Summer of No Fun

Hi All,

Just realized today is the one year anniversary of my ATR. I am home with pneumonia, so started to wonder if summer just does not agree with me! Yikes.

I have not been logging on to the site much these past few months…once I stepped back in the fast lane, there didn’t seem to be another stop for a while. (Hello, pneumonia.) I am glad to see so many people getting support and info from this community. It provides a wonderful service. Thank you, Dennis.

I continue to go to PT, and am considering a switch to a more hands on PT who can work with the tendon and the tremendous amount of scar tissue I have due to the 3 surgeries at the same site. My range of motion is excellent, strength is coming back, the repair feels strong. But the scar tissue is a real problem. The entire scar track is stuck to the tendon, and it means I get a pulling sensation in certain weight bearing and non-weight bearing positions. It can be very uncomfortable. It makes the area feel very hard all the time…I often describe it as feeling like it is made of metal.

The reality is that while it is very uncomfortable, I am still able to do a lot of physical activities. I walk without a limp. I am power-walking for exercise more and more, starting to bike ride again, hiking, swimming, playing with my kids. The only thing I have not tried is….tennis. I have done a lot of exercises at PT to simulate some of the stresses on the court, and they have gone well. I just have some fear about getting back out there. I read some-one’s post today about discomfort in the “good” AT, and I have to admit that I have been experiencing some twinges in my good leg since I have been more active, and I do not want to rupture the other side. Please.

Strength seems to be my biggest issue right now. I can do a single leg toe raise just barely. My foot is weak. The calf is weak. The quad is weak. Despite all the work in PT…it is a little discouraging. Both my surgeon and my PT insist I need to adjust my expectations. 5 months of non-weight bearing does not put me on the same time-line as many other surgical repairs, and I need to remind myself of that constantly. Very recently my PT advised me that I am about 50% of where I want to be. That sounded terrible, until I realized that I am pretty good now, and better is just…better!

So. Appreciating where I am and what I can do. Looking forward to more mobility and agility to come. Patience and perseverance. Always a lesson to be learned.

Hilary

Hi All,

Will post an overdue 6 month update soon.

In the meanwhile, I met a fresh ACL replacement at PT. She is moving to Paris and has not been able to find any recommendations for PT. I believe there is someone out there on this site in Paris? If you read this, can you please let me know your thoughts? Thanks,

hilary

Greetings fellow ATRs.

I will post an update soon….briefly: working hard in PT and making small progress, but struggling with tendonitis in another tendon in the ATR leg which makes the work very difficult and simple walking painful….but I carry on and try to do as much normal activity as I can tolerate.

Now where are all the drugs when you really need them?

Just wanted to say I still read the blogs to be inspired and to offer spiritual healing thoughts to all the new ATRs.

Music continues to save me…Writing and playing music with friends and family keeps me going.

I am deep in the journey.

Peace, hilary13

Today at PT I had excruciating pain and “hardness” around my ankle when trying to do heel raises on the shuttle machine and from standing. The seated lifts were not as bad. May have some irritation of the tendon that runs up behind the ankle on the outside of the leg (haven’t looked it up yet).

I have been walking well around the house and short distances without the crutches for the last week, swam last friday and wore shoes (dansko clogs) besides sneakers over the weekend. Have been teaching piano at home again, and only icing in the evenings. All this combined to be too much too soon after 14 weeks of NWB, and I am now back on crutches, and cutting my schedule in half.

Cried (but only for a second, I swear to god I am done with that), and then did some stretches and more seated heel raises. My flexibility remains good, thank heavens I haven’t lost any of that…it was hard won!

My fantastic PT is optimistic that with some rest and careful exercise, I may feel back to where I was a few days ago (when I felt fantastic and very positive) next week. So forward and back, I am still thrilled to be doing what I can, and will continue to press forward to add new activities…but listening to my body, and learning the difference between the good, the bad and the ugly pain.

Swam today for the first time since July 12.

Felt amazing to be in the water, after months of lame showers sitting on a chair.

Did about 10 laps, but just arms, as I was surprised how much kicking hurt my achilles. I have made so much progress in PT, I was on a real high. But kicking was just too much, and I was warned that there is a certain pain in another tendon running up the outside of the leg above the ankle bone, that I was NOT supposed to “push through”, so I used one of those floaty things to hold up my legs and just dragged my ass through the water with my arms. Man, it felt good. Breathe, pull, pull, pull, breathe, pull. Plus, I got to hang out with the family at the pool, and see my kids swimming like fish (little D could barely get his head under water the last time we were at the pool!)

But the BEST part was the hot tub. @#$%&*! That was bliss. Pure bliss.

Getting in was pretty easy, getting out, too. My upper body is stronger than I thought, even though I mostly used the scooter, not crutches. Only really awkward moment was trying to stand up with one leg from a seated position on the ground by the pool, with nothing to use for leverage. Graceful? NOT! Worth it? YES!

Didn’t realize how hard I had worked until I got home a few minutes ago. No pain, if your pain threshold is high, but almost unbearable stiffness…but still worth it. Nothing a little ice can’t cure.

Can’t wait until next week. Pour me another one. Cheers.

Yep, two shoes. One on each foot.

Just started today…so a little wobbly, but yikes it feels good.

Slept last night without my boot or a cast for the first time in 14 weeks. Oh my god.

Was cleared at Monday’s post-op with Dr. H to start wearing two shoes (at home at first), to ditch the boot for sleeping (yay) and to swim (with waterproof bandages over the scar…little bit at the heel end still scabbing over). He feels the tendon is where it should be after 14 weeks, and the scar is good for 6 weeks. So I feel like I have finally reached the beginning of the end of this journey. I know there is still a long road ahead, but I am glad to have turned a corner…new scenery at least. Don’t see Dr. H for another month. Will miss our visits, but nice to know I can go out in the world without him! (And I am sure he won’t miss me and my incredible wound-that-wouldn’t-heal!)

LOVE the new PT clinic I am going to. Two times this week, and already see progress. Mostly the same types of exercises that Kaiser was recommending I perform at home, but much more variety and better assistance. Just an example: one exercise that targets the calf muscle had been shown to me at Kaiser, so I had been doing it at home for two weeks…without ever engaging the calf muscle! When I was shown how to do it properly at Active Care, the entire experience changed…the AT engaged (I could tell because I felt like throwing up) and it was very clear how to do it the right way. I am a true believer now, if there was ever any doubt (there wasn’t). Also, Kaiser recommended I begin standing on tiptoes (what is that called?)…two feet together, the day after being cleared to come out of the boot. Active Care recommends waiting until the calf is a little stronger…so definitely some differences in the two PT protocols.

So onward in two shoes…but one hitch. The new PT also recommended that I use two shoes with crutches for a while, to avoid more stress on my good AT, which has been bothering me since I started walking a lot in the boot w/o crutches. Just hate using the crutches at home…same old same old, can’t carry anything, move around slowly, kitchen stuff is a bitch. But the shoes, the shoes. Love feeling a little normal for a change.

Mr. C returned the knee walker yesterday…little D was so sad. He wanted one last ride. He is already waxing poetic about all the good times he had on it. Remember that…mama?

Went back to work yesterday.

Really don’t need the crutches anymore in the house…still like to take them with me out in the world for uneven surfaces and stairs. But I can see that I won’t even need to do that anymore fairly soon. The boot is not the easiest thing to walk in, but with no muscles to speak of, it feels like a necessity at this point. Don’t know when I will be able to manage two shoes…slowly but surely, like everything else.

Had strange and very painful surges in the tendon area last night…probably from spending almost the entire day on my feet. It was so intense late at night that it made my stomach churn with each pang. Weird. Finally calmed down, though oddly the icing didn’t help, and that usually works wonders for me.

I am going to continue my once a week, 30 minute sessions that Kaiser provides as ATR PT protocol. But I have decided to invest in my future by going with a private PT clinic as well. They come highly recommended by a friend who had a serious ankle/ligament injury last year. The clinic is called Active Care and is in SF. They specialize in getting people ready to engage in intense sport after injury. Not that I’ll be entering a triathlon anytime soon, but I was so active before this happened, and I always imagined that as my boys got older, sports would be something our family could do together…skiing, tennis , biking, climbing…my 8 year old is already getting really into all these activities, and I want to do them with him. Seeing as how I can barely walk at this point, I started getting a new wave of depression and anger. So this PT clinic seems to be the right thing for me to do to feel like I am making every effort to get back in the game.

So…a better late than never return after three surgeries since July…wound complications…and a total of 12 weeks NWB.

Look out world, here I come!!

I have finally done it.

“Walked” across the kitchen without crutches.

Between the boot and the swinging arms, I’m just not sure you can really call it walking. That might be premature. And now I have to wear a clog on the other foot to bring that leg up to approximately the same height as the one in the boot. I don’t usually ever wear shoes in the house. And now I need to wear it anytime I step out of bed, off the couch etc. Let me just say there was a moment the other night where I found myself for whatever reason needing to get from one end of the house to the other in a hurry and not finding much to cover up with…I was caught in the act by Mr. C who probably hasn’t laughed that hard for a while. A proud moment. Very dignified.

So, yes, I can get around on two feet in my own special way. I still use the crutches when I go out in the world…as a reminder to myself and others that I am not totally steady yet. To celebrate my new-found sense of freedom, my friend K kindly came and picked me up (still can’t drive) and we had lunch and went to a movie in the middle of the afternoon. Decadent. Vicky Christina Barcelona transported me to another world and the Slanted Door filled my deep craving for crispy imperial rolls and papaya salad. So good.

This was followed by my first PT appointment. Two weeks ago I had an intake appt and was sent home with exercises to do to begin getting some movement back in my ankle. I did them dutifully, and yesterday had good results…more flexibility at all angles measured. This time the PT did some intense manipulations of my foot…alarming at first, but then…the heaven’s opened and angels sang…my ankle felt released from a great constraint, and felt almost normal for about an hour!

Now the thera-bands have made their appearance and I have a new set of exercises to do, in addition to standing (yes, standing) in my bare feet (yes, you heard right, bare feet) holding on to the kitchen counter and swaying my weight side to side and doing mini-squats. Yikes! Are you kidding! This has been the scariest transition for me…bearing weight without the boot. I did it in the office yesterday, but I haven’t tried it at home yet. I know. Wimp.

But seriously, you have never seen such a limb of flab. Nary a muscle to be found, not in the foot, or the calf, or the thigh…you get the picture. I used to have such a nice calf, a nice leg really, it was one of my better features, now that it is gone. Sigh.

So I will continue to walk the walk and do the work…even though the thera-band flex-ercises give me the heebie jeebies. Every time I feel the AT moving, along with all the scar tissue and adhesions, it just about turns my stomach. I guess I just want to stop feeling it all the time, thinking about it all the time. I am ready to move on. Finally.

Oh, did I mention I am going back to work on Monday? Teaching piano. Yep.

Okay, so finally the day has arrived. The wound is (mostly) closed. There is a little bit at the very heel end that is still oozing a bit. But realize that I have NEVER seen my leg look as close to normal as this since the rupture. Well, normal if having literally no calf muscle was normal. But no redness, no purple area, no pain. At the time, I had no idea just how bad the wound really was, now that I have this to compare it to. And after three surgeries, I must say the scar looks like it will be a good one! I will post some pictures next time the steri-strips are off.

So I am back in the boot, and allowed to put as much weight on it as I can. Which turns out to be hardly anything at all what with the shooting pain in my heel, the fact that my ankle feels like it is made of paper, and no calf muscle to speak of. But still…PWB!

I have my first PT at Kaiser tomorrow. Anyone else at Kaiser? I don’t think it will be as spa-ish as others have described, but I am excited anyway. Activity, of any kind sounds so good…and I have got to get that calf muscle back. I really hope someone there can teach me how to walk again, too, because I seem to be having some trouble!

So thank you Dr. H for not giving up on me and getting this thing back on track. I am ready for the next phase…and thank you to all you achillesbloggers out there who have been an incredible support system through a dark time for me. xohilary

Thinking, thinking, thinking…

about L healing from his surgery (sweet, brave boy)

about how i am approaching 11 weeks NWB

about how i might get to PWB tomorrow at my dr. appt.

about how nervous i am about walking again (was hoping to just be excited about it)

about how after three months of on/off percocet due to three surgeries, i need to drink a lot more wine

about how grumpy i have been all weekend

about blood clots and weight gain and muscle atrophy and

…time for bed.