georgiemac’s AchillesBlog

Alcohol goes straight to the tendons

March 17, 2013 · 16 Comments

.. is what my Mum’s doctor friend said to her when she found out I snapped my achilles tendon completely in a nightclub in Sydney. In reality, I hadn’t actually been drinking too much, but I guess it paints a scene.

I’m nearly 3 weeks post my operation and going stir crazy at home. I have really struggled with not being able to look after myself, clean the house or even carry a cup of tea.

Post operation, I had a ‘fun’ two weeks. I had intense pain and discomfort and ended up doubling the dose of painkillers. My Mum flew down from Darwin to look after me which was a lifesaver. She set up bathroom with a chair and a hand held shower. When I would make the effort to shower or move with the crutches (not often) I would get an intense pressure at the rupture site. I basically spent most of the time in bed watching movies, tv shows and reading. i’ve now caught up on most of my tv shows so I’m looking for whats available now in the USA! I was very nauseous and lost quite a bit of weight.

I have also discovered online shopping in a big way. After my Mum left I had all my groceries delivered (including a ton of things I don’t need like stockings!) and have made quite a few purchases of clothes I hope to be social and mobile enough to wear soon. It is a great time killer, browsing and loading up your shopping cart, but it is also very dangerous!

I was told to go back to the doctor at 2 wks but actually got called in at 10 days. I saw an orthopaedic registrar who said my wound had healed very well and that I wouldn’t put weight on the foot fot 6 wks but would go into a boot. This was the same as the discharge instruction papers I got from the hospital but no doctor ever actually spoke to me about the process for recovery before I left the ward.

I then went to the hospital physio to be fitted with the boot. She had a different protocol in front of her, and said I could start putting weight on my foot and throw away the crutches. She also gave me a ton of exercises to start doing but didn’t check the motion of my foot. I could barely lift my toes after coming out of the cast and the whole ankle felt stiff.

I thought I misunderstood the previous doctor and we began the process of putting my foot into the air cast with 3 wedges. My foot wouldn’t even decline enough to touch 4 wedges and the pressure in my leg was intense. The physio was determined and kept pushing until eventually my friend said to stop as I was in a lot of pain. The physio then tried to find the doctor, and eventually came back and said it was too early and I was put back into a cast.

The day was very draining and I really ended up back at square one. I’m going back in 3 days to try the process again, and this time will be more prepared with questions as to the path of my recovery.

At this stage I’m hoping to go back to work on the 27th of March. I hope I will be able to balance better with the boot and hopefully not fall over as much. Work is hard enough when I’m fully fit so I am not looking forward to going back. They sent me a ‘Where’s Wally’ card which was a good distraction for 15 mins. I thought they would have called more, or offered more support. They have said things like ‘we are very busy and could really use you’ but when I offered to work from home they said it was too difficult to set up.

My friends in Canberra have been good to me. They’ve bought me over food and magazines. The days are long between visits though. My housemates have been good too but it is frustrating when I can’t do things for myself, or even clean up during the day. My friends from home have their nose out of joint because I didn’t answer my phone for 2 wks. It is hard to explain how ‘busy’ I was.

When I look at the bright side of this injury, I see that I have actually been able to take the longest break I’ve had from work in 4 years. Even though the location of my holiday (my bedroom) isn’t ideal, I’ve still been able to fully switch off from work pressures. I’ve also been able to save a bit of money, and will hopefully pay down my credit card and have a look at my finances. I also think that I can now see what true friends I do have, and that maybe a small amount of great friends is better than having friendships that are one sided. I’ve also been able to put the time into doing job applications for jobs in Sydney which I would never have enough time to invest normally.

Canberra has begun to get cold. I’m glad I didn’t start this journey in winter as my house has terrible heating.

On a practical note, does anyone have an opinion on different boots? My discharge paper says I will be in a dark CAM Walker boot where as the physio bought up the Aircast which looks like a rollerblade boot. I guess I prefer the CAM Walker on a superficial note, as it is dark and won’t look as intense when I return to work and my work wardrobe. However, the Aircast may be better for my recovery? Any assistance would be appreciated.

Hopefully the above wasn’t too drawn out! I tried to post some recovery photos but had no luck.

Categories: Uncategorized

16 responses so far ↓

  • normofthenorth // Mar 18th 2013 at 12:39 am

    Most boots do a simple job and well enough. The fancy ones have ankle angles that can be adjusted and also set to “hinge” freely through a set range. I like that feature, though the evidence that it produces better outcomes is very slim. A boot that’s the right size and adjusted well is a good boot. Mind you, the folks here who’ve used the Vaco mostly rave about it.

  • georgiemac // Mar 18th 2013 at 1:01 am

    Thanks Norm, I will investigate a hinged boot to see if I can order one online and take it to the appointment. When the physio was trying to push my foot into the boot it was very stiff. I’m a bit worried the tendon is just too short and will need physio just to get into the position with the wedges. I’ve always had tight calf muscles.

  • kkirk // Mar 18th 2013 at 2:27 pm

    I didn’t use the Vaco, but my boot was hinged and I loved it. The fact that I was NWB for so long, I think it helped to get a little bit of that motion back (about 20 degrees, or so) ansd stiffness out when I started FWB.

  • Hillie // Mar 18th 2013 at 2:44 pm

    A hinged boot, adjustable angle, no wedges, is the way to go for sure. As your range of movement increases over a few weeks your calf muscles can flex more than in a non-hinged boot and therefore (IMHO…) suffer less muscle atrophy and help the move into 2 shoes. I’m sure that the ankle is better off too with this type of boot too as it is is only restrained for a relatively short time.

    The only evidence that I have is that it worked for me - and judging by the Vaco feedback mentioned by Norm (mine was a Vacoped Achilles Pro) lots of others feel the same way. Light(ish), cool (temperature and looks). I guess that at least some its design was down to research and evidence.

  • Hillie // Mar 18th 2013 at 3:02 pm

    In my boot I progressed from 30º PF (i.e. foot angled downwards) to a ROM giving me movement from 30º PF to 10º DF (foot angled upwards). Walking barefoot and moving to 2 shoes was so simple after that. Walking barefoot before full ROM? I couldn’t admit to such a move…

  • normofthenorth // Mar 18th 2013 at 3:43 pm

    I think Hillie’s experience — letting a hinged boot go past neutral or 90 degrees — is unusual. When I was walking around in a hinged boot I tried it briefly, disliked it, and put the stop back at neutral.

    Kevin, you didn’t have your Vaco free to hinge while you were still NWB, did you? Last post sounded like that…

  • Xplora // Mar 18th 2013 at 4:03 pm

    There are a few ‘downunder’ around here. I was due to move from Sydney to our property in the Vic High country when this injury happened to me. From what I have read, I would flick the hospital physio and find one of your own that is up to speed. Many of them have CAM walker boots. A proper fit is important and you could be in between sizes. I had an adjustable boot and found I was weight bearing in it very quickly. I also found that wedges in the boot meant the angle could be reduce but the required plantar flexion was still there. This made walking (weight bearing) easier. Hillie’s boot was a bit different and there would not be any point putting wedges in it. It is a long road to recovery and you will test your good friends. Obviously work does not understand the extent of the injury. Do you work for the government? Hope it goes well for you.

  • georgiemac // Mar 18th 2013 at 9:28 pm

    The thought of being in a boot angled at 90 deg is scary enough, let alone angled upwards! I guess it would help with the stiffness in the long run.

    I won’t be able to get a hinged boot delivered in time for my appointment tomorrow so I think I will just go with the wedges for now, and get a hinged one if I’m not happy. I will ask the hospital about the hinged boots availability anyway.

    Xplora - I’ve had a ton of recommendations for physios in Canberra, they all seem to be specialists in sport injuries which makes me a bit wary. I think I will just have to pick one. If I’m not comfortable in the boot I will just take it to the physio and ask them to help.

    I work for the government. They are understaffed as we haven’t been able to recruit for 12 months. It is a pretty demanding department on the best of days! Are you still in Syd? What are you going to do in rural Vic?

  • kkirk // Mar 18th 2013 at 9:37 pm

    Only for the end of the last week week whenever they made the final adjustment to neutral in my boot (If I remember correctly). IT stayed that way for the duration. My physio decided on that and my doc was fine with it.

  • kkirk // Mar 18th 2013 at 9:39 pm

    Nope, I was wrong. After looking back it was moved to neutral with the slight hinge the day I started PWB (7 weeks), although it took about a week to put much weight on it.

  • Xplora // Mar 19th 2013 at 12:07 am

    Georgie - I felt you must be working for the government but not just because you are living in Canberra. My injury was nearly 2 years ago and it happened just as we were about to move and build a house. The story is on my page if you care to read it. We are just about finished the house and ready to move in. Once that is done then I guess I will be busy riding my horse, fishing for trout, hiking in the mountains and maybe some backcountry snow stuff. Throw in some white water rafting and my life will be fairly busy. I gave up real work a while back after a serious accident and they pensioned me off. Sports physio’s in Canberra are a dime a dozen. Write a list of questions and see if you can speak to one without making an appointment. You will have to get past the recetptionist. All the modern protocols they talk about here are pretty good. Weight bearing early is important as is some early ankle movement once you are in the boot. Make sure your physio treats ATR’s and is up to date. Anyway, hope things improve in all areas. Not sure if you want to disclose your department? A new government is 6 months away. What changes will it bring?? You should be back to relative normal by then. I had started building by then. It was hard at first but things improved every day.

  • georgiemac // Mar 19th 2013 at 2:57 am

    A pension in rural Vic does sound nice. I use to go skiing, but I did have quite sore calves and tendons, even just because of the position a ski boot puts you in, let alone after a day of skiing. I’m hoping to try snowboarding as the boot seems better, however that will mean starting from the beginning again!

    I’m hoping to be able to go back to the gym to at least swim/walk at first, to try and get some fitness back. Hopefully I can start this by the end of April. I might need to find a waterproof strap or something for my ankle.

    Would prefer not to disclose my Department but I’m a lawyer so the work is pretty standard. Some of my work will be impacted if there is a change of govnt. I’m hoping I will be successful in getting a new job in Sydney by then!

  • Hillie // Mar 19th 2013 at 4:01 am

    Hi Georgie

    “let alone angled upwards!” in my post didn’t refer to a fixed position (you were kidding?) - that would be pretty uncomfortable!

    The ROM means just that - your foot can move freely up and down through a range of movement, getting ever closer to ‘normal’.

    Norm - “unusual” - maybe, I don’t know. The boot is designed for just that type of controlled ROM and it worked well for me. My specialist and the physio’s prescribe that regime and they do enough of these procedures to be well informed - they even run an Achilles-specific clinic each week. Having all that movement, PF and DF, takes a little time to get used to (but less than a day), and at that stage of recovery, just before ‘2 shoes’, is great preparation.

  • georgiemac // Mar 19th 2013 at 7:38 am

    Hahaha glad I was mistaken.

    The ability to have a ROM in a hinged boot makes sense working up to a shoe.

    It still seems scary at this stage.

  • Ripraproar // Mar 19th 2013 at 10:43 am

    Hi, has anyone experienced calf pain during fwb .
    I’m 4weeks non op , I’ve done some leg lifts also, really worried I’ve re damaged

  • Xplora // Mar 19th 2013 at 4:56 pm

    Georgie - I have worked for state and federal governments and when asked at parties what I did for a living I would often make something up to avoid the impending usual conversation. I know a few people around Canberra and the joke there was if anyone told you they were a marine biologist then they worked for ASIO. I put my boot into free plantar flexion before going to shoes and as Hillie said, it works great. You will understand later but it is hard to walk in the boot when it is locked. Not a natural thing. Freeing up the plantar flexion and ‘more’ natural gait.

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