Joy and Pain

I am officially post-operative.  I am laid up here on the couch in quite some pain.  The leg is iced up and elevated.  I’ve been prescribed the Norco along with diazepam (valium) for the muscle spasms.  I start the xeralto tomorrow to prevent clotting.  I’ll be in a cast when I schedule my next appointment.  Thanks to the nursing team and doctors at the Glenbrook Hospital in Glenview, IL part of the North Shore University Health-System.  Amy Jo Ptsazek performed the surgery through the Illinois Bone and Joint Institute.  Thanks to my wife Tiffany and parents who drove from Detroit to support and encourage me.  Pops will be here through the rest of the week.  And praise the Lord for empowering me to make through the surgery.  Now strengthen me for the recovery.


20 Responses to “Joy and Pain”

  1. Xpf72q on April 19, 2012 8:31 pm

    Hang in there you will get through this! Praying for your steady good recovery also do keep us posted. Bilaterall tendonosis here much worse in left leg trying to avoid surgery with the boot and eccentrics and such but this site is helping me prepare mentally and physically for both. How are the muscle spasms and how often?

  2. jenniferanderson on April 20, 2012 12:55 am

    Hang in there! The first few days are the worst. Make sure you take your pain meds as prescribed to stay ahead of the pain. I tried to tough it out and wait for pain to hit before I took my Vicodin. BIG MISTAKE. Once the pain hits and you take your pill it’s a good half hour before it kicks in during which you seriously think you could kill anyone who crosses your path with your bare hands. Kidding (sorta). After 3 days or so I was able to take them less frequently and after a week I didn’t need them at all. Good luck and speedy recovery!

  3. jimminyc on April 20, 2012 8:05 am

    As Jennifer says, the first few days are the worst. From my experience I would say ‘elevate, elevate, elevate’! It helps the healing and also the pain. Stay strong!

  4. laughitupfuzzball on April 20, 2012 12:24 pm

    @xpf72q - thanks for the encouraging words. You hang in there also. I pray that the Father strengthens you through your recovery. The spasms were worse last night before I fully went to sleep, then the diazepam kicked in. There not very frequent.

    @jennifer - thanks Jen. That happened to me yesterday. However, I believe that it is somewhat under control.

    @jimminye - thank you. Foot’s elevated. Stinging a little right now, but I took the pain killers about 45 minutes ago.

  5. Harry H. on April 20, 2012 1:16 pm

    Hi all
    Full ATR, Non Op
    I have previously posted on this blog my progress to Week 12.
    Now on Week 16 the ankle is still swollen, stiff and painful.
    Still limping, can walk about a mile but it is very uncomfortable.
    It seems to be taking ages to regain full strength in my foot and calf although I am working regularly on the physio.
    Foot is always a strange purple/redish colour unless raised.
    I was confident that I would be much more mobile by this stage but it looks like being another few weeks yet!

  6. normofthenorth on April 20, 2012 1:45 pm

    Harry, have you tried lots of elevation (& icing & maybe compression, too)? Swelling can linger, & it creates a bunch of those other symptoms even if all else is well. I posted about getting very tired of swelling from my ATR, and I also posted about a later swelling episode on the OTHER ankle, from a bone bruise on my shin. I was shocked how much that UNinjured ankle felt like my ATR-healing ankle, all from some swelling!

    Good Luck, and Good Healing.

  7. laughitupfuzzball on April 20, 2012 1:52 pm

    @Harry - hang in there bro. Since you went the non-op route, do you get massages down there to work with scar tissue? I heard something about Glastonbury massage, but know little about it. Stay encouraged in your recovery.

  8. laughitupfuzzball on April 20, 2012 1:53 pm

    Sorry about the darn IPad spell-correct, it should be Glaston massage NOT Glastonbury.

  9. Harry H. on April 21, 2012 1:22 pm

    Hi Norm
    Thanks for your reply, it is greatly appreciated.
    I do keep my leg raised a lot during the evening. When I do this the colour returns to normal almost instantly, that is until the leg is lowered again when the red/purple returns just as swiftly.
    I have also started to keep my feet/legs elevated in bed by resting them overnight on a few pillows.
    My physio said that the swelling was due to lack of exercise but when I walk, cycle or simply stay on my feet all day the swelling appears exessive. The tendon is also painful at this time though I assume that it is the swelling that causes this.
    I have recently started to wear football socks (I read on this blog that it helps) but it does not seem to have worked for me.
    My ankle is at its best first thing in a morning when the swelling has eased overnight.
    The hospital consultant last saw me at 12 weeks and then instructed me to make a 6 month appointment for my next visit.
    I was told at that time that the swelling can take up to 12 moths to disappear, but my worry is that at this stage it seems to be getting worse, not better!
    Any further helpful advice will be warmly accepted.
    Many thanks.

  10. starshep on April 21, 2012 1:42 pm

    Harry:

    After I was in my boot for 2 weeks after being in a cast for 4 weeks, my doctor noticed I still had a lot of swelling. In addition to having me get a compression sock, he also sent me for an ultrasound to see if I may have a blood clot. The ultrasound found that I have a couple of clots in 2 superficial veins. While it highly unlikely these clots will cause me any trouble, the doctor put me on an aspirin regimen and is having me go for at least 2 more ultrasounds to confirm the clots are not getting any worse. You might want to suggest that your doctor send you for an ultrasound just to make sure your swelling isn’t caused by a dangerous clot. BTW in my case, the compression socks did clear up the swelling in about 3 days, but the doctor wants me to continue wearing them for at least 2 more weeks.

  11. Harry H. on April 22, 2012 5:35 am

    Starshep
    Thanks for your advice.
    I am in the UK and using the very inconsistent NHS service!
    Hospital appointments have generally been “lets have a quick look” then sent home to get on with it. I have not seen the same doctor/consultant twice!
    Physio is not much better. I only had 4 visits where I did minimal exercise for about 2 minutes each time, then given a very poor diagram/instruction sheet to take away.
    After my 4th visit, although the ankle remained very swollen I was told “if you need another visit make sure you book an appointment within the next 4 weeks or you will automatically be discharged”. With this statement I assumed that they did not wish/need to see me again!
    During my few phsio visits there has been very little encouragement. Never got further than a few heel raises. No bike, no stepper machine, no other apperatus (although they are there in the department) except for a step.
    The tendon area does occasionally feel very warm particularly when the swelling is at its worst (at the end of the day).
    I would have expected that if a clot was evident that physio should have spotted it, but following such superfical treatment I am going to follow your advice and visit the doctors.
    Take care and thanks again.

  12. starshep on April 22, 2012 2:58 pm

    Harry:

    Clots are not always easy to spot especially if they are in a vein deep in the leg and they don’t always show all the classic symptoms.

    I have no idea what life is like under socialized medicine. I am fortunate to have some pretty good insurance. Still I never feel comfortable dealing with doctors unless I feel that I know about as much about my treatment options as they are supposed to. I always try to be prepared to give them a good argument if what they tell me doesn’t coincide with what my research indicates. I feel I have to be my own strongest advocate.

    Maybe all you need to do is to keep your leg elevated as much as you can, wear a compression sock all the time and ice the ankle 3 times a day. Yet being as swollen as you are and for as long as you have been seem unusual.

    Good luck.

  13. normofthenorth on April 23, 2012 12:15 am

    I think getting some more medical attention makes sense, since your experience makes you an outlier along the ATR-rehab path. DVT is significantly rarer among non-op patients than it is post-op, but it does occur.

  14. laughitupfuzzball on April 23, 2012 8:18 am

    I’m the ATR post-op dummy here, but I hope that things work out better for you Harry with some of the suggestion and encouragement. I would imagine that deep vein thrombosis has to be awfully painful. And with the limited health care you’re receiving, it’s no wonder the process has been long. Are you able to take anything over the counter to deal with the clotting like aspirin, ibuprofen, or Tylenol? Would massage help along with the compression of the socks and your boot? Of course everyone is encouraging you to keep your leg elevated and try to do less, but that can only happen if you have a strong support system. Are there any family and friends that can really partner with you in this? How are you socio-emotionally? How we feel can also affect our recovery. Is depression or anxiety creating barriers to relationships or lifestyle on top of the physical injury? Hang in there Harry. Hopefully it won’t be like this for longer than it has to.

  15. Harry H on April 25, 2012 4:28 am

    Hi laughitupfuzzball
    Thank you for your kind words and advice.
    After reading your comments I had an appointment with the physio so I mentioned everything to her.
    On seeing the colour of my foot and the broken veins that were appearing she also suggested that I need another visit to the hospital as it looked like a circulation problem.
    So, yesterday, with a purple foot and very swollen ankle I returned to the hospital.
    The doctor informed me that it is normal for it to be this colour and so swollen after being immobile for such a long period and stated that all that I require is plenty of exercise.!
    I have certainly not sat around all day and have tried to keep active as much as possible so his comments were a surprise. He also stated that at 16 weeks the tendon has healed and the chances of a re-rupture are about 5% so to just go ahead and dont’ worry!
    Music to my ears. Still, I remain very surprised that from the day I ruptured my Achilles that I have never had an ultrasound, scan or X-ray.
    I will be trying a few increasingly long walks now and I will keep you posted how it goes.
    Thanks once again for your support, it is greatly appreciated.
    When all this is over, I hope to be able to help others with words of encouragement as the support of folk on this blog is brilliant.

  16. jonboy1968 on April 25, 2012 7:38 am

    Harry. Your experience sounds very much like mine. I am 2 year on from my rupture. Non Op, 3 casts over 9 weeks, no boot. After cast was removed went on hols next day to Canary Islands. Noticed foot red and purple when not elevated.

    Rang English speaking doctor on Island was recommended that I go to A&E. Which I did. The Spanish Docs thought it was a DVT. So was confined to hospital for 4 days with Blood thinning injections.

    On return to the UK went to see GP who sent me straight to the surgical assessment ward of the local hospital. They did an Ultrasound scan, an MRI scan and a heart echo test. All of which showed no problem.

    Despite me constantly telling them that I had been in plaster for 9 weeks with an ATR and despite being, still, on crutches. They were convinced that there was something wrong. So for the next few months as well as appointments with the Physio, and appointments with the orthopedic consultant, I had appoints with the vascular docs.

    They only signed me off when the foot gradually returned
    to the correct colour as I became more active.

    Just remember that the calf muscle acts as a pump as it contracts. So as strength returns to your calf then the blood will not pool in the foot.

    Good luck with your recovery.

  17. Harry H. on April 25, 2012 6:16 pm

    Hi johnboy1968
    Thanks for sharing your experience. It is a shame that your holiday was affected by your “circulation problems” and I can certainly appreciate your worries.
    I find it so strange to look down and see such an angry looking foot, only to be told that there is no problem.
    I now intend to work hard on building up the strength in my wasted leg muscles, mainly by walking and cycling at this stage. I do still feel some uncomfortable pain around the rupture area though this is mainly at the end of the day when the swelling is at its worst.
    How is your leg now? Do you still experience any problems or are things just as good as they were before the rupture?
    Take care.

  18. jonboy1968 on April 26, 2012 7:47 am

    Hi Harry.
    Think the message is Dont worry. It will sort itself out as you are able to work the calf more.

    Walking is good as long as it is with a correct gait. In other words striking with the heal, transition to a flat foot and then pushing off with the ball of the foot.

    No funny walks ie foot pointing out to the side. Cycling is good, as is cross trainer if you have access to one. Also therabands are very useful to use while lounging around in the evening.

    Unfortunately the best way to get strength back into you calf is single heal raises. If you cannot do a single unsupported heal raise on you bad leg then, with your heals hanging over the edge of a step, go up on both toes. Remove the good foot. Then try and hold the heal raise on you bad leg. If you cannot hold it, try and control the way it comes back down. Its brutal but very effective….

    You will probably need to hang onto something at first while you do this.

    Another good one is walking backwards.

    Also if you have access to a pool, talk to your physio about hydropherapy.

    Dont do any of the above without talking to your physio first.

    I had a NHS physio for 6 months and got nowhere. So went private with a specialist sports physio in Huddersfield.

    Still experience some discomfort as one of the reasons I got nowhere with the NHS physio is because I have heeled slightly long.

    I was due to have corrective surgery last year but the private physio was a lot more aggressive in his approach (on my instruction)So that has been postponed as function wise nothing is holding me back from doing what I want to do. I would struggle to run a marathon but I dont want to. So that is fine by me.

    As things are at present pretty comfortable with a 7 mile hike with some serious hills.

    To answer your question Nowhere near as good as before the rupture.

    I am the exception rather than the rule.

  19. Harry H. on April 26, 2012 7:33 pm

    Hi johnboy1968
    I have attended physio and can do the heel raises on a step using both feet. It is impossible at this stage to support my weight on my injured foot as it is still very weak, though I will try your suggested techniques as they certainly sound helpful.
    I have just tried your ‘walking backwards’ and although it feels strange I can certainly see how it helps.
    I do have a hydraulic stepper in the garage that I am using (or was using until the roof developed a leak during all this confounded rain we are having)!
    I am sorry to hear that you are not as good as before the rupture. Like you, my running is now finished but as long as I can walk up the hills and dales, ride my bike and play golf I should be quite happy.
    My aim at the moment is to try get rid of this limp. I am sure your suggestions regarding strengthening of the calf and foot should rectify this soon.
    I also have a bike so I will try this as well.
    NHS pysio is very basic at best, I will certainly consider private treatment if progess does not improve more rapidly
    Many thanks once again.

  20. jonboy1968 on April 27, 2012 5:46 am

    Harry. I think the physio is more important than the orthopedic treatment. Certainly more hands on. My surgeon barely laid a finger on me. Once to confirm the gap in my achilles, and then to confirm it had heeled.

    He only instructed the plaster room as to how he wanted my foot set. They did the rest.

    The physio, both NHS and private, was where the real work started.

    Is your physio doing a deep tissue massage on and around the tendon to reduce the scar tissue on the tendon? Excruciating but since it was the first thing both NHS and private physio did. I would say essential.

    Ask your physio about therabands (if you are not using already). These are elastic resistance bands in different colour grades. You wrap these around the ball of your foot while hanging onto the ends to form a loop around your foot then flex your foot downwards. Hopefully getting a calf contraction. You can do these exercisers while watching TV in the evening.

    Brilliant exercise because you dont realise your doing it. In an evening you can do 500 to 600 reps.

    NHS physio would not give me them.

    First thing, after deep tissue massage, the private physio did.

    The other thing my private physio was big on was hydropherapy. Just trying to walk normally in whatever depth of water you feel comfortable with. Early stage it may be chest deep then as strength returns waist deep. Then knee deep.

    Good luck with the rest of your heeling.

    I can do all the things you mention with an elongated tendon, so you will be fine.

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    About Me
    Born in Birmingham; born again in '84; raised in Detroit; live in Chicago. I currently work as a teacher's assistant at a therapeutic day school. My wife and I have lived in Chicago nearly nine years, and we have grown to love it. We are involved in ministry at our local church and lead a small group in our home. Discipleship has become important to us, and the relationships we've developed here have also helped to grow us spiritually in the Lord.
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