kickstand’s Nonsurgical

Going the conservative, nonsurgical route… my experiences and choices

Archive for the ‘CAM Walker Boot Phase’

Week 7/8 - 2nd Week In Boot

Refresher: It’ll be 8 weeks since my ATR on July 14th. I’ve been in the boot now for almost 2 weeks. The ortho doc gave me the green light to go into 2 shoes at the end of the 4 week boot period.

I went to the doggy beach in Huntington Beach this weekend (Labor Day) and gave my boot a "run" for its money in the sand. I gotta tell ya walking in sand is not the easiest thing in a boot. You really have to be careful not to over extend your tendon. A few times the sand wanted to send my foot in the wrong direction but fortunately if you walk slow enough you don’t have to be too concerned. What was concerning was what I’d do if my dog (a small Cavalier King Charles Spaniel) got en-snarled in a vicious fight with one of the other larger breeds that were looking to chew their way to dominance!

I took the boot off to get some badly needed sun on the pale area that was covered in Cancun with the cast. And as I was sitting there enjoying the beach with the family and watching Uno happily play in the sand I realized if one of the other dogs decided to make him a chew toy I had no way to get to him quickly without re-rupturing my Achilles. Well, that wasn’t going to happen and if it did they’d probably have to drag me away in cuffs for tearing all four tendons on the poor dog that chomped on Uno. I can’t say I’m a violent type but a man has his limits!

Anyway, I didn’t make the news that night but ironically my daughter’s friend’s brother did! I should really be thankful that all I had to worry about was hobbling over to rescue my dog. Our friend’s son was nearly shot when some thugs showed up uninvited to his party and robbed some of the guests. His roommate wasn’t so fortunate and ended up being shot in the chest. He’s in critical condition and recovering but will have a much tougher route to recovery than any of us ATRs. Apparently a girl at the party who also was shot was the reason he wasn’t killed. Seems the bullet was deflected off of her finger before hitting the roommate. Crazy circumstance! The university is one of the greatest in the US but happens to be located in a rough area of the city. Our friend’s son is a senior and a great kid and student.

Oh yeah, my Achilles. Well, not too much to report this week. Like others here I’m really nervous about going into 2 shoes. Most days my tendon feels flexible but it is still slightly tighter than before. It seems to be tighter at various times and after I walk more. I do walk around a bit out of the boot at home but I’m extremely careful not to stumble. I don’t have any noticeable swelling but I suspect there still may be some because parts of the bottom of my foot still feel "unfamiliar" when I walk on it. I’m putting a little more weight on the front of my foot and I notice that it’s starting to feel more natural again. But I stop immediately whenever I feel a tug on my tendon.

As I mentioned before, I have a lot of motion and can barely detect a difference between the good foot and bad. However, I do feel the tightness when I pull my foot all the way towards me even though I can reach the same distance as my good foot. I think PT will help with this. My foot itself is pretty loose and I can move it like before with no problems.

My calf is still loose and there clearly is a difference in muscle size primarily right where the muscles meets the Achilles. My thigh and gluts are feeling strong again but I think I need to get on a stationary bike to get things moving along. Today is Labor Day so I’ll try to spend some quality time swimming in the pool before hitting the tasty barbeque ribs!

Oh, and I had time to customize my blog page with widgets and a new header. Check out the page I added on Thetus and Peleus, the mythical parents of Achilles. I’m sure you’ve all read something but I thought it be fun to post it here! Just think, if Thetus had dipped Achilles’s heel in the Styx river maybe none of us would have to worry about ATRs!

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!