The Operation

The day after flying back home, I went to the appointment with the doctor in the morning. He took away the splint I had on, did a bit of testing, and found the rupture very quickly in the “typical spot”, about 5cm up from the heel. The foot wasn’t really swollen at all, and so I was off to surgery prep within about ten minutes of meeting the doctor (we had discussed the treatment options etc on the phone previously).

I had a brief discussion with the anesthesiologist, and opted for a spinal block instead of general anesthesia, which was also her recommendation. My decision was mainly based on curiosity of wanting to be awake during the surgery, as well as lack of grogginess and need for strong pain medication immediately post-op.

Eventually I was taken to the operating room, got a cannula in my hand, and the spinal block was done. This was completely painless, and pretty soon my legs started to go numb, a pretty strange feeling as such. At this point they washed the foot, turned me over, set the automatic tourniquet on my leg, and were ready to start the operation (sadly they didn’t have a monitor available for me to follow what they were doing).

Once they opened the foot, they found out that I had also ruptured my plantaris tendon, which I understood to be somewhat rare. This turned out to actually be a good thing, as they used the plantaris tendon in tying up the achilles, and spread it over the stitching to “create a slicker and smoother surface” over the rupture. In my op report this is called the Lynn technique. Apparently they wouldn’t fix the plantaris otherwise, but would’ve just basically thrown it away. At this point I also got the nurses to take a few pictures of the finished product before closing, one of these pictures below (the white part is my plantaris tendoen spread to cover the ATR fix). It is actually pretty difficult to associate the picture as being my own foot…

In the end they set the foot in a plaster cast, with the foot almost at 90 degrees. They doctor was quite happy that it got so close to 90 already immediately following the surgery, as in his view that will make the transformation to the boot ultimately easier. He prefers to use a plaster cast compared to a synthetic cast as it is more absorbent and he has seen better results of the wound healing with the traditional cast. Also, he noted that it might as well be the boot immediately following the operation, but having a cast at least removes the temptation of taking it off for the first weeks.

All in all the surgery was very smooth, I felt no pain or discomfort at any stage, and refused all the offers of sedatives / relaxants throughout the surgery. It was all over fairly quickly, the report states that the automatic tourniquet was active for 41 minutes.

After the surgery, it took a few hours for the spinal block to start wearing off, starting with my toes moving up. The last thing to recover feeling was my butt J Before the effect wore off, they gave me some mid-level painkillers, so at no point did I feel any pain at all. I was out of the clinic about 9 hours after walking in the door, of which about three hours was spent waiting for the operation.

I’ll get back to my planned recovery protocol and the plan going forward in my next post shortly…

1 Comment so far

  1. gravity on October 29th, 2014

    On a technical note, how do I add a picture to the post? I’ve managed to upload the picture to the media library, but when I click insert in post, the add media pop-up just goes blank…

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