kickstand’s Nonsurgical

Going the conservative, nonsurgical route… my experiences and choices

Archive for August, 2011

Week 6 - More Information

Reading other blogs about their procedures I thought I’d clarify my protocol a bit.

If you didn’t read from the beginning, I’m now in a boot at the end of 6 weeks in 2 week interval fiberglass casts. My boot is the Ossur Equalizer Walker model W0600 which extends up over the top of my calf muscle. It’s not fancy like the Vaco boot but when I questioned him on why they did not use the Vaco boot he said that is primarily used when you use the boot in lieu of casting since the foot angle can be adjusted as you progress. Makes sense to me. My boot online runs about $52 versus the $290 Vaco. If I was going more aggressive then I’d likely choose the Vaco.

So the day I received my boot my ortho doc cleared me to walk and cycle as long as I wear the boot. I was also allowed to swim without the boot of course. No running or jogging at all. He also said I should do some ROM movements when sitting around but no other exercises like toe lifts or stretching. After he examines me in 6 weeks he’ll start me off in PT. But again, I have almost full ROM already and he thinks since I did not have the surgery that I may not need as much PT. My Achilles is still tender to the touch and slightly tight when I bring my toes towards me but I have nearly the same range as my good foot.

I’m not pushing things now. I’m happy with taking it easy in the boot. While I’m a believer in early motion and weight bearing I still think you have to be patient and give your body the time to heal. And again the danger is stumbling forward without the support of the boot which will likely result in a re-rupture. Incidentally, 3 days after receiving the boot I did just that in the garage! I actually stumbled and caught my weight on the boot foot. I can safely report that the boot performed wonderfully and I didn’t even feel stress on the tendon! Knock on wood though because this has made me a humble being.

Going forward, I wear the boot for 4 weeks FWB (skipped PWB) then start using 2 shoes. He recommended I use a gel insert under my heel for support. I go back for a follow up with my ortho doctor in 6 weeks at which time he will start me on PT (he didn’t want to start PT until after the 3 month mark). No sports activities until after 6 months. I can live with that!

Oh, and I’ve dropped down to normal doses of vitamin C and only drink the protein supplement once a day now.

Week 6 - The Boot Finally!


Thursday, August 24th after 6 weeks in casts I am in the CAM walker boot! Words cannot describe the feeling of getting my hands back and getting rid of those damn crutches! If you’re driving on the 91 freeway in Orange County watch out for a pair of crutches cuz I’m seriously considering chucking mine out of the window!!! LOL!

When they took off the last cast my skin under my heel especially was really dried and peeling. I know TMI (Too Much Information) but this blog is to help so I’m being forthwith. I was able to wash my foot between each cast and only had minor peeling. I attribute this last episode of dry skin to getting in my spa with the Gumby Foot which must’ve torn slightly when I rubbed it against the side of the pool. At any rate when I took it off (after an hour of soaking) I discovered my cast was leaking water everywhere. Interestingly it dried out completely by the next morning, which is probably why I got in the spa the next week and got it all wet again :-(

Okay, the ortho doctor said I could walk as much as I wanted with FWB and that I could actually swim or cycle (cycle with the boot of course). I am not allowed to run or jog even with the boot (as if anyone could possible do so). I’m to wear the boot for 4 weeks after which I can start using 2 shoes! Essentially, the boot is there to protect me from a re-rupture should I stumble forward on my bad foot.

He squeezed my calf and we both witnessed my foot move so I’m definitely re-attached. I’m truly amazed at how it has healed on its own without the surgery. I have some swelling still, which showed up sometime during the duration of the first cast. The little amount of bruising I had has gone. He said that I should come back in 6 weeks at which time he will begin the physical therapy. He mentioned that I might not have much to do since I didn’t have surgery. My Achilles shouldn’t be as tight as those that had the surgery so I may not have much difficulty getting my full range of movement back. He said my Achilles if anything is probably longer now.

The second best moment after freeing my leg of the cast was taking a shower and washing my foot! I’m happy to say all the dead skin washed away and my foot looks about normal. I’m still nervous and haven’t fully begun to trust the boot. When I take it off to shower I notice my foot isn’t working like normal (i.e. toes spreading out as I put pressure on them) and is still a bit "reluctant" to act normal. I’m sure with each day I’ll be more confidant and work towards my next big milestone in 4 weeks! Patience is the key definitely!

Week 4 to 6 - Back in the Saddle

I got my 3rd and last cast at the 4th week mark (beginning). I had to go back to the full size which extended just below the knee. But in the neutral position this one is a lot more convenient than the first and second. When they took off the one (2nd cast) from the Cancun trip a bucket of sand poured out and my foot was a shade lighter than my upper leg!

I tried to convince them to let me go into the CAM walker boot at 4 weeks but the ortho doctor wasn’t comfortable with this since in the boot there is too much movement. No weight bearing until the boot!

Not much to mention except in week 4 to 5 I began to feel a slight tightness in my calf. After reading articles on healing again I think this might be the beginning of the shrinking of my collagen as it rotates and remodels into my new tendon. Reading about how scars shrink at the end of the repair cycle I’m pretty sure that is why I am feeling this slight tug.

As I get closer to the end of week 6 I can hardly keep my foot still in the cast. I’m extremely restless and I have the urge to move it more and more. I’ve always had a lot of movement and a good range of motion.

Counting down until the boot…

Week 3 - Cancun Here I Come!!!

Not much information in this post if you’re seeking advice or opinions on non-surgical recovery. But I thought I’d share my adventure with cast number 2 and 90 degree weather!

I got my second fiberglass cast on the Friday we were leaving for Cancun. I still don’t know how I managed to pack and be ready for the trip.

After telling the guy doing my new cast that I was heading to Cancun that day he gave me a shorter cast that hit just below the calf muscle. He explained that you never want to have the edge of the cast hit in the center of a muscle like the calf muscle or you could be in some serious pain.

Anyway, I chose blue and later that evening realized that it had a slight catch at the heal. It was too late to get it fixed so I grabbed some tape and threw it in my suitcase.

Oh, I was able to swing over to a pharmacy that carried the swim sleeve they told me about at Fullerton Ortho. It was in Whittier. If you’re planning a trip where there is water this thing is worth every penny! I called it my Gumby Foot because it looked like a giant blue version of Gumby’s foot. Anyway, I couldn’t do my usual crazy pool volleyball but I went all the way out to the ropes in the ocean. In my mind I figured if a shark swam to eat me I’d offer up my Gumby foot with the crunchy center. My guess is the shark wouldn’t even want my cast!

If you’re going anywhere with a cast that involves an airport ASK FOR THE WHEELCHAIR! Can’t tell you how fast you get through security! Even in Mexico we breezed through immigration in a record 5 minutes! Even the timeshare people left us alone! I was at the taxi with bags and a margarita inside of 20 minutes–15 of which was waiting for the bags and margarita! I’m seriously thinking of wearing my CAM walker when I travel next! ;-)

I won’t bore you with all of the craziness being in Mexico on crutches. I will say that each day I had 4 bullets to use. I used up one hobbling down to the beach and one coming back up to the room. After that I had 2 to use between dinner and lunch–breakfast was a rare treat if I could manage to get down to it. Needless to say, there was no dancing on the tables or wild Tequila nights!

I probably cancelled out most of my vitamins with all the Tequila I did drink.  I was worried that after 6 weeks I could have an extra heel or some other defect from the Tequila. Oh well, life is too short.

3 days into the trip I’d ripped the heel off the cast and was leaking padding. On one of the trips into town we stopped at a pharmacy and I bought a knee brace which worked wonderfully to not only conceal the hole but to protect it from all the other hazards hobbling around in Mexico. Fortunately there was a washer and dryer in the room because it was too ripe each day to sleep with.

Funny thing there was another guy at the resort with the Gumby Foot thing and we sat around laughing at all the stupid things people were saying about us!

Week 2 - The Wait Begins

Monday after my ATR I called the original ER pod doctor, who’d scheduled me for surgery that Wednesday, say I’d opted to go non-surgical and that I was under the care of the ortho doctor. I also informed my ortho doctor that I’d decided to stick with the non-surgery route.

I put myself on an aggressive vitamin and protein regimen which included what I could find from reading various websites about healing. I’ll include the list here but I gotta tell you I can’t vouch whether any of it was the right thing to take or not. It’s just what I could find for the healing of broken bones, repair of tendons, and development of skin tissue.

Vitamin C (10k mg), Vitamin A (10k-25k), Zinc (80mg), L-Cystine (500mg x 2), Coenzyme Q10 (Co-Q10, 60mg), Calcium (1,500mg), Magnesium (1,000mg), Vitamin K (as recommended), and a protein supplement (I used GNC’s Super Whey with 40g of whey protein twice a day).

You have to spread the doses out and drink plenty of water. I tried to find the best natural form vitamin C available to assist with absorption.

Besides the total inconvenience of crutches I was still without pain. However, I really thought I was developing arthritis in my thumbs and shoulders from hobbling around on the crutches.

Oh, and I should mention the here-to-now unparalleled feeling of claustrophobia of having a cast on my foot; especially at night when I’m trying to go to sleep. I had wild thoughts of sawing it off (the cast ha ha) and taking my chances with an Ace bandage! But that feeling dissipated over the first few weeks and eventually diminished into just a feeling of despair about having it on for 6 weeks!