My Achilles’ Last Stand

Had my 17 week post-op visit today. The OS was very pleased with my progress and my wound has FINALLY closed. It sure has been one long process (see previous posts, if interested). The family and I went away for 4 days last weekend and it was the first time since being in 2 shoes and FWB that I did a lot of walking. We were in Steamboat Springs, a mountain resort here in Colorado. I had a difficult time as my lower back and hips are still very weak. I am following my PT protocol to a T and my achilles is totally pain free. This pain in my back is making it difficult to walk for very long. In addition, my PT copay is $50 per visit. I currently am going 2 times a week, however, I would like to drop down to 1 visit per week and add in 1 massage per week, which is also a $50 copay. I am not sure if this is the right thing to do or not. I am not financially able swing anything more than that. Even $100 a week is tough as I have been out of work with no income at all since the ATR on March 6th. I realize that I had been NWB for 13 weeks and I need to strengthen all areas. I should be thrilled to finally be walking, however, I feel quite depressed that my achilles is doing great and I am having such a hard time getting back to normal walking. I did tell the OS about this and his response was that I was going to need a lot of physical therapy.

It has been 14 long weeks since surgery. I am now walking in 2 shoes, albeit slowly, but walking nonetheless. I seem to start limping when my foot swells up or if I have been on it for too long. Talking smaller steps seems to help when this happens. Tonight I also returned to the studio where I take Zumba classes. I had no intentions of participating, just there to see some friends. However, the instructor set a chair up for me and had me take her class sitting down. Of course, I didn’t get a workout like I normally would during an hour class but I did break a sweat and got a great upper body workout. The best part was feeling “normal” again. I know I have a long way to go before being able to do Zumba the way I had been prior to the ATR but I am hopeful that eventually I will be back at it even stronger than before since I always suffered after a class with terrible achilles pain. The OS had told me it would be a year from surgery before I will be able to go back to it at full force. I hope it won’t be that long. Has anybody done Zumba or something similar after recovering from an ATR?

I saw the OS yesterday and the wound doc today. Both were happy with the way the incision was looking. The wound specialist gave me an iodine based cream to apply every 3 days for the next ten days. He feels this should help to have it fully closed by then. I inquired as to when I can get in the pool and was told not for a month after it has fully healed unless I use a waterproof cast protector. That was good enough for me! The temps are going to be in the high 90’s over the next few days here in Denver so on the way home we hit Walgreen’s to buy one. Has anyone used a cast protector in a pool? I have read how great it is for the shower but I am wondering how it will do when fully submerged. The box does say it can be used for swimming. I guess I will have to have the hubby test it out prior to me using it. I sure don’t want to take a chance of water leaking in. The last thing I want is another setback. I sure hope it keeps the water out. I sooooo want to get in the pool. It’s been no fun watching the rest of my family enjoying the pool and being unable to join them. Most importantly, I really have been looking forward to doing water therapy. Zumba is my addiction and although the OS assures me I will be able to do it again, it won’t be for at least a year post-op. I literally teared up when he told me this at our very first visit. However, I will be able to do Aqua Zumba once I am able to get in the pool. If anyone has had a good experience when fully submerging a cast protector I would appreciate knowing the brand just in case the one I bought fails. Thanks in advance. Have a great weekend!!!

I was wondering if anyone has experienced lower back pain when in 2 shoes? I have gone straight from NWB to WBAT in 2 shoes at 11 weeks post-op. I totally skipped wearing the boot and am wondering if that is why my back hurts. Does the boot make it easier to walk once out of it or is it mainly for protection? I feel like I can’t stand completely straight and it is making it hard for me to be up walking for more than a short period of time. I tried lower back/piriformis stretches which helps for a little bit but after walking for a short time the pain returns. I realize my whole body is stiff and tight from being immobile for so long but I sure hope skipping the boot phase hasn’t caused any additional issues. If you haven’t read my other posts, I didn’t skip the boot by choice. It was irritating my incision preventing it from healing. It still hasn’t fully healed so no boot. I feel very fortunate that my OS finally ok’d walking and PT.

I have taken the advise of all who have responded to my last post and started to PWB in the boot, as opposed to my OS’s instructions to get 2 shoes on and start walking. Being that I can’t use crutches because of a neck issue, I opted for a walker instead. At first I was putting most of my weight on the walker but as I got the hang of how to properly walk in the boot I was able to put more weight on my foot. There was some pain, mostly in my big toe area. I imagine this is because of the tendon transfer that was done. All in all, I was presently surprised that I was walking so well for the first attempt. I was able to put all my weight on my injured foot when walking up stairs. I have gone up and down the stairs on my booty since the day of injury. It felt great to walk up the stairs “normally”. I still haven’t attempted going down yet. After the last couple of days of feeling stressed and more than a little scared I feel I have gotten passed the mental issue that was holding me back. Hoping to continue in a forward direction without having anymore issues with the incision. It is still not closed fully but the boot is no longer rubbing on it so hopefully it will close up very soon. I really want to do some rehab in the pool!!! Wishing everyone well as the journey continues!

Hi there,
Today was my 11 week post-op visit. I saw a wound care doctor on Tuesday who instructed me to continue using the Medi-honey on the incision and actually gave me some. The OS was impressed with the improvement. So much so, he said I should ditch the boot and get into 2 shoes. I double checked to make sure he remembered that I only had the boot on since yesterday due to it rubbing on the incision site. I had been in a splint lined with fleece since week 6. I hadn’t even begun any type go weight bearing as of yet. In fact, I have only done a small amount of ROM excesses because the OS didn’t want the wound aggravated. He said that being it was already week 11 he felt I could go directly to two shoes with crutches. I was totally psyched about this until I got home and tried it!!! I felt so unsteady, awkward and apprehensive. There also was a pretty bad pain in my ankle and bottom of my heel. It made me kind of jump when I stepped down. Has anyone else gone from NWB right into 2 shoes? Don’t I need to wean my foot from the boot to no boot? My calf muscle seems nonexistent. Don’t I need the boot for support? My PT is out of town until next week so any advise would be greatly appreciated. In addition, is it “normal” to feel scared at this stage?

Good evening all,

Today I had my appt. with the Wound Care Specialist. To briefly recap where I am at on this most “fun and exciting” journey, I am at almost 11 weeks post-op and still non-weight bearing due to a stubborn incision not wanting to heal. My OS took me out of the walking boot a month ago after only being in it for a week because it was rubbing on the incision. Last week I took matters into my own hands and starting using Medi-honey to dress the incision. I noticed a difference as soon as 2 days after beginning the Medi-honey and have been using it since. The wound doctor also likes the Medi-honey and instructed me to continue using it, however, only wants the dressing changed every 3 days as opposed to twice daily. Yay for the little things!!! He also wants me to put the big, bad boot back on and start to bear weight. He feels it will help with blood flow and circulation. He gave me a silicone heel cup to wear over the dressing only when wearing the boot. He wants the boot off when I am immobile. I am to f/u with him in a week. I have 2 wedges in my boot from when I was initially put in it but my foot is now at neutral so I would imagine I no longer need the wedges. Does this seem to make sense? I have a PT appt. tomorrow so I will wait until then hoping the PT will be able to advise me on whether I need any wedges or not. I also have an OS appt. on Thursday and would LOVE to “walk” in to the office instead of scooting in on my scooter. (I am unable to use crutches due to a cervical spine issue I am also dealing with). In closing, if anyone has been dealing with a non-healing incision, please be an advocate for your own medical care!! My OS was against me trying the Medihoney and only wanted me to do wet to dry dressings. Once I started using the honey and the OS saw the results he then ok’d it. You can purchase Medi-honey on Amazon for under $20 a tube. It has done wonders for my healing. I wish I would have tried it a month ago.
Wishing everyone a speedy and painless recovery!

Hi all, I finally had my first PT appt. today. My OS hadn’t ok’d me to start because my incision is not healed but I finally convinced him to allow me to begin, however, only light stretching and massage was approved for now. The PT measured my foot at neutral and was able to push it to 6 degrees beyond neutral. She feels once I am able to get back into the boot, (I am in a fleece lined splint because that big, bad boot was rubbing on the incision), I should be FWB fairly quickly. The only pain I have is soreness where the incision hasn’t healed. I am going to a Wound Specialist on Tuesday hoping he is able to suggest something to quicken the healing process. I know how important early weight bearing is for this injury and am extremely concerned that I am at 10 weeks and have not been able to start weight bearing. I am wondering if anyone else had to wait this long and how it effected recovery. Any info is greatly appreciated.

Hi all, I went for my 9 week post op visit this afternoon. To quickly recap what has been going on since it has been awhile since my last post - my incision does not seem to want to heal, thus, I have not been cleared by my OS to begin any type of weight bearing nor did he clear me for PT. Each time I go to an appt., which has been weekly for the past 3 weeks to check on the healing process, I am told to give it another week. I asked to be referred to a wound specialist and was told it wasn’t necessary. I have been doing wet to dry dressing changes twice daily but have seen no improvement in the size of the incision. I was told it was not infected, hallelujah, but the dang thing won’t close up. I have researched different wound care methods/products and mentioned them to the OS but he seems to have an “only what he has been taught” viewpoint. I don’t know if I should try an alternate dressing treatment on my own or not. I fear it might make matters worse. Has anybody experienced this and what are your thoughts on all this. I have been stressing quite a bit over this, along with being extremely frustrated, as well as, very sad and depressed. Any help, pointers, suggestions would be so greatly appreciated. Thanks in advance!

6 Weeks 5 Days Post-op

Hi all,
I hope this finds everyone doing well. I saw my OS on Friday, May 1st and my incision has still not fully healed. There is one spot that doesn’t seem to want to heal. There was also a small amount of drainage, but supposedly there is no infection and I wasn’t given antibiotics. Should I get on an antibiotic just in case? I have not been able to do any kind of weight bearing at all. The OS wants the wound to be fully healed before I start any type of PT. Has anyone else experienced this? I am very frightened at this point because I keep reading so much about early weight bearing, etc. I have been extremely depressed since the appointment on Friday. Will the incision heal? Will I ever be able to walk normal? Any feedback is greatly appreciated.

Hi there, I hope this finds everyone doing well or the best possible under the circumstances. I was wondering if anyone has any suggestions on how to deal with the uneven leg when in a boot. I have tried the Even-up, however, it is still not high enough. My right hip (non-op) side becomes very painful after just a few minutes. I haven’t actually started PWB yet but even when using the crutches and just toe touching causes my hip to hurt. I can’t imagine what this does to the back, and in turn, the rest of the body. Any suggestions would be greatly appreciated!

I had my 4 week post-op visit on Friday, April 17th. As I suspected, the cast had been rubbing on my incision, causing some irritation. I didn’t get to see my OS, but his PA instead. He opted not to take out all stitches, only every other stitch since the incision wasn’t all the way heeled. And then he wanted to put me into another cast!!! I put my foot down (my uninsured one, lol) and insisted on a boot. After a few minutes of pleading and having both my husband and I swear on the Bible that under NO circumstances would the boot come off, the PA relented and gave me the boot. What a difference a boot makes! There is no incision rubbing meaning no more pain! And no more pain meds! And I am proud to say that I haven’t even opened the boot! Ah, such temptation! All, in all, I left the OS’s office with a small sense of victory. Next appointment, Thursday, April 23rd when hopefully I will be cleared to begin PWB-ing. Until then, happy healing!

Hi fellow ATR sufferers,

On Friday, March 6, 2015, a day I will never forget, as I was walking down the stairs, I heard a snapping sound and felt a sudden sharp, excruciating pain in my left calf.  As many others have experienced, it felt as if  I had been whacked in my calf with a baseball bat. I fell to the floor and was unable to bear any weight upon standing up.

My husband helped me hobble back up the stairs to our bedroom where I began the wonderful process of  RICE-ing. (Having a son who played football all through school left me an expert). And there I remained, in bed, with an ice pack on a foot which was elevated to the sky, all weekend long!!! Little did I know, this was just the beginning.

Since I was stuck in bed I had plenty of time to self-diagnose.  After tons of Google searches I had pretty much figured I must have done something” to my achilles. But what? I had no clue until my OS appointment one week later. Yes, one week from March 6th, Friday, March 13th. That should have been a sign.

Upon examination and ultrasound the OS determined I had ruptured my achilles. He was pretty certain it was fully detached from the heel. He went on to explain if this was the case that a tendon transfer and possible tendon lengthening might be necessary.  Surgery was scheduled for the following Friday, March 20th.  I was sent home in a boot and instructed to RICE, bear no weight (as if!) and prepare for the long journey ahead.

The week leading up to the surgery was quite the unexpected emotional roller coaster. I had so much time to think and my normally busy mind was on triple overdrive. I worried about everything and anything. I also did a bit of crying which would just “happen” for no reason and which I could not control.  It was when I finally found this site that I was able to focus better. All the wonderful advice, support and encouragement and hearing about other people’s experiences has made what seems like an impossible journey more possible. Thanks to all who have shared.

I got through the pre-op week, as well as some pre-op anxiety and it was finally surgery day.  Check-in went smoothly and shortly after I was prepped for surgery. Fast forward 2-1/2 hours later. That’s how long the length of the surgery was. Yes, 2-1/2 hours! The OS’s suspicions were spot on. My achilles had fully detached from my heel bone. The surgery comprised of removing a Haglund’s deformity, debridement, FHL tendon transfer and achilles lengthening. I woke up from surgery wearing a splint wrapped in ace bandages and no pain. A nerve block had been administered so there was no pain for 12 hours post surgery.  The OS told my husband the surgery went extremely well, so well he wished he would have recorded it. UGH! (Actually not really that strange considering my OS writes and teaches about ATR repair methods). Glad to know lewd video of my achilles won’t be hitting the internet any time soon!

I had my first post-op visit on Thursday, April 2nd, one day short of 2 weeks post-op.  My splint was taken off, however, my stitches weren’t ready to be removed yet.  Much to my dismay, I was placed in a cast and told NWB for another 2 weeks. I was so hoping to be put into an air boot, as the cast is so heavy. On a happier note, the cast is purple, my favorite color!  :)

So here it is almost 1 month post-op, my next follow-up appointment is this Friday, April, 17th. I expect to have my stitches removed and put into a boot.  At my last appointment I was told it will be at least a week in the boot before PWB. That will make a total of 7 weeks of NWB (pre and post op).  Ahhhhhhh!

And now getting to my title. At this moment my husband and I should be soaking up the sun on the beach in Cabo San Lucas,  sipping a foo-foo cocktail, but no, instead I am stuck in bed RICE-ing, wondering if I will ever walk normally again and unable to bear weight for at least 11 more days.  But who’s counting?

I will post again after my follow-up visit on Friday. In the meantime, there is a reason for the above rambling. I have a few questions I was hoping to find answers to.

1.  So many others have been able to bear weight fairly quickly. Do you think I have to wait because of the extent of my surgery, or is my OS being conservative?

2.  My cast has loosened up and twists and moves up and down some. I can’t tell if it is rubbing on my incision but feels like it might be. Has anyone else experienced this? Can it effect healing?

3.  I still have pain, especially at night. I don’t take any pain meds during the day but still need to take them through the night so that I can sleep. Is this normal?

4.  I have read conflicting info regarding NSAIDS. Do they slow down or prevent achilles healing? I would love to switch from the Percocet to Advil for the nighttime pain.  I will also check with the OS on Friday.

With this, I bid you all a good night.  Or as I should be saying, Buenos Noches. Thank you for taking the time to read my story. I apologize for the length. Once I started I just couldn’t stop! Thanks again for sharing your stories, thoughts, advice, etc.  This is one great website!