Jul

27

Week 8-Non-surgical success!

July 27, 2009 | | 4 Comments

I feel bad for not having written in a while, especially since I have been making huge strides since week 5.  In short, here is a snapshot of what I have been through since having my cast removed on Friday, June 26th (after 4 weeks in full plantar -flexion):  

My doctor sent me home on crutches with an ace bandage wrapped around my ankle-that was it!  No boot or anything.  He told me to work on moving it at home, and I’d get the walking boot in a week. Needless to say, I was a bit scared of taking a misstep and screwing my achilles up more, so I took it real easy for a few days, spending most of my time in bed and in the bathtub (reading, writing, internet, phone).  Then, on that Sunday, I felt the urge to try putting a little weight into my foot.  I walked to the bathroom with my foot WAY out to the side, but I was walking!  It was a great feeling.  Week 5 felt like a magical week of recovery, as I made probably the most noticeable of my strides since getting hurt at that point.  Since then, I have expereinced noticeable improvements daily, some days more than others, of course.  From the end of week 5 to week 7, I’d say it was  a series of big gains, and slight plateaus.   

I started PT on Friday, July 3rd,exactly 5 weeks post injury upon the consult of a different doctor.   It was kind of funny-the doctor I saw this time was a collegue of my doctor, and figured I’d had a partial tear, since I didn’t have surgery.    When I  informed him that I did indeed suffer a full rupture, he was surprised, and told me he would have operated.   He ended up concluding that my doctor must have thought that the ends of my tendons came together well when I pointed my toe.  When I told him that I was supposed to get my walking boot that day, he figured I didn’t need it, since I was doing well without it and would probably only need it for a week anyway.  So, no boot at all.  Right to 2-shoes from week 4 on. 

Pretty funny side note- I am moving back to where I am from in late August, so I’m starting to pack up.   Since the doctors told me initially that I would be in either a cast or a walking boot until the end of August/early September, I figured I wouldn’t be needing any of my right shoes.    Therefore, when I went home during weeks 2-4, I brought all my right shoes with me, since I knew I wouldn’t need them until I got home.   You can imagine how I felt when doc told me no boot.  Pretty silly, but it makes for a funny story, eh?  Luckily, one of my friends lent me a pair of cute sandals I can wear with just about every outfit!  Oh joy! 

 Upon starting physio, I wasn’t gaining much range right away-I think I started out at -20 degrees from neutral with my leg straight, and -10 degrees with it bent.   I showed little to no gains in dorsiflexion until about the end of week 7.    My PT has told me that pain is my guide -to approach it, then back off.   There was a lot of   “not good pain”  during this time, so it was a little  frustrating.  At PT last Thursday, I had a huge jump in dorsiflexion, going from neutral to +10 degrees since my last appointment 2 days prior.  My PT seemed like she was genuinely happy with me for the first time!   She was even happier today, as I am now almost even in my dorsiflexion with my leg straight and bent.  I rode the stationary bike today for a few minutes, and she has cleared me to ride a bike around town.  Fianlly, I can get some cardio in!  Although I have managed to stay in good shape with my yoga practice, I have missed out on my daily cardio routine.  I also walked my old walk last night for the first time-about 2 miles from downtown to my house-yippie!  It only took about 3 times as long though-patience, I know!

My last doctor appointment was Friday July 24 th.  I haven’t seen him in a month, since he is a locum and not always in town.  He was very pleased to see me walk with just a hint of a limp.  It was that Monday that I ditched the crutches (used them a little on Tuesday, as I had to rush to an appointment on foot-so week 7.5).  After taking a look at my achilles, he told me that I am a “marvel”!  Yeah for me, right?  He seemed really happy, and finally admitted to me that I was an “experiment”.  He said they would have typically opereated on me, but wanted to see how I did, since there is now a lot of research backing the non-operative treatments.  At this point, I couldn’t be happier with my care and current state of recovery.  I know there are a lot of folks out there who feel that this is an injury that needs to be operated on to successfully heal.  There is a lot of data out there suggesting this, and I’m not saying that non-surgical is for everyone.  However, I don’t have to worry about an ugly scar that could adhear to the tendon.  I don’t have to worry about the extra scar tissue that forms inside because of the repair.  And if I am still worried abotu re-rupture, i can get PRP therapy.  My achilles will always be a little thicker than the other one, but it would be even thicker if I had surgery.  There my be a slightly higher re-rupture potential, but I will take that, accept it, and move on, knowing that I made the best decision I could for me at the time, based on lots of personal research, thought and support.  I have a good feeling about my future, as far as athletic pursuits.  This injury has made me more aware of the other chronic injuries I have, and made me realize I need to take better care of myself.  I need to eat better, I need to be kind to my body and listen to it when it speaks to me through pain (and other feelings).  I feel very lucky to have had a great doctor and PT, which I wasn’t sure I was going to get up here in the sub-arctic.  My gut feeling is that this injury to going to heal pretty close to where it was before I ruptured.    I have a long way to go still, but it feels like week 8 is the beginning of a new phase in this process :)

Jun

26

One month down, 2 more to go

June 26, 2009 | | 3 Comments

Today, 6/26/09, marks a big day for me in my recovery.  I have been casted in full equinus for 4 weeks now, and today had my 2nd cast removed (I was casted twice because I thought there was a bit of “play” coming into the first cast, which now that I look back on it, there really wasn’t-just paranoia:).  My doctor wanted to increase the angle for the 2nd cast, but I asked him to keep me in equinus because it would be less awkward for when I practice yoga.  Plus, I wanted to give my achilles more time to heal that way.  You would think the longer you keep the mending ends together the better.  The doctor didn’t argue with me, but said that it may take a little longer for me to get to neutral.  I got my 2nd cast on 6/12/09, and then headed off back home to be with my family-Yeah!  Workers comp is a great thing :)

Although this has been one of the most serious injuries I’ve ever incurred, it has also been one of the least painful.  I’ve had more than one person say ”oh, it must have hurt so bad”.  The truth is, this has been a virtually pain-free injury.  From the moment it happened, the only real suffering I’ve been through is mental and emotional.  For example, when I ruptured it, there was no pain at all.  I didn’t even realize I’d hurt myself until I thought about it for a second and then looked at my heel.  On a scale of 1-10, I’d say my average pain has been about .05.  I had a little bout of pain day 2, which I’d rank about a 2. I did read an article that said about 1/3 of those who go through this experience a pain free rupture-I guess I’m one of the lucky ones in that sense.

Getting back to today, I believe the pain is about to begin.  I’m feeling pretty vulnerable without my cast, as I was able to hobble around quite well with it, even loading weight onto it going up stairs.  I told the doc today about my “cheating”, which he says was probably good for it.  I believe that is true, because moving it stilmulates collagen production and blood flow.  I don’t have too much atrophy either, and no problems with joint stiffness.  All in all, I think I’m in good shape for the next phase of this.

I am quite used to this injury now, and am left with only an ace bandage and my crutches for the next week.  In my opinion, this is the scariest week.  I can see and feel that the ends have reattached themselves, and I don’t want to mess that up.  I don’t want to trip or put too much weight on it (which I’ve already done accidentally), so I have to be super careful.  If I’m not, the pain will be immense-I can tell!  It is quite sore & tender when I try to move it to neutral.  I am excited about being out of the cast, though.  It feels great to finally move it around (my leg was getting clostrophobic, if that is possible).  After I washed it (and shaved my leg :), I massaged it.  I have a crampy kind of pain in my calf, which goes off when I sit back on my heels.   I’ve been out of the cast for about 10 hours now, and the whole ankle started swelling up about 5 hours ago.  I have a feeling the massaging may have triggered it, and maybe the little bit of exercise I gave it too. 

I go back to the doctor in next week to get my boot.  He said I should be in neutral by then (provided I work on moving it around with no WB at all).  I’m doing ankle circles, ankle alphabet, pointing and flexing, side to side, and theraband work to strengthen it.  He also suggested the hot tub soon to help loosen it up.  I’m thinking a few beers to go with that time in the hot tub would be nice (my sister the bartender tells me it helps increase blood flow)!  That’s what I need, more blood flow!   Anyway, he said I should be in it for a month, which again surprises me.  I thought the boot was to be worn for 2 months?  My doctor seems to be moving me right along, which is great, but at the same time I don’t want to rush it.  Does this timeline sound fast to anyone?

Time to go to bed–I can’t wait to see how it looks and feels tomorrow :)

Jun

6

Only 3 weeks til the boot???

June 6, 2009 | | 2 Comments

Yesterday, Friday 6/5/09, I had my first appointment since rupturing my achilles on 5/28/09. I made the decision to follow the doctors advice, and allow for natural healing. My initial thought was that if I can avoid surgery, that would be my preference. However, once I got into researching achilles rutures, it seemed like there were more studies and data backing up the surgery. However, after a little more digging, and watching both forms of surgery on YouTube, I feel confident with the natural healing option. The stats on re-rupture are maybe a little higher, but all in all, I think it’s the only way to go for me. I’m not a high-power athlete who needs to get back in the game to be employable. It is tricky b/c I’m a gymnastics coach, and I won’t be able to coach the same way I did before. I still have to find out from workers comp when I’ll be allowed back to work. When it really came down to my decision, which was very hard (becasue I do need to have a strong achilles back at some point), watching the surgery helped. All that is holding your achilles in place is some surgical nylon-they just take the two ends and tie them up. There is still the collagen/scar tissue that is going to form and act as the false tendon, so if time is not that big of an issue, why bother getting cut open and dealing with the complications of surgery?

Anyway, I am in the same cast up to the top of my calf for 2 more weeks. At week 3, they are going to increase the angle a little, and keep it there for another week. After that, I will move on to the boot. Does this seem early to anyone? From all the research I’ve done, it seems a little premature to get me to neutral, with natural healing by week 4. It seems like most people are in the boot by week 6 or 8?

I hate crutches, and have been hopping around making my left leg really strong. In a way, I thank God this didn’t happen to my left leg, because I had ACL reapair on it 12 years ago and it has always been weaker. Because my right leg is already super strong comparitively, I’m hoping to have a recovery that is not too bad. Maybe this will finally balance me out?? :) Also, the doctor said I can put weight on my bad foot, since its casted in equinus, and it can’t move anyway. I started putting weight on it yesterday, and it doesn’t seem to bother it at all. It actually helps me hobble around a little better.
As I stated in my first entry, I am trying to see and take advantage of the silver lining to this. My yoga teacher and I have figured out a way for me to stay not only in Yin but in Vinyasa class! I did it yesterday for the first time in a week, and it totally went well. I used a chair to support my back leg, and did some poses kneeling instead. I was able to do about 95% of everything, and was so happy! Totally worked up a sweat…it was really hard, but I’m so thankful I can still do yoga. If I had to quit yoga for 3 or 4 months, I’d hate to see the shape I’d be in. My advice to everyone with this is to not stop working out. I was so happy after class yesterday, because yoga makes me feel alive and fit. Just becasuse you have an injury doesn’t mean you can’t work around it. I’m going to be going at least 5 times a week, so no excuses!

Jun

2

Boredom, sheer boredom

June 2, 2009 | | 1 Comment

Geez, it’s only been 5 days, and I’m feeling maybe not so bored, but just understimulated.  I have lots to do, no matter what.  I can always find stuff to do.  I just wish I was back home with my family, so I could at least be spending this quality time off of work with them.  Hopefully I’ll get to go home soon….miss you all very much :)

Jun

2

I need my leg back!

June 2, 2009 | | 2 Comments

It was just this past Thursday night, 5/28/09, when I ruptured my right achilles tendon for the first time.  I am a gymnastics coach and choreographer, so bouncing around and leaping are just things I do, and love to do more than anything.  Although I just turned 41, I am in excellent shape from demonstrating basic gymnastics skills, yoga, running and walking, all of which I do daily.  I was approaching a simple split leap when this happened.  For those of you who understand dance terminology, I did a chasse, step, and never got to the leap. 

At first, I thought there was something wrong with the floorboards, as I did this on a regulation gymnastics spring floor.  Once I hit the ground, it took a second for me to realize it wasn’t the floor, but me.  I felt no pain at all-zero.  Just a rather creepy sensation, now that I look back on it.  I don’t like to think about the way it felt-gross.  If you can imagine holding a stick, and breaking it in 2, that was the sensation.   There was  a very noticible gap, and I knew right away what I had done.  Years ago, a co-worker who did the same thing on a tumbling move described her injury to me, and so I always had it in my head that I never wanted to sustain that injury.  She seemed very debilitaed by it, and I knew what that was like.  I had ACL repair 12 years ago, and felt like I had my fill of serious leg injuries.  Now here I am with the injury that I dreaded. 

I should have headed the warning signs better.  About 3 weeks prior, I “tweeked” my achilles for the first time upon landing a leap.  It was very sore for a couple of days, so I followed the RICE method.  By day 3, I was almost 100%.  I kept telling everyone around me that I don’t want to mess with the achilles, and that I needed to take care of it.  I should have been more intune with my injury, but hindsight is always 20/20.  The pain was gone, and I would only expereince mild soreness in my achilles while walking or running once in a while, until Thursday, when the unthinkable happened.

I am a choreographer, dancer, gymnast and all-around athletic and hyper person.  Although a part of me is absolutely devestated by this injury, I am determined to turn this into a positive experience.  There has to be some good to come out of this, and I am feeling it already.  It has made me think more about my priorities and if I am really doing the things I need to get what I want in life.  I guess the saying “sometimes you have to slow down to speed up” is true.  I have to believe that this injury is something else telling me to wake up, slow down and rethink how you do things.

I’ve gotten lots of support from the people in my life, although I wish I was back home in the states dealing with this instead.  Nothing compares to the love of family at a time like this.  At least I speak with them everyday. 

I will be using my “time off” from my lower right leg to catch up on things I really never make time for, because I’m always at work.  I am going to write, and strengthen my upper body, core, and weaker left leg.  My hope is to come out of this more fit and balanced, and on a more clear path to my goals and dreams.

It has been barely 5 days since the incident, and I am currently on a non-surgical healing path.  I can still change my mind, but both of the surgeons I saw suggest I go with natural healing.  I’m in a cast up to my knee, but am going in tomorrow morning to have my cast changed to a double-slab, so I can take it off and let my leg air out.  I just have to keep it pointing down at all times when it’s out of the cast.  I am also considering PRP therapy, as the research on it looks good and makes sense.  It’s been a tough decision for me, and I hope I am making the right one.  I want to dance around and be able to flip again.  I dont care if I can only flip on a trampoline, I can live with that.  Moving physically is what has always made my soul sing, so I need my leg back!!!!

If anyone at all had input for me and my situation, I would appreciate it greatly!  Thank you, and good luck to everyone out there dealing with this “life altering” injury.  hopefully everyone life will be altered for the better-that is my goal and the only option :)