Nov 30 2010

Moostax

Newbie Blogger!

Posted at 12:23 am under Uncategorized

Well here goes, 40 years old and this is my first blog so forgive me if it’s a bit amateurish.
I’m now 3 weeks post operative and so glad I found this site; I was starting to think I was the only person out there going through this!
I injured my left Achilles on October 13th chasing a thief from my house! Did I catch him? Yes, but I couldn’t do much else because it felt like my shoe was filling up with blood and I was more concerned with getting back home.
I knew what I had done as soon as it happened but didn’t expect the pain that came with it. When I got home I couldn’t move so it was a blue lights and sirens ambulance trip to hospital for me that night – another first!
I have nothing but praise for the ambulance guys, totally professional and reassuring. Unfortunately when I got to the hospital is when the care level of care took a down turn. When I eventually saw the doctor he examined me and carried out what I think was the Thompson test. When he peeled my off the ceiling he said I had probably ruptured my tendon. I had a back slab plaster fitted given some anti inflammatory drugs and sent home with an appointment in the fracture clinic in 6 days time.
After a two hour wait in clinic with my foot on the floor (it had swelled up like a balloon by then) I was seen by a doctor who could not find my notes, he thought I had a broken ankle even though I told him what I had done and then began to examine my broken ankle! (Another very painful experience).
I was then sent home in another back slab cast with an appointment for a scan the following week. Unfortunately over the weekend I caught a fever and had to cancel my scan appointment on Monday, to my dismay I was then told the next available appointment was in 3 weeks time. At this point I lost all confidence in my local hospital and sought the possibility of being seen as a private patient in another hospital. (fortunately after some negotiations my insurance company agreed to pay the costs) Thankfully after my initial private consultation things moved really fast, and I was examined, scanned and operated on within 24hrs.
The scan revealed a 90% rupture of the left Achilles tendon and the consultant said he always recommended surgery if the tear exceeded 50%, so under the knife I went.

I was back home in the back slab the following day with a sack full of tablets, and strict instructions to rest with the injured leg raised and of course I was now non weight bearing.

Two days later back to the hospital for the dressing changed and then back in a back slab.
A week later I was back for another dressing change of the wound and an examination from my consultant. He was pleased with the scar and said I was a good healer (hopefully this will prove to be the case long term!) During this visit I had the back slab removed and was fitted with an orthopaedic boot at a fixed angle with my toes down. I read on other blogs about boots and air casts and assume this is the same, though I think some other people’s boots allow a degree of movement?

During the above week I also had the misfortune of injuring my left shoulder (rotator cuff) which is apparently a common injury for people new to NWB Crutch life! So more enforced rest. A point to note though I injured the shoulder climbing the stairs as instructed by my physiotherapist so maybe the best way is to go up on my backside?
Not wanting to risk further injury though I have resorted to sleeping down stairs on an inflatable bed (Argos 634/1378 £50 and worth every penny).

Next appointment is December 17th so I assume it just healing and dealing with the boredom until then, pain is not too bad now although the leg is completely immobilised. My consultant is adamant that I rest but I see from other blogs that people are quite active post op (is it too early at 3 weeks post op?)

As I said the pain is manageable now without pain killers so that must be progress and that feeling of throbbing in the foot when you stand up has gone so that must be a good thing.
The worst thing now is dealing with the boredom, working from home helps pass the time, but I’m sure as most of you know going from an active life to NWB recovery is hard on the mind.

Any suggestions on how to stay sane would be much appreciated!

15 responses so far

15 Responses to “Newbie Blogger!”

  1. heatheron 01 Dec 2010 at 11:59 am 1

    Hi,

    Sorry to hear about your level of care but at least the worst is behind you fromthat point of view and you are now in the recovery stage. I myself am at 6.5 weks since my op and I from my experience i would say that week 4 is to early to be doing much. You need to keep your leg up as much as possible. After 4 weeks my boot was at 15 degrees and the swelling was good enough to allow me to go to teh gym for upper body works out twice a week and for 10 mins a day on a stationary bike, with my bad foot, heel on the pedal only. At week 6.5 I can put weight thru my foot and walk around the gym with the boot on zero degrees, still only twice a week for training but that is now more down to when I can and can not get lifts, but I am up to 20mins on the bike a day. But I must say that I do still have to keep my leg up for most of the day, a good time before and after to keep the swelling under control. My doc tells me that the leg may well still be swelling anythingup to 6 months after the injury, so it is very important to keep the leg up and rest as much as possible each and every day.

    Hope that this help, but everybody is differant and it is important not to rush your recovery and to only do what you and your leg feel that you can do. DONOT OVER DO IT, would be my best piece of advice.

    Ggood luck with your recovery

    Heather

  2. ickyon 01 Dec 2010 at 1:26 pm 2

    Great first blog! You should teach a class :)

    Sorry to hear of your injury (injuries) but it sounds like you’re dealing well.
    40 years old seems to be a common phrase with this injury… I, too, am 40… I’m just past 2 weeks post injury (non surgical)…
    Hang in there! We’ve got a long row to hoe but this site will make it easier.

  3. liverpoollasson 01 Dec 2010 at 2:26 pm 3

    It’s sad that you had such a poor experience at the hospital. But no point in looking back focus on moving forward. Keeping your mind active is relly important, I’ve kept busy by baking, working from home, reading, computer games and even on line games!!! Whatever works for you really. Good luck with your healing.

  4. aileenscotlandon 01 Dec 2010 at 2:44 pm 4

    Welcome to the best site on the net, the guys on here are really great for keeping you motivated. I was down last week as I felt that my treatment was going really slowly compared to others, but I got some great responses that lifted my spirits. It’s a real family network.

    One of the most useful things that I’ve done is to put chairs at strategic points around the house. I’ve got one by the washing machine, one between the cooker and the sink, and one half way down my very long hall. I just hop on my crutches from chair to chair and then either sit or kneel. I can now do 90% of my housework - even ironing which I hate! A padded stool in the bathroom to kneel on is also very handy.

    You soon get in to a routine and time starts to pass more quickly - tv, computer games, reading, checking out everyone’s blogs, reading all the links from this site to the various treatment protocols is really interesting.

    Good luck, keep in touch and remember there is always someone on here with the answers to any questions.

  5. teresa1on 01 Dec 2010 at 2:47 pm 5

    Sorry to hear you had such awful treatment at your local hospital, it made me realise what quick treatment I had (appointment in 2 days, op 5 days later) though I was plastered in the wrong position at the minor injuries unit on the Scilly isles where I was on holiday. Hopefully things should go according to plan from now on.
    I am now much improved at sudoku, online scrabble, an antique and home improvement expert thanks to the awful daytime telly. I have sold my high heel collection on E Bay and read a load of journals and papers that I wouldn’t normally get time to do.
    Hauling myself up and downstairs on my bum (no downstairs loo) gave me a work out and doing simple everyday things took ingenuity and a lot of time.
    How to stay sane? Use this blog, it really helps to get support, information and encouragement especially at the stage you’re at.
    Good luck

  6. Parriskion 02 Dec 2010 at 12:16 am 6

    I think bottom-shuffling up and down the stairs is much underrated and great for your triceps! At least that was what I convinced myself when I did it for the first 5 weeks. I also borrowed two sets of crutches, one for upstairs and one for downstairs. And made life a whole lot more comfortable by wrapping tennis grip around the handles which helped minimise the pain and blisters on my hands. The most difficult bit is adjusting to the enforced inactivity although i must confess, the crutches did make doing any job 10x harder and everything took so much longer that I found I didn’t have much time to spare (i was lucky enough to be able to carry on working from day one so didn’t have whole days to fill). think you’ve got lots of good feedback here on things to do - so I wish you a speedy recovery :)

  7. snapdragonon 02 Dec 2010 at 5:22 pm 7

    If ATR and shoulder problem then knee caddy, leg trolley thing is my recommendation. You can work standing up and carry drinks better than with crutches.
    Something to wee in at night to save crawling to toilet. Later not such a problem as you can knee walk.

  8. normofthenorthon 17 Dec 2010 at 1:46 pm 8

    Moostax, sorry to resuscitate an old blog, but I was totally distracted by my open-heart surgery while you were posting this(!). :-)

    Do you know HOW you injured your shoulder with the crutch? Was it adjusted so high that it normally hit your armpit, or did it hit it when your hand slipped off the grip, or was the injury caused in a different way? Stair-walking on crutches is definitely not for the faint of heart (I call it a “leap of faith”, in BOTH directions), though a few tricks and techniques can help. And having a good strong banister on your cast/boot side on the way down can make a HUGE improvement.

    And AFAICT, there is ZERO evidence to support your surgeon’s opinion about 50% ATRs vs. 90%, etc., etc. ALL the randomized trials comparing surgical and non-surgical treatment have been done on TOTAL ruptures, 100%. SEVERAL of the best and most recent ones have found no difference in outcomes with or without surgery, other than the scar and the risk of complications. Others — including all the old ones — used slow protocols for everybody or slower protocols for non-op patients, and found worse outcomes for non-op (mostly higher re-rupture rates). One or two recent studies seem to have done things right, and have still found somewhat higher re-rupture rates without surgery. Still room for disagreement, though I think the results from using bad protocols shouldn’t count in anybody’s decision.

    It’s not easy (at least for me) to compare the “absolute” excellence of the results from study to study, but I think the results of the best studies — like bit.ly/UWOStudyPub — suggest that the best non-op treatment can equal the results of surgery with that same post-op treatment (and without scar or surgical risks). It sounds logical that non-op would work even better with partial tears, but I don’t think anybody’s every tested that theory, so it’s just a theory.

    Anyhoo, surgery works well, and you sound like you’re healing well, so keep healing! You had an unusual level of pain early on, which also probably means your extra moaning and groaning from the surgery may have been unusually low, if not zero! :-)

  9. Moostaxon 21 Dec 2010 at 5:41 am 9

    Hi Norm,
    I hope you are recovering well from your surgery. Regarding your recent comments the injury to my shoulder was not in whole caused by incorrectly fitted crutches; although subsequently I have been told that they were set too low which may have initially set off, or led the shoulder to be more vunerable. The shoulder injury was caused because the stairs in my house spiral upwards the effect is, when climbing the stairs the left hand banister raises at e very sharp angle. With an injured left AT this required me to lift my arm above shoulder height to grab the banister to “pullI myself up with a reduced load then on my right crutch. it was at this point that I damaged the rotator cuff in the left shoulder. Thankfully with rest (and now sleeping downstairs!) this injury has subsided. I intend however to continue to “live” downstairs until i can FWB.
    I take on board your comments on my surgeons opinion and have asked for him to explain his protocol. Apparently his conservative approach to recovery (6wks NWB 30 degrees foot incination and no ROM) was taken because of the extent of injury observed during the repair. I suppose i cant argue with that is he has seen my AT not me.
    I hope this helps with your questions, if not let me know.

    Thanks for your valued response, Mark.

    [WORDPRESS HASHCASH] The poster sent us ‘0 which is not a hashcash value.

  10. normofthenorthon 21 Dec 2010 at 11:55 am 10

    Thanks, Mark. I’ve got a tall old-house staircase that takes 2 90-degree turns at landings. I’ve never even THOUGHT of negotiating a spiral staircase on crutches! After my first ATR (banister on the wrong side, descending), I did conventional “leap-of-faith” crutch-walking, going down and up. This last time (same banister, other AT), I could descend the easy way, leaning on the banister, but I still ascended with the conventional “leap-of-faith”. It reminded me of skiing a double-diamond (top expert) run — somewhere between “YIKES!!” and “You fall, you die!” The first time, I lost my balance once going up and once going down, no real damage either time. This last time, I escaped the slips, mostly because my time before FWB was so much shorter, with a good aggressive modern protocol. (I wonder how many of the excessive re-ruptures from bad old slow protocols are the direct result of spending way too much time at risk of slipping on crutches!)

    Deciding how much faith to put in our Docs, when their approach seems to vary from the best Evidence-Based Medicine, is generally tricky. Did you get an extra screw mounted in the back of your heel as part of your repair? If so, that could make your decision even trickier (because those repairs weren’t included in the randomized-trial studies). If not, and you got a standard repair, then the Doc who’s examined your own AT “up close and personal” is just as likely to be ill-informed and out-to-lunch as anybody else. See for example, bmj.com/content/319/7225/1618.full , “Seven alternatives to evidence based medicine”. (h/t to doug53)

    In my experience, most patients who assume that their off-beat untested protocol has been carefully crafted to match their exact circumstances, are deluding themselves. I’d give him copies of my fave two documents — the UWO protocol and the UWO-study’s results — as part of your discussion about his protocol. At the least, you’ll find out if there’s any serious evidence behind his approach (I bet not), or just logic and hunches and anecdotes and expert judgment — all of which have been proven wrong in this field by almost every serious study that’s ever been done!!

  11. Moostaxon 21 Dec 2010 at 12:29 pm 11

    Hi Norm,
    I agree with your staircase comments; so for now the high banister is out of reach! and the stair case remains open only my wife and children, I’ll stay (and sleep) down stairs until I get more confident with my recovery.
    I agree with your thoughts on my doctors approach as far as I know it was a standard type of suture repair (no hooks or screws have appeared on the bill!). As you can see from my latest post, I attended physio today and seem now to be on a more aggressive protocol. So I look forward now to seeing some more positive progress.
    Take care and have a happy Christmas,
    Mark.

  12. normofthenorthon 23 Dec 2010 at 9:14 am 12

    All the best, Mark. I hope you’re walking crutch-less by Christmas! :-)

  13. Moostaxon 24 Dec 2010 at 5:05 am 13

    Hi Norm,
    Best wishes and Happy Christmas to you and your loved ones.
    Crutchless by Christmas? I’ll put that one on my wish list
    Take care, Mark.

  14. normofthenorthon 24 Dec 2010 at 11:43 am 14

    I’m old enough to remember a silly pop song “All I want for Christmas is my two front teeth”. I’m sure all of us here have a “stretch” wish for Christmas, and another for New Years, etc.

    May all our wishes be granted! :-)

  15. normofthenorthon 07 Feb 2011 at 12:56 pm 15

    So when DID you start walking crutch-less?

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