The Rupture

Tomorrow is surgery day.  I’ve changed sheets, got freshly laundered clothes & towels & am headed to do my first scrub down with Scrub Stat.  Went to pre-admit on Friday & they told me to make sure everything was freshly laundered & they gave me the Scrub stuff saying it wasn’t wonderful.  Tomorrow morning before heading to the hospital, I do it again & make sure to not use lotions or deodorant.  Freshly laundered clothes they say.  My husband took 3 days off to play nursemaid.  What a champ!  I’m looking forward to the surgery because I know that will mean I’m on the road to recovery.

It’s really the pits though.  I looked out at my garden today.  My potatoes are getting tall, my tomatoes are looking good, my bean plants are coming in nicely, my green peppers are less than wonderful & my watermelon are showing they may take over.  Didn’t even check my pumpkins.  My parsley has bolted & I’m ready to chop it down— if I were 2 legged.  My garlic looks like someone trampled on them.  hmmm…. Guess that’s the last good look I’ll get of that garden as I’ll be back to 4-legged status after tomorrow.  Well, I guess 3 legged since it’s non-weight bearing for at least the first month.  We have such a short growing time here in Colorado.  I hate I’ll be inactive most of it!  My garden will be at the mercy of my sons- neither one probably knows bind weed from my plants!

Having been thru this ATR once before does bring a different perspective in that I know what to expect.  Not the same doctor, but the same procedure & expecting roughly the same recovery & PT.  A long road to go from the night before perspective.  Let’s just get this over with so I can start to get mobile again!  I’ve cheated, I know, I’m not supposed to be walking on it even with the boot.  But that’s because I know what a pain being 3 legged is going to be!

Nothing else to eat or drink.  Guess I’d better get my drink in now!  It’s been hot today- over 105°.  Need my water now, take my scrub down & go to bed.

I know when I come out of the anesthesia tomorrow, I won’t know what’s going on. I expect it’ll be like last time.  I come out slow & am loopy.  Thank goodness my 16 year old is planning to cook!  He’s going to get a lot of practice while I’m non-weight bearing.

Sitting here getting ready for Achilles surgery —again.  The first time was just over 3 years ago on my right Achilles.  This time, I go in for my left Achilles.  Joy.

It started out last Tuesday on June 19th to be another smoky morning here in Colorado with wildfires running up & down the state.  I’ve just started a new job working at a senior living facility teaching a sitting flexibility class.  In my certification work for fitness training, one of the discussions was to change up an exercise routine to continue steady gains in strength or weight loss.  I thought it was time to change up my routine.  I had just found a group that played competitive badminton.  I hadn’t played since just after college— “A long time ago in a galaxy far, far away…”  Tuesday was my first day to play with them.  I was being good doing my warmups and paying special attention to Achilles stretches among others.  We warmed up a bit hitting the bird back & forth- the first time in about 40 years!  Sure felt good!  Then we started our game of doubles.  We’d not even broken a sweat when I stepped back with my left leg into a guarding position waiting for the bird.  Snnnnnaaaap!  Yup.  I heard it like a muffled shot, felt that all too familiar pop in the heel, felt that baseball bat hit my heel area, then my heel hit the floor.  I grabbed my Achilles & hopped off the floor thinking, “No, no no!”  But, yes, yes, yes…I’d snapped my left Achilles!   We hadn’t even gotten up to 10 in the score!  Had barely played 10 minutes.   I sat in a bit of shock I think, knowing all too well I wouldn’t be able to play anymore badminton for quite a while!  Rats rats rats!!!!   Since I knew what to look for, I checked out my leg though it was quite painful.  My Achilles area felt like mush & I couldn’t feel that familiar band in the heel.  Just felt like a divot instead.  I had trouble dorsi-flexing  & plantar flexing my foot.  My soleus & gastrocnemius were sore.  They weren’t contracting & I couldn’t put any pressure to try to go on my tip toes even without weight on it.   My partners came over to check on me thinking I’d just sprained my ankle!  I wish.  One found some ice!  Ahhh!  Still in much pain (about an 8), I could tell my voice was strained.  After icing for about half an hour, wistfully watching them play,  I hobbled out to my car.  Thank God I can drive & my car is automatic!  Not like last time where the right Achilles ruptured.  Once in the car with my window down & my left leg hanging out,  I called my doctor’s office to get an OK to go to urgent care.  It was only 8:10 am.  I’m debating whether to go home for my boots (Yes, I had 2) & crutches or just head over to the hospital.  But if I go too early, not sure when I’ll get out & my son has to be picked up from school.

I know I can’t just go to urgent care without my docs ok (unless I want to foot the bill) so I decide to head home to retrieve what I know I’ll need & wait on their returning my call.  I’m closer to home anyways.  I hobble downstairs to retrieve my crutches, then hobble 2 flights upstairs to retrieve my boots, get a drink,  then go back out to the car.  By then it’s 9:30.  My son needs to be picked up from his jr. college class.    I’m in pain, exhausted already & dreading the inevitable.  The dr’s office calls & tells me to head over to ER instead.  Once I pick up my son & explain it’s his turn to take me to the ER, we’re off.  Surprisingly, I’m taken right into the ER & put on a monitor & asked all the questions.  The doctor comes in, does the Thompson’s test, checks out the Achilles & gives me the look.  Don’t even need an MRI he tells me.    I’ve already told him I’d gone thru this once.  I didn’t bother to tell him all the drama that entailed.  He said no movement on the Thompson’s & divot behind the heel all indicated a complete rupture.  He sets me up to see the Orthopedic Center of the Rockies– the same group I tried to get with the first time I did this.  Surprisingly again, my insurance guys approve it!  Unfortunately, the next day, when I see the doc there, he’ll be out of town until Monday (tomorrow).  Unfortunately, my insurance group won’t let me get the surgery there so I have to wait until Tuesday morning to get it done at the Medical Center of the Rockies.  But it’s better than the 6 week wait I had with my right one & I saw the right kind of doctor right off the bat on this one too.  So, 2 more days & I’ll be healing instead of waiting.

In the meantime, my ice machine has been out doing it’s healing thing.  Ahh! feels good!  Not as much pain now compared to last Tuesday.  Propping up the leg often & icing as much as possible.  Still have a fat calf-ankle with lovely discoloring.  I also worked on some lovely fat cushions for my crutches.  May as well have those comfortable as possible as I’ll be spending lots of time on them.  Contemplating getting one of those knee scooters.  I’ll have to call my insurance tomorrow to see if they cover that.

My sitting flexibility class has been most sympathetic.  I teach tomorrow but not planning on Wednesday after surgery & we’ll see about Friday.

Hey, we ought to post pix of our stick legs & see how we’re all doing!  I’ll post my latest pic.  Any takers out there?  Want to show off your calves-or lack of calf?!   Maybe we should have a chicken leg pageant? 

15 week pic

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!