Underwhelming 1 week appointment

On Thursday 5th April I had my first (of many, I’m guessing) appointment to check up on how my ruptured Achilles tendon was going. I drove myself to the hospital - driving an automatic is absolutely fine with my left leg in plaster, thank goodness it wasn’t my right AT. The car park that I used 4 months ago, when my wife was here giving birth to our son, is now a building site. Great. I think parking is a problem at every hospital in the world. After a couple of laps of the surrounding streets, I found a space within a stone’s throw of the main entrance. Result.

I crutched across the street, through the main entrance and to the outpatients department, with about 5 stops on the way. Walking with crutches is bloody tiring! Wiping away the sweat from my brow I presented myself at the outpatients reception desk only to be told I was at the wrong outpatients reception desk. Fortunately, the correct outpatients reception desk was directly behind me. After half an hour’s wait, my name was called.

The doctor/orthopaedist/physiotherapist (to be honest I don’t know who he was – I assume he worked there) asked me to describe what had happened and I mentioned it was like somebody had thrown a brick onto my Achilles tendon. The doctor/orthopaedist/physiotherapist picked up on this, emphsising it to the trainee doctor/orthopaedist/physiotherapist who was also present. Apparently, Australian netball player Sharelle McMahon had made a similar comment when she snapped her AT in 2011. In fact, she had been so convinced somebody had assaulted her, she turned round shouting “who the f*ck did that”. I had been more reserved in front of all the Year 12 students.

He read through my file, noting that there is a 4.2 cm gap between the two ends of AT (that sounds big) and double-checked with a colleague that operating was not an option. “You can stitch tendon to tendon. You can’t stitch tendon to muscle”. He then said it was best to keep my leg in the same position, in the cast, and they would see me again in 3 weeks time.

Is that it? Did he not want to examine my leg? Do another ultrasound? X-ray? MRA? Brainscan? Nope. See you in 3 weeks, when I would see the chie f Orthopaedic Surgeon, who had made the initial assessment of my injury. Feeling underwhelmed, I tried to recall all the questions that had been going through my head during the past week. What happens in 3 week time? (The cast might come off, it might not). What happens when the cast does come off? (You’ll have a boot, with wedges to raise the heel). Will I still need crutches then? (Yes). When can I exercise again? (No running for 12 months).

With that I crutched off to get some additional fibre glass applied to my cast, so that it wouldn’t wear away too quickly. (I’ve been leaving white dust and marks all around the house). I opted for boring black thinking it wouldn’t stand out too much, when I’m wearing a suit. I made my appointment for 3 weeks time and started the crutch back to the car.

On one of my rest breaks, a fellow crutchee with her leg also in a cast, sidled up beside me and also stopped for a break. She was an elderly lady and her English was not that good. However, we managed to exchange stories about casts and crutches. She had been in a cast for a month already and they had just decided that they were going to have her operate after all, on her broken ankle. I felt for her but then powered past her on my crutches as I exited the hospital. A small victory perhaps, but I’ll take it. Might be the last for a while.

Below is a photo of the precise second my Achilles tendon snapped. (I’ve not included the shot a few seconds later when my teammate, bundles into me, as I’m writhing around in agony).

the-moment-my-achilles-ruptured

4 Responses to “Underwhelming 1 week appointment”

  1. If your based in the UK and get treated by the NHS that’s pretty standard way to be dealt with by them, I got no scans or anything done, only the A&E doctor along with the 1st “specialist” I saw actually even felt the leg without me pretty much putting it infront of their face and saying “at least look like your being payed to actually do something” (obviously more diplomatically than that), they have a protocol that they follow, written by someone else, and its very hard to get them to budge from it (lots here have gone “against doctors orders”).

    I got to the point that I was so annoyed that my appointments seemed to consist of nothing more than “oh he is still alive, go make this slight change (without any diagnostic) and see you in x weeks, that I printed off a load of the latest studies (showing faster rehab protocols than I was put on) and asked the “specialist” if he had read, or for that matter heard of them, and erm no he had not!! That was rather cheeky (I’m a physical scientist, probably the worst patients bar doctors themselves :p) but it did prove my point quite well and he did look a little sheepish after! I’m assuming private health care would not have such an occurrence?

    That’d said, it does appear to be working out fine, I’m at week 16 now, 5 weeks in shoes after getting out of the boot, range of motion making good progress, walking fine with only the slightest limp, which I can make go away if I concentrate and I just returned from a 28mile cycle on a road bike :)

  2. The non-op approach can produce fine results, but going quicker does better on avg than going slower. I wouldn’t go any slower than bit.ly/UWOProtocol , which produced excellent results.

  3. From reading different forums, etc, it seems that the UK is not unique in varying widely across its health service, with widely different opinions from the specialists, including preference for operative or conservative treatment, duration between recovery stages, type of boot, etc. Scanned and treated by my local NHS hospital fracture clinic I was NWB in lightweight cast for 2 weeks with toes down; then into Vacoped boot, static at 30 degrees PF and full weight bearing, coming off crutches where safe and confident enough. Boot adjusted after 2 more weeks to give ROM 30-15 degrees. Next week, ROM will be taken to 30-0, then -30 +10 step through after 2 more weeks; then (after 1 more week if all ok) out of boot and into shoes with heel pads indoors; after 1 more week no boot outdoors unless ‘unsure’ of terrain.

    Maybe I’m tempting fate, but to give credit where it is due, my treatment by consultant and physio’s has been first class. I have a full written treatment plan so that I know what to expect, and a direct phone number to the physio’s. It seems so obvious you wonder why they can’t all do it…

  4. Mark - At least you got some answers but be well armed for the next appointment. I would think that 12 months to running is a bit on the conservative but that is what doctors are like. When you do better than that then they will say they are not surprised. Push hard for a boot and if they say no then ask for some very good reason as to why they are not following more modern rehab protocols. By the way, there is no need to examine your tendon for a while. It is still coming together and you wil probably find they will only feel around next time. I would also think the cast will come off on the next visit and they may want to put a new one on at a different angle. Back to the boot issue. They are also cheaper than changing casts and you should be able to walk in it almost straight away. Good luck. At least the weather is cooler.

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