So I had follow up surgery after 7 months where the doc went in again and cleaned out the stitches and scar tissue, etc. Now I have stitches that come out this week. After the stitches are gone, can I exercise, or do I need to wait for it to become unswollen, etc? Will there still be infection issues?
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There’s a fairly active “trade” going on in many communities through craigslist (www.craigslist.org) and kijiji (www.kijiji.com) for rehab equipment of all kinds. You can name your own price, including zero.
Both websites are organized locally (unlike this one), so you can eliminate the packaging and shipping.
I recently soaked the liner of my AirCast walker boot in detergent and Oxy stuff. One of my PRP injections “leaked”, so there was a dilute blood stain down the back. After about 36 hours of soaking and a bit of wringing, it looks like brand new.
When I tore my first AT 8 years ago, I got surgery, 3 casts, and a Donjoy “MC Walker” hinged boot, which I loved. I saved the boot, being a packrat in a big house. The experts who slapped me in a boot in December for my second ATR (other side) sold me an AirCast boot instead. I think I should have saved the Cdn$150 and used the hinged boot, and I eventually switched into it, partly because I wanted to use a hinged boot as a transition between a fixed boot and 2 shoes.
Now that I’ve run out of ATs to rupture — touch wood!! — maybe I’ll even sell the Donjoy hinged boot! Ma
[...]mattmecs - Congrats on moving on from the boot!
I had setup this page: http://achillesblog.com/things-you-might-need/donated-achilles-equipment/
There was one person that mentioned wanting a boot (someone from India), but when I followed up with her, I didn’t hear back.
In the end, I ended up throwing mine out. Yeah, it would have been good to donate it somewhere, as these boots can definitely be reused after washing the padding.
I say turn it into a planter.
That’s a great idea to find a place to donate your boot. If you are unlucky enough to A) rupture your Achilles and B) not have insurance to cover the boot- it’ll cost almost two hundred dollars!!! And I agree- here’s to all of us never needing one again.
The most important thing is whether the new incision drains after the stitches are removed. If it is still draining 2-3 days after the stitches are removed call the doc immediately because it is probably infected. Demand that a culture be done if needed. I’ve had more infections (and 2 extra surgical procedures) than anyone else here that I’ve read about. If the infection gets out of hand it can cause the incision to open up and then things can get really ugly.
Yes, make sure you get all these questions answered this week when you see the surgeon!
If you go to physio, they need instructions also from the surgeon what you are allowed to do.
When I went in for my first post-op visit, I brought a list of questions with me, so I wouldn’t forget to ask them all. When you see your doctor to get the stitches out, be very assertive about getting your questions answered. It can be hard, especially if the doc is in a hurry, if worse comes to worse you can just hand him/her the paper with your questions on it. Sorry to hear you are still dealing with these issues after all these months. Get better every day!
See if you are interested in trying the Sea-Buckthorn oil. I was 20 years old when I had a 2-3 degree burn on my left foot. I went to every doctor I could find, tried every existing drug, but nothing wirked. 2.5 month in bed…
Then, my great uncle, who was a renouned surgeon, stopped by and told me to get rid of all the dressing (open the wound) and cover it with Sea-Buckthorn oil. Within the next 4 days my wound completely closed.
Years later my Dad was receiving a chemo therapy and started developing mouth sores. He could not eat as it was, so we had to get read of those annoying things. The cream he got in the hospital barely relieved the discomfort. Then I remembered about the Sea-Buckthorn oil. My Dad used it ever since and did not have one other mouth sore.
I hope this helps,
Marina
Oh man, I know how you feel, but 7 months? They actually fooled around for 7 months before deciding to do something? I’ve been told that that the lower leg is a really lousy place for wound healing; there’s a fair amount of lateral tension on the skin and not very good blood flow. I highly recommend that you talk to plastic surgeon. I had a second surgery to clean out infection and close the original incision, but it was a miserable failure. I finally had a third procedure, Z-plasty by a plastic surgeon that relieves the lateral tension and allows the original incision to close. Talk to a plastic surgeon right away.
Sorry to hear the bad news…. what does it mean afterwards, the tendon is intact, so I hope you do not need to be in cast/boot?
How is your calf strength? Are you progressing with that?
Oh, good luck!
Another West Side Story lyric, for those earlier in their recovery:
I feel shitty!
Oh, so shitty!
I feel shitty, and gritty, and gray!
And I pity
anyone who feels like me today.
apologies to Stephen Sondheim
From one Jet to another:
Boy, boy, crazy boy!
Stay loose, boy!
Breeze it, buzz it, easy does it.
Turn off the juice, boy!
Go man, go,
But not like a yo-yo schoolboy.
Just play it cool, boy,
Real cool!
Stay cool and don’t over do it.
DD
Thank you everyone for your feedback and support. I have follow up surgery with my wound specialist on Thursday which is promised to be less intrusive, etc. than the initial one. I still wish it was not necessary but with the various infections, and the tunnel connection the two scabs, all my doctors seem to agree this is the way to go. Hopefully I will only be in a cast for about 1 week as opposed to 4, but I guess we will see. For the record, what an expensive freaking injury this has turned out to be. co-pays, meds, mris, etc. ugh!
Hi Matt –
I’ve been reading your posts and was meaning to respond earlier. I was in your shoes in May after my wound would not close and painful lesions kept popping up along my sutured areas. I developed several infections which required very aggressive antibiotics, including a 2-month intravenous treatment.
It may or may not have been an allergy, but it was certainly a reaction to ETHILON, the nylon suture that was used on me. My Infectious Disease specialist said that bacteria likes to lodge between artificial material and that such material does not have the natural antibodies to fight them. As a result the tissue surrounding it gets infected, irritated and delays tendon recovery. The antibiotics can work during their rounds, but unless the cause of the infection (the sutures) are removed, it can be a constant battle.
My second surgery to remove my sutures happened almost 6 months after my first procedure. My second opinion surgeon agreed with my original surgeon’s recommendation for a debridement and also said that a 6-month window is usually when doctors go in a second time. This way, some tendon has already
[...]Matt, sorry to hear about what you’re going through. “Allergic” is not really the right term, but I’m not surprised to hear that your surgeon put it to you that way. The suture that is most commonly implicated is called vicryl (long i, short y, accent on vi). It is an absorbable (dissolving) suture that is usually used to close deeper layers. I am an anesthesiologist and have taken care of people who have had these sutures pop up years after their surgeries. Personally, when I had some skin cancers taken off of my face, I “spit” all of mine. Fortunately, the deeper layers had already healed, so I don’t have strange-looking scars. Unfortunately, I forgot to tell my achilles surgeon this, and he used them, so I am just waiting for mine to start popping up. One thing that the wound specialist may tell you is that they might be able to be taken out with just local anesthesia (which is what my dermatologist did for my face). Good luck, Ron
Matt,
Look at it this way - at least he’s not going in to redo the surgery on the Achilles! At this point, it’s been so long, and you have other issues “popping” up that it really might be best to just have them redo the wound, you know? Like 2ndtimer wrote, this time, your wound would likely close fast and normal.
Your wound specialist (and they are pretty amazing) may have a totally different take and make a suggestion that does the trick without surgery, too. Whichever way you go, you’ll be better for it to get it resolved sooner rather than later.
Tamar
I am sorry to hear your trials are still not over yet….
But I hope the removal of the stitches will not disturb the tendon much (that should be healed by now) and your wound will close fast afterwords.
Mattmecs- I left a pretty detailed comment about sutures on butrackrunner’s page: http://achillesblog.com/butrackrunner/2009/09/30/6-months-post-apocalypse/. I’ve had a patient who needed to have deep sutures removed from her neck several years after her initial surgery. Good luck. Ron
Wow, Matt! I can’t believe this kind of stuff is still happening to you! What’s the verdict? Did you see the doc yet?
How does your PT know you use only the lower part of your calf muscle?
What are the reasons - consequences of that?
I am sorry to hear that you have yet another problem - at week 22 one would have hoped that you would be over these!
Wish you luck.
Matt,
How does that work? Having only the lower calf muscle move? What does that feel/not feel like?
And that wound is still open?! Goodness gracious.
Tamar
Hey there! I had an open wound (staples didn’t hold the incision) so, 1 inch diameter hole w/tendon exposed, MRSA, etc. My wound was large (and I am young, healthy, etc. as are you) and it took 6 mths to close and it only closed with the help of regular visits to Wound Care Ctr where I used a wound vac, and had a few synthetic grafts on. So, since Oct. when it closed…I’m left with this scab..it’s gotten slowly smaller…but, your scab will eventually go away…it’s just going to take a while. Daveleft and I had the similar thing…you’d think after mths and mths that finally the scab would come off and be nice skin…but nope, only more scab. In time though, you’ll be scab-free. 
Happy healing!
Hey there! I had an open wound (staples didn’t hold the incision) so, 1 inch diameter hole w/tendon exposed, MRSA, etc. My wound was large (and I am young, healthy, etc. as are you) and it took 6 mths to close and it only closed with the help of regular visits to Wound Care Ctr where I used a wound vac, and had a few synthetic grafts on. So, since Oct. when it closed…I’m left with this scab..it’s gotten slowly smaller…but, your scab will eventually go away…it’s just going to take a while. Daveleft and I had the similar thing…you’d think after mths and mths that finally the scab would come off and be nice skin…but nope, only more scab. In time though, you’ll be scab-free. Happy healing!
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Agree. I took the stiches too early and had a small opeing in my scar short after. Only about one centimeter. But it still kept me from doin proper rehab for a while and, as mentined above, kept my phys therap from working on the scar. After towo rounds on antibiotics and loads of creams and what not one doctor finally said: “U’re overdoing it. Just leave it to the body to take care of it. Leave the wound for some days, then just soap and water and no more creams and u’ll see that the body takes care of it itself”. And it did… So now it’s a “good looking” scar tissue on it. But once again: this was a very small opening and not especially deep. But it was open for a months and a half before finally producing the sufficient scar tissue.
Matt,
After having my own wound issues, I highly suggest that you get help in closing yours. The longer it seeps and stays open, the more prone it is to infection. Booklady is also a HUGE wound infection sufferer and if you read her blog, it’ll make you get on the phone right now to contact your doctor.
Even a teeny tiny part of the wound not being closed at almost four months is a risk. Definitely get it taken care of.
Now that you’ve started PT/rehab, I would also find it unlikely that your Physical Therapist will be able to do adequate scar manipulation, and this is very important for getting in there and breaking up the scar tissue.
Don’t delay - a wound being open for this long is a sign that something is amiss.
Mine was closed at 5 weeks first time around. Whether or not you ditch the boot should not be based on the scabbing. It should be based on your doctors opinion and your progress toward recovery.
Chuck
Matt-I’m sure the antiobiotics will work. I guess what the Dr. is thinking is he’ll go back in and clean all around the area. I guess he thinks there’s enough tissue around to sew it back together. If you don’t opt the surgery route I would find a really good Wound Ctr in your hospital…they specialize in Wound Care and have all the latest greatest potions and thinks to try and heal your wound. All will be ok…don’t worry…you’ll be good in no time! Trust me, I know. Sending happy, healing thoughts your way!
Matt, you may have rsd. I hope not, but some of the signs are, discolored skin, thin skin sweating. felling of cold or hot in limb affected. irritation of anything touching limb even a small breeze may irritate. im not even on antibiotics so i have no advice for you there sorry, but look up rsd on google you will see the signs and symptoms there. Just curious what the doc would do if he went back in??? I feel for you I am going through the same thing as you. wendy
Hey, matt, read your question. Is cipro a steroid or antibiotic? dont know much about it. I am a 2x rupture myself. 1st surgery was in 11/09. never fully recovered from that with constant pain and swelling. 2cd surger was may 12/09 i am now 6 weeks post op. I had two insicions because i had tarsal tunnel as well ant then the at repair. Well the tarsal tunnel scar healed great, but the at insicion, i had my stiched in for 4 weeks. Now my wound is still ozzing, open, very red and swoolen and actually larger then the insicion itself! I am very worried. I start pt today, the doc mentioned rsd which is very scary, hope i dont have that. He tried to put me on a steroid again and I declined. I have still yet to recieve an antibiotic. I was never in a cast just a regular walking boot non weight bearing. any suggestions? thanks….. very worried about recovery so slow. Wendy P.s. if you want to email me or ever need some support you can email me at wendyluvlights@aol.com. good luck
Hi Matt,
If by “citro” you mean cipro, or ciprofloxacin, you might want to talk with your doctor about this! There is great concern about cipro as an actual cause of tendon ruptures. (Do an internet search on ciprofloxacin and tendon, and all sorts of hits will come up, including lawyers looking for business.) Cipro appears to interfere with tendon metabolism and healing. Given that you, like most of us in this “club,” probably already have a strong tendency toward tendon issues (tendinosis) anyway, the use of cipro could be especially risky. I suggest you ask your doctor if there are other antibiotics, (and not another fluoroquinolone antibiotic, either), that might do the job. While interfering with your injured tendon’s healing alone is an issue, the scariest thing would be if it weakened your other tendon and led to its rupture, which is about the last thing you need right now.
Good luck,
Doug
Matt,
My girlfriend told me I was over stepping with my involved foot putting most of my weight on my heel. I know exactly what you mean. I’m 9 months post op. I was in a cast for 6 weeks. 4 non weight, 2 full weight bearing. 2 weeks in a boot.
First step with the full weight bearing cast was very hard. I was very hisitant. Now I may favor my involved foot now and then. I try not to, but it happens. Just a matter of getting your leg back to pre injury strength.
I had the same experience as you.
Good luck
Glen
I think it is totally normal to have the weight on your heel at first, I know I did. In fact the sole of my foot under my heel got quite sore. I wore birkenstocks around the house which helped and gradually over about ten days my weight started to transfer to the forefoot. I had a weird hesitation in my walk for a long time - up to 15 weeks at least. Hope this helps.
Im in the U.S and mine is the same way. Cast for 4 weeks and this is my 4th week with the boot, but I did have inserts in my boot. Each week I took one out and now the boot is flat, will probably ditch the boot at the end of the week. I think it has more to do with the doctor and your age.
I’m in Ontario, Canada. My protocol is different, maybe more conservative. Had total 8 weeks non-weight bearing broken down with 2 weeks in a cast after surgery(March 19). Then switched to a boot. Started at 30 degree plantar flexion(away from head) for two weeks. then up to 20 degrees for 2 weeks, 10 degrees for another 2 weeks. Partial weight bearing allowed after 8th week doc appointment with start of physio 3 times a week for 2 months. Still PWB with 2 crutches. Quite slow going.
I’m in the US NY and my treatment was very similiar. Hard cast for 5 weeks into boot for almost 3 weeks then 2-shoes. No wedges in the boot either.
Thank you for the feedback folks! i guess I will just suck it up and listen to doc…..
I have been reading this blog for a year now, and I have read about reruptures when people took risks or were unprotected. (and of course, some just happened despite everything…)
I absolutely agree with the doctor on this one and would strongly advise you to listen to him. If you are not as fearful of a rerupture, another surgery, or increased healing time, then ditching the boot would be ok.
Hi Mattmecs,
Good to hear that you are healing well. I was wondering if your consultant fitted you with any wedges/heal inserts in your boot. If not, then I don’t see it being a problem for you to walk barefooted indoors on a flat surface (must be very carefully - making sure you DON’T have any accidents/slips).
However, if your consultant did place inserts/wedges/heal lifts in your boot - then I guess he/she does not want your foot/tendon to stretch beyond a certain angle. But, since you are not experiening any pain - I think you should be ok. The only concern is that at the 5 week mark the tendon may not have fully healed yet. It’s one of those situtions which is difficult to provide advice. On one hand everyone heals differently and in some cases it may be good to pursue a rapid rehab protocol. On the other hand this needs to be balanced with complacency and the risk of reinjury. Sometimes, I think it’s important to just listen to your own body and how well it responds to movement/exercise.
With regards to muscle atrophy - most of this occurs during the first few weeks of imbolisation and will take some time to re-bu
[...]I’m 8.5 months Post OP. Swelling took months to go away. Try and keep your foot elevated and ice it after walking or Therapy. As I remember, I had swelling for about 5 to 6 months Post OP. My repaired Achilles is thicker than my other one. Now I have to keep my uninvolved achilles healthy. So far so good.
Good Luck
Glen
San Diego
I had the same question for my trainer when I started walking with my boot. She said that it’ll be at least a little swollen for awhile; it will probably be a few months until it goes down completely. I’ve noticed mine is gradually getting smaller over the past few weeks, but I can still tell it’s puffy. Also- the repaired Achilles will always be thicker than what it originally was. My doctor went through this whole ordeal himself a few years ago and I felt his repaired tendon- it was noticeably larger than the other one, but nothing too crazy.
I want to thank everyone for their input. Unfort, I will have to live with what the doc says, but I can at least gingerly try to do things on my own. stay tuned, and good luck to everyone as well. i really appreciate all the advice!
The key is to listen to your body and what it tells you. My Dr. was more conservatiive and wanted to wait a full 8 weeks for all the biological healing to take place. When I was out of cast at 4 weeks I did a lot of ROM stuff and light resistence with a towel or theraband. Have not regretted going slow. Granted I did push myself in a very deliberate manner. I always knew what the Dr. would say or what the next step would be because I was already trying PWB, FWB and finally two shoes. As a result of being conservatively aggressive. I should be back on the tennis courts at around the 6 month post op mark. Also doing PT 3 times a week as well and highly recommend it.
mattmecs - Here’s the average days gathered on the Group Marathon Tracker:
Average Age (when injury occured): 37.1
Average Time to PWB: 4 wks 5 days
Average Time to FWB: 6 wks 6 days
Average Time to 2-Shoes: 9 wks
It’s really best to follow what your doctor says. It’s probably not likely to happen, but during the boot to 2-shoes is the most vulnerable time for re-rupture.
When I went in for my first post-op visit, I brought a list of questions with me, so I wouldn’t forget to ask them all. When you see your doctor to get the stitches out, be very assertive about getting your questions answered. It can be hard, especially if the doc is in a hurry, if worse comes to worse you can just hand him/her the paper with your questions on it. Sorry to hear you are still dealing with these issues after all these months. Get better every day!
Yes, make sure you get all these questions answered this week when you see the surgeon!
If you go to physio, they need instructions also from the surgeon what you are allowed to do.
The most important thing is whether the new incision drains after the stitches are removed. If it is still draining 2-3 days after the stitches are removed call the doc immediately because it is probably infected. Demand that a culture be done if needed. I’ve had more infections (and 2 extra surgical procedures) than anyone else here that I’ve read about. If the infection gets out of hand it can cause the incision to open up and then things can get really ugly.