Me and my Achilles!

Maybe I’m the first person to be able to claim they ruptured their Achilles in their sleep??

I got up on the morning of Saturday 5 August and although I wasn’t in pain as such, I thought something wasn’t right, as I was experiencing difficulty going up and down stairs. By Monday 7 August I decided I have better pay the GP a visit as it was getting worse, not better.  I had previously had tendonitis on several occasions over the years and abouth a month beforehand had had a steroid injection to help me through a holiday, but the GP I saw didn’t seem to take any of this into account and said that the pain was too high up my leg to be my Achilles tendon.  The examination was perfunctory to say the least and no Thompson test done.  The GP said he would make a physio referral and I would get an appointment in about 4 weeks.  I asked whether a scan would be wise and was told that he didn’t want to pre-empt the physio by asking for the wrong sort of scan.

I arranged a private physio appointment for the next day and was again told my Achilles wasn’t ruptured,  and was given heel raises to do, which were agonising.  Prior to the next appointment I lived on painkillers and was going up and down stairs on my bottom.  At the next appointment the physio agreed to get in touch with my GP and ask for an MRI scan, which I eventually got on 3 September.  I went on holiday on 11 September for two weeks and was in permanent pain and when I got back there was a letter from the surgery asking me to make a non-urgent appointment to discuss my MRI scan.

Given that my ankle had been permanently swollen in the course of the holiday and I was in lots of pain, I made an appointment for the next day and the GP I saw said that she would make an appointment for me to see an orthopaedic consultant.  She said that the MRI results were very complex and hard to understand even for a GP, but even at this stage there was no mention of a ruptured Achilles, however when I saw the consultant on 8 October he said that from the scan he could see that the Achilles was ruptured, confirmed by a Thompson test and that there was a gap of about 5 cm between the ends of the tendon.  In addition, there were lots of other problems with the foot, including plantar fasciitis and osteoarthritis of the ankle, with no cartilage left, so basically bone rubbing on bone when I walked, hence all the swelling.  I was told that if the tendon was already weakened, it would have been perfectly possible to rupture it by stretching when I was asleep.

However, the GP who referred my had sent me to a clinic that only did minor surgery for bunions etc, so the consultant told me I would have to be re-referred by my GP to the correct hospital, so the whole referral process had to begin again from scratch!!! On re-referral I was put under the care of a consultant who specialises in Achilles tendon injuries and had my appointment with him in early November.  He said that he could do surgery within a couple of weeks and to have all the pre-op tests done then and there.  I didn’t even get to pass go on this one - my BP was far too high, so I had to wait until it was ok, then could have surgery.  It came down by February 2014 and was all set for an op on 11 February which was cancelled when my MRSA swabs were positive!!

Finally I had my surgery on 10 March, and had a triceps turndown with plantaris transfer.  Only one night in hospital, two weeks in plaster NWB and foot elevated for 55 minutes of each hour, with daily Enoxaparin self-injected (not easy for a needle phobic).  Plaster came off on 25 March and I have a scar about 20cm long, which I only saw briefly before being transferred to a Vacoped boot - no more hopping along with a walking frame (I was a bit too unsteady with crutches) and able to walk around the house at last.  The Vacoped is set at neutral for for weeks and will be altered at my next appointment.

4 Responses to “Me and my Achilles!”

  1. So you’re at FWB now in the Vaco, walking without crutches or walker? That part sounds as good 2 weeks post-op as the rest sounds awful! I can’t recall another “nocturnal ATR” here in the 4+ years I’ve been hanging out here, though we’ve had a few whose condition gradually deteriorated toward a rupture. Most with Haglund’s, which you haven’t mentioned. And outnumbered by the typical ATRs, most of them out of the blue.
    Good luck with the rest of your rehab!

  2. Hi Norm

    Thanks for your good wishes. I’m ok to walk without crutches, but may have overdone things since Tuesday I think. I had a pain at the front of my leg that felt a bit like tendinitis and when I arranged to see the hospital physio yesterday to get it checked out it was a bit swollen, which she attributed to trying to do too much too soon. Even though I was initially told to keep the boot on at all times for four weeks, she decided that in my case I should take it off a couple of times a day and keep it elevated for 1-1.5 hours and monitor the swelling. I’ve taken the Vacoped off this afternoon and it looks a lot better.

  3. Jacqui, when you’re boot-walking, FWB, all the load a healthy AT bears is transferred through the boot to the front of your shin, at the top of the boot. If that spot is tender, or the boot cuff doesn’t match the shape of your leg, it’ll hurt. You’re allowed to add some padding etc. to make it work. (We skiers sometimes pay big $ to boot fitters for similar solutions!)

  4. Hi Norm

    I’ve been taking the boot off twice a day since Friday and that seems to be relieving the swelling, but adding a bit of extra padding sounds like a good idea.

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