Post Op 1 1/2 Weeks, Recovery Update

May 7th, 2013

(Friday, April 26th) Arriving home after surgery, really not all that bad.  I got home around 5pm.  Sleep wasn’t too bad, I was taking my pain meds and it was bearable.  I was a little ‘woozy’, ate some mac and cheese for dinner, what I could eat of it anyways and went to sleep…

I woke up at 5am with extreme pain.  Pain meds were laughable, I was taking the recommended amount but it added up to zero is what it seemed anyways.  At 1pm, we figured it may be due to the swelling being inside the ’soft cast’.  I took a Tylenol, within an hour that unbearable pain change to manageable pain.

Beginning Sunday, April 28th, I no longer took any pain pills other than just your basic Tylenol which was plenty enough to resolve the swelling.

From then on until today, May 7th life was easy, laid on my back basically all day aside from making sure I keep the blood flowing in my legs, I would get up every few hours (especially immediately following surgery, don’t want any blood clots!) and crutch to at least the restroom and back. Only 1 little mishap with my first shower after surgery, we bagged it up, wrapped it up with saran wrap, and then even taped that at the top… water still got in, thankfully it didn’t dissolve the soft cast, it did however get fairly wet so we took off the wrap and put it in the dryer for about 30 min while I held me left up and motionless.. a little scary.  Called the doctor and based on how wet it was, they said it should be fine until we saw them again.  Think I’ll change to taking baths now.

Today, May 7th, I visited my doctor for the first time post surgery.  The nurse came in and cut off my soft cast.  My foot was very uncomfortable at first, my knee down was basically shivering and shaking a bit.  I managed after a few minutes to resolve that pretty well, I assume it was just general fear of possible pain.  My doctor came in and took a look at the awesome ~5" cut on my leg.  It looks really good, much better than I expected and much better than some others I’ve seen online.  I’m healing great as far as that goes he said.

The doctor broke out my MRI’s and wanted to show his assistant the photos of my injury because it was so rare.  He pointed out where the tear typically was, mine was basically at the top right at the muscle and 5cm lower was where the bottom part of the Achilles was.  He said that typically at this height they do not do surgery, but because of the curvature of the lower piece of Achilles, he was concerned it may not heal correctly.  So surgery it was, interesting for me.

So now the question was cast or no cast, he said typically at this point he is being more inclined going straight into a boot; however, because of having to stitch my Achilles into my calf muscle, and muscle stitching being less secure, he placed me in a hard cast and I will be in it for 3 weeks.  NWB at all until I see him again May 28th again.

I’ve been doing well mentally, I’ve been finding things to do on my computer, finding shows/movies to watch.  Thankfully my wife has been able to spend a lot of time at home during this recovery as well so I’ve had help whenever I’ve needed it.

Ohh yeah, and he estimates I’ll be out of work for another 3-4 months, I do a lot of walking and lifting of products at my job.  Hmmm, that’s a long time.  Short term disability sad to say for me…

19 Responses to “Post Op 1 1/2 Weeks, Recovery Update”

  1. hattrick30 on May 7, 2013 9:04 pm

    Question for you guys..

    Now that I’m in a hard cast (see above blog post), they didn’t angle it at a specific angle. I was simply told to angle it down some if I could. I couldn’t really, I sort of just let it hang and they casted it. The doctor himself did not verify it, the nurse casted it and was the one who requested me to angle it downward if possible.

    Any concern about this? Should it have been angled further down?

    Probably over thinking.. But hey, we all probably do that with so much time on our hands!

  2. kellygirl on May 7, 2013 9:12 pm

    Interesting question. I’m going non-op and I asked the Dr. the same thing. I thought it would be casted at a more exaggerated downward point. He said not to point my toes–just to let it hang naturally. Curious what others say too.

    LOL about the over thinking. I definitely think it has something to do with having so much “free” time.

  3. normofthenorth on May 7, 2013 10:32 pm

    It used to be fashionable — post-op and non-op — to immobilize (cast) ATR patients “in gravity equinus”, meaning at the angle that the foot hung naturally (usually with the calf vertical, I think). It’s probably as good as any other angle (and maybe better) post-op, because it leaves the repair immobilized but not forced into an unnatural position, either compressed or stretched.

    For non-op treatment, leaving the torn AT relaxed and as-is may well NOT be the best approach. I don’t recall any of the recent successful non-op studies using gravity equinus. As I recall, they all used specific angles (or heel-wedge sizes), identical for all patients. And because they got excellent results — and because the average OS or clinic hasn’t even kept track of their results, much less published excellent results — I’d go with the approach from UWO or the 2007 NZ study for non-op care, rather than experimenting with anything else.

  4. hattrick30 on May 10, 2013 12:16 pm

    A few questions..

    1: My left leg is in a hard cast for 2 1/2 further weeks. Is it okay for me to move my toes around, I know when the injury occurred I could barely, if at all move them. Post surgery now, I can move them almost as normal. Should I stop this action, I’m doing it hoping it will prevent some of the atrophy..

    2: Would it be okay to do other workouts while waiting for my Achilles to heal? Like pull-ups, 1 leg pushups, sitting curls? Only reason I would think it would be a negative would be increased swelling in my Achilles area due to increased blood flow.

    Thank you for the help everyone.

  5. loumar747 on May 10, 2013 12:57 pm

    Hi everyone,

    Thank goodness I’ve discovered this site. Think I might be the oldest user (65)! Anyway, just ruptured my achilles tendon playing pickleball. I’ve always been athletic and have continued to be active in sports since my retirement. Can’t believe that I’ve totally destroyed my summer. The ortho surgeon believes in the non surgery route so now, day 3, I’m in a splint which I’ll wear for 2 weeks and then into the boot or something. I didn’t get much direction as to activities I can or can’t do other than not to flex the toes. Am not loving the crutches and am finding that crawling is a pretty convenient form of locomotion. Also, wasn’t given any direction as to what I should or should not do. Is it okay to do floor exercises - sit-ups etc., work in garden kneeling down …..

  6. kellygirl on May 10, 2013 1:04 pm

    I’m curious myself about your first question. I’m going non-surgical and my doctor said it was okay to do core exercises or pretty much anything that didn’t put pressure on my left leg. I’ve been doing push ups, sit ups and light housework with no problems. Moving around seems to alleviate the heaviness/ache-yness I feel in my cast leg. I try to keep it elevated when I’m just laying about. Hope that helps.
    @loumar747: welcome to the club. You should start a blog :) I’m seven days ahead of you.

  7. hoppymodo on May 10, 2013 8:22 pm

    Hi Hattrick, while in hospital I was asked to wiggle my toes several times, and a physio gave me exercises to do when in bed - leg lifts and hip rotations. Since coming home I have done leg lifts, light weights and push-ups, though less than half what I’d do if I was 100% (due to laziness haha). Then spend a lot of time with leg elevated but since ten days post surgery I haven’t noticed or felt swelling, increasing my confidence exercise! Keeping in mind that my surgery was less “invasive” than yours, though, and I am still on anticoagulants for a total of 3 weeks.

  8. ryanb on May 10, 2013 9:46 pm

    Loumar: My thinking is that increased blood flow to the area is a good thing. One reason the ATR is such a slow-to-heal, difficult, injury is because blood supply is so poor to the area. I’m told that’s also why infection can be such a risk. I did everything I possibly could to elevate my heart rate. If you are careful not to stress the area, you may actually find that getting the heart pumping might help to flush some of the inflammation out of the area; it seemed to help me in that regard sometimes.

  9. loumar747 on May 11, 2013 5:30 pm

    Thanks for the suggestions. It certainly is comforting to know that there are so many of you in the same boat. I have had some difficult days with pain and am afraid I may have slowed my recovery which is a tad worrisome as the dr. said they might operate if there is no sign of healing after the first week. I unknowingly did a few things that ‘tweaked’ the injury- like riding a borrowed scooter not thinking that the foot rests, which were slanted up, were straining the injured tendon ( basically creating a toe flex which I was told not to do. I only clued in when the pain started - and it was pretty intense. Up to this point, I hadn’t been on pain killers but now am having to take them every 6 hours. The next day, I was feeling good and thought that gardening on my knees on a knee pad would be okay. Wrong again- would have been okay if I’d kept my toes off the ground but didn’t think of that - more pain, more pain killers. The pain was pretty intense so had my nurse friend come over. She rewrapped the leg for me and said I had aggravated the injury but that it should settle down if I could quit doing things I shouldn’t. It was pretty creepy seeing my foot ‘flop’ when I hopped (with crutches) about two steps to where she was going to do the bandaging. It just kind of bobbed like a limp fish. Then last night, I did my first face plant when one of my crutches slipped from under me and I hit the floor like a felled tree. Luckily don’t seem to have injured anything more. So, am spending the day basically on the couch trying to rest. I can’t, however seem to find a comfortable way to lie with the leg. Seems to feel best when I just let it hang over the side. Did most of you, just ‘rest’ the first few days or did you go about daily activities as much as possible. I really think I should have been given a bit more direction as to what I should and should not be doing. Am trying to stay positive though and am trying not to think of all the great summer fun I’ll be missing but am trying to take this time to ’stop and smell the roses”.

  10. Ripraproar on May 12, 2013 4:07 am

    Hi loumar,
    Your right, people need more of an explanation from docs, if your not mechanicaly minded you don’t get the obvious, until you feel the pain and think it through or get advice from here, there’s def some things I did that I wouldn’t of if some docs give me indications, like flexing toes , also had a slip on wet floor with crutches, also got told at ultra scan I’d separated the AT , thankfully this wasn’t the case,
    So what would I do if there’s a next time I’d rest the leg for 2weeks but do upper body exercise , basically I’d use Uwo as my yard tick

  11. kellygirl on May 12, 2013 1:09 pm

    @Rrr: What do you mean by flexing your toes. At what point was this detrimental, in your opinion?

  12. kellygirl on May 12, 2013 1:09 pm

    @Rrr: I can’t wait til you get your blog figured out. No pressure–LOL!

  13. loumar747 on May 12, 2013 2:24 pm

    Thanks for the comment Ripraproar! I am trying to now ‘rest’ the leg but it certainly is hard to do as I just want to get up and get going. However, today is day 2 of resting and I don’t have any pain which is wonderful! Am doing some situps and leg raises throughout the day. Getting up and down on one leg is good exercise too as is crawling up the stairs!

  14. normofthenorth on May 12, 2013 2:38 pm

    Kellygirl, that was loumar who was told not to flex his toes, not RRR. I think gently wiggling your toes in a cast or boot — or bootless — is probably harmless even very early on, and helpful at least >2 weeks. What loumar was doing while riding a motorized scooter was not like that, though, and his ankle was being loaded and flexed, all while the scooter and road were adding vibrations and such.

    Another way something like “toe flexing” can cause problems is during strength rebuilding, when several of us have overused some smaller muscles and tendons in our feet to compensate for a weak calf-and-AT. One of the guys posted recently that the trick to avoiding that is to avoid (over-)arching the arch of your foot when you’re doing strength exercises.

  15. Ripraproar on May 12, 2013 3:58 pm

    Hi kg
    Norm is right
    I mean toes pointing upwards when I was driving for instance , my car as a foot rest and In the early days used it to rest my foot and it hurt put a strain on tendon
    But I do believe my pt caused me a problem that I still have from first day of physio she said with all my strength draw the towel in with my toes as hard as possible , I did it and she said harder, the lump hasn’t gone neither the pain, the towel was on the floor, hope that makes sense, what this injury has taught me is learn to say no, I’m normally quite reserved,
    Anyhow just back from a great Italian meal, felt really good today after gym n pool session but tonight a bit down can feel my tendon pain, certainly a journey of ups n down
    Take care

  16. kellygirl on May 12, 2013 5:55 pm

    @Norm: Thanks for clarifying. I’ve been wiggling my toes at times–sometimes because of pins and needles. I understand you are talking about something else now. My foot is immobile in a hard cast and I am careful not to weight bear at all on those toes.
    @Rrr: Thanks for chiming in on that. I would think that towel stretch would be good but you think that overstretched your tendon? Good pain vs bad pain–I’m assuming the towel stretch was the latter. So many things to keep in mind when I get this cast off.

  17. Ripraproar on May 12, 2013 7:08 pm

    Hi Kelly it wasnt the towel in hand as you would use a t band she pl aced towel on the floor, which is ok it in itself she just said after one try do as hard as you can , too be honest it isn’t her I should of just thought no incremental, but so far I’m still hanging in there, this eVening is a bad one calf on fire and so is underfoot , however I hope I’m back tomorrow saying alls good, don’t let my downer get you down, I may feel good tomorrow I still have my doubts but that just probably me I’m up n down with progress,
    Keep in there Kelly G and as always there’s more success than failure the odds are with us all

  18. kellygirl on May 12, 2013 7:27 pm

    Aww, that’s such a drag. I hope you feel better in the morning. I have to say that I’m making sure that I’m not missing out on any fun while NWB. It sounds like this is the “fun” part of the recovery.

    Sleep well :)

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