The Rupture

Went to see my doc on the 22nd of Dec.  We compared scars.  My keloid impressed him but he liked the healing so far.  He liked my scar better than his.  Hmmm.  His was scabby looking but I saw a nice line shaping up on his scar, no earthworms crawling up his leg like mine!  Ok, time for another picture I guess.  Not that it shows a lot anyway.  Compared to the Nov 10th pic, the scar is lighter in color but it has become broader.  Not sure why it’s discolored at the top and I still have suture marks.  Doc says it should lighten even further & flatten out with time.

He also said to be patient on the chicken leg as it would improve with time and fill out.  No timetable for that.  I’m finally able to start to get up on a one legged toe raise.  Not pretty and darned hard but getting there.  Doing lots of toe raises, hoping to help that calf along.  Since we have stairs in our home, lots of opportunity there.    I can kind of “run”.  Not pretty but a darn sight better than before!   My 13 year old laughs as I try to speed up to a trot.    I caught sight of myself gimping while on the treadmill working out.  Yikes!  I looked like some old geezer barely coming off the ground.  Come on, we’ve all seen these poor guys out there “jogging”.  Ok, this 56 year old is NOT a spring chicken but don’t fit me for the rocking chair yet!   Doc also warned against jogging yet, even when on the treadmill.  He told me I’d get too much swelling & to give it more time.  Can’t help it.  I almost feel “normal”  and try to move faster!  Ah well, patience, patience, patience!

Lots of  rubbing down the scar with vitamin E, also Eucerin to keep the scar area soft.  Helps keep down the itching too.  Aches & stiff in the morning till I get a few paces.  I forget sometimes I’ve got a “bad” leg and find myself crushing empty milk bottles or crunching down boxes to stuff in the trash.  I can walk the dog about a mile before I notice it’s getting tight but no real pain.  My new normal must be coming into effect.  You can see the right calf is smaller.  Never did get an initial measurement but know it was smaller before!   Oh boy! Looking at those legs makes me realize how long I’ve been out and not getting enough exercise!  Took an ATR to make me look! 

I woke up to see it snowing pretty good up here in northern Colorado.  We had about 4 inches by noon with it coming down pretty good as I was getting ready to leave to take my son to school.  He takes a couple classes in a brick and mortar school (we homeshool the rest) & he was kind enough to shovel a pathway to the car so I wouldn’t go slip sliding away!  Last thing I want!  Took it pretty slow down the driveway to the car! Took it even slower on the interstate as it was snow covered and a car that had slid off into a ditch was one of the first sights to “greet” us as we came on the on ramp.  We had some idiots zipping by us on the snow covered road despite 5 or 6 accidents within the 1st 2 miles!  Made me think of able bodied people that zipped by me when I was crutching around or hobbling on my boot.  Though it was treacherous driving, it was nice TO BE driving!

After I drop my son off, I head to the rec center to do some treadmill work where I’m still working on my gait.  Practiced trying to jog verrry easy though.   I lift weights and also working on some leg presses and heel stretches, core strengthening then it’s off to the bike for a few miles.  When that’s done, I’ve been swimming laps as well as hopping & jumping (!) in the pool.  Sure feels strange to have that feeling again after so long being groundbound! When I kick I can feel the push on my Achilles but no pain.  No pain or even twinges when I kick off the wall!  By the end of that, my leg is feeling pretty wimpy, swollen a bit and tired.

Down to 1 a week PT sessions now.  We start off with the usual laser and ultrasound.  The laser is supposed to help the cells’ ability to produce adenosine triphosphate (ATP), which is largely responsible for supplying cells with energy. This is supposed to help it heal and aid in pain reduction.  It seems to have helped the keloid to lessen in color and the scar tissue thickness also.   Then the best part is the massage.  Ahhhh!  Until the head therapist decides to mash on it.  Hurts good though.  Today she tried something new.  A neuroprobe.  That did NOT hurt good.  I wasn’t sure what to expect so was taken by surprise when she stuck that sucker over the most sensitive part of my scar.  Made me jump as it felt like a electrical shock, but then I guess, it was.  Most of the time, when she had it dialed in right, it felt kind of like a pin prick but not as irritating.    Then the usual slant board, shuttle, dome, Baps and rebounder.  My leg feels like jello afterwards.

At the end of the day, lots of icing with the cryocuff.  Ahhhh.  Even on a cold day like this it still feels great.  My son jokes about just dunking it in the snow.  Tonight it’s supposed to go down to about 8 degrees.  Brrr.

I’m in my 10th week and time & progress seems to have slowed down. Can’t get rid of my limp.  With the holidays upon us, I have to make sure I get my exercising in regardless of how tired or busy I’ve been.  Hard to do.  I’m tempted to get out to the after Thanksgiving black Friday sales, like a crazy person.  Any of  you intrepid US ATRers (that should be a real word) ready to face the masses and “run” out for the sales?  How about you ATRers in other countries? When do you start doing your Christmas sales?  I’m totally 2 shoes now and haven’t even slipped the boot on for security when out & about.  Just tight and a bit irritated feeling on part of the incision.

Seems that around the scar where its rubbed by my shoe, I’ve got this pins & needles irritation.  Asked my PT about it & was told to keep massaging the Achilles & scar as the nerves are growing back.

Trying to do one legged semi-squats doesn’t work too well yet.  My balance is shot.  I’ll have to keep working on that.  My routine, 2 or more sets of 2 legged 10 heel raises on the stairs per day.  Massage scar and Achilles.  I rub vitamin E over the scar.  Ride the stationary bike for a few miles, making sure I keep my heel low and use good technique.  15 minutes on the treadmill making sure I’m using good heel toe action. I find this the hardest.  The PT keeps telling me I’m still favoring my right and not pushing off adequately.  She says it’s strong enough.  Though it’s tight and stiff, I should be able to walk without the limp.  Hard to do that.  I’m trying hard not to but it’s like I forgot how to walk right!  Crunches and hip extensions using a stability ball. I try to swim 3Xs a week at least.  Now that I’m down to 1 PT/week I hope to get to 4X for swimming.  I “jog” in the pool too.

PT visits are now 1/week.  Usually start out with laser & ultasound followed by massage.  Then on to Achilles stretches.  Balance on the dome, station 2 (upside down) 2 & 1 legged.  1 legged clockwise, counter-clockwise, front & back on Baps (Biomechanical Ankle Platform System)  board.  One legged press & 1 legged toe raises on the shuttle using 4 & 3 bands.  Next week she wants me working on a slight “jog” and cutting!

Happy Turkey day guys!  I’m thankful my guys are not making the meal & I’m fit enough to do it!

I’m at 8 weeks and I know if I’ve been up on my feet too long or using the leg too much. It seems after a vigorous PT session & the normal walking around just leave me so fatigued by the end of the day. 7pm rolls around & I’m falling asleep! How about the rest of you?  Wiped out more than normal by the time your day is done?

I had been swimming, lifting weights, walking the dog, trying to clean up & do the mom things with 5 kids around our house with less frequent taekwondo classes thrown in before this injury sidelined me.  As the summer went on, my older 3 struck out on their own, en masse it seemed & now just the younger 2 at home, so I was playing chauffeur for them.  Sometimes dog walker.  (That’s what the younger guys are for, right?)  They’re the black belts and have been encouraging me to get my black belt.  Not a good idea.

Now I find myself feeling tired out by 7 gives? I know being injured and recouping can take a lot out of you but surely by 8 weeks, my body should be getting stronger & used to the injury???

Pre-no problem, post-ATR I can barely stay up!  Anybody else having trouble with that?

Think I’ve got a keloid going here.  Anybody having trouble with that?  What did you do to lessen that?  It’s kind of red, more puffy ribbed looking over the scar, shiny, itchy and more sensitive to touch.  Not getting the tidy neat line scar that I originally thought I was getting.  Looks more like an earthworm creeping up my ankle.  Does laser or ultrasound help to break it down?  Will this scar flatten out and eventually lose that dark reddish color?

This second pic is the scar as it appeared at first.  No ribbing, no puffiness.  I include it for comparison.  At the time, I had those 2 spots that hadn’t quite healed.

When my eldest was born, I had a c-section and the doc then used vicryl.  I developed a keloid from that and was told if I had future surgeries to tell the doc to stay away from vicryl.  I did.  The doc didn’t.

At my 7-1/2 week post-op period, For PT I was working on the slant board, shuttle (kind of like leg presses to help with strength & leg length)- I worked 2 leg, 1 leg and pushing to my toe, dome- 2 legged and 1 leg, working on balance and strength.  Got pretty shaky on 1 leg after a while.  Worked on this other board with a removable ball underneath.  Had to balance & rotate on my bad leg.  Next week, they change to a bigger ball underneath making it harder & ROM increases.  Also increased tension on the stationary bike and rode for 10 minutes.  More Achilles mashing massage, ultrasound & laser.  My wound at the top looks like it may have finally closed!  Now maybe I can get in the pool!  But now it looks like I’ve got a keloid going!  Drat!  How to reduce that?

I went to PT yesterday and the therapist remarked about my flabby calf.  7 weeks, 3 days after surgery I thought I was doing good.  She had me try a 1 legged calf raise but I couldn’t get off the ground so tried 2 legged.  It’s like my right leg forgot how to do it.  I had to think hard to get that leg to get up on my toe.  Didn’t get very far but she says I can practice on the stairs at home.  Not to worry about the Achilles as it was strong and I didn’t have to worry about rerupture.  Easier said than done.  She wants me to be doing 1 legged calf raises by next week!  She also had me practice heel toe walking as she didn’t like my gait.  She told me not to favor that leg so much.  If I wasn’t in pain, focus on a good gait.   She was tough yesterday!

So today, I’m trying to do calf raises from a flat floor.  I’m a bit afraid to do it on the stairs.  Rerupture, rerupture keeps going thru my head.  Am I going too fast?   It’s hard enough doing it on a flat floor.  I keep trying to get over the fear by getting on the stairs & trying it anyway.  I find myself relying heavily on the good leg.  What a wimp I am!  What about the rest of you doing calf raises?  How’d it go for you?  How long did it take you to do a decent calf raise?

Ok, I know, I’m not quite out of the boot but the end is in sight!  My doc says 1-1/2 more weeks in the boot and then I can go to 2 shoes!  He says stay in the boot for a bit longer because the 6 week post-op period was when the ATR was the most vulnerable and he wanted to make sure it was protected a couple more weeks.  But he said I could drive!  Yippeee!  What a freeing experience!  I carry a shoe around in the car just in case I get stopped, but obviously take the boot off to drive.  I went out walking for about a mile with just the boot.  True, it did swell a bit but ice & elevation sure helps!  My dog should be happy as my 2 young guys have not taken her out much.  This way, she & I both get our exercise.

Today is the 5th visit to PT.   More massage & Achilles mashing I’m sure.  But it’s been nice to see improvement, no matter how small.  Doing light theraband exercises along with core strengthening, stationary bike riding & ROM.  Feeling the expected tightness in the Achilles and still crabbing down the stairs as it pulls too much to go down “normally”.  Guess we have to define a new normal as we all adjust to life after ATR.  Still haven’t found my cowboy boots my doc had on his rehab notes but did get some other boots with a modest heel and good ankle support.  All waiting & ready for my two shoe day!

I went thru the whole day yesterday & today without the sticks & didn’t miss them!  Not one bit.  In fact each day brings me closer to chucking them in the closet.  I walk around the house most of the time without the boot or crutches.  Still crabbing down the stairs.  Too much strain trying to go down the old normal way.  Gotta listen to the  body.   Today, my daughter & I went into the mall & I didn’t even think to grab those crutches!  Not once!  In fact, it wasn’t till we were coming out that I realized, stick free!  Whoooohoooo!  I’ve been making more & more short trips without them and actually got around the block without them, though yes, I was limping.  When I come home, I see them leaning against the sofa, looking so lonely!  Haha

I’ve had 3 trips to the PT and yesterday she massaged the heck out of that Achilles & I got that hurts good feeling, if you know what I mean.  She really mashed on it but said it had good integrity.   Also got some more laser & a bit of ultrasound.  Can’t quite do the whole thing as I still have one area, the one on top, that’s still open a bit.  (See my last entry with pix) I asked with some hope when I could drive again.  She said if it was up to her, she’d drive but I’d better check with my doc tomorrow.  I will, I will.  I did something like a leg press and then over to the slant board.  The weirdest exercise was standing on a dome & balancing on that.  Puts a mild stretch on the Achilles and as I looked down, it was evident how much more weight I was putting on my left leg rather than my right.  Can’t quite even it out without the ouch factor coming out so, I don’t push too far.  The constant rerupturephobia crops up and keeps me from doing something stupid (I hope). Also got to ride 10 minutes on the stationary bike, two shoes!  Kind of strange putting 2 shoes on even though I just rode on the bike.

My dear daughter has been my chief chauffeur & bottle washer this last week & a half & I’m deeply grateful for her help.  She helped me find my dress and shoes for my eldest daughter’s wedding.  (I know that was cutting it close but after surgery, I couldn’t get out!  You know how it is!)   We saw some really hideous things that she took phone camera shots of just to prove to friends they were really some truly awful designers out there.  She also “helped” pick out shoes.  I kept telling her I only needed one.    We tried flats. Ha! Can you say Quasimodo limp?  Then we tried heels, except she brought me some stilts.  Now I was limping the other way.   I asked if she was going for my other Achilles.  Heels and I aren’t usually mentioned in the same sentence.  Finally found some.   Unfortunately, my dd is headed back to Hawaii soon.  I’d love to go with her but ah well, obligations.    It’s been great to have her over & not just for her help.

My eldest is off on her honeymoon-nobody knows where.  Her husband kept it all a secret.  She didn’t even know.  Can’t believe she’s married! It was a nice but non-traditional wedding.  They did all the planning.  I  made it thru with one heel on my good side and actually ended up limping less!  Height equalizer.  Try it sometimes.  You’d almost feel normal.   Though, by the end of the night, I was pretty tired and foot weary, both sides.

Now after the wedding, my son has gone back up to WY to go back to school & work, #2dd is back to Hawaii for work. (Her job is to help out on a scuba diving boat. Tough job.  Somebody’s gotta do it.)  My eldest is off with her new husband.  Whew!

Tomorrow I see my doc.  The burning question of the day will be, “When can I drive?”  I got a copy of the drs report to the PT and noted this week, I am supposed to start wearing cowboy boots.  Great!–except I don’t have any.  Not everybody in Colorado owns a pair. We’ll see what he says tomorrow.   I think I’m done with the sticks though and am NOT planning to go to the doc with them tomorrow!  Will I give my boot the boot tomorrow?

I had my first session of PT today. I’ll be going twice a week. My “homework” is to draw the alphabet with my foot, do foot circles, eversion (push outward, sideways) /inversion (push foot inward toward midline) isometrics-hold ten seconds (done while sitting) , dorsiflex (toe toward shin), plantar flex (toe point), eversion and inversion range of motion (done on my stomach to stabilize the knee so it doesn’t turn the foot!) , 2 exercises for core stability - since wearing that boot has thrown my alignment out of whack. I do the core stability exercises twice a day, 10 reps each, holding for 10 seconds. The rest I do as often as I can but not straining. The therapist did some massage and laser therapy to help break up scar tissue (even on the bump I have on my “good” left Achilles). She wasn’t able to go the length of my scar since I have 2 small areas still weeping. She was worried they might try to get infected so told me to clean with hydrogen peroxide then add an antibiotic to it twice a day. Said we had to watch out for staph infections in the wound.  You can see the 2 reddish wet spots I’ve got left.  The one on the top of the incision and the other about 3 stitch marks up from the bottom.

She also took measurements as a baseline. She measured against my good leg. I can’t remember all the measurements but it will be interesting to see the progression. I’ll have to ask her for them Wednesday when I see her again. Next time, I get to (stationary) bike ride! Woohoo! I can start progressing towards full weight bearing more quickly! Hopefully by next week I can put those training leg sticks in some closet-far far away!

This Friday my eldest daughter is getting married. I’ll still have to wear the boot but at least I’m pretty sure I can make it thru without the sticks!

What are the rest of you doing for PT?  What exercises did you start out doing?  What was the progression of PT you went thru?

OK, lesson learned yesterday. I didn’t sit much and didn’t ice & elevate.   By the end of the day when I finally took the boot off and looked at my foot, it was looking pretty fat.  Should know better.  My foot was so swollen, my toes looked like little sausages stuck to a puffy foot.  Not good.  I spent the rest of the night doing what I should have during the day, iced & elevated!  Now, a day later, things are almost back to normal. At least I can see spaces between my toes again.  Let that be a lesson!  Rest-Ice-Compression-Elevate!

Monday I start PT.  I’ve been up on two legs limping badly but no more sticks—unless I go anyplace. I walk too slow without the sticks yet.  What am I in for on the PT?  Not fun I’m sure.

Still having heel pain when trying to limp on bare floors barefooted.  What a nuisance!