POD#1 after re-rupture repair
August 11, 2012
WARNING: I AM INCLUDING SOME GRAPHIC PICS OF MY REPAIR IN THIS POST. FYI.
So it’s 1 day after re-repair of my Achilles. I spent the 11 days in between my injury and re-repair in a CAM walker. At first I couldn’t put any weight on it at all, but the day before my case I was walking around painlessly with just the boot. I could completely dorsi- and plantarflex without pain. I couldn’t walk around without the boot but it really made me doubt whether I needed the surgery at all. I planned to ask the surgeon prior to doing all the necessary stuff in the preop area, but they moved so fast at the hospital that I didn’t even talk to him before the anesthesiologist had given me some sedation, and at that point, I didn’t really care what they did.
I chose to do spinal anesthesia again with peripheral nerve blocks. I requested a short acting spinal agent so I would be able to hop up the stairs to my apartment after I got home. The anesthesiologist was surprisingly rigid in her plan and said she would give me a longer-acting medication in case it wore off while I was on my stomach. Being an anesthesiologist, I was less than pleased. For those of you about to have this surgery, it should only take an hour or so and agents such as mepivacaine and demerol will be more than enough. If they use bupivacaine (which is what I got), you won’t be able to stand on your good leg for 6 hours or so. They also convinced me to have the sciatic catheter again, even though last time I felt the saphenous block was more effective. I’m glad they did, because even now, my foot is numb and I have no pain. I don’t know why the catheter wasn’t this effective last time.
The block and the spinal went well and the surgery only took 40 minutes, which I spent listening to music. Here’s a pic of my tendon prior to repair.
My surgeon said (and you can see) that it was completely ruptured, so I’m glad I went through with it. Now a picture of what it looked like at the end of the repair.
After they closed, they put me in a splint, which I’ll wear for two weeks. After the surgery, I spent about 30 minutes in post-op before they tried to discharge me. My dad basically had to put his foot down and make them let me stay, as I couldn’t move either leg at this point. We hung out for about 90 more minutes, at which point I could move my left thigh but not my lower leg. I was wheeled out to my car and 3 people helped me into the car. We went to get my prescriptions and some dinner. Whole thing took about an hour, and by the time we got home I could bear a little weight on my left leg. I rode my scooter to the stairs and used the railings to get up, which wasn’t too bad actually.
Today I’m hanging out on the couch and watching TV. The sciatic catheter is still working well and I haven’t had to take any pain pills yet. I ordered another apparatus from goodbyecrutches.com so hopefully this week I’ll be a little more mobile at work and actually be able to do my job. This is what I got. Once I’m a little more proficient at it, I’ll get a picture up of it.
August 11th, 2012 at 15:43
Cool blog. Really cool pics. No mesh or other stabilizer around the tendon?
August 11th, 2012 at 16:52
Good luck — you’re due. Are you planning to spend more than 2 weeks NWB? If not, that’s not long to get some value from the springy knee-walker… Won’t you still use crutches for PWB?
August 11th, 2012 at 17:13
No mesh or stabilization that I know about, but I was kind of out of it. Planning on the knee walker as tolerated Norm. NWB for 4 weeks then PWB for 4 more. Crutches, scooter, and knee walker. My plan is to be conservative at home but active with PT as we discussed.
August 11th, 2012 at 19:54
Did you get the infra gluteal or popliteal catheter?
August 11th, 2012 at 20:16
Popliteal Wes. Bolus lasted about 24 hours. A little saphenous pain creeping in now but it’s covering pretty well I think.
August 13th, 2012 at 10:25
Take care of yourself.
Steph and I are looking forward to seeing you in Ireland. Will have to keep the walking down to a minimum which may require more time on a stool - guess you will need to be careful there too.
We get to see your better half tomorrow evening for dinner.
Don’t understand much of the posts - NWB?, PWB?
August 25th, 2012 at 06:00
Hi Hoody,
I know this is late to come to you re this thread but I re ruptured last night. I was non op. Interesting that you could walk around in your boot no pain and yet when they cut you open you can clearly see the two ends of the tendon don’t meet. How are you getting along now and how come you are NWB for a month. Is that because of the re rupture or just the protocol your hospital uses? When you read up on all the re ruptures did you see any that had opted for non op a second time around?
Hope you’re good at the moment.
August 25th, 2012 at 18:23
Hi Sheena,
I’m very sorry to hear about your rerupture. The first couple of days are very, very hard, and I was very frustrated with just about everything. When I was reading other people’s stories, I seriously doubted the comments that said “things will get better” and so on. But let me assure you that indeed things do get better. I am now 15 days post-op for the second time, in a cast, and doing well. I will post a complete update soon, but to answer your questions, I was non-weight-bearing for the first two weeks (actually about 12 days) in a splint before switching to a cast. I am now actually full-weight-bearing, but unable to really do so because I am still in equinus position in the cast. My surgeon has given me the go-ahead to put as much weight on it as I want, since the cast basically prevents any stress on the tendon. In two weeks I will be out of the cast and into a CAM walker with heel lifts, and start PT.
As far as my options were concerned, my surgeon strongly recommended surgical repair the second time around. He quoted some literature, but as I understand it, the scientific literature is somewhat sparse on rerupture, so I went with what he said. I am not regretting that decision. Take some time and think about it, and if you decide to go with surgical repair, find a surgeon that talks to you openly and honestly, and for more than 3 minutes. Surround yourself with people you love, and time will pass quickly. Good luck to you!
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