My complete Achilles Tendon Rupture

Today, 5am, I woke up from a nightmare remembering it vividly: The doctor is examining me to see if I re-ruptured my Achilles tendon. He performs an incision right above the top part of the foot, and we see bubbles of blood and some yellow liquid coming out of it. The doctor decides that it is fine, and my wife (she’s a doctor too) concurs, but I don’t understand how come; after all the tendon in the back of the heel, not the front… I ask them but the dream fades away. I wake up knowing that the night is over for me.

Going back to March 24, 5 weeks post my ATR repair, I went to see my surgeon. He was all happy about the healing and asked if I was ready to start pushing some pressure on it. “Of course” I said, and got the green light to start walking, with the splint on. “Keep the splint on for another 6 weeks”, said the doctor, “Oh, and you don’t need to see me again”. How happy I was.

“You don’t want to go there“. That is what several people, most of them doctors, told me. They meant that I better not re-rapture my Achilles tendon. It requires another repair and the recovery process is much slower with a higher chance of complications and future ruptures. I thought I understood. Did I really?

Sunday, March 29, a few days after I started walking, I went to the walk-in clinic in the hospital where my wife works. My heel was swollen and there was a questionable infection. The family doctor wasn’t sure if the infection was only superficial or not, so she gave me antibiotics and recommended that if things get worse I should see my surgeon again.  I think the infection wasn’t deep, but later that week I had some blood and yellow liquid coming out of the incision scar (probably the image that I saw in the dream) and my physiotherapist recommended to air it as much as possible so it can dry and heal.

During the following week I was walking more, with high expectations to see a rapid improvement, but still with some redness and inflammation that bothered me. Taking the physiotherapist advice, I didn’t wear the splint at home, trying to air the incision scar, let it ‘breath’ and maybe, subconsciously, convincing myself that I’m healing fast enough to have the freedom of walking without the splint while at home. I did, however, put it back when I had to walk out.

One of the challenges of the injury, is to learn how to handle basic activities, like showers, walking up and down the stairs and even making and carrying a cup of coffee. Most of us are not thinking about such day-to-day activities, but as soon as I started using my contraptions, I realized I had to think about almost every movement, and especially in potentially risky situations (like stairs) where one little mistake can become an injury.

Tuesday, April 7. I just finished the antibiotics, and after some more physio sessions, things felt good. I had a busy morning at work, and I was sitting at my desk the entire morning, not wearing the splint. Then I heard the bell ringing and I knew it was the delivery service bringing the new headset I bought. I knew I had minute or two to get there before the delivery guy leaves, so I got up and rushed to the door, carefully walking down the stairs. I got the package and said thanks. The delivery guy said ‘Bonjour’ and left. I started climbing the steps while thinking about the ‘Bonjour’ and looking at the package. In the second step I collapsed while feeling a sharp pain in my injured heal and the sensation of tissue stretching and tearing. Oh-my-god, I thought, that’s it. I just did the mistake I was dreading. One moment out-of-focus, and I was instinctively trying to climb a step using my injured, unprotected (no splint on) leg, putting too much pressure on it. If I was focused enough to think about my steps I would be more careful.  If I hadn’t rushed to the door I would probably realize that I’m not ready to handle stairs without the splint on. If I was a bit more careful, I would still be with my splint on during the day, as the doctor suggested, but now this might all be too late. I will have 24 hours to think about it again and again and again, unable to escape the torturous thoughts.

1 Hour later, I’m at the hospital, with my wife in her clinics, being examined by other family medicine doctors. They can’t determine if I re-ruptured or not. Thompson’s test looks negative, but we all agree it’s not very reliable. I am sent to do an Ultrasound. This is the first time I realize my heart is pounding as I am lying on my stomach and the ultrasound technician is checking me. I really accepted my first injury in peace, and was very positively thinking about recovery. But now I feel like an idiot, and fear the worst. I don’t remember being so nervous. After bringing in another doctor to see the imaging, they both tell me that they can’t determine weather it is OK or not. Unbelievable. What is the next step? MRI? well, your surgeon will decide.The Ultrasound technician is direct enough to conclude: “Well, if it is torn you will be operated again and then you will be like a saint for a year”. My darkest fears in simple words.  So I walked back to my wife’s clinic and call the surgeon clinic to get an appointment for the next day, 1pm. Oh boy, this is going to be a hard day (and night) to go through.

At home I was trying not to think about it, to occupy myself with work. But when my thoughts were drifting back to the injury, I felt like trapped in a vicious circle. Why did it happen? Is it torn? What should I be expecting now? and the horrible echo of that warning: “You don’t want to go there”. Well, I might just did.

The next day, after I woke up from the nightmares, I had to pass though the morning hours before I see the surgeon. Work was the remedy to my stress. Then I drove to the clinic and eventually got into the examination room. Seating there on a corner chair, I waited for the verdict.

I’m OK. My tendon is still connected, thank God. More luck than brains. The surgeon confirmed after 20 seconds of looking at my leg. I asked all sorts of questions but he concluded that I probably just pulled it, and there is no reason to do an MRI. “You have to respect the 6 months it takes for it to heal” he said, not for the first time. I’m being prescribed 2 weeks of no weight bearing, and then start all over again with physio. I accept it with love; after all, this is nothing compared to what was expecting me if the tendon was torn again.

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