iski7b’s AchillesBlog

2.13.11: Week of many milestones ending on a good note. Cleared to drive and spent the week enjoying it. PT said I can continue on my own, don’t need to come in anymore. Will consult w/her in 6 weeks to get my next set of exercises to do on my own. Doc. said I don’t need to see him anymore unless something unforseen happens. He’s pleased w/my progress and likes the look and feel of how the achilles has healed. Good mobility and he said the area is “supple”. Spent a couple of hours at the gym today and felt FANtastic! Ditched the hiking boots once I got inside and slipped into my sneakers…OH they felt so good, nice and cushy. The hiking boots have been great for stability outside in the ice and uneven ground, but they are very stiff-soled and aren’t the most comfortable to stand in all day or, for example, walk around the grocery store in. Anyway- I’m in my sneakers, I’ve got no cane and I’m feelin’ free as a bird…biked for 35 minutes, then lifted weights (w/my hands free (’cuz no more cane), I could finally get back to lifting with free weights and move away from the “machines”), and then did my PT exercises and some abs, then headed down to the pool. Walked barefoot on the cement pool deck from the locker room to the pool (about 70 meters) with no discomfort to the achilles and no limp. Bottom of my foot is still sensitive though (feels like there’s no “meat on the bone”) but has really improved. There was one section, though…on my way to the pool stairs, where you walk accross this plastic/rubberized/texurized mat thing, I guess I’d say it’s like an anti-slip mat or something, it’s right outside the stairs to the hot tub, anyway…WOW! Talk about sensitivity on the bottom of the foot. It felt like knives…a million tiny little knives. Fine on the good foot sole, torture on the bad. Luckily the mat was only about 3 or 4 feet wide. It reminded me of those circus or magic acts where the person lies on a bed of nails! Swam 15 minutes of freestyle w/the pull buoy and 10 minutes of freestyle using my arms AND legs. Man it feels good to get my legs flapping and swishing through that cool water. Then a quick reward of 5 min. in the hot tub and 5 min. in the sauna, and my workout was done and I felt absolutely AMAZING! Can’t wait to hit the weights again and get back in the pool later this week!

2.6.11: What an amazing week. Started walking w/o the VACOcast on Monday. Since Monday, when not in the VACOcast, I have been walking in lightweight, high top hiking boots, when I’m out or at work, and in hightop bedroom slippers, at home.
Monday thru Thursday, at work, I wore my VACOcast the 1st half of the day, and switched into the hiking boots the 2nd 1/2 of the day, and at the gym. I felt really strong, and on Thursday after work, I swam in my “naked feet”. That felt so incredible! Really loosened things up. On Friday, I put the hiking boots on in the a.m. figuring I’d take them off when my foot got sore sometime throughout the day, but it never did, and I was walking comfortably ’til 8pm w/no limp!
…Then…today…I drove! OMG! It brought tears to my eyes to finally have my independence back. I took a test spin (my car is manual trans.) on our dead-end gravel road and even did a few “fake emergency deer jumping into the road” stops to test things out, and it felt great!
Now going over to our friends house to watch the Packer’s kick some butt in the super bowl. Even if they don’t win…it’ll still be an amazing week, one of the best of this recovery! Feeling strong.

2.1.11: So, it’s been a 1/2 day at work of walking in my high top hiking boots w/my cane. I don’t do a lot of walking, in general I either am sitting at my desk, or standing at my lab bench and walking short distances to get ingredients. So far today, I’ve been mostly at my desk and doing short walks to and from the copier, around the building, etc.
Things are going well.
My hiking boots feel really comfortable so far, and very sturdy and safe. I feel pretty well supported in the achilles area. I don’t have a limp at all, and that really makes me feel great! I’m not really walking excessively slow, either. Slow and careful, but at a somewhat normal pace, like the pace of someone who worked-out too hard at the gym the day before, or something.
I’m just so thrilled!
I’m thinking that many short walks is a good way to ease into eventually being able to actually take a somewhat long walk here and there, so that’s my plan, so far…many safe, short walks indoors for now and soon, when I feel able, a 10 minute walk somewhere safe and flat.
Lovin’ it! Can’t wait to get my foot strong enough so I can drive again!

1.31.11: Just left PT. Spent the first 10 minutes on the bike….OUT OF MY BOOT, and IN TWO SHOES! Super! Felt really great. Then onto working on walking. Walked for 6 minutes on the treadmill at 0.5mph, concentrating on heal to toe, then took walked on the regular floor a bit, and also did some crutch work. Felt really good. I have no limp to speak of, and feel really strong, with no pain. My PT then had me do some seated ankle flexibility/ROM work on a balance board type thing, and some strength work where I do a calf raise w/the good foot, then join the raised foot w/the bad, and then lower together slowly. I guess I”m really doing a “bad” leg controled calf lower, rather than a raise, at the end of it all. Not sure what that exercise is called. Then, we ended w/our usual massage therapy. Also, my PT has suggested that I only start coming once a week for an hour, instead of twice, as I can do much of my work at the gym, now.
I was told to work on walking in 2 shoes (ones w/good ankle support like my high-top hiking shoes) at home, and at work (in a safe environment), but wear the boot (now in 0 degrees dorisflexion and unlimited plantar flexion) when I’m outdoors, since it is REALLY snowy and icy around here, right now.

I feel really good with this, and am so happy to have hit this new “high point”!
This was a great day!!!!

1.27.11: Many new exciting milestones passed and many yet to come, I’m sure. I’m back to work, and I was FWB as tolerated in the VACOcast w/crutches, then moved to FWB w/a cane and am supposed to start discontinuing the VACOcast (boot) over the next 2 weeks.
Last weekend I went up to BC, Canada to the hotsprings w/my husband and walked (naked feet!) in a chest deep, warm, mineral water pool, while he held my hand. I did a short “lap” and it felt so incredible! I asked him if he minded if I did another lap…”we’ve got ’till 11pm…do as many laps as you want”, he said! What an amazing evening. I had perma-grin for hours. Since then I’ve made it to the pool at the gym once to walk, as well. I did about 6 laps.
I’ve been sticking to my twice a week PT schedule and also working out 2 days a week doing abs, LOTS of arms, 20-30 minutes of biking (boot on and strapped to the pedal) and leg and hip strengthening exercises. Then, I do my PT stretches at home as often as I can. I’m particularily LOVING the feeling of the “towel scrunch” exercise. It seems like it must be working muscles in my feet and leg that haven’t been awake for quite some time, as it feels wonderful, like that first stretch of the arms overhead in the morning!
I’m a little scared for my first “dry land” walk w/o the boot. My leg feels strong, but I’m nervous about my achilles, and what if I trip, etc. Am gonna be putting a lot of trust in my PT these next few weeks to help guide me through. Any advice you all have would be great, too.

12/24: Had a PT appt. on 12/23. Have gotten into a really nice routine. Start w/10 minutes on the stationary bike (no resistance) just to get my legs spinning and active. It feels SOOO good! Then onto the table for some leg strengthening exercises to get my quads, hips and hamstrings headed back to normal. My right leg is SOOO skinny right now. It’s truly amazing how quickly the muscle loss comes, but how slow it is to build. Next I get a really great “good pain” sort of massage all along the sides of my calf and on the surgical scar and a lighter massage on the back of my ankle, on the tendon.
I am hoping I can figure out how to post a dang picture ‘cuz I’m SOOO proud of my scar! It is looking phenomenal.
So, after my Dr. appt. on Tues. I was a little unclear about my weight bearing protocol. Doc. was clear, and went through it all, but I managed to not commit most of it to memory, so I asked my PT if she could go over it with me so I could write it all down (my PT and my Orthopedic surgeon are in the same office so they are in constant contact, which has been fantastic!).
So…here’s my big excitement…my Christmas present from the Doc, so to speak…Monday he wants me in 20degrees plantar flexion in my VACOcast and to weight bear as tolerated w/crutches! I’m a little scared, but also excited. I’m gonna start slow and see how I feel. My PT asked me to bring my crutches on Monday and we’re gonna go through crutch work/technique(s) and whatnot so I’m prepared and “safer” on my crutches than if I just jumped on them and “figured it out”. This whole time, I’ve pretty much been on the knee roller and only used crutches in the upstairs part of our house in the bedroom and bathroom, but 90% of my time is spent downstairs on the couch and utilizing the knee roller- which I also use when I go outside, as well.
So…now the Doc and my PT have me on the same page…here’s my protocol:
Wk 4: 20degree plantar flexion in VACOcast weight bearing as tolerated
Wk 5: 10degree plantar flexion in VACOcast weight bearing as tolerated
Wk 6: Foot Neutral in VACOcast working towards weaning off of boot
Wk 8: Discontinue boot

I am hoping everyone’s recovery is going equally as well, and I wish everyone a very wonderful (I’m sure it will be memorable!) Holiday season!

12/21: Dr. looked at my surgery area. Incision is healing fantastically. No swelling. Slight adhesion, so he suggested I massage w/Vit. E, and alert my PT to the area for more intense massage to minimize or eliminate the adhesion. No bulging of the AT on the repair area or anywhere else….yippeee! Would like me to start very light PWB in the VACOcast at 20deg plantarflexion, and at 4 weeks move to FWB as tolerated in my VACOcast, I believe, if I remember right…moving from 20deg. to neutral over the course of 2 weeks…not 100% sure, though…I started to loose track a little, and really. Doc. makes the notes, and my PT takes care of following-through so I’m sure she’ll help make sure I stay on the correct track, since she and the Doc. set-up and agreed on the protocol together at the outset of this whole deal.
I was going to attach a picture of my wound site for posterity : ), but I can’t seem to get any of my photos to link to this post. Not sure if it is my lack of computer skills, or my somewhat slow internet connection.

12/20/10: Got on the stationary bike at PT today for 10 minutes- no resistance, nice warm up to get the old legs moving. Then got a few more measurements take on plantar and dorsiflexion. Did a couple exercises and got some nice calf and wound/scar massage. Am still doing the PT exercises at home 2-3 times/day, but have also added some core muscle work (sit ups) and per my PT will start also adding some upper body strength work using therabands and/or light weights for the triceps, biceps, etc. Feels good to start “working out” (using that term loosely) again. Have an appt. to see the doctor tomorrow for my 3 week follow-up. Most likely will move to PWB. Plant to ask him his thoughts on my starting to swim the first week in January. Healing seems to be going well. No inflammation or swelling, no pain, and scar is looking good. Will post a picture soon. Just received my “Achilles blog. com t-shirt” I ordered. I got the “paitence” one. It’s super cute and inspirational. I plan to wear it to my doctor visit. I think they’ll get a kick out of it!

I would like to make a comment regarding the awesomeness of the knee roller/scooter. It has been SOOOOO nice having it rather than relying on crutches. I do use crutches upstairs (which is just our bedroom and a bathroom), but downstairs and “out on the town” it’s knee roller all the way. I can get all around the house (downstairs), do laundry, put in and take out movies and stuff, fill the woodstove, go out to movies and out to eat, over get to and from the bathroom, and even make food…not just quick stuff, either, I made braised lamb chops one night, roasted ribs another night, for example (this was probably 1 week post-op). Week of surgery I was too tired and “loopy” from the meds to do much of anything.
I outfitted mine w/a little pink basket and a bell on the handlebars, and a fringed pillow on the “knee seat” that makes it look like a magic carpet!
I feel really safe and secure on it, and both of my hands are free once I’m stopped. Hugely recommend!

Friday 12/10: Went into town w/my husband and my knee roller to a back country ski film festival at our local theater. Rolled into the lobby, got a brownie and a glass of wine (both fit perfectly in the little pink basket on the front of my knee roller) and my husband and I headed over to the handicap area of the theater (flat, cement pad in back w/folding chairs). I transferred into a folding chair, and rested my leg (in the Vacocast) up on the knee roller seat and enjoyed my wine, brownie, great films, and the feeling of being out of the house and a “normal” person.

Saturday 12/11: Went to an avalanche class and a winter safety class at the community hall, again…folding chair w/my leg on the knee roller…very comfy. Then off to lunch, in town and again…feeling like a “normal” person.

Monday 12/13: 9:15a.m. 1st session of Physical therapy begins! My good friend and PT took measurements of my injured leg and of my uninjured leg. She also gave me a disc w/all the surgery pictures on it! She did a lot of great massage on my calf and around the incision site. Felt great! She noted NO swelling or inflammation, in fact was astonished at the lack of swelling. I’ve been really good about keeping my leg up and iced while on the couch. Slept for 3 hours immediately after PT. Wow.
She gave me 3 things to do at home 3-4x/day on my own:
1. passive plantar flexion (very light stretch to no pain)
2. active dorsiflexion (very light stretch to no pain)
3. side to side (inversion /eversion) (very light stretch to no pain)

No narcotic pain meds since 12 days post-op. I’ve been using Tylenol only once in a while, since. Usually for headaches more than achilles area pain.

Thursday 12/16: 2nd PT appointment. Super cool! Wore the vacocast and my PT got me onto the bike. No resistance, primarily using my non-injured leg to pedal, but was nice to get the legs moving. I have lost 5 pounds (which I am sure is ALL muscle) already and my calf AND quad are tiny! So great to get on the bike. She also provided me with some additional exercises to do at home to keep my hips and quads working and get some muscle and fitness back.
1. Short arc quad extension
2. quad sets/extension
3. hip abduction
4. hip extension
5. hip adduction
6. hip flexion