Dr. Appointment and Surgery
Oddly, my Achilles rupture did not hurt the next day. I’m not sure if the Vicodin was still working (I only took a half of one the night before) or if there really was no pain. I got to the doc (on crutches that my friend loaned me) and he diagnosed it as a full tear. He explained the ins and outs of surgery and that if I was older and not so active, a boot alone might be a solution. By doing the surgery I would get full recovery and be able to resume all my sports. He predicted a 12 week recovery. Because of the lack of swelling that the doc attributed to my good tissue, we scheduled it for the next day. After my appointment I traveled south 30 minutes to attend my son’s volleyball game with little discomfort. Icing and elevation that night helped me sleep well.
I was not nervous about the surgery. My doc has operated on everyone in the family but me with perfect outcomes. He is a very high achiever, Stanford trained and with a great reputation. In our small community, it is not uncommon to have a friend be assigned as your nurse or anesthesiologist. In my case, my surgery nurse was a mom friend. I immediately felt at ease when she came in. An anesthesiologist friend who stopped by (but was not on my surgery) suggested that I request anti nausea medication which I did. My daughter had meniscus surgery a few weeks ago and did not have this and vomited after the surgery. It helped me avoid this. I woke up a few hours later with my cast up to just below the knee. The pain was easily thwarted by the Norco. I went home, got in bed, elevated my foot and relaxed. Fortunately my husband and kids enjoy cooking and are quite good at it. I was in good hands.
May 18th, 2011 at 8:09 pm
Good luck from a volleyball-ATR “two-timer”, 8 years apart!
Interestingly, I got the same spiel — “if I was older and not so active, a boot alone might be a solution. By doing the surgery I would get full recovery and be able to resume all my sports.” — after my late-2001 ATR, but the spiel had changed (at least here in Toronto) by the time I tore the other side, at the end of 2009. My Sports-Medicine clinic (at U. of Toronto) said that the case for surgery had weakened since my first, though I could still choose it if I wanted to. Then when I saw a very prestigious sports-med Ortho Surgeon (the chief surgeon of our pro football team, among other accomplishments!), he recommended that I skip the surgery, based on the latest studies he’d seen presented at international conferences.
The study that impressed him the most (and still impresses me the most) was from U. of Western Ontario, and he told me that he’s stopped repairing ATRs after discussing the results with the authors. It’s posted here, on this site, in full text.
Regardless of the op/non-op decision, the fairly fast protocol in that study seems to have produced clinical results about as good as any study, with and without surgery. The fact that you’ve been given a cast rather than a boot makes me fear that you’ll be immobilized and NWB much longer than the patients in that study — and without any gain in return for the extra “pain”. OTOH, if your Doc is promising you a full recovery (and back to volleyball) in 12 weeks, he may be planning to push you very fast.
Most of us found it helpful to get a detailed protocol/schedule from our Doc, partly so we can have a clear idea of where we’re going. If you can get one, compare it to the one in the UWO study, since it produced excellent results in a large group.
May 19th, 2011 at 7:04 pm
Thank you! I progressed to the boot yesterday (day 13). My doc did give the complete history of protocol for treatment of this injury up to the most recent change in the last six months which once again advocated for surgery in active folks. I trust him completely. I’m not usually like that with doctors but because of his success rate treating family and friends I’m going with it. I haven’t yet read the study you suggested but it’s on my list. I did inadvertently bear most of my weight and then some on my bad ankle a little bit ago when I slipped. Maybe it was a blessing in disguise!
May 20th, 2011 at 2:34 am
Joann, I trusted my recent (2nd-time) Ortho Surgeon, but that’s helped make me DIStrust most of ‘em! Then I went in for open-heart surgery, and I more-or-less let them do what made THEM comfortable!! So I can see it both ways now! When you get around to it, I’d love to know what changed your Doc’s (or your hospital’s) procedure back to surgery. I’m still telling all my ATR pals to skip it — and most or all of them are doing better than I am, which isn’t half bad!
And don’t let them keep you casted or on crutches for too long, with or without surgery!