Crutchless

Four weeks after surgery and a much better week this week.  Spent all of last weekend in bed resting up a strained thigh muscle but back on my feet by Monday.

Major milestones this week

  • Now completely comfortable sleeping without my airboot on
  • Walking around the house completely crutch free
  • Through necessity climbed a number of staircases at work/social events and found it easier than I thought

Walking around the house with both hands free is a major improvement and I’m beginning to feel vaguely normal again.

I may have to get on a plane in a couple of weeks to attend a conference overseas, would be a 9 hour flight or so, Dr said it’s doable but I should be sure to take aspirin a week before and after - maybe compression socks as well.

I can see it would still be a challenge, even at some airports you have to walk miles these days between the plane and customs.  I’ll make a decision next week but would appreciate any advice/experience others can share?

A week in a boot

Three weeks after surgery and just completed my first week in the Aircast - a bit of a mixed bag overall.

Whilst taking the boot off has been wonderful in the shower it’s taken a bit of getting used to at night, found I was very conscious of my unprotected leg just lying there - had nightmares (some triggered by stories in this blog) about unthinkingly getting up in the night and walking on it!

Getting used to that now though and sleeping a bit better as a result.

Still on two crutches but have gradually increased the weight bearing and can do short distances on just one crutch.  I also bought a Procare ‘EvenUp” shoe balancer because I was sick of being so lopsided due to the Aircast boot.  This has been a great purchase and restores some normality to my movements.  I only came across it though because of this blog - why didn’t my OS tell me about this kind of thing!

Appears I may have overdone the walking though as I seem to have pulled a muscle in my thigh and lower back on the injured side.  This has actually given me the worst pain of anything to date - far worse than the original injury.

Planning to spend the weekend resting up in bed and hope the pain has gone down by Monday otherwise I’ll have to go back to the Dr’s next week.

Anyway two steps forward and only one step back hopefully, counting down another 4.5 weeks till I’m supposed to be out the boot and can drive again - fingers crossed!


Cast away

First visit to the OS today two weeks after surgery.

Got seen by a nurse who took my cast off and removed the sutures which luckily didn’t hurt at all.  The wound looked okay and she seemed happy with it although it felt very strange to have the ankle unprotected after 3 weeks of being in a cast.

This reminded me that when I first went to see the OS I had asked him about the various surgical options for ATR repairs including percutaneous vs open; thinking I was clever I also mentioned some fancy technique involving buttons that I’d heard about from the registrar at ER!

He just looked at me, shook his head and said these new techniques were all b******t and that over the years he’d tried every fancy innovation that had been invented but now does his repairs exactly as they would have done it in the 1950’s; basically just slice the ankle open and sew the tendon back together….fair enough I suppose, at least he’s experienced!

After removing the stitches I was given the choice of two types of boot either an aircast with inflatable pouches ($220) or another boot with no inflation ($160), I chose the aircast as it sounded more comfortable and the nurse fitted it with 6 heel wedges.

The OS then came in to see me but didn’t even bother looking at the wound.  My progress plan is PWB over the next two weeks using two crutches and gradually moving to one.

After 2 weeks I should be FWB and crutch free.  I have to remove one heel wedge per week and go back to see the OS in 6 weeks time.  No PT until after the boot comes off in another 6 weeks.

I have a possible overseas business trip in 4 weeks so I asked about flying with the boot, he said that in general he would avoid it due to the increased risk of DVT but if I have to travel then take a daily aspirin one week before and continue for one week after the journey.

So I’m very happy to be on the next stage and the promise of being able to drive in 6 weeks time now beckons!

The boot feels okay but it’s going to take a while to build up the PWB  I think, I guess you’ll just know what feels right as you gradually increase the weight.

I’m also planning to sleep in the boot for the next few days as I don’t trust myself in the middle of the night!

1 week post surgery - Showers and office

Managed to make it into the office for a couple of days this week (one week after surgery).  Was worried I might be going back a bit soon but my leg hasn’t been hurting and I’m lucky that I have a desk job so was able to sit in moderate comfort with my leg more or less elevated.

Some unexpected difficulties though such as the gents toilet being on a mezzanine floor with several steps to descend - not practical in my state so I had to negotiate with the ladies in the office for temporary access to their toilet!

Other big win this week was working out a shower routine, the critical success factors were: a shower seat sourced from a local charity shop, disposable gloves and an elastic band (to keep my cut finger from getting wet) plus a surgipack half leg shower protector which we got from the chemist.

This combination worked a treat, a bit fiddly but well worth it for the sheer joy of being able to have a shower every morning.

Next milestone is hopefully getting the cast off next Wednesday, fingers crossed.

Future dancer

This site has been a great source of information and comfort over the last two weeks since I joined this club so I figured it was time to add my own simple story.

I’m a near 50 year old male living in Australia who started playing squash again recently after many years off the court.

A couple of weeks ago on the 16th February I was well warmed up after playing 4 or 5 games when I made a sudden turn and felt a sharp pain at the back of my right ankle.

I naturally accused my 13 year old son of hitting me with his racquet but realised that there was no way he could have done so as he was standing on the other side of the court! Assuming I was so uncoordinated that I must somehow have hit myself I hobbled off court promising to be back in a minute.

First thing I noticed was that my sore right ankle looked visibly different to the good left one, a bit less definition, slightly swollen and not solid to the touch….hmmm.  It was sore but not unbearable and felt slightly floppy but with a mostly normal range of movement.

By chance one of my mates in our social group that afternoon was a nurse.  I asked him over and said somewhat naively “this may sound like a dumb question but can you just snap your achilles?”, he looked at me and I knew from his expression that this wasn’t good…’’ this is going to take a long time to heal” was all he he said!

My mate said that he’d never actually seen a snapped achilles but given the pain and pure sponginess at the back of my ankle I should go to emergency to get it checked out.

My next mistake was trying to drive myself to hospital in an act of pure bravado, I got in the driver’s seat but as soon as I gently touched the brake pedal I knew this wasn’t going to be an option so I asked my mate to drive me instead.

At the emergency department I got seen separately by a nurse and a Doctor who both declared immediately that I had completely ruptured the tendon.  From reading this forum later I guess they were using the Thompson test to determine this but I didn’t know that at the time.

No imaging was done and I was put in a half cast with my foot pointing down, sent home and told to call an Orthopaedic surgeon in the morning, they said that I would need to be operated on within two weeks for best results.

I googled some of the surgeons names and found one who’d worked on some famous Australian tennis players, figuring that they would have had money and got good advice I managed to get an appointment the following day.

At the appointment I was given the option of a conservative or surgical approach and he fairly described all the pros and cons around chance of re-rupture, strength of join, risk of infection etc.  I had already done some reading around this and opted for the surgical approach mostly because I wanted to get active again as soon as possible and minimise the recovery time if possible.

The surgeon told me that his expected recovery plan was:  2 weeks in full cast post surgery, 6 weeks in a boot after that with gradual weight bearing, physio commencing after eight weeks.  He told me I couldn’t drive for at least 8 weeks, should be walking well after 3 months and back to sport in 6 months.  All in all this was somewhat better than I had expected!

I was booked in for surgery on Tuesday 25th (9 days post injury), he said he preferred to leave it 10 days or so as the tissues are easier to deal with after that time.

A week after the achilles rupture I thought it would be a nice idea to cook dinner for my family whilst my wife went out for a run.  I was in the middle of preparing everything when I decided to cut a corn cob in half, slipped with the knife and just about sliced the end of my finger off.  Back to emergency for the second weekend in a row, six stitches and a giant bandage on the finger.  Unfortunately this doesn’t help much with crutch agility, washing myself etc but it did cause much hilarity amongst my work colleagues - silver linings?

Surgery went well, I had a GA and a nerve block that lasted 24 hours.  I was kept in hospital overnight - the worst part of which surprisingly was trying to pee in the stupid bottle they give you, for some reason I found this extremely difficult, not sure if it was performance anxiety on a shared ward, the effect of medication or just the physics of peeing when lying mostly flat in bed - I was never so happy to go to a proper toilet again the next day I can tell you!  Sorry if this is too much detail :)

Went home the next morning with a prescription for Oxycodone (synthetic morphine).  When the nerve block wore off it was sore and I couldn’t seem to find any comfortable position to lay in bed without the cast digging into the wound.  Luckily this seemed to resolve itself after half a day of elevation and since then I’ve been mostly pain free.

Spent the first week after surgery pretty much in bed with feet up -a great chance to catch up on some reading and TV watching .  I haven’t been sleeping well though, I’m restless and twitchy at night, already starting to get paranoid about the possibility of re-rupture whilst in the cast due to excessive leg movement.  Is this even possible?

I’m going back in to the office today (8 days post surgery) for the first time, I’ll sit with my leg elevated and just see how it goes.  The cast is due to come off in another 7 days and hopefully I’ll go into a boot.

I also had the stitches out my finger yesterday so things are progressing in the right direction…one day at a time…