Nothing too exciting to report around here. I got the Boot again and have been patiently waiting out round 2.

So I had my first post-op appointment of round 2 on March 18 (13 days in the cast). I had the cast and staples removed. My incision does not look quite as good as last time.

Got the boot again with a slight wedge. My boot is the CAM air cast walker, not the Bledsoe boot. I asked about the adjustable boot, and my doc said that most people he puts them in think they are uncomfortable and end up switching to the CAM. He then pointed to the trash can, with the Bledsoe boot in it from the previous patient. What timing!

My doctor said he wants to take it even more slowly this time. Ironically, we weren’t taking it “fast” last time, I just fell without the boot on. I talked with him about alot of the things I have been reading on this site, early weight bearing, early rom, massage. He said early rom was fine. He said he’s been doing achilles recovery with the 6 weeks of mostly nwb and pwb with great success for many years. He said he did not want me to do any massage yet (I’ll ask again next visit). He predicted I should be 2 shoes 10 - 12 weeks from surgery, which will be June. He cleared me for the rom exercises at home, and said I could start the PT at 6 weeks and some electro stimulation sooner if my insurance covers it. He also said I should be touching my foot down with the crutches and slowly increasing the amount of pressure I put on my foot.

He did let me know that they were surprised that my achilles didn’t look more healed on the inside. The doctor thought the tissue looked more like it had been operated on 1 week prior, not 6 weeks. My husband pointed out that they don’t usually get to see what’s going on inside the repair, so maybe its not that big a deal. Doc thinks maybe I’m just a “slow healer”. I’ve never had that issue before, and have not other health issues.

So I’ve had the cast off for 2 weeks now, wearing the boot almost 24/7. I had a big talk with the doctor about exactly when I’m supposed to have it on, and he said I could take it off for sleeping, and when I’m sitting on the couch, so I am. I put a pillow at the foot of the bed to prop the blankets up to keep the pressure off my foot and have been sleeping with the 4 foot “body pillow” to keep my entire leg elevated. Other than that, the boot is on all the time. I no longer reach for anything with the boot on. I’m used to it now, and am well aware of the danger, so its not so bad.

The area around my incision looks completely different now. The first time the skin was very tight and almost rippled or bunchy looking. Its much smoother this time. I think its because I really wasn’t wearing the boot much at all last time, and I think the boot helps to stretch the skin and achilles. My scar is not healing nearly as quickly this time. I still have some scabs and I’m almost 4 weeks post op. No signs of infection, though.

I’ve been doing the ROM exercises (tracing the alphabet in the air with my foot). I went to the gym for the first time yesterday. I did the recumbent bike for a little while, and another machine that was like an arm bike (don’t know the name). Got my heart rate going a little bit, and I definitely slept better last night. The doctor said I could try the bike with the boot on as long as it didn’t hurt. I got some pretty strange looks crutching around, but it was so good to go.

I’m PWB now, increasing a little more each day. The arch of my foot is a little sore today (maybe from the bike?), so I’m going to back off the pwb a little today, and do a little more icing.

Two more weeks to PT!