Booted…
March 8, 2012
So, yesterday I was 12 days after my surgery and had my follow up appointment at Poole Hospital. I arrived 20 minutes early (keen to progress) and was called in straight away. I have got to say that so far Poole NHS Hospital has been great in every way, fast, efficient and friendly. So, they cut my substantial cast off to reveal my little leg and ankle. I had a 3 inch scar up the back of my heal, stapled together, the wound apparently looked to have healed very well, keeping it elevated at all times seems to have done its job. Staples removed and the consultant came for a look. He was happy, said it looked great and that he would see me again in 6 weeks to see how I am doing with physio which I start tomorrow.
Off to the plaster room next where they issued my with an Aircast Boot, 5 (yes, count them) heal wedges, a pump, some instructions and a hygiene cover for bed time. Overall it is heavier than I imagined and I think my foot is more downward flexed than it was in the cast, this hurts the upper part of my foot a bit (I am not very flexible) so I will discuss this with my physio tomorrow and see if we can make it more comfortable. The swelling has stopped a bit now, I think the boot helps with that.
So, physio tomorrow, back to the office Monday (I have missed work), will keep posting progress.
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1. stalledminidriver | March 8th, 2012 at 11:28
Sounds great! You’re weeks ahead of me…
The hospital I’m using (RSH in Southampton) doesn’t currently issue the aircast boot for this. I’m planning to be the first though! I’ve been in contact with the local sales rep for the vacoped boot and we are planning to persuade my consultant that it is the way to go.
Good Luck - I’ll be watching your progress enviously.
2. jimminyc | March 8th, 2012 at 12:27
It is very strange how the approach can be so different 35 miles away from my hospital. Are they proposing you use a cast only during the entire course of treatment? So, effectively Cast > Shoes and walking or will they do Cast > Boot > Shoes but at a slower pace, say 4 weeks into a boot, as you are non operative? I have been given a protocol by Poole on a sheet of headed A4 entitled ‘Guidelines for management of ATR using an aircast boot’. It has columns for both operative and non operative approaches. For both operative and non operative it says boot on day 10. For non operative (where we differ) timeline it states day 1-10 NWB, Day 10 onwards mobilise shadow weight, weeks 4 to 6 mobilise partial weight bearing if able, week 6 onwards mobilise full weight bearing. Overall, op or non op, the physio and rehab column is the same and overall timescale to recovery is similar. When I am back in the office next week (Monday) I will scan it as a PDF and mail it to you, it may be useful for your cause? Would that help? Normofthenorth will be able to give you some good advice on this also I feel?
3. Janus | March 8th, 2012 at 14:43
5 wedges? I’m across the pond where everything is quite different, so my 3 wedge boot experience seems irrelevant to the discussion. What’s the schedule with that — a wedge to be removed every week? 10 days? 2 weeks?
Congrats on the good first two weeks of healing. You start PT right away? That’s a difference as well. In my corner of the USA, PT starts roughly 6 weeks after surgery — sometimes later. PWB, and even FWB in the boot might come first.
Seems the nearer thing the medical profession has to an international discussion of ATR treatment, rehab and recovery is the forum provided by AchillesBlog here — and almost none of us are healthcare professionals. Well, so long as what you’re doing works.
Happy for the good news, and all best.
4. stalledminidriver | March 8th, 2012 at 17:13
Yes Please - the scan of those guidelines would be great.
I know, the difference of 35 miles is very annoying from this side! THe current proposal given to me by the hospital when I had this cast (after being in a front slab for 1 week) was 3 weeks in this cast (Equinas) followed by 2 in a cast at mid position then 2 more weeks in a third cast at right angles. Totally archaic and at odds with all of the information on here.
Your waiting times are better too, I was waiting for an hour to see the consultant at my last appointment. Maybe I should move to the other side of the Forest…
5. pablomoses | March 8th, 2012 at 20:08
Good news amigo.
Here’s some Aircast recommendations.
I had the aircast as well for 5 weeks and I did alot in it, and yes its a heavy b*$#@. (5 of those wedges seems really tall - I started with 3, but they had me at almost neutral in my splint). If you’re getting crazy bottom-of-the-heel pain, double check that the hard foam wedges haven’t moved forward so you’re stepping a little bit on the edge of those things. I think you;re going to have that pain no matter what, but when that happened it made it debilitating.
I added a bit of foam from a camping pad with duck tape to the top of the shin piece once I was striding through my steps with it. Kind of like a ski boot when you are leaning your shin into it, and the extra padding at the top edge was nice. Also, be super careful to make sure the the velcro is well connected when you put it on, esp. the top strap… I stood up and walked out of it at about 5 weeks post surgery. Scary & painful - but no lasting damage. I actually added a wrap of ducttape around the top of the boot as a back-up after that if I was going to be working, lifting, etc. The other addition I made was to add a custom orthotic from my snowboard boots - helps a bit with the bottom-of-heel-pain.
Good luck with it!