Suture rejection?

I am now just short of 10 weeks post surgery and haven’t posted for a few weeks. I am now fully in two shoes and have been for 2 to 3 weeks. I am in physio, back in the gym (stationary bike only for cardio at this stage) and have even had a full night out (first since injury). I am still walking with a slight limp but this is reducing. Still no leg raises, etc but feeling pretty normal again. If anything, the main concern is that I need to remember that the achilles is still in recovery and so continue taking extra care when getting about. The more the limp goes the more the risk is that you forget to step off a kerb leading with the bad leg, that you can make the crossing if you hurry, etc. Also, when back in two shoes, there is no warning for other people (not that commuters concern themselves with people with crutches, etc anyway) so you also have to second guess the stupidity of others.

In my last post at week 6 I talked about my wound becoming irritated and then opening up and considered whether this was an infection or whether my physio had been over rough. Doctors opinion at 6 week check up was that it was fine and it was just irritation from activity, etc. The surface wounds were only superficial but was enough to scab over, etc. Like any right minded person, I would obviously pick my scabs and on doing so, a small knot and an inch or so of suture came out. After initially being concerned that this would lead to my whole achilles coming loose (comedy unravelling of a scarf style), I quickly realised that this wouldn’t happen (the suture disintegrated once out so if my achilles was relying on this I was in a bad way).
On carrying out a bit of googling, I suspect the irritation to the wound, etc was actually my body rejecting the suture material and rather than disintegrating internally, my body forced it to the surface. Has anyone else heard of this happening? I will ask my doctor on the next check up this week but had not heard of the possibility of this before the googling.

Once the suture popped out, my wound has quickly cleared up and there has not been any negative impact on recovery.

Hope everyone continues with recovery and take care.

6 weeks “blister”

I am now just short of 6 weeks since surgery and current status:
- FWB in the boot most of the time
- limited walking at home in two shoes with a wedge
- started PT last Thursday

All going well but seemed to have a reaction to my PT massaging the tendon (to move the build up of fluid) and my ankle swelled up and the very bottom of my scar opened up slightly (only on the surface) so I have been left with a bit of a blister/wound at the bottom of my scar. My initial concern was that the internal sutures had not disolved and the massage ripped/irritated these. All very sore and knocked me for a few days where I just stayed in with my leg up fearing that some damage had been done to the achilles. I am sure everyone is the same but the paranoia is constant that if there is any pain I am feeling for a gap in the tendon, etc.

Has anyone else had this following a massage in PT? Probably the down side of early weight bearing is that the wound is not fully healed when it is being moved and irritated by the walking action in the boot as well.

Saw my surgeon for the 6 week check today and he was not at all concerned and said it was ok (I think effectively having a blister is a very slight concern in the scheme of things). He has passed me for walking outside as and when I feel comfortable to do so. He does tend to put the onus on me to decide when I want to progress which is good but not 100% sure what my being comfortable is.

Too Fast?

Had my 4 week check up with my surgeon and on walking into the consultation room (ie in the boot without crutches) he commented - “so you’ve decided your recovery will be very fast?”. I did point out he said that I could move to full weight bearing but couldn’t work out whether he was being critical or not.

Anyway, he seemed very pleased with the healing and the strength in the foot and said that I can move to two shoes around the house assisted by crutches and in 4-5 days without the crutches. I said “so you’ve decided my recovery will be very fast?” but he didn’t seem to get the joke.

That would be two shoes and full weight bearing less than 5 weeks post surgery. I am more than happy to get back to normal asap but that does sound a bit fast (I had full rupture and surgery) but has anyone else done this and did they have any problems?

I had a previous rupture which has healed very well and used the same surgeon (I remember that being fast too) so I am happy to go along with what he says. I am going to obviously be very careful and still use the boot when out. I would like to pass on words of wisdom to anyone wanting the healing to be quicker but I have not done anything specific and assume I just have a progressive surgeon.

First blog second rupture

By way of background, I ruptured my right Achilles in January 2009 (35 at the time) playing football and had a successful recovery. Was in a cast for two weeks, then the boot for another four. Walking normally soon after that and in the gym, etc by about 4 months. Probably never got 100% of the strength back but about 90% and enough for me. Was very happy to ditch the crutches but kept the boot which was handy as…

On 11 July (two and a half years since first atr) went and snapped my LEFT Achilles. Was playing tennis this time. When it happened initial thought was that someone had hit a tennis ball and it had hit my ankle but a fraction of a second later I immediately knew what I had done. Was very depressed knowing what I had done and knowing exactly how long it takes (albeit I know my last recovery was on the shorter side).

Three and a half weeks on and have had the surgery (the next day with the same surgeon I used last time - I had to say whilst repeat business shows I was happy with what he did last time, I was not pleased to be seeing him again). Again, cast for 2 weeks and now fwb in the boot with one wedge which I think can probably come out now but I am seeing the surgeon on Wednesday so will leave it for him to confirm.

Few thoughts having had this experience twice:
- the first time I ruptured I stupidly walked on it for about a week. I knew it was something serious but was in denial - lesson learnt the second time and got it sorted immediately. This meant the surgery was much easier and neater.
- first time I was also naive about recovery and not until the day of the surgery did I acknowledge I would have to have time off work (genuinely thought that it would be cut me open, stitch me up and off I walk in the boot). If I had taken a bit of a look at a site like this I would have been better placed but was a bit of a lacking in the doctors who assume a bit too much about the common sense of a patient like me. The shock of knowing how long recovery is can be pretty upsetting but I think short targets are useful (eg I will be in the boot in 2 weeks, I will be walking at 3 weeks and I will loose the boot by week 6). longer term targets are also useful to keep us going. My first one was to be skiing the next year and this time it is to be quicker and better than last time. It is important that these are realistic though as depressing to keep missing your targets.
- whilst we all have plenty of time to research in the 1st few weeks and knowledge is power, everyone’s case is different so do not take anyone else’s story or guidance as your protocol. When you mention to anyone that you have ruptured your Achilles, they or someone they know also did that and was walking normally in 2 weeks or never walked again. Everyone loves to exagerate or pretend they know more than they do. You have to learn to listen to the right people.
- whilst my Achilles probably had a weakness, I didn’t properly stretch, etc when I ruptured the second time. Massive lesson learnt (even if it took two ruptures to instill), if I do get back to sports this will be my mantra. All people reading this approaching activities, please listen to the physios. They do know what they are talking about. Whilst there are always cases of rerupture, there always has to be a balance of quality of life vs precaution. Don’t give up the things you love but use the knowledge you gain to prevent it happening again (yes, a lesson I should have learnt the first time).

Anyway, more than enough from me for now. Wish everyone out there a speedy and successful recovery.