The Rupture

Gimping up the stairs with my DH behind me the other night.  My toe caught the last stair & I ended up barking my shins & forearms on the edge of the floor.  Ouch! That’s gonna leave a few marks!  Knocked the splint/bandage gizmo out of whack a bit.  No damage done, just an out of whack splint I was able to jockey around.  My DH says, “Oh boy.”  So, I never claimed to be graceful, but that was the night before….

Stitches out and now I’m casted.  Wish I’d remembered to bring my camera to take a pic of my leg!  Ah well.  Next time.  It felt really nice to get that splint & bandages off.  Got to do some do some foot circles & mild toe points.  Ahhh. Like an itch scratched.  My gastroc moved!  Wooohoo!  Stood up for a bit without weight on it just to see how far off the floor my heel was.  My DH got nervous and told me that was enough.  Stitches out,  and it looks puckered and still a bit swollen.  Thought I’d been putting it up a lot & taking ibuprofen to help keep the swelling down.  Dr. says it’s fine and normal.  The spot on my ankle that was firing and causing such discomfort turned out to be pressure on the anterior tibialis and with extra padding and more dorsiflexion that feels fine now.  Made my toes feel like they were burning on top and at other times, like they were wet.  Also that pain in the heel just needed additional padding and no problems there either.  The scar is on the medial aspect (inside) of the ankle and is about 4 inches long.  He said it looked like a bomb had gone off inside.  The cast is a bit shorter than the splint/compression bandage.  I can at least wash my toes of the betadine and dead skin!  Now in the cast and he said as long as I didn’t walk on it, I could put maybe 50% weight on it.  He adjusted the plantar flexion so now I’m within 10 degrees of normal flexion.  Could tell when he adjusted the foot there was a bit of a stretch but not uncomfortable and it soon felt fine.  I’ve tried to put some weight on it and it feels good to have my foot back in an almost normal position rather than that toe pointed plantar flexed awkwardness.  I keep tellling myself it’s ok to put a little weight on it.  Gingerly learning to trust the weight while just standing. Ta-da!  I can stand without training wheels- kinda.  He said he hopes to have me back in the boot by the end of next month!  Yeah!  Hopefully just in time for my daughter’s wedding and I’ll just limp instead of crutch around!

I go in this afternoon for my 1st checkup post-op and take out stitches.  I’ve felt so claustrophobic in this splint/compression bandage thing and found myself wanting to take it off to take a look.  Today’s the day though.  It’s been 2 weeks!  Hard to believe but on the other hand, walking 2 legged seems a distant memory.  Can’t wait to get back to it!  Reading other blogs, I chuckle as I see others doing the same things, slipping or dropping stuff.  I drop stuff & it feels like I’m staring down an abyss wondering how I’m going to pick it up.  Or  like the other day, just leaning over to water plants and I almost took a header into them. (in my last blog).  It was either into the plants or into the dogs food/water bowls.  I think the toughest thing about being on training legs is being so dependent on others for the simplest things.  We used to think nothing of it before but now, have to rethink how we do everything!  I’m thankful for my DH and 2 boys.  They’ve been terrific trying to help out- though they’re not always overjoyed about the extra duties.  Having my youngest help me make a simple spaghetti dinner shows what a wimp I’ve become.  My good left leg was so tired and aching just standing to cook!  I think I need a bigger kitchen.  2 of us around the stove is crowded.  Pulling up a chair for my bum R leg to kneel on instead of crutching is pretty crowded too.

It does seem that surgery is almost a distant memory now.  Finally healing!  Crutching around with the training legs is getting more “normal” though having to wait on people for help still is a pain.  Goes to show how we take our 2 legged status for granted.  Everything we do on the training legs seems to be magnified in difficulty.  With older kids around, I rely on them to do the simplest things like going out to our garden to pick veggies or weed the yard.  Things I did before without a thought.  Now I find myself contemplating the risks before I do anything from picking up junk off the floor to going out to the garage pantry to get something to make for dinner.  Dinner prep has to be easy & fast as it’s pretty tiring to make dinner still.  My guys aren’t old enough to drive but they are old enough to help with dinner- thank goodness.   If I drop something,  I have to balance to bend over to pick it up.  I was leaning over to water plants and almost fell over- I ended up taking a hard break check on my bad leg to keep from falling into the plants.   Yipes!  I sat down to do some damage assessment but it seems everything is ok.  Close call.  Since we have lots of stairs in our house, I’m careful about crutch placement to give as much stability and balance as possible.  I’m glad this NWB time is a relatively short 6-8 weeks and not longer.  I’m looking forward to a 2 legged state again.  It brings to mind some people who don’t have even that to look forward to.  I know the day will come when I won’t need the training legs but there are some out there who are in much worse shape than us.  They’re confined to wheel chairs or worse with no chance of being up on their feet ever.  Many of our soldiers have come back without their 2 legs and have to remake their whole lives.  I consider myself fortunate then.  These inconveniences are but for a moment.  How about other ATR people out there?  Any close calls or has your healing been uneventful?  I read about one of our group with bilateral ATR.  That’s really tough!  But we all look forward to our 2 legged status again.

Not sure how I got this out of sequence or how to get it rearranged but here it is–

After that not-so-wonderful 1st day in LA, the rest follow in a blur. I painfully hobbled onto the beach with my sister, her family & 2 of my guys. I found flipflops work a lot like snowshoes, keeping the foot from sinking into the sand. Still wasn’t fun to walk but more doable than barefoot! I spent most of that day at the beach sitting with my leg propped up. It was definitely discolored and swollen. It looked like I’d sprained an ankle badly, except for the discoloration starting at the calf. My guys had a grand time boogie boarding and I got some great pictures. The cold water sure felt good on the leg! I also spent a day & a half hobbling around my aunt’s garage, trying to help her clean it up. I know, I know, I should have gotten it checked out. I didn’t want to make my family take me to ER to check out the damage. I figured I could grit my teeth & maybe it wouldn’t be as bad. I’d sprained my ankles so many times in the past, I was hoping this old body would absorb this injury too and go away with time. I had ace wrapped the leg and iced as much as possible. I found I could drive if I used my whole leg but definitely not with just my foot. I also couldn’t walk with the normal heel-toe gait. I had to turn my right leg sideways to walk off the instep and not push off the toes. So, I hobbled around LA with my family, trying to enjoy the time we shared. The leg was looking ghastly. It was bruised from the gastroc down to the instep. The top of my foot looked like two-face with bruising showing from about the middle toe to the pinkie, like a line drawn down my foot. There was a spidery pattern of bruising on the medial side of the gastroc and still, my soleus ached and my gastroc didn’t. I didn’t have an ankle bone on either side- an cankle- I think it’s called. So, with my two young men to help me, I hobbled back on the plane to take us home to CO. Good thing the gate was close to the elevators at the airport!

Watching football on the TV. Good thing I like football.  I can’t get to the library to get anymore books.  I’ve even done the crossword puzzles, Sudoku and Crypto quizzes for the last week.  I haven’t resorted to reading the phonebook as mentioned tongue-in-cheek by another Achilles blogger.  Can’t drive since my right foot is involved.  My DH is usually gone Wednesday thru Saturday on the job.  My 2 left at home are thankfully being picked up by car poolers.  Can’t get out to shop unless my DH comes home.  He still has to take me out shopping for a dress for my daughter’s wedding coming up next month!

In the meantime, I’m feeling like a chicken on a spit, turning over and over in bed, trying to find a comfortable way to sleep.  Anybody have any good advice out there?  Part of  my problem is a torn ligament in my ankle (in the front) that aches & aches.  That couldn’t be fixed.  I was told they don’t usually bother with that.  So in this plantar flexed position, it aches most of the time.  Also, I’ve been doing my toe wiggling and curling but found the top of my foot burning last night.  What’s up with that?

So since I was so out of it after the surgery & never heard the docs explanation or advice, how  the heck am I supposed to sleep? Propping the leg up & laying on my back doesn’t do any good because it lies on the incision and I’ve read that’s not good.  Besides, it’s darned uncomfortable.  It feels like stitches on  my heel are prickly but that doesn’t make sense to have a horizontal incision.  Besides, I feel the pinch up the back of the ankle where it feels like stitches.   I’ve loosed the sheets at the end of the bed so they don’t tug.  My dear husband thinks I’m nuts.  Since my right leg is affected, I try to sleep on my right to face my DH but I end up whacking the poor guy with it & it’s not really comfortable for my left leg.  So, that wouldn’t be good.  Can’t get comfortable on my left side with my leg hanging off the edge of the bed as even with the splint & ace wrap, it’s uncomfortable & heavy.  I wake up several times to find a more comfortable position or just to put my leg up in the air to massage it.  Maybe that’s my mistake, I’m assuming someone recouping from ATR can get comfortable enough to sleep.   Sleeping on my stomach gives me a neck & back ache.  Yes, I’m griping.  It was not a good night last night. I’m feeling like a contortionist trying to find a comfortable way to sleep.   Anybody have advice to help this grouchy lady get a good nights sleep?  Her DH & kids would be eternally grateful.  Maybe my DH should be glad he’s out of state on business?

16 September 2008. Hurrah! I’m on my way to healing now & not just waiting for the docs or my insurance guys! Took only 40 minutes for the surgery. The Dr. came in to tell us what he was planning to do. He’s expecting lots of scar tissue and again said he wished he’d gotten to me 6 weeks ago. Saying with all the debridement, stitching the two ends together with a baseball stitch using the fascia, he’s expecting a longer and harder recovery too. Wonderful. But really, it’s finally being taken care of & I can start healing! The anesthesiologist comes in to tell me what he’s got but I know from past experience, once that stuff goes in, I won’t know what’s going on. He gives me his “cocktail” and almost immediately I feel woozy and start drifting off. I comment to my husband that I can feel it already. I’m out. The next thing I know, someone is stuffing a dry cracker in my mouth. I remember the nurse had said before that they would have me eat something then make sure I was taking lots of deep breaths to blow out the anesthetics so I wouldn’t have pneumonia complications. I’m all for that but wonder how many people were sprayed by cracker bits. I don’t remember much about the surgery at all. They had said there is an amnesia med in there that causes that memory loss. I can hear people talking but I’m focused on my husbands voice as he tells me to cough repeatedly to clear my lungs. Can’t get my eyes open! I don’t remember the doctor coming in at all. Don’t know what he said or even how I got dressed to leave. I don’t remember leaving the hospital. I don’t remember the half hour ride home either. I do remember being very groggy as I tried to navigate up the stairs to our house. I had to be really unsteady on those crutches. My guys were already asleep and all I know was that was where I wanted to be. I asked my husband what the doctor said. The poor guy. He tells me he’s already told me about it 5 times but I don’t even remember asking him! But my patient husband says the doctor said he was surprised there wasn’t more scar tissue and the Achilles was actually hanging by a thread. He cleaned up what was there and didn’t have to use the fascia but used a teflon(?) thread to join the tendon. 17 September - Still fuzzy headed this morning & not remembering as much. It clears by the afternoon but I’m still incredibly tired. 18 September- I am so tired of this soft splint & ace wrap! I long for the days of the removable boot! Goes to show how we really never realize how “good” we have it and should be thankful each day for the little things! I’m moving my toes around, doing leg raises, working muscles on the left leg trying to minimize muscle loss on the right leg. As I move my toes, I’m greeted by the sight of movement in the medial gastrocnemius! Something I haven’t seen for 6 weeks! Got my toe in that classic pointed down position I’m sure you’re all too familiar with. I go back on the 29th to change out the cast for a hard cast and take out stitches. He’ll reposition the foot too. Can’t wait to get back to 2 feet without the training wheels and even the boot! Will I make it to the boot by the end of October for my daughter’s wedding? It’s going to be reallllllly close!

2 September- I’m calling my doc, the scheduler/insurance guys, orthopods in Cheyenne to find out who’s available from the contract list, calling anybody to get this leg seen! Wish I could have gone to Orthopedics of the Rockies. I know they would have known what was going on & how to fix it, BUT, I have to work within this broken system. sigh. thanks Hillary. No contract with them. 5 September, finally get a referral. The soonest appointment I can get is on the 10th. I take it. When I finally see him, he looks at the MRI then says he wishes he had seen me 6 weeks ago! I do too! From the looks of it, and since it’s been 6 weeks, he’s expecting lots of scar tissue to have to debride (scrape away) and then he’ll have to fish out the tendons, clean up the ends, then join them using fascia from the muscle around it. Let’s get it done. Time’s ticking away and the end of October is coming too quickly. I explain I’d rather not be crutching it to my daughter’s wedding. He hopes to have me back in the boot by then. I’ve resigned myself to that.  The date’s set for the 16th-when my husband will be around to drive!

25 August- The MRI results come back - even the addendum. What I read sends my heart plummeting- “There is a complete disruption of the Achilles tendon 4 cm above the calcaneal engagement, distal to the musculotendinous junction.” Other words say there’s lots of swelling and thrown in there to add insult to injury- “There is disruption of the anterior talofibular ligament.” -that’s in the ankle. They’re not going to do anything about that tear. Rats! It IS the Achilles, I start reading everything I can about Achilles injuries & treatment and run across this blog. “Good idea for later”, I think. Still haven’t seen a real doc. After seeing the last guy, I put in a request to see a doc up in Cheyenne since we’re close. No way I want the other guys working on me. 28 August. Why haven’t I heard about the referral to the Chy doc? I find out the referral wasn’t in the system! I call up to my doc only to find out they will be out of the office Friday and the following Monday is Labor day so they won’t be in then. It’s too late in the day to do anything Thursday.  The soonest anyone can get back to me about the referral is the 2nd of September! Arrrrrghhh! Less than 2 months to my daughter’s wedding. Will I be there without crutches?

I’m still calling trying to find out where my MRI referral went to. Finally I find out they sent it to the wrong department. I try to give them the right fax number but am told the number they were given is the one they have to use. I try to simplify my language to let them know the radiology department has no idea where that fax is going but they know it’s not them! No dice. I give radiology their phone number so they can let them know they aren’t at the number the scheduler/insurance people have and leave them to straighten this out. In the meantime, it is now closing on to 2 months away from my eldest daughter’s wedding! What are my chances I’ll have this taken care of by then? 19 August, I finally get my MRI! They call be back the next day because the doctor has seen something and wants to do an Achilles protocol. In the meantime, doctor “you have a muscle tear” has sent a referral to start PT. I got that referral pretty quick. Wondering why it took 19 days to get my MRI done

This boot is getting reaaaaallly old!  But I realize the day is coming when I’ll probably consider days with the boot as the “good old days”!  I hobble and limp around the house without it but have also tweaked it when my heel has slipped below the stairs! OUCH!  My leg has lost all it’s colorfulness from before but my son says it looks like something is missing on the inside of the calf.