First Total Reconstruction - new here

I am a 47 yo nurse and, until the last couple of years, an endurance rider.  My husband and I rode our horses in 25-50 mile marathon races.  Over the last 15 years, I have had progressively more pain in my heels and AT after I rode that I ignored - I put it down as part of playing in distance events.  But, I noticed that my hubbie didn’t have this problem…

As I rode, my heels acted as “shock absorbers” for the horse’s bounce.  We would ride for 6-10 hours on a 50 mile race in the mountains, so there was a LOT of wear & tear on my AT’s.  I developed micro tears in both AT’s, developed bursitis and excess bone formation on my heels.  I ended up going up 2 shoe sizes - the bumps looked like golf balls on the back of my heels.  Over time, I lost all flexibility in my AT’s and had constant pain.  PT, anti-inflammatories and braces didn’t help the areas “calm down” anymore.  I decided it was time for surgery.

On Sept 24, 2008, I had the tendon detached from the left heel, damaged portions debrided, a tendon lengthening in the mid calf area, then the whole thing re-anchored to the bone in my heel.  I thought that I would bounce back after a few weeks - NOT!  I am not a patient and inactive type of person.

My doc put me in a splint for 2 weeks until he removed the stitches & staples, then gave me “The Boot”, but NWB for a total of 6 weeks. 

Crutches were a real treat coming home.  I spent the night at the hospital and was over-medicated.  My blood pressure was in the 60/40 range when I left.  When I got home & tried to make the big step up from the garage to the house, I lost my balance and fell face first!  As I sat on the ground, I tried to figure out just HOW I was to get up with just one good foot!  After my hubbie hauled me up to a chair, I decided to tackle the stairs up to my own bed.  One look & I decided to go up the stairs sitting down.  At the top, the PT had suggested standing up near the top, sitting onto a chair, then getting on the crutches.  Hubbie chose a chair with a vinyl seat - part way onto it, I had visions of sliding off feet first to the bottom of the stairs!  I was never so glad to get to my own bed.  Looking back, it is humorous, but not at the time.

Hubbie has set me up in “the dorm room” upstairs - our home office with an added frig & microwave.  I look out onto the pasture to see the horses - hope they still remember me!  I bought a knee scooter and ditched the crutches.  It has been a wonderful way to get around, except when our Rotts lay in the hall like speed bumps & refuse to move.

I’m slowly removing heel wedges in the boot to get to a true 90* angle for my foot.  As much as I want to start weight bearing, I worry that I might pull out the bone anchor if I start too soon.

So here I am, waiting impatiently to get outside & start walking again.  I’m just not looking forward to doing the OTHER foot next year.

Linda

17 Responses to “First Total Reconstruction - new here”

  1. Welcome! (if that is the right word…) You are something a bit different here, something interesting for us standard ruptures to think about. I was 48 last June with my ATR - dancing, and had no warning of any pain, just a loud painless POP! But there must have been microtears or some inflammation for that to have happened. Yes, it’s all one long drag, but that’s what this website is about: something to read, learn from (esp. about reruptures…), and add to. So keep it up because your case is a different enough for us all. I didn’t bother with stairs either - just moved into the basement room and had folks bring me food from upstairs, San Francisco-two-story house style. Bananas and apples kept downstairs when very hungry. Slipping on a crutch is so easy -bathroom floors must be kept DRY by everyone in the house.

    Don’t give up! We are still young! But take it easy…

    Mary

  2. Horsinround: I had almost the exact same surgery on July 28. I am 12 weeks post-op now. I too am waiting to get my other leg done. I have a little different story but it’s mostly the same. Good luck with your recovery. Everybody on this web site is so wonderful and helpful and I hope you feel good soon.

  3. Smish,
    How long was it before you were able to start to walk on the repair? I have to say that this has been harder than even my ACL reconstruction. Then, at least, I was weight bearing as tolerated & back to work in a week.

    Linda

  4. Mary,

    My urgeon said that there is always some degree of weakening before a tear of the AT. He told me that in my case, they WOULD tear - it was just a matter of when. I opted to end the pain & have surgery at a quiet time at work & before the snow & ice are here in full force.

    I have to say that the operated side is less painful now than the unop side - and I have more range of motion after surgery than I did before in my left foot. The heel bone is achey after having so much bone chiseled off.

    There were a few days where I woke up and said “I quit - I don’t want to do this anymore.” I think that it will be the right decision in the long run. I may croak when I start seeing the hospital bills come in!

    I need to tease my surgeon about making sure that both feet are the same size when he gets done! I have enough shoes without having to buy two sizes! My husband might disown me. :-)

    Linda

  5. Linda: I was able to start weight bearing at about 5 weeks. I didn’t do much, but that is when I started. My doctor told me he wanted me completely off of the scooter by eight weeks. When I saw him at 10 weeks he told me to start working my way into shoes. I have to tell you that if I know that I will be doing a lot of walking (taking kids to the mall/grocery shopping) I will still bring my scooter along. I figured the scooter would be in storage by now waiting for the other foot to get done but I still keep it close. My Achilles feels great (that incision is about 6 inches). The lengthening incision did not hurt until I started walking (that incision is 2 inches) but it is not bad at all. The place I have felt the most pain is the heel bone where all of that work was done. Ouch! That area has caused me problems with shoes. Oh well, the first week after surgery I was saying there was no way the doc was touching my other leg. Now I am already looking at times to fit in the other surgery. My fixed leg is SOOOOOOO much better than I thought possible. I still have a long way to go but I am thankful to my awesome doctor and I am thankful my right leg is done. (I did have a complete rupture and surgery 2 years ago, it was horrible!) Did you have any kind of a graft done?
    -Smish

  6. Hey Horsinround! Nice to hear of your procudure, well sort of. Guess it is as I had the exact same thing done on the 15th of September. Doc also mentioned perhaps stretching the other leg’s AT at the same time but we thought better of it! So, like you, splint for two weeks then have been in a cast for the last 4 weeks, all NWB. Go in this Thursday to get it off and hopefully into the boot with partial WB. Hopefully! Doc said the treatment of this is exactly what he would do with a rupture…so be it! I feel fortunate that my other heel has no pain but I was told that I’d propably would be back in 8-10 years to get the other one repaired. Seems to run in my family as 15 years ago my mother had this surgery and mid-July of this year she had the AT on her opposite leg stretched. So it is what it is. Oh, and the falling thing? Yup! Ditto! Feeling a bit cocky on the crutches and took a tumble face first down 3 stairs. Argh! Hope your recovery goes well and quick for you!

  7. Linda: You mentioned that this surgery had been harder than your ACL reconstruction. Thankfully I have never had knee problems but I have heard others, who have had both, say the same thing. A guy at my church has had several vertibrae fused together and he said his ATR was much worse. I had to have my face fixed. (ha!) I was kicked in the face, by complete accident, in a soccer game and had to have my nose and cheek bones reconstructed. I would do the face fix and childbirth again before I would want to do an ATR again. For me, the ATR was a total nightmare. Redefined my pain scale.

    Padawg: How are you feeling now? How is your mom doing? How does her leg feel that was fixed 15 years ago? Which lengthening procedure did you have? It is sooo nice to find others that are going through the same thing. I hope you are feeling good.

    -Smish

  8. Smish,

    I’ve had devastating injuries when a horse fell on top of me at a gallop - but I was able to be up and mobile in a short period of time. (With big animals, it is when you get hurt & how bad - not “if”…) I’m no stranger to getting hurt.

    The ACL repair was miserable for the first couple of days - no doubt. But I was up & about with weight bearing as tolerated by day 2 - visiting my firend’s new foals in their pasture. I was back to work in a week. I was out hiking to clear our ATV & horse trails at 8 weeks (admittedly in a knee brace). Rehab was hard work to get full ROM & there was muscle wasting, but recovery time was only limited by the amount of hard work I was willing to put into it.

    The AT surgery has incapacitated me for longer than any of those things - I guess I’m not a patient person. Other than moving my foot to regain some ankle flexibility, there isn’t much I can do for that lower limb just now at 4 weeks.

    I’ve set my foot down a couple of times without any real weight & I can’t imagine what walking will be like where the bone was removed. I have parathesia in my first three toes where nerves were touched in surgery. I suspect that it may play a part in balance. I don’t mean to sound gloomy, but this gets old fast!

    In a normal year, we’d be out riding our horses in the mountains, enjoying the leaves changing color, camping, hiking.

    Linda

  9. Padawg,

    We’re on a similar schedule! I was surprised when I got a boot & not a cast at 2 weeks. I had spoken with surgeons in the past who had outlined something like your doc’s approach. Dr. C allowed a boot for “early mobilization” as long as I promised to be compliant.

    Good luck this coming Thursday!

    At my 2 week post op visit, Dr. C said, “If you look down in a few weeks and see a giant “S” on your chest, it DOES NOT mean Superwoman. It means you are thinking of doing something STUPID. Don’t do it!” I keep telling myself that. :-)

    Linda

  10. Linda: Does parathesia mean numbness? If it does, I have that too. I have that in my 3 middle toes. Big toe and little toe is OK. I have actually noticed it getting better as I have been walking more. I thought that may have happened with the poplitiel (sp) nerve block. Anyway, I agree with you, this got old fast. I have had nights where I’ve freaked out feeling clausterphobic with not being able to get away from my leg. Sounds weird huh? Now I am just happy because at 12 weeks post-op my leg feels a lot better than it did before surgery. One problem with walking was finding shoes. I can’t wear the ones I used post first surgery. I didn’t have any heel work done then . My doctor suggested a nice pair of Birkenstocks or Crocs. I have never been a fan of Crocs but I chose a pair of those because of cost (they have some new styles out now that aren’t too bad). At 4 weeks post-op all I was doing was range of motion stuff with a thera-band. THAT REALLY HELPED WHEN I STARTED WALKING! I didn’t get to see my leg for 8 weeks post-op after my rupture surgery and that, I am convinced, caused a lot of extra work and pain.

    I had my biggest freak out about a week after I was cleared to start walking in the boot. I think because I had gotten a lot of the pain to settle down before walking and then when I started walking again, I had a bigger pain increase than I expected. A lot of the pain was nerve and heel pain, not Achilles pain. I started icing 3 times a day and a hot water soak at night. That helped a lot.

    I like what your doctor told you about the “S” on your chest. That’s funny. When is your next doctors appointment?

    -Smish

  11. Smish,

    Yeah - parathesia = numbness. Dr. C said there are two nerve bundles that have to be moved aside to be sure they were not cut. He’s sure they were moved, but maybe bruised? It feels like your fot is asleep & just waking up - numb, tingles, sort of aches.

    I go back to the doc on Nov. 4th - election day. Hubbie is taking the day off so we can go vote, have lunch out, & see the doc.

    Shoes - I’ve been in backless shoes for so long because of the heel bumps that I have a nice selection. I got tired of constantly buying bigger shoes for the growing heel lumps. The only problem with backless shoes in the winter is the snow gets in them. I have some big winter boots that I use heavy socks with for barn work & snow shoeing.

    If you haven’t tried them - look for Ariats! The have a wide toe box (for the swollen sausage toes), a gel foot bed, a steel shank for support under the arch & heel, and an anatomical heel lift. My orthopod suggested them about 10 years ago & I was hooked. They have some nice clogs. You can find them on line or in Tractor Supply stores in the US. A nice pair of clogs range from $60-$90.

    Linda

  12. Linda: Sweet, I have two pairs of Ariats already. I hadn’t tried them yet because I have really narrow feet and most clogs fall off unless they have a little back strap to hold them on. The strap on my Ariats are pretty intense. I may try those today. The back strap I have on the new Crocs I found are totally adjustable and seem to hit me at a good place. Probably just luck. These Crocs are actually a leather top. Not the best but they will do.

    I’ll be thinking about you on the 4th. I don’t go back until the 24th.

    -Smish

  13. Smish; I am not sure what the procedure was called to have the AT lengthened. I’ve read several different ways in which it is done, mine? About a 2 inch incision done halfway up the calf, other than that, I’m clueless which is probably not a real good thing! I’m feeling pretty good, I can sit here and feel the heel doing some strange things, can’t quite pin point if it’s the incision that is healing or the AT itself growing into it’s new home. Hopefully all of the above, guess I’ll find out Thursday. Mom’s 15 year old repair has never given her any problems and she just finished up her PT last week for her July surgery. Her surgeon told her that she is a very fast healer and was quite pleased with her progress. Her hips and back have bothered her for several years and now she realizes that this was a result of her limping all the time! For 80 years old she is doing great!!

    Linda; I am amazed at the different protocols that different doctors prescribe. Mine is very conservative and having gone through it, it gives me shivers to think of having any kind of WB after just a couple of weeks! As it is, I am excited to get out of the cast but very very apprehensive about putting any kind of weight on this foot. I don’t know what to expect, how much I can do or anything! I look forward to PT as well. The other day I was in shorts and was shocked to see the difference between my repaired leg and the normal one! Where did it go? Oh well, I am hopeful for Thursday as I have a date to go watch my beloved Washington Huskies get their collective rear-ends handed to them by Notre Dame of all teams…sigh…it’s been a miserable year to be a sports fan in Seattle. Anyway, missed the last two games as I knew there was no way I was going to make it up the stairs at the stadium, this week though, I’m there!! Take care ya’ll!!

  14. Hi,

    I too am a 47yr old nurse with the same thing….same surgery after a short few years of tennis….sigh….which I hope to return to and in the meantime get my weight down so the “heel spur” doesn’t grow back.

    I am 8 weeks post op…keep reading here because the recovery is about the same either way and now I know of at least 5 people who haven’t completely “ruptured” but have had the reconstruction you and I had.

    We clearly could have ruptured if we continued but the pain before my surgery was immediately cured with the debridement, while the soreness of the tendon contines to recover. Doc said to give it 8 months before I play again.

    MarilynRD

  15. The heel bone is achey after having so much bone chiseled off.
    Hi Linda,
    Why did the heel bone have to be chisled off? Was it due to a heel spur or a result of a reattachment?
    I recently underwent a procedure where a tendon was harvested from my foot and used to repair the achilles. I am still NWB, surgery 3 weeks ago, but I don’t feel any tenderness or pain in the heel - I’m wondering if that’s something I have to look forward to.
    I was assuming that the usual timeframe for an acute achilles tendon repair would not apply in the case of a reconstruction since it is a more complicated procedure and would most likley need a longer recovery. I also wonder what level of functionality I can expect when all is said and done. I would love to be able to return to running.The surgeon is optimistic but from where I am right now I have my doubts.

    Bob

  16. Hey Horsinround…
    So you are the only other horse person I’ve found. I ride as well. We show western and English. My ATR was this year, June 7, surgery June 11. I’d like to know how it’s going and how long it took you to get back to riding. My dr won’t give me a date yet. I am at 8 weeks post op. . You can read my story at achillesblog.com/jandmseaman . Thanks for any horsey help ! God bless, Michelle

  17. Linda,
    So, questions I have:
    1. What did you consider conservative…do you just mean he took his time getting you back to FWB? Some I know mean by conservative that there was no surgery just casting. I had surgery, but I know that my dr is not in a hurry to get me back FWB. My 8 wks will the the 12th…I am in a boot, NWB now. He told me it would be a year before it was “like new”.

    2. When my dr operated he found that my tendon had attached to the bone spur on my heel. He had intended to take the spur totally off until he found the attachment. He shaved it as much as he could. My tear was about an inch above my heel.

    3. Once I am released to do this, I wondered about the heels down…I wondered if I put a English saddle in the house and assumed the posting position if that wouldn’t help me to strengthen it before actually being on the horse…what do you think?

    4. On mounting, I assumed I might not be able to torque my ankle to mount ever….can you mount now? I thought I might be to mounting on the off side….???

    5. I am with you…I am not a patient person, and not a good patient at all….I am doing EXACTLY what the dr says and when he says it. He’s amazed actually…he knows how bad I can be. LOL. I don’t want to go thru it again….dr did tell me that a bilateral rupture wouldn’t be a surprise….ARG.

    6. Thanks for your help…I’m so glad I found a horse person to commiserate with.

    Blessings, Michelle

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