Archive for April, 2014

Apr 28 2014

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goldman

Molasses time

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I think most everybody who reads or posts to this site who has suffered ATR injury will agree that the perception of time sometimes moves as if the hands of the clock are stuck in a giant bowl of thick goopy syrup. Notwithstanding that molasses is sweet it is a rather weak consolation considering how much of a PITA it is to lose use of a leg.

Now I didn’t really mean for this post to start out on the negative side, because the past week has been fine, pretty even keel. I’ve been periodically reading the posts on this site, and on a personal progression have been transitioning from PWB to almost FWB. Tomorrow is six weeks to the day post surgery. I’ve been splitting most of my walk time between one crutch and no crutch, but my heel hurts too much to be exclusively zero crutches. I am finding that the one-crutch “walk” is slower, but offers the ability to lighten the load on my injured side. The one sort of funny side effect is that I have almost tripped on my one crutch several times as I set it aside nearby in case I need it but then forget I have set it down. I guess it is payback for the many times I have almost tripped up my boy and my wife in the common spaces of our house :-)

After reading about it on this site on Friday I immediately bought an Evenup shoe balancer and had it shipped expensive 2nd day so that it would arrive by Saturday. That turned out to be a good purchase and I have had it on my left shoe since receiving it.

Today I meet with Ortho surgeon to discuss progress and to find out why o why was I recommended to not get on an exercise bike for three weeks. So a blog would not be a proper blog without at least some (more) complaining ;-) I am mystified by that advice. Somebody, please clue me in as to why I am ok to put 90 pounds of force on my leg, albeit protected by a nice sturdy high-tech plastic boot, in a downward motion with thrusting force that sometimes ends in a stomp. And yet I should avoid sitting pleasantly on an indoor exercise bike and pedal for a few minutes? Oh come on get real people. Ok, enough complaining I’ll get that answer later today, time to move on.

On an unrelated note I am finding that as I heal it is getting more difficult to do the exercises. I am not sure why, because Lord knows I don’t need much more motivation to get better faster. I don’t drink. I don’t smoke. I don’t drive. Life’s pretty boring right now. But somehow I am finding that I have to push myself to do all the exercises. But then I guess that is part of the reason why the ATR happened in the first place. And as I type I realize that is the problem: the exercises to speed recovery ARE boring. Every single part of this recovery is boring. I mean what one wants to do is go fast. Run fast. Ride fast. Ski fast.

Oh well, at least molasses is sweet.

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Apr 18 2014

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goldman

Happiness, elevating, grateful

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Today was a good day. It’s been four weeks three days since surgery. Seven weeks five days nine hours since injury, but who’s counting. Last night I got a rare seven hours of solid sleep, woke up, did some overdue work, then napped for another hour. Bliss. I am grateful for a good night’s sleep. Later in the morning I had my foot out of the boot elevating, then massaging it and doing the Ankle flexion and circles exercise. For the first time in seven weeks the foot felt normal for a time. I am grateful for that nice experience. My 10-year old son spent the first day of his April vacation working on a school project and other non-video game activities. I was amazed. I was happy. For bits of time I even forgot I was wearing a boot. I remember reading other blogs on this site about gratefulness. I can’t remember what they were grateful for but I am grateful for my family, and this day. Whoever invented elevating - I am grateful to that person or persons - elevating my leg for a few minutes at a time a few times a day really really helps and is easy to do. I am still worried about the DVT that was diagnosed on Tuesday. But for now I can not detect any side effects from the medicine. I have been trying to stretch my injured leg more, wiggling my toes more, trying to think positive thoughts about the blood clot going away. Tomorrow I go look to buy an exercise bike. But now, this moment right now, I am grateful for today.

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Apr 16 2014

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goldman

Welcome to the clot club, Xarelto or bust, and oh by the way don’t slip on the ER floor

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This week, week 4 post op and PWB seemed to start out on decent footing, pun intended. That is until yesterday happened when my family and I spent 8 hours at the hospital, 5 of which were in the lovely ER.

I had been noticing some odd ropy swelling near and below my calf on the surgical side for a few days. But I was in the boot, splint, and casts so often the past 7 weeks that I wasn’t paying close enough attention. At first I thought it was “normal” fallout from allowing some nice guy to cut me with a knife and fix my shredded tendon. I had a little bit of pain in the calf, but I thought that was holdover from the two weeks unpleasant surgical splint which had a pokey edge at that spot. It finally dawned on me that I should check this out. One phone call to the triage nurse with me uttering the magic words: “I have some pain in my calf.”

With a slightly panicky sound in her voice the triage nurse informs me that I need to immediately get into the office for an ultrasound and evaluation. After a flurry of phone calls and some logistical help from my wife, we manage to get set up for scanning at the closer by facility that my surgeon is associated with. It’s nearing the end of the work day, so my wife hustles down to my work office, picks me up, and whisks me to the hospital. That’s the last time of the day that anything happens fast. After a long two or three hours waiting for ultrasound, the painless but ticklish procedure, and the consult of ultrasound guy with my Doctor, the ultrasound tech comes out and informs me I need to head over to ER. It’s about this time that my blood pressure starts rising.

“ER?” I say. Why is that — did you detect something? The Ultrasound tech mumbles something under his breath about needing a doctor to evaluate the results. Since it is already 6pm, and my surgeon has headed home, and the hospital day doctors have cleared out, the only doctor available is one in ER. The guy hands me a form as we arrive at ER and tells me to give it to the check-in gal. I am thinking, oh oh, this does not sound good. I look at the sheet of paper and there are three neat little check marks next to “DVT” line items.

ER is crowded. It’s a pretty good sized area, with a waiting room, and various examining rooms, hallways, and waiting rooms. It seems as if every room has people, multiple people it them. Family members, patients, etc. And the hallways are lined with hospital beds with several patients lying in them, waiting. Waiting for what I don’t know but my blood pressure rises some more.

After checking in I notice that the floor around the check-in desk is unusually slippery. I am in a wheelchair so no concern of falling or damaging my precious newly fixed tendon, but my hiking shoe and boot glide seamlessly over the surface as I push away from the desk. I have trouble getting the wheelchair to back up my feet are sliding so much. I mention this to the check-in nurses and they laugh and say, “Yeah, somebody else mentioned that too.” At this point my thoughts turn a bit towards the nasty with ideas like this running through my head: “Duh lady! Somebody old, and or infirmed might take a spill while checking in. Do you and the ER want to be sued?”

At this point I realize I have not peed in hours and desperately need the restroom. There is a huge guy in a hospital bed in the corridor completely blocking the restroom door. He gets moved for me, and I crutch into the restroom. It’s small and difficult to navigate, a bit dirty. I suddenly realize that we are in the “3rd world” part of the hospital.

More time passes and finally a qualified nurse brings me over for some questioning and vitals. She must feel relaxed around me, why I don’t know because I was pretty agitated, but she starts to complain about how far in outlying towns people were coming to be at that hospital. I suggested to her that maybe the people in ER had their regular doctors there, or like me had moved around a bit further and further afield to find affordable housing, but had kept their primary at the hospital. This did not placate her. In any event she took my blood pressure: 155/105. Now I know that’s a bit high, and if this had been 3 years ago I wouldn’t have thought too much about it since I do, or did have high blood pressure. But with my recent health and nutrition kick, losing some weight, dropping the alcohol (mostly, but not completely), ditching cigar use, I had managed to get my blood pressure down to a normal range of 120/80 confirmed by multiple tests and devices. So now I am looking unahappily at the numbers. She informs me that I probably do have a clot, and that hopefully I will be released with medication and not have to spend the night. Sigh. The blood pressure ticks up.

Unbeknownst to me it turns out that once you are in the ER (at least at my hospital) they are required to take your vitals every hour. So apparently after an hour (but if feels less) another nurse tech comes over. This time my blood pressure rings in at 177/110. I look at the numbers and then the tech. He mutters to himself: “that can’t be.” Turns to me and says, “let’s try again.” At first I am concerned that the numbers are going to only go up forcing them to go into some sort of emergency life-saving mode. I take a deep breath, and luckily the readings drop to 155/110.

Much more time passes. Some blood is drawn to “save time.” My wife and kid head to the cafeteria before it closes. More time passes. At some point I get tired of being in the wheelchair, get on my crutches and start heading for a padded chair. As I crutch by the check-in desk it happens: FLAM! My crutch hits the super-buffed-more-slippery-than-ice waiting room floor. I head down for a crash. Ah ha! But fall down, not me. I have two feet. Unfortunately one of them is the foot with my achilles repair, but this all happens in a flash. I plant my bad foot (luckily in Aircast boot) down hard. Pain surges into my foot and up my leg. F***K I exclaim. I manage to keep from crashing down. After regaining my balance and a kindly gentleman helping I GLIIIDE into a chair. I angrily look at the check in nurse and say: “Maam! I almost fell. Do something about that ungodly slippery floor already.” I check my Achilles and as far as I can tell: no re-rupture. Phew.

The wife and kid return and I angrily describe the incident. After a little while I go back to the desk and ask the gal if she’s called anybody. I calmly explain to her that if I fall and re-rupture my Achilles, I am suing the ER. She informs me that she has indeed called somebody, twice. Nobody ever arrives to de-slick that floor.

Finally I am wheeled in to the swipe-badge only part of ER where the real action is, and lots of beds filled with people. More time. Finally the ER Doctor comes over and confirms it’s a clot. Informs me of my options: Take anti-coagulant medication, or not. But really the “not” option is not an option, so I recommend you take the medication, since that’s your only choice other than very bad things happening. Choose between a) Cumadin, or b) the newer fangled Xarelto. At first I was going to go with the more well known Cumadin because of it’s better known ability to be reverted, in the event that I were to get in accident or internally bleed and therefore need to get my blood coagulating again. But we end up opting for the Xarelto because it requires less (none really) monitoring, thereby potentially saving my wife several extra trips driving me in the car every other day to have my Cumadin levels analyzed.

Another hour in the ER and finally the medication and prescription is actually delivered. The pill is about the size of 1/4 of a pea. I am now “laughing” inside. Eight hours for a tiny pill.

So now it is one day later and I have only taken three doses. So far no nasty side effects, but I am only at the very beginning and I am told that I might have to take this stuff for six months!

Anybody else on Xarelto?

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Apr 13 2014

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goldman

Where is NYC?

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Hi All,

I enabled the NYC Marathon Widget and it is showing in the dashboard in the Currently Active Plugins section (see below). But it is not showing up in the sidebar on my “home” page. Anybody have any idea on how to fix that?

Not sure if this is related but at the Main AchillesBlog.com Page, when I scroll down and see my username ‘goldman’, it shows my status as “2-shoes” which is not accurate. I’m still PWB.

Where is NYC?

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Apr 10 2014

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goldman

A picture is worth a 1000 words - Rehabilitation Protocol weeks 3 through 8

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At 3 weeks post surgery my Doc put me in the boot PWB with light stretching and exercises phase. They say a picture is worth a 1000 words. I thought it useful to others at or near my phase a re-print which visually shows the exercises and stretching one should (could) be doing at this stage. Note: brace is the same as boot in the descriptions below.

Exercises weeks 3-8 post-Op

Exercises weeks 3-8 post-Op

Reference: this information can be found on this site at

Achilles Tendon Repair Surgery and Rehabilitation Protocol, Massachusetts General Hospital Sports Medicine Service

3 responses so far

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