Posted by: johnskier | March 2, 2008

cast and iwalk-free

achilles-cast-2-weeks.JPGachilles-iwalkfree-2.JPG

  1. iwalk-free
  2. Cast in blue (boring I know, but they didn’t have basketballs or skiers)

click to enlarge

Posted by: johnskier | March 2, 2008

Pictures 12 days after surgery

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12 days post op.

Posted by: johnskier | March 2, 2008

More lessons learned

  1. Ice packs - I am using and old “knee” Dura Kold ice pack.  The cold does transfer to my ankle inside the cast.  Great product, reuseable pack.  Check out www.ice-packs.com for a Dura Kold product designed for ankles.
  2. A local hotel car valet guy suggested a small towel on top my my crutches, held on by duct tape.

Posted by: johnskier | February 28, 2008

Doctors’ visit - 12 days post surgery

The highlights:

Learned interesting facts about the surgery - used “fiber wire” for stitches (Kevlar). The Plantaris (a tiny, pretty much useless tendon) was also ruptured and it was used for reinforcement of (by weaving into) the Achilles.  He said that if it wasn’t ruptured he would have “taken it anyway” and used it for the same purpose.

Stitches out, looks good (relative terms).  I would call it a “sting” when they came out.  Not bad.  The horizontal blue lines are to “line up” each side when it’s stitched back up.  The left calf is already smaller than my right.  Here’s an interesting one - he put a “sterile superglue” on the incision to essentially provide more support for the incision (keep it from separating).

My doc wrote a scrip for an “iwalk-free” but I’m not sure if insurance will pay or not.  (I did find it on-line at www.wheelchair.com for $450).  He was not concerned about the risks and we also talked about the “stool” that rolls as a possibility for travel.

I have a  general idea as to the expected protocol:  First two weeks - soft cast (splint actually - just complete), next week - hard cast (blue).  After first 3 weeks = boot (w/ heel lifts) and limited weight bearing.  Increased weight bearing and reduced lifts over time.  PT (of some sort, like stretching) starts after about 6 weeks.  PT will probably go until a total of 4 months from surgery.  Maybe out of the boot as early as 8 weeks.  We’ll see.

I can go snorkeling on my trip in 3 weeks (or 5 weeks from surgery) if I take off the boot and have a gore tex cast put on for the trip (breathes I guess).  Still limited weight bearing.  Guess I have to weigh the benefits of  snorkeling in Belize vs. the invonvenience and relative immobility of the cast traveling for 9 days.  Might be tricky getting in the water?

Can’t do anything to “isolate” the calf and exercise.  Exactly the wrong thing to do.  I can wiggle my toes though.    :).

My left side of my foot/little toe are somwhat numb - that will get better, apparently the nerves are “irritated” (no kidding, I’d be irritated too).  He said the throbbing when my foot is down after awhile (not elevated) should subside in a week or so.

I’ll post pics when I get them from my wife’s camera. 

Posted by: johnskier | February 26, 2008

Lessons learned:

  • Rest
  • Ice (”Game Ready” or similar).
  • Compression
  • Elevate
  • The acronym for that is “RICE” - you’ve heard it
  • Ibuprofen.
  • Research on your own.
  • Be your own advocate, question.
  • Find a blog/site for support/information.
  • Be positive, seek out positive people.
  • Be as active as possible.
  • Focus your energy on the process.  I’m convinced the results will happen.
  • Shower chair and shower bag for “the” leg.
  • Put bar stools in convenient places.  Like 1) in front of your mirror, near the shower and 2) in the middle of the kitchen.  Then it’s not that difficult to make a meal.
  • Crutches with fold down spikes for ice and snow (I’ll try to get a pic).

There’s the list so far.

Posted by: johnskier | February 26, 2008

things to ask the surgeon about 1st visit post op

  • Get Operative Report - curious how much tendon removed, etc.
  • Protocol - general timetable as to casts, boots, weight bearing, etc.
  • Early weight bearing protocol.  Think I agree with Dennis to be conservative - maybe moderately conservative as it relates to early weight bearing protocol.  
  • PT protocol and general timetable
  • iwalkfree a possibility (insurance pays?) - I have several trips to make.  Think it may be critical in terms of mobility.  Risks?
  • Additional exercises - anything isometric to isolate the calf?
  • Mobility on trip (3 weeks from now, 5 weeks post op).  Can I snorkel?  (pipe dream, eh?)
  • Shower bag brand
  • Frequency of icing….Keep Game Ready for another 10 days?
  • Continued meds…how long with Percocet, sleeping pill?
  • Get pics

Posted by: johnskier | February 26, 2008

Why this picture as the header of the Blog?

It’s beautiful.  Cheers me up.  It reminds me of the Big Island of Hawaii…and it may be the Big Island. 

Posted by: johnskier | February 26, 2008

day 10 post op….

Let’s see if I can catch up on some details.  Night before my surgery a “Game Ready” was delivered.  Basically a tank for ice water, a boot, some hoses and 30 minutes of icing at a time.  A lifesafer.

The anesthesiologist did  a “block” on my lower leg.  Said that it’s better post op for pain.  My leg was dead (and really swollen) for about a day.  I was also under a general although I had the option of a local.  An hour or so in surgery.  Awake after 1 3/4 hours.  OUt of the hospital a couple of hours later after some crackers, crutches training, and my post op directions.  Percocet for pain. Ambien to sleep.  Don’t get “behind” on the Percocet because it’s “hard to catch up”.

Spent the next 9 days at home.  Worked some….maybe 1/2 time.  Only took the Percocet during the day for a few days.  Lots of Ibuprofen though.   Still taking one Percocet and one Ambien at night to sleep.  One 325 mg aspirin to reduce clotting risk. 

The first couple of days are the hardest.  It is really hard getting around on crutches.  You learn to be economical in your movements.  When you go to the bathroom, you also get water, a snack, etc.  Keep all the essentials by the bed/couch.  Cell phone, land phone, pills, water, periodicals, computer (wireless!). 

Frustration:  Called the surgeon’s office with a bunch of questions.  Finally after trading calls hooked up with the PA. two days later.  The normal questions…how long in a cast, in a boot, non weight bearing.  Lots of information that’s on web sites BUT wanted to know specifically what 

Emotions…bummed, frustrated.  Encouragement from friends helps.  After about 6 days decided to check around, look at research, blogs, etc.  A friend of mine who had the same injury last year found achilleblog.com.  Dennis has done a great job and it’s really great to know others are in the same boat and to get the benefit of their knowledge and insigts.

Exercises:  Riding the stationary bike with my bad leg on  stool.  Also leg lifts (tighten quad and lift).  Tomorrow or Thursday I’m going to start to lift weights (upper body).  the PT folks said it was fine as long as I’m non-weight bearing.  My right leg is really sore and is going to be so strong from taking all my weight.

The essentials:  the leg boot for the shower., the shower chair 

The reality:  This is no fun, but it isn’t life-threatening and it isn’t a long-term health problem.  Get over the self-pity thing.

The “cringes” when people hear it’s an ATR.  Ok, I get the “sorry”, “get better”, etc.  I don’t want to hear how tough it is.  My new response to a cringe.  “You forget how tough I am”. 

Cool thing:   the “tracker” in Excel that my friend “Go 11″ emailed me.  He did an amazing job on rehab and skied like a maniac this past winter, maybe 8 months after his injury.  An inspiration.  

Was at work today - day 10 after op.  Draining.  Everyone was very helpful in terms of getting me water, coffee, etc.  If only they could go to the bathroom for me.

Posted by: johnskier | February 25, 2008

My Valentine’s Day present

At age 47 I ruptured my achilles skiing on Feb 14…hit a depression and tumbled forward and the ski didn’t release. I did stretch that day…and had skied several runs (cat skiing on Vail Pass).

The injury REALLY hurt…now I believe I might (or maybe I have no clue)have a sense of the pain of child birth.

When I first stood up and tried to put weight on it I got dizzy and had to sit down.  Skied down to the cat on one ski…didn’t want to hold up everyone by making the cat come back up with the sled.

I didn’t go to ER as I was pretty sure what I had done. just called the doc’s office and they got me in.  I had a good outcome before (same surgeon, miniscus and cartlidge) and I also get comfort when the MRI, radiology folks say “you’re in really good hands”.

I have not had other achilles issues. Could I work out and stretch more? Yes and that will be a focus long-term. I expect 100% recovery and will continue to ski and bike. I had already given up other high impact sports (running , basketball).

The first week after surgery is really depressing. I feel much better after even a week…not the constant throbbing…and I have elected not to take the Percocet during the day (after a few days) because I hate that feeling. I am elevating and icing the ankle like crazy.  

Sutures out on the 28th then we’ll see what the protocol is.

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