14 Weeks, and the rest of my life to go

3 months since the start of recovery seems to be an important milestone for many of us. We’re mobile again (yeah!) with the use of both our hands (no more crutches) but walking remains an effort (boo!).

We can wear 2 shoes but finding the right ones is problematical since our injured leg changes shape throughout the day (swelling!). We can walk but to do so without a limp means walking more slowly than we’d like.

Some of us can even walk at a normal stride without a limp. But must concentrate to do so since the repaired leg does not have the fluidity of movement that the other one does. And there is a price to pay for walking for any length of time (RICE).

Nevertheless we’re happy to be doing all those things again after weeks of accommodation and inactivity but a brutal realization begins to take hold. No matter how positive we may be about recovery or assiduous about physical therapy, we’ll be recovering and rehabbing all of our lives.

I’m confident I’ll play tennis again, hike with a pack and do all those things I did pre ATR but there will always be a greater physical cost than before my injury.

I’m at the phase of recovery where I see progress everyday, especially after a strenuous PT session.  It continues to amaze me that every morning I can focus a little less on my repaired tendon.

I’m aware though that the rate of recovery will plateau and progress will happen more slowly. Then I’ll just have to keep reminding myself that it’s a marathon not a sprint.

2 comments January 2nd, 2012

2 Shoes, Ministry of Silly Walks

Finally got the OK for 2 shoes at 11 weeks post surgery. My recovery path has been conservative; NWB till week 8, was full bearing a few days after that. Start PT later this week and was told by the surgeon to walk without a limp, no mater how slow I go.

And slow am I walking. With time and PT it will get better but right now I feel like I’m in the Ministry of Silly Walks (If you don’t know what it is, check out Monty Python on YouTube). At a pace Tim Conway’s old man character would like.

2 comments December 13th, 2011

Another great thing about sleep

I’ve discovered another great thing about sleep.  Every morning I’m walking better than the day before.  Is that cool or what!  Yeah I’m stating the obvious but it was not to me when I started walking in my boot 3 days ago.

I got the OK to start PWB  on Thanksgiving day and progress to FWB at a pace I’m comfortable with.  It’s been 8 weeks since surgery so my leg has been inactive for quite a while. After a few days I’m able to walk slowly without a crutch although do use it when outside.  I suppose waiting 8+ weeks before starting weight bearing does have some benefits.  Ankle flexibility is surprisingly good, it’s at zero degrees pretty easily.

I have no idea if this is appropriate progress or not but to me it’s wonderful having the use of my arms again.

During my NWB period I slept in the boot, which I hated.  Who’s comfortable sleeping with a high tech moon boot on a bunch of pillows?  I certainly was not.  Waking up in the morning was my own personal Ground Hog Day and like Bill Murray, I dreaded the the alarm knowing that today would be the same as yesterday, boot still attached.

Now waking up is great, no boot and walking better every day.  Of course the pace of recovery will soon become maddeningly slow but today I’m relishing the progression to becoming a fully functioning biped again.

Only things I’m not happy about are the popping sounds emanating from my cranky ankle and chronic knee soreness. But having not used the ankle or knee for 2 months that’s to be expected. Just have to remind myself that there is a lot of scar tissue to be broken up.  I’ve been through that before when rehabbing my knee 20 years ago. Ah the memories …

2 comments November 25th, 2011

A shoutout to our partners

It’s easy to forget that our partners (wives, husbands, whatever) suffer from this injury in big ways too.  The list is endless, especially in the early stages of post injury recovery.

Suddenly the time we don’t spend doing stuff like picking up the kids after swim practice or any activity that requires a functioning achilles tendon falls on them.  Not to mention the increased stress level that the whole family shares in spite of our best efforts to contribute to household activities.  Which in the first few weeks of recovery is mostly well intentioned, not particularly helpful and often counter productive.

I do not suggest walking your 75 pound energetic golden retriever 2 weeks after surgery while on crutches, trust me on this.

So, I try to thank my wife every day for all the extra stuff she has to do. Try is the operative word because I don’t manage to do so as often as I should but I’m aware how fortunate I am, even if I don’t always articulate it.

For sharing this experience our partners deserve a medal and buckets of gold, which of course they won’t get.  But acknowledgement and appreciation for what they do for us, let’s make sure they always know that.

Of course my wife does remind me at times, especially on those days when all the extra stuff really piles up that the moment will come when I will be a fully functioning human again able to pick up my share of the family schlepping. And I will do so, gratefully and with good cheer.

I suspect payback will be a bitch but fair is fair :)

4 comments November 21st, 2011

Snug hard cast

Just had an interesting discussion with my surgeon regarding how snug a hard cast should be.  My concern was the cast was overly snug, exposed toes are red and even mildly purple’ish when leg is not elevated.

The doc said a snug cast is preferable to a not so snug cast following the first few weeks of surgery.  I take that to mean the less the repaired bits move, especially during the beginning of the healing process, the stronger the repaired bond will be.

Of course if the leg gets painful or I cannot feel my toes than the cast will need to be removed and replaced, but that has not happened yet!

Makes sense to me, the inconvenience of elevating my leg while at my desk is a fair trade for maximizing the quality of the healing process.

My assessment of the surgeon’s healing and rehab approach is he’s on the conservative side.  He’s had the same surgery which I think helps and he had to do more repair on me than typical for an ATR so I get where he’s coming from.

In any event there are just 11 more days to getting a removable cast, although I still won’t be allowed to weight bear at all till 6 weeks post surgery, ahh!  Not to mention I’m warming up to my shiny blue cast :)

Add comment October 10th, 2011

First post op surgeon visit

Been 10 days since surgery, uneventful visit.  Was told I was a fast healer (that’s good) but be patient about rehab (oh well).  Was re-cast in a style’n blue hard cast.  Will be back in two weeks to have sutures removed and get boot.  Short term recovery timeline is predictable, PWB 4 - 6 weeks post surgery, FWB 2- 4 weeks after that.

Am on the fence whether to get a knee scooter.  I’m getting around pretty well on crunches but miss the use of my hands for mundane activities like bringing a hot cup of coffee to my desk (Yeah I have a thermal mug with a top, bowl of cereal though is challenging)!  On the other hand scuttling around on crutches takes lots of energy, which I like.  It’s the only aerobic exercise I’m getting these days.  Looking forward to swimming but that won’t happen until sutures are completely healed.

2 comments October 7th, 2011

Easily Exhausted

It’s only 6 days post surgery, and I’ve been good about keeping my leg up unless I’m moving about and there’s been precious little of that. However, when I do even the smallest things like making breakfast and emptying the dishwasher, I finish these arduous activities exhausted.  Yeah I understand at 56 I have less energy then 26 but I’ve always been an active person.

So, is a sudden and stunning lack of stamina a typical result of surgery and healing?

3 comments October 3rd, 2011

New member to ATR club

I’m a new member to the ATR club, tore mine September 18.  My story is pretty similar to most; while playing tennis I felt and heard the discouraging snap on the back of my lower leg (right) and immediately had a pretty good idea what happened.  The injury has not been particularly painful outside of the initial discomfort and shock and I was pretty good about following the RICE protocol for the first 48 hours.

Less than 2 days after the event I was diagnosed by an orthopedic surgeon that sure enough I tore the achilles tendon, no surprise there.  She recommended not to have surgery because of my age (56) and stating recent studies indicate there is not a meaningful difference in length or quality of recovery between surgically repaired achilles tendons and those that are immobilized and allowed to heal on their own.  All this information in less than 15 minutes!

I was given an immobilizing boot and told to expect to wear it for 10 - 12 weeks and to return in 4 weeks for a followup.  My concern leaving the practice was the treatment seemed to be different than what is discussed on achillesblog site.

Specifically I was allowed to weight bear, my ankle is in a 90 degree position and, the decision between surgery versus noninvasive treatment is more complex than the physician led me to believe.  Net, my sense was the doc saw me as a middle aged guy who’s not going to be very active so did not give the diagnosis or treatment options much thought.

Since my initial diagnosis I’ve seen two sports medicine orthopedic specialists, one in non-invasive treatment, the other a surgeon that does ATR reconstructions regularly.  Also I had an MRI to accurately gauge the severity of the injury.  Turns out the tear is 100%; there is a wide gap (4 - 5 cm) between the two ends and more to the point it is quite high up, near where the tendon meets the calf muscle which is not the typical location the achilles tendon usually ruptures.  Leave it to me to be a statistical outlier.

For my treatment I’ve chosen surgery (and of course lots of rehab) because even the non-invasive specialist said that was my best option.  So fellow ATR club members, the deed will be done on September 27 in a Philadelphia hospital.

Perhaps the biggest takeaway from this experience to date is be your own medical treatment advocate.  Oh and be married to an amazing wife who knows the medical system and got me appointments with the right people on short notice.

Like all of you, I’m not looking forward to the next 4 - 6 weeks when I expect to be in a cast and later a boot.  Not to mention since it’s my right leg I cannot drive until I’m out of any immobilizing apparatus!  And I’m fully sanguine that daily rehab will be part of my routine for a very long time.  But given the choice to be active through my doddering old age or not than … ya do what ya gotta do.

Will update this blog when I’m a few days past the procedure.

6 comments September 24th, 2011

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