for bravery and the risks are very high in case of a fall.  Oh, and lastly about the shower…bath mat….bath mat…bath mat.  Don’t slip and fall!  It hurts and it’s embarrassing to have to call 911 for the fire dept and paramedics to come hoist your wet naked injured body out of the shower.  For one, it’s not easy.  And two, you don’t look as good naked as you think.. haha.  I don’t say that from experience as the guy in the tub….I say that as the guy who has to come get you out!

So, like I said, the week was pretty uneventful.  I took a shower.  That was exciting. I weaned myself off of the Norco by Thursday evening.  My pain has remained at a zero or near zero so I’m very thankful for that.  And then the weekend came.

You see, this whole week consisted of me getting up with the wife and kids and helping as best I could to get them out of the house for work and daycare.  I spent the rest of the day “recovering”…or…doing as little as possible.  The stress was low, the house was quiet, I slept when my body got tired and all was okay.  And then the weekend came…

The weekend came and brought with it 103 degree F days with little to no help from our air conditioner.  Yes, I realize that I’m complaining about A/C when many people of the world can’t even fathom the concept.  Sorry.  It was HOT.  My kids, although I love them to death, were loud and needy.  I was tired.  All the moving around from the day was getting to me and eventually I blew my top a little bit.  It was an accumulation of frustration from being injured, not being able to totally fend for myself, being hot (I hate being hot), being tired, moving around much more than I had all week, constant noise (my son hasn’t stopped talking since the day he learned how to make noise and he has no idea what an inside voice is!), being stuck inside almost all week, and every little stressful thing that makes up a normal person’s day.   All these things collided at one time and I just blew up.  I yelled at my infant daughter (not a proud dad moment…shame),  snapped at my son and wife, had a pity party for myself and pretty much just shut down.  It didn’t last long fortunately but it was a quick look at how the little things add up and how easily they can boil over.  I eventually apologized and spend the rest of the evening with my wife next to our fire pit enjoying a cold (much needed) beer.

Sunday was better. The temp was down and I knew a little bit more of what to expect of the day so all was well.  I was nervous about going back to work the next day as I wasn’t exactly sure what I was going to do.  Going back to work was 100% my decision.  I could have stayed out and I had more than enough sick time to do so but just don’t like the thought of using sick time when I don’t really need to.  Well, in hindsight, I should have stayed home ONE more day but there’s more on that to come.  It’s its own fun filled adventure chocked full of terror, suspense, fear, uncertainty just to name a few!

First Night

I had my surgery on a Monday and I felt great afterwards!  I’d attribute much of that to the pain meds coursing through my veins.  I began taking my Norco plus other pills noted in a previous post.  I slept well and continued to have no pain.  I am fortunate enough to have a bed that I can elevate the legs so that assisted with being comfortable.  I didn’t put it up the whole way since I didn’t want to make my wife completely uncomfortable so I supplemented the elevation with a couch cushion which helped a lot.  I was uncomfortable having my leg directly on the bed so the cushion and it’s padding did the trick.  Otherwise all was good,  I had a little bit of discomfort but that was due to not being able to move my foot much and I felt like my wound dressing was pulling at my stitches and scabs a bit.  At times I could feel a cool sensation at the incision point which I just figured was oozing blood.  Pain = 0

Morning after….

I woke up at a normal time and to my amazement, I still felt like a champ.  Pain still nil.  I had an orthodontic appointment at 9 am that I wasn’t sure prior to the surgery that I could make it to but I felt like it wouldn’t be a problem once I woke up and felt the way I did.  In fact, I considered driving myself to the appointment even though I was told not to drive any vehicles for at least 24 post op.  I had already spoken with my mother about giving me a ride around town in the morning to run some errands so I just let her take me even though I felt good enough to drive.  Turns out that I’m very glad that I did.  Once I got up, started moving around and about halfway to the orthodontist’s office I felt sick to my stomach and a little woozy.  I breathed my way through the sensations, sucked it up and didn’t say anything.

The dentist trip went well and was fairly quick, the next stop would be the voting booth.   I can’t pass up my opportunity to vote….its my right and it’s very important.  The voting site was not busy at all and after explaining to the booth workers why I was all bandaged up and on a knee scooter, I cast my vote and went on my way.  During this time I found that I was quickly moving downhill.  I felt groggy and tired and the nausea had returned.  Upon leaving the voting site, I mentioned needing to renew my driver’s license and my mom said it was no problem for her to run me over there.  By this time I was barely hanging on, the grogginess was increasing but fortunately I still had no pain.

We arrived at the DL office and I could see from the outside that I wanted no part of waiting in line or dealing with renewing my license at this time.  I told my mom, no way….I can’t do it…take me home.    I was home 5 or so minutes later.  I took my meds as I was up against my 4 hrs since I’d last taken them, got a small bite to eat and laid down.  That’s the last I remember.  I passed out and was out for hours.  Looking back, I think that with all the moving around that I did that morning I mobilized any latent anesthesia still in my system which proceeded to bring back the nausea, grogginess and eventually an unconscious state.  Oh well…at least I got a nap.  After i woke up I felt fine and the rest of the day was uneventful.

Pain = 0.