Kevin’s ATR

Hello all.  It’s been a long while since I’ve updated my situation.  I had surgery this morning to close the orginal surgical wound from an ATR repair back on May 5th.  I don’t know much about the procedure, but I’ll follow up after I get to speak to my doc.  I was a little out of it this morning, and my wife didn’t ask all of the questions I would have asked.  This is what I know:  Doc carved out the walls to make the wound as “meaty and bloody” as he could, then he sewed it up.  I’m wrapped up in an ace bandage right now, and I’ll see him on Tuesday, the 21st.  I have no pain.

To refresh quickly, ATR on April 29th.  Surgery to repair the AT on May 5th.  After the cast was taken off to remove stiches on May 23rd, the wound was open and has slowly healed from inside out over the past four months.  During that time, I have used “wet-to-dry” daily dressing changes, 3 weeks of wound vac therapy, “packing the wound” with dry gauze daily, and just simple band-aid coverage to prevent minor leakage.  The combination of all of this has slowly healed the wound from the inside, but it has not completely closed.  I have no pain, but a little discomfort and aggravation beyond words!!  The tendon has healed properly, but my leg is still weak because I can’t rehab the way I need to due to the wound.  I have been walking freely in two shoes since the end of July.  I still limp to this day, but I hope that will improve with rehab once the wound issue is over.

My doc determined that my wound has basically been open long enough that the skin has grown down the interior walls and will not fuse together and close  (his analogy:  just as the bend in our elbow will not fuse together–no matter how long the two sides touch each other).  The wound would appear closed, until I moved my foot down–the wound would then open, as if it were about to actually begin to speak!!  A buddy of mine is an athletic trainer, and everytime he would look at it, he said he had a severe urge to put a quarter in the slot of the wound!!  He has issues.

I’ve read through a few of the “older” injuries, ones closer to my injury date.  I’ll keep reading to get a grasp on everyone’s progress.  Curious to find out about Kristen’s open wound, and I did read that Daveleft has an open wound as well.  This is part of the ATR that most do not have to worry about.  This “extra” stress and aggravation with this injury has been difficult, but I feel like I’m definitely close to the end of all of this.  I hope…..

Here are a few details for anyone concerned about taking that vacation that is already planned and paid for long before this wonderful injury interrupted life as we know it.  If you want to do it, it’s possible…

Day 1:  Airport was fine.  No issues.  I’m in a boot and FWB, so it wasn’t bad.  I only had one piece of luggage.  I did not take my golf clubs because I knew that it would make it harder on me at the airports-I was borrowing clubs from a buddy.  I was traveling by myself–meeting 5 other guys there.  Played 18 holes that afternoon.  I topped my first three shots, then I figured out how to swing with all of my weight on my left side, which is my good leg by the way.  It wasn’t pretty, but I was playing golf.  The easiest part was swinging.  The hardest part was walking to my ball around the green–negotiating the subtle slopes and undulations.  I had to go very slow, but no one seemed to mind.  It was 115 degrees on day 1, and we had the course to ourselves.  I’m a PGA member and it was hard for me to struggle through the round–I’m used to scoring much better.  I shot 90 (from the tips).

Day 2-3:  My AT was so sore that if I lightly touched it, my leg would jump.  Still, I played on days 2 and 3.  We were scheduled for 36 holes both days, but I only played 18 each day.  Scoring improved slightly, 87 and 84.

Day 4:  Finally, my AT felt stronger.  I was still walking with a limp, but I felt good.  Scoring still struggling–85.  That evening, I took my boot off and I walked around in flip flops.  Not the brightest idea that I had on the trip, but it actually felt okay.  I still couldn’t go swimming, because of the open wound issue.  In all of this Arizona heat, swimming would have been so good.  Oh well.

Day 5:  We only played 9 holes on our last day (shot 41).  Overall, it was a good trip, but it would have been better if I would have been out of the boot.  The wound held up and actually continued to heal during the week of stress, which baffled me.  Overall:  The days were hot, food was great, the beer was cold and delicious, and the golf courses were awesome.

Back Home:  I was feeling so good about my week of golf that I entered a local tournament for professionals.  One day.  18 holes.  I shot 81 with a quadruple bogey on my first hole and a double bogey on #17.  I felt great about the effort.  I won a little dough–not for my 81, but in side games, so all in all it was worth it for me….mentally.  The home health nurse came back yesterday and put the wound VAC back on to help with the closure.  The VAC will stay on through this Friday.  Next doctor’s appt. is not until July 8th–hopefully he will consider moving towards two shoes.   

 

Day 54 Post-ATR

My home health nurse came by this morning to remove the wound vac (4 day cycle–2 dressing changes).  Wound looks much better and seems to be closing as expected.  I leave for Phoenix, AZ for a golf trip in the morning, so I’m back to “wet to dry” dressings for now.  No vac.  Changes will be every other day instead of daily, unless the discharge becomes heavy, then back to daily.  My doc will re-evaluate my wound after the trip to see if the vac goes back on.

Kristin–thanks for the update on the boot and the use of the vac.  I wore my boot all weekend.  No problems.  I appreciate it.

After the vac was removed, I put my boot back on, and left the crutches against the wall.  I put all of my weight on my boot and tried to take a step.  Big limp.  Real big limp.  My knee is very very weak.  But, I’m walking around the house now without crutches—I just look like I’m auditioning for the next “igor” role in a horror flick…..YES, MASTER, WHATEVER YOU SAY MASTER!!

While sitting with my foot flat on the ground, I can lift me heal off of the ground, which will make my calf muscle fire.  This feels very awkward and a little scary.  My doctor has not prescribed any ROM exercises or plans for PT yet.  This is because of my wound not closing yet.  So, as my wound gets better, I’m taking baby steps with the other expected ATR recovery progress on my own.  After reading a couple of posts about re-rupture, I am being extremely cautious. 

So, in my cautious frame of mind, I’m off to Arizona to play golf with a bunch of buddies…we do this every year and I was not gong to miss it due to this wonderful injury.  My plan is to just ride along, drink beer, and hit a few shots for fun.  I have no plans of trying to play all 18 holes every day.  I’ll do what I can.  If I can swing and get around okay, I might try to play every other hole.  We’ll see……

Have a great week. 

I have a short boot–the DonJoy MaxTrax Ankle Walker—it does not isolate the calf muscle.  From everything I have read about boots for an achilles tendon repair, most of the boots that most patients get will isolate the calf muscle.  I do have wound issues, so maybe I have the short boot because of that??? 

Has my doc given me the wrong boot???? 

Well–I’m back and THANK GOODNESS!!  What a trip.  We spent 7 nights at WDW and I truthfully believe that it was the most crowded I have ever seen it (9th trip since 1994).  We decided on the way home that we will definitely be back, but no time soon!  Even though it was very crowded, we had a good time, but not as good a time we would have had if my wife and kids could have kept up with me….yeah right.

Okay–here are the details about this type of vacation for those recovering from an ATR. 

1.  Airport:  To be honest, the airports were no big deal, other than the fact that I couldn’t help my wife and kids with the luggage.  I am in a boot, but still on crutches.  I sent the crutches on the conveyer belt and limped through the metal detector.  They did not make me take my boot off at the security checkpoint, but I had to go over to the little “YOU MUST BE A TERRORIST” section for close inspection with the magical wand.  Even here, I did not have to take off the boot, which surprised me.  After I was cleared and declared a safe American traveler, we were off to our gate on a courtesy cart–GOLDEN.  We were the first to board the plane–everyone can spot my beautiful crutches.  They must have shined and sparkled under the bright airport lighting.  The flight was fine (only 1 hr 45 minutes), so my leg was okay.  Same routine at the Orlando airport.  Courtesy cart and then the Disney’s Magical Express directly to the resort.  Pain free so far, other than a little swelling.  Return trip–same song.  No issues.  Much easier than I ever thought it would be.

2.  Disney World:  The biggest mistake I made was not doing enough research on the ECVs (Electric Convenience Vehicle).  Many guests had rented an ECV from an offsite dealer to have for the duration of their trip to use at the resort, parks, and elsewhere!  My plan going in was to rent one daily at the park ($45 rental fee) to help with my endurance and mobility around the massive happy grounds.  Well, my brother and his family met us there, and my wife talked my brother into just pushing me around in a regualr wheel chair ($10 rental fee).  We did that for 4 days (through the end of his stay)–my brother didn’t seem to mind, but I felt more of a burden than I should of been.  I rented an ECV for the rest of the trip at the parks.  HERE’S THE PROBLEM WITH THE PLAN I HAD GOING IN:  I had to crutch everywhere other than inside each park on my entire vacation, which limited my fun because I didn’t feel like doing anthing but going back to the room to rest and ice my leg.  I had to crutch daily to and from the bus stop at the resort (about 500 yds).  I had to crutch daily from each park’s bus stop to the entrance and back to the same bus stop to go back to the resort (avg 400 yds).  The crutching to and from to the bus stops alone wore me smooth out!!  If I wanted to go to the central food court at the resort, I had to grab my shiny darlings and head that way.  Brutal.  In hindsight, an offsite rental of an ECV would have made a world of difference.  Everyone I spoke with spent about $30-$35 per day for their offsite rental (and the rental place drops it off at your resort!!–NO BRAINER).  Hopefully there won’t be a next time with this issue, but if so……

The GAC (Guest assistance card) was our golden ticket or “permanent fast pass” for the entire trip.  We picked up ours at guest relations.  They didn’t ask for any medical documentation–once again I think the shiny crutches and black boot tipped the WDW employee off to my condition.  The GAC could be used at all attractions and shows and it was good for every member of my party.  This was huge.  We were able to ride all of the major attractions through the fast pass line, which was a very minimal wait most of the time.  My top three rides:  1.  Expedition Everest  2.  Rock N Roller Coaster  3.  Soarin’.   The GAC is a must.  Swallow the pride and flash the card!!

Loading and unloading the rides was a little tricky, but no big deal.  I was able to keep my crutches with me whenever I waited in line.  For the thrill rides, an attendant simply escorted my shiny helpers to the unload side of the ride.  They were waiting for me as I unloaded.  I could limp on and off the rides without much of a problem.  Several rides were a tight fit with my boot–space mountain in particular–small cars.  A few of the rides allowed the ECV to drive right up to the load spot–NICE.  Some of the fast pass lines were long walks (long crutching trips), but overall it was fine.  I always made sure that my good leg had the most weight on it when I was getting on and off of a ride.  I looked a little slow and cautious to everyone I’m sure, but so what…..

3.  Surfaces and Crutches:  One of my biggest fears was slipping and falling with my crutches during this trip, but I didn’t.  In fact, I didn’t even slip at all.  It rained every day we were there–at some point usually in the evening.  The streets and sidewalks around the parks and resort were always wet, but no slippage.  My guess, other than complete blind luck, is that WDW uses “slip free” materials during their surfacing around the resort??  I’m not sure, but it sounds good I guess.

4.  AT, Wound, and Swelling:  My tendon hurt the most every morning.  Very tender and tight, but it would loosen up after a little bit.  My wound, as some of you remember, is still not healed, but it didn’t really get any worse over the trip.  We continued with the “wet to dry” treatment plan and it seemed to prevail.  My leg swelled more this week that it has during the entire recovery process–for obvious reasons.  I iced my leg every evening–swelling subsided–loaded up with advil. 

Overall…..it was a good trip.  I’m getting the wound vac on today.  I’ll update with that later…..

Kevin