May 08 2012

7 weeks post op appt….That’s it?!?!

Published by jenniferanderson at 6:27 pm under Uncategorized

Today is 7 weeks since I had surgery and I had a follow up appt with my Dr. He gave me a stretchy band to use to work out my foot and two wedges to put in my shoes. He said to walk in the shoe, with the wedges, for one hour today. Then go back in the boot. If it feels ok then I am to spend 2 hours in the shoe tomorrow and then go back to the boot. I am supposed to increase the time spent in my shoes by one hour each day, unless it starts to hurt. If it hurts I’m supposed to repeat the previous days hours spent in a shoe. Once I am able to walk in the shoes full time for a week I am to take out one wedge and walk with the remaining wedge for 2 weeks before I can walk in just shoes. He says this entire process will take around 2 months. He is not going to send me to physical therapy, he just wants me to increase resistance on my foot using the band he gave me. He also says he does not need to see me again. Really? This is all the instruction I am to be given? I am frustrated, confused, and feel abandoned. For the first time since this happened I can not find a happy place. I have been all over this blog in the last 2 months and I read about people going to physical therapy, working towards 1 legged heel raises, etc. I have been given a band and wedges and been dismissed. The Dr. had me push on his hand with the ball of my foot and said I had some good strength (that’s good) and he doesn’t think I need physical therapy (I don’t know if I agree with that). Thank goodness for this blog or I would be completely lost. I will be searching this site for exercises that others have done to strengthen their calf. Any exercise tips would be much appreciated.
I have also read about people needing deep tissue massages to break up scar tissue. I have one bump that I asked him about. He felt it and said it was pretty small (again, good) and I should be able to massage it out myself (ok…..). Guess I’ll be researching that as well!

22 Responses to “7 weeks post op appt….That’s it?!?!”

  1. mike44on 08 May 2012 at 8:23 pm

    Hey Jennifer, I am also 7 weeks post op and have been going to therapy for 5 weeks. I feel that it is helping alot and you could greatly benefit from it as well. I would recommend seeing one and possibly seeing a new doctor cause that just sounds sorda crazy for him to say “here ya go, bye” just like that. If you would like a brief description of the exercises my pt gave me I’d more than gladly give them to you.

  2. jenniferandersonon 08 May 2012 at 8:44 pm

    That would be awesome, Mike! I did the one exercise he showed me with the band, but there has to be more that I can do. He did say I could start using a stationary bike (after I asked him. :-/ ), so I’m looking forward to finally getting some cardio in.

  3. Tony B,on 08 May 2012 at 9:08 pm

    In a nutshell, your doctor sucks out loud, let me tell you. Ask him this question: “If you ruptured your achilles tendon, would you go to PT?”

    People should start PT - THE DAY OF THEIR INJURY. e.g. working their leg muscle so they don’t atrophy so badly. The worse the atrophy, the longer it takes to come back. The more immobilized, the more the joint tightens.

    What an a-hole.

  4. starshepon 09 May 2012 at 1:18 am

    Jennifer: I totally agree with Tony. I’ve been in PT now for about 4 weeks and I feel the guidance I’ve gotten is invaluable. Plus they have a lot of equipment that you just can’t duplicate at home. After being off for so long, not only have your muscles atrophied, but you have also lost a lot of the skill to walk properly. The weakness and the lack of skill could really put your recovery in trouble.

    I also agree with what Mike said about getting a second opinion. If it gets down to it and your insurance won’t pay for it without your doctor’s approval, it would be well worth it for you to pay for at least a few sessions out of pocket.

  5. starshepon 09 May 2012 at 1:27 am

    Jennifer: Just another thought. I didn’t start walking in 2 shoes until last week (10 weeks after my ATR and 3 weeks after the start of my PT). The therapist started me off by walking in 2 crutches and only for about 5 minutes with very little weight on my ATR foot. The next week I was down to one crutch and about 10 minutes of walking. I don’t know if others have had similar experience transitioning into to 2 shoes but what your doctor told you to do sounds pretty risky based on my limited experience.

  6. ryanbon 09 May 2012 at 1:56 am

    From my perspective, PT seemed to offer 4 different things:
    1) Guidance (and sometimes equipment) on exercises. They showed me what to do.
    2) Motivation. They could push me to work my injury harder.
    3) Treatments. Ultrasound, heat, massage, etc.
    4) Objective observation. They have experience with this injury (other patients), know what progress I should be making, know what trouble signs to look for, etc.

    I didn’t need help with #1 and #2. I had access to several gyms, pretty much knew what exercises to do, and had resources - such as this blog community - who could help guide me through a rehab path. Motivation wasn’t an issue for me; if anything PT was usually trying to slow me down.

    Because of that, my doctor also suggested that I probably didn’t need PT. But, when I explained that I mostly wanted them for items 3 and 4- he was happy to write me a prescription… it didn’t cost him anything.

    You can always go to PT if you want. They’re usually happy to take your money. To get your insurance to pay for it, you’ll probably need the prescription though. Have a reasoned talk with your doc- explain why you’d like PT, and I’ll be surprised if he denies it for you. Alternatively, you might be able to get a prescription from your primary care physician - just explain the situation.

    Good luck-

  7. ryanbon 09 May 2012 at 2:02 am

    As for the transition to two shoes- rather than type up a whole explanation, I’ll just point you at my blog entries from Oct 2011. I transitioned to two shoes early: less than 6 weeks post surgery. I pretty much went cold turkey with the boot.

  8. Lorylon 09 May 2012 at 3:00 am

    I agree with what ryanb said about PT. I am six weeks post op and my doc also said he didn’t think I would need PT, but I think I will be able to talk him into a prescription for it. I just want peace of mind with this. I am still in boot and in another week and half I go back to doctor and he said he wants me to bring my shoes, he will give me the two wedges and a couple exercises to do. I am also going to ask for PT scrip as well. Good luck to you I hope you get to do PT.

  9. Cindyon 09 May 2012 at 11:35 am

    Jennifer: I agree with what everyone said here - PT is really helpful. I would definitely recommend it to you. I just started PT last week (I’m at 9 weeks now, non-surgical). At 8 weeks, my doctor gave me a scrip for PT 3 times a week for 4 weeks (not sure what will happen after that). I have gone to PT 3 times now and my foot and ankle are markedly more mobile and I’m walking better (I’m in 2 shoes at home, boot outside). The therapist is really good - each session starts with heat on the ankle, and then we start doing exercises - she also gave me a list of exercises to do at home. She also massaged my foot & tendon area at the 2nd session - I hadn’t realized how stiff my foot was until then - it is much better now. Seriously - PT will help you - even if you just go a few times to learn the exercises.

  10. jenniferandersonon 09 May 2012 at 12:59 pm

    Thanks for th advice everyone. Tony, your first sentence had me cracking up! Thank you. I needed a good laugh. We are going camping this weekend so I have decided to just focus on that and pack. I am going to do my band exercises everyday until my ankle feels stronger and then attempt shoes next week. I don’t want to risk hurting myself before our trip. I NEED this camping trip. A book, a beer, and a campfire. Heaven.
    I have a question though. My boot still has two wedges in it. The wedges he gave me for my shoe are half as tall as the one in the boot. Should I take a wedge out of my boot so I’m used to that height before I do it in a shoe? That seems to make more sense to me than just going straight to a shoe.

  11. kimjaxon 09 May 2012 at 2:45 pm

    Jennifer - do you have wedges in a flat boot or a boot already at 30 degrees? I couldn’t stretch to 30 yet and was wondering if the wedges might help? Enjoy your camping trip!

  12. starshepon 09 May 2012 at 4:02 pm

    Jennifer, My doctor had me drop 1/2″ in wedge height at a time. For about a day it felt kinda weird at the new height but after a day, it felt okay.

  13. gkraemer14on 09 May 2012 at 6:13 pm

    Jennifer, It sounds like you would like to go to PT so I say just do it. It’s that simple (depending on your insurance/financial situation of course) I’m sure the doc will give you a script and if he doesn’t then that’s a real problem and I would agree with Tony. Some states allow direct access to therapy services anyway so a script isn’t always necessary (again dependent upon insurance). Have a nice camping trip and err on the side of caution when you’re weaning off the wedges.

  14. jenniferandersonon 09 May 2012 at 6:35 pm

    Kim- Thanks! I plan on it! My boot is flat with 2 wedges.
    Starshep - My wedges are 1/2″ so maybe I will remove one of them. It just doesn’t make sense to me that I should walk on 1/2 an inch of wedges in my shoe and then go back to a boot with an inch of wedges.
    Gkraemer - My insurance requires a Dr referral for PT. I haven’t decided yet whether or not to push for that referral. I haven’t even tried to put on a shoe yet. It’s a very scary step. (Pun intended)

  15. starshepon 09 May 2012 at 11:01 pm

    Jennifer: Your reference to the “very scary step.” is another area where therapists can help too, the psychological. They can help us manage the fear. Too much fear and we can’t do what we need to do. Too little fear and we do something we shouldn’t or do something too early and we can wind up hurting our recovery.

  16. doryton 10 May 2012 at 2:12 am

    Wow! No PT recommended By your Doc it’s like day and night to my experience with Kaiser Ortho. The ATR is such a long recovery and different for everyone. So important to no only stretch the tendon but to do it properly. I am at 8 months and just had a real run today at crossfit. My 200meter sprints were more like a gallop. If you want to know what Kaiser ordered for me and what my PT is like I would be happy to share with you. Enjoy camping! We are going end of may to San Elijo can’t surf but will still enjoy it!

  17. normofthenorthon 10 May 2012 at 3:28 am

    JA, I generally recommend PT, too, though many people here have done fine without, and PTs have been known to do harm, too (including pushing patients into reruptures!) I’ve never seen a study comparing patients “with PT” and “without PT”, so we just know that it SEEMS helpful, and that most modern successful studies (like UWO) do use it. (We’ve got no scientific proof about the various high-tech gizmos many PTs use, like ultrasound, lasers, electro-shock, etc., either.)

    One lonely word in your Doc’s favor: The approach he laid out for weaning off the boot is progressive (i.e., it keeps advancing), but INCREMENTAL, and I’m a huge fan of progressive but incremental. “Listen to your body” can often get an ATR patient into serious trouble, because overdoing can do serious harm without warning, esp. during the first 12-ish weeks or so. But if today’s push seems OK tomorrow, doing a bit more then is a sensible approach, IMHO.

    At around 8 weeks, the boot is more valuable for protection from scary places, than for general support, IMHO. Also, the question of whether to use any heel wedges in “2 shoes” or not, or how many, or how quickly to remove them, varies hugely among docs. Some successful studies use ‘em, and others (including UWO) don’t. Nobody knows, I’d say.

  18. jenniferandersonon 16 May 2012 at 11:11 pm

    You’re back!! I haven’t been able to log on in 4 days! Not on my phone or laptop. Was the site down? I’ve been going crazy not being able to check in and read about others adventures going into 2 shoes! Thanks for your reassuring words, Norm. I have been following my doctor’s instructions and I am walking around the house and using my band and my ankle is getting stronger. Still on the fence about fighting for PT. As my husband pointed out, I hate having strangers touch me and unintentionally pulled away everytime the Dr would try to move my foot. Maybe he picked up on that. Doing it on my own also appeals to my stubborn side. So we’ll see. As long as I keep making progress I’m happy. Hope everyone is doing well.

  19. eastcoastrunneron 17 May 2012 at 7:58 am

    Jenniferanderson– I wasn’t able to get on the site for a couple days, either. I’m also glad it’s back! I look forward to seeing how everyone is doing each day. Gives me hope! (I really, really, REALLY miss running right now!)

  20. Janiceon 19 May 2012 at 1:29 pm

    Hi all. Jennifer is am post op, second time around. The first, I did PT for like 7 weeks! I’ve not heard of anyone doctor not recommending it! I am probably choose not the do the PT this go around due to the expense, and I learned (enough) to do on my on. Now, for my question…I had a cadaver to replace my achilles this time. At 6 days I saw the doctor. He didn’t remove splint, just asked what my pain level was, and said for me to come back in 5 weeks. Then, into a boot..(the stitches will come out on their own) Doesn’t that seem like a LONG time, NOT to have him even look at my foot/incision?!?!? Would love some feedback. Good luck to you all.

  21. beralicon 19 May 2012 at 6:09 pm

    My NHS doctor said the same to me, 10 weeks I went back into two shoes and the doc was like “tata off you go and live your life” no PT nothing (I had asked about PT earlier in my recovery and was basically laughed at…) , needless to say I was not impressed, but the best I managed to do that appointment was get him to make me another one for a couple of weeks down the line.

    In the meantime I had a couple of private physio sessions and they helped at lot. When I went back to see my doc there were a couple of students present (hospital is linked with the University) and I asked again if I could get PT cause I thought I needed it and you could just see he wanted to give me the same nonchalant answer but instead gave me free NHS PT which I am still attending, thank Christ for those students! have lodged a complaint with the hospital as it should not have taken such effort and basically students guilt tripping a doctor to get it!

    Hope you have found enough info to make you feel comfortable, bands are great for the initial few weeks for working the ankle in all 4 directions to build balance muscles back up but you quickly move to just things like standing on one leg, eyes closed, maybe get yourself a wobble board once balance on one leg on the floor is fine :) My current goal is to try and juggle whilst balanced on just my bad leg on a wobble board, I certainly could not pre-injury so going to be a fun challenge!

  22. jenniferandersonon 20 May 2012 at 12:24 pm

    Janice - that sounds like an awful long time to be in a cast but your surgery sounds more complex than mine. I would suggest looking around the blog for someone else in the same situation. There is a search box at the top of the main page. Good luck!
    Beralic-I can’t juggle to save my life! What a funny mental picture! Good luck with that. I have been walking around the house more. I’m very slow but my ankle feels stronger everyday and the tendon feels looser. Oh, and I found a way to get some cardio in. I play Just Dance (with the boot on) with my son. It’s a hoot!

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