The paradox of Achilles and the Tortoise
Dec 9th, 2011 by gabe
The classic paradox of Achilles and the tortoise is ancient history. For us ATR brothers and sisters, however, the paradox endures. My brief example: after pleading to be seen and have the leg checked earlier to no avail I had the cast finally removed yesterday. My poor calf was tender and suffering. The question of DVT was raised and after doppler a small one seen on the posterior tibial vein. Placed on lovenox self administerd injections for now. Cast stays out for now. Still strict NWB. TBC…
Hi gabe,
Thanks for posting. Were you advised to take aspirin or baby aspirin for a few weeks following surgery?
I hear DVT is a risk with ATR surgery and aspirin may help prevent this. Keep us posted.
Claudia
Hi Claudia, thank you for making the suggestion of baby aspirin. I wasn’t advised on it after surgery. I’m not sure if it’ll be worth while after the lovenox but I’ll ask. How are you coming along?
FWIW- I was also put on twice daily aspirin post surgery. I stayed on it for about 2 months. The reason given was to reduce the risk of clots/DVT.
Gabe–sorry to hear you have a clot. No strong evidence that aspirin prevents clot (although my doc recommended one a day). Now that you have a clot and are on lovenox I wouldn’t take aspirin as well unless your doc recommends it. Good luck with your continued recovery…
Hi Gabe
Sending healing thoughts your way! Hang in there.
FWIW UK practise where I was had you self administer the injections until you got in a boot (4 weeks but 2 in my case). At worst the injections are like a mild pinch which is better than the alternative!
Thank you all for your comments and healing thoughts. Part of the Achilles paradox is that there is no consensus on treatment or preventative measures such as aspirin and lovenox. As far as benefits of early mobilization which incidentally would also help prevent clots, I have found that there is abundant medical literature including a clear moderate recommendation from an association of orthopedics. Paradox that we still need to convince our own docs on not just allowing it, but even more important, to actively support it so we can do it right avoiding unnecessary risks/pitfalls…Best recovery to all,
Hi bccur, it is interesting they use injections in the UK until you move to a boot. Given my experience kinda makes sense or at least moving earlier and/or taking aspirin… For me it is still in question for how long I will need to continue in treatment. Btw there are some interesting side effects with these injections… I will have a new doppler on Friday and then a decision. The good news: I Had first PT (with no calf mssge allowed) and it was great to get some activity! Doc: move to boot : x
standing on the boot with crutches: x I guess this is PWB? Yay!