Week 15 - The road less travelled

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Oct 11

I’ve taken the road less travelled.  Literally.  Over the last month, I’ve been able to hike 6 miles and ride a bike.  What a difference a few weeks makes!

At the start of 2-shoes, it felt like I was walking on a sprained ankle.  I started again on crutches on the 1st week, but was able to ditch them by the end of the week as I got more comfortable putting weight on the foot.  My first instinct was definitely to protect the foot, so once I got over that mental block, I started making progress.

My biggest hurdle wasn’t really the tendon, but the soleus muscle and heel pain.  The big calf muscle is usually the gastroc, and the soleus is the muscle under that - basically right above the achilles tendon.  It was really tight, which limited how far I could dorsiflex.  For the first two or three weeks of PT in 2-shoes, I basically did a lot of stretches and massage.  After one particularly vigorous session, it felt like a light came on - the muscle was less tight and I could focus on walking.  After that, strength exercises were added, with the goal of getting my regular walking stride and pace back.  Again, after two weeks, the light came on for some reason, and I was able to make further progress.

Today, I’m able to walk normally most of the time (there are some bad days) and easily do 2-heel raises.  The heel pain is mostly gone, though if I’m on my feet all day, or if I wear dress shoes too long, the pain returns.  The swelling is mostly gone too, though there are bad days there too.  I’m doing more strengthening exercises to try to get comfortable jogging, and ultimately do a 1-heel raise  It feels like I’m not making much progress towards the latter goal, but if history is any indication, at some point, it will just click if I keep working on it.

Week 8 - Boot gets booted

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Aug 26

Woohoo!  I was officially green-lighted this morning for two shoes with wedges!

It was a quick appointment - the doctor looked at my scar, flexed my foot, squeezed my calf, felt the tendon, and compared it to the good leg.  I asked him about the sensitivity along the outside of my foot next to the tendon, and he said it was due to the nerve in that area that runs all the way to the foot.  The nerve takes a while to recover from surgery, but as long as I have feeling and no odd pains, it should be fine.  He did say “if you were being treated the old school way, you’d still be in a cast.”

I’m going to miss the boot a little.  The last four weeks just flew by.  It’s amazing how the little things, like being able to grab a drink from the fridge, makes recovery more bearable.  But the boot liner is beginning to stink.  Covering it up with Febreeze doesn’t help - you end up with a weird scent combination of freshness and foot sweat.

Week 6 - The doctor was right

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Aug 9

It’s been a week and half in the boot, and wouldn’t you know it, the doctor was right.  I went from PWB to FWB in about a week.  In fact, the foot is feeling pretty good.  For the first time since the surgery, the foot feels NORMAL.  It still gets a little swollen by the end of the day, but icing it and sleeping with it elevated fixes it by morning.  I’m still using the knee scooter to get around the house when I don’t have the boot on - it’s quite a luxury if you can swing it.

I’ll bet my feel-good-foot is digging the physical therapy I started last week.  In the first session, the PT took a bunch of ROM measurements, did some massage on the scar and to get the fluid out of my ankle, and did some electro-stimulation.  In the second session, I got some more massage, except much harder this time.  When I asked the PT why it was more intense the 2nd time, she cracked "the first time was the demo."  Got to do some ankle circles on a board with a ball under it, got some more electro-stimulation, and that was it.  Hopefully, she doesn’t turn the massage up another notch next week.  She’ll probably say "the second time was your free trial."

Week 4 - The cast gets the boot

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Jul 28

Cast off!  Cast away!  I was excited about getting the cast off and into a boot.  The doctor looked at my incision, made sure the allergic reaction was gone, moved my ankle around, felt my tendon, and set me off into boot land.  He warned me not to dorsiflex beyond 90 degrees, but other than that, put as much weight on it as I can stand.  "Let the pain be your guide."  Such wise words, not-so-young-Paduan.  When I asked him how long until FWB on the boot, he said "You’ll probably be able to do that in a week."  DANG!  I hadn’t even gone PWB yet.  They stuck one heel wedge in, showed me how to walk PWB with crutches, and sent me on my way.

On a side note, after seeing the ad for the Vacocast, it was a bit of a letdown to get Generic-Orthopedic-Walking-Boot-Number-One.  But at least I got to watch them pull it out of the plastic so I could have a bit of the "unboxing" experience.

Week 2 - I get to scratch my leg

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Jul 8

I was soooo excited about the 2nd post-op appointment.  Why?  The big plaster splint comes off and I can finally scratch that itch.  Plus the sutures come off and I get to see what the incision looks like.  Over the last week, I kept on getting my toes wet in the shower because the plastic cast cover I used had a little leak somewhere.  The padding would dry off, but unfortunately, it got rougher each time.  At the very least, I could get a fresh splint!

The splint was removed and… ewww, kind of looks ugly.  A little raw and lots of skin scaling off.  Plus something that looks like an infection.  Diagnosis?  The doctor said the wound was reacting right where he put the antibiotic after surgery, so it might be an allergic reaction to the antibiotic.  Otherwise, the incision was healing great, but the sutures would stay in until the wound heals a bit more.  So they redressed the incision, gave me a fresh splint (yay) and prescribed a round of different antibiotics (boo).

Jul 12

A fews days later, they checked the wound again (it looked great!) and I was cleared for suture removal.  There was no pain at all - it felt like someone was forcefully removing dead skin.  At this point, I was hoping the doctor would change his mind and give me a boot.  No luck.  I was getting a cast, just as he promised.  At least the fiberglass cast was lighter than the plaster splint.  You may as well stamp Reebok on it and sell it as a leg weight.

This is was also the point where I realized how unimaginative I was.  You get your choice of color for the cast, and I chose white.  Not blue, not green, nor purple.  Standard white.  The Ikea of casts, without the funny name.

Say no to drugs

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Jun 29th

When the nurse told me to "stay ahead of the pain," I believed her.  When she said "you should take the painkillers every 6 hours, even if you have to wake up in the middle of the night to do so," I believed her.  What she forgot to add was that Vicodin makes you feel like a sloth, and makes you poop like a sloth (if you’re able to).  But if this was the sacrifice I had to make to be pain free, so be it!

Having nothing better to do, I religiously kept my foot elevated and iced.  Because I couldn’t apply ice over the splint, the doctor recommended I ice behind the knee, to chill the blood on its way to the ankle.  That sounded S-M-R-T, and it seemed to work too.

Jun 30th

Unfortunately, I had to be on my feet for a few hours today.  Having entered escrow on a new house, it was time to do some of the in-escrow things, like a home inspection.  I don’t recommended being on Vicodin and moving around with a swollen foot.  The doctor said that being completely sedentary was bad, and that I should move around a little to get some blood flow to the foot to promote healing, but I don’t think this is what he had in mind.  At the start, my mind was fairly clear - "Yes, I understand.  That makes sense."  At the end, it was a little less clear - "Huh? Whatever."  Thank goodness my real estate agent was a good family friend.

Jul 2nd

Four days post-op and no pain.  Literally none.  Drugs are great.  In fact, so great, with nothing really to do, I tried working from home.  It would’ve been a success if I could have thought clearly and not dozed off.  I’m going to have to downgrade drugs from great to good.  But knowing that it could be addictive, and that I was pain free, I decided this was the time to get off them.  Goodbye my friend - I hardly knew ye!

I love general anesthesia. No, I hate it.

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June 28th

I arrived at the outpatient clinic and was given a refresher on the day’s events:  a little over an hour for surgery prep, an hour for the actual surgery, and about 2-3 hours to recover from general anesthesia (give or take whatever time it really takes to recover).

Surgery prep was uneventful.  Repeatedly answered the same questions from the nurses and the anesthesiologist.  The surgeon came in and marked my left leg.  "Don’t worry," he said, "we only get it wrong occasionally."  I’m not sure my insurance covers comedy.

In the operating room, I remember breathing through the mask and wondering how long the anesthesia would kick in.  Next thing I knew, I woke up in the recovery room with my left leg in a new splint.  At this point, I was loving anesthesia.  I remember saying to the nurse "this hurts less than I thought it would."  She replied "that’s how painkillers work.  Take them and stay ahead of the pain."

A few hours later, I was lucid enough to be discharged.  Got home and drank some water - that seemed okay.  An hour later, I tried to eat some food - that was less okay.  It was inevitable.  I grabbed a bag and threw up.  At this point, I was hating anesthesia.

Silver lining?  I felt MUCH BETTER.  So kids, if you’re nauseous after general anesthesia, just throw up and get it over with.  It’s worth it.

It’s not the highlight that gets you…

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June 23rd

Another point for the other team.  I knew I had to do something heroic to change the momentum.  I followed the volleyball like an eagle preying on its next meal.  Set… spike… I dove to dig it out and then… well, nothing really happened, I just looked good missing the dig.  I ran after ball, stretched to pick it up, and THEN it happened.  It was a burning sensation on the back of my left heel, and I knew exactly what it was.

I went to urgent care that night and they put me in a splint.  The doctor did a Thompson test and said it was definitely an Achilles rupture.  "But you knew that already, didn’t you?"  He told me that podiatry/orthopedics would call me tomorrow morning to schedule an appointment, and I should follow up in the afternoon if they don’t.

June 24th

Of course they didn’t call in the morning, so I called in the afternoon.  The next available appointment was… JULY 21st.  Holy crap.  "It’s an Achilles rupture.  Maybe you should double-check if I need to be seen sooner."  Some pleasant hold music followed and then they scheduled me for June 27th.  Sweet.

June 27th

I checked out the doctor they referred me to.  Podiatrist… okay.  Board certified in foot and ankle surgery… good.  Specializes in reconstructive ankle surgery… that can’t be bad.  In the office, he basically did another Thompson test, felt my Achilles (or lack thereof) and went over my options.  I knew I wanted surgery.  If he had told me the non-surgical option came with free unicorns, I would’ve still taken surgery.  He assured me that he’d done hundreds of Achilles repairs, averaging about three surgeries per month.  I signed some consent forms and got scheduled for the next day.

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