mpderbec’s AchillesBlog

And the well-wishing is ongoing. You had a personal decision to make and you made it on the basis of your own values with your eyes open, as it should be. That’s especially important when there are no guarantees. The worst feeling is dealing with “potholes” when you weren’t comfortable choosing the road in the first place.

I met with the surgeon today and I’m going under the knife tomorrow. I did consider the non-op route, but my logic was this: Immediately after I injured myself on Saturday, it was interesting that I really wasn’t too upset or stressed out because I knew exactly what was going to happen (assuming I went the op route again). While contemplating the non-op route, I could feel myself getting nervous and stressed out, since it would be a whole different ballgame. And in the end, the potential benefits didn’t stand out enough for me.

Thanks again for all the well-wishing and advice.

I will reliably miss all the Led Z references!

Having had a great op recovery on one side is no guarantee of avoiding the potholes on the second, of course. But neither path comes with a guarantee.

If your antibiotic was Cipro or related, I’d suspect it. I don’t think the mechanism is well understood, but if it weakened your AT in August, that could have contributed later. We’ll never know, and it doesn’t really matter - but I’d avoid them (and I do!) from now on!

So very sorry that you ruptured your other Achilles so quickly after your first rupture. Interesting that you took antibiotics in August. I would think that would have been plenty of time for it to leave your system but wondering if it is more than just a coincidence.

I ruptured mine in June and had surgery and am very pleased with the results. Saying that, I would most definitely consider the non-op surgery for my second (hoping I never injure my other Achilles) after reading about the success of many people’s experience with it. I was initially a skeptic of it but you can’t deny that it is less riskier and less invasive.

Good luck with whatever you decide - I really like your attitude! I guess it would indeed be less scary the second time knowing what to expect.

I can understand your caution and sticking with what you know but after reading Norm’s post and the warnings that surgeons give about potential op risks, it must surely be less risky to go non-op. Looking at Cecilia’s blog that N talked about it is also pretty clear that non-op done well is a good way to go, just as successful and no complications.

Maybe give the non-op a shot next time? Maybe I’m biased, only tried that way.

normofthenorth… It’s interesting that you blew both yours on December 1. In both of my cases, it was relatively cold outside, and I came indoors to a relatively warm basketball court. The first one happened around January 6, the second on December 6.

BTW I’m not sick as well. I’ve just been titling all my posts after Led Zeppelin songs and “Sick Again” was the closest match.

normofthenorth–

1) Thanks for the detailed recommendation. To be honest, I hadn’t even been considering non-op because my last recovery was so successful (at least, from my standpoint). I hate to play dice with a non-surgery method, especially if I have to find someone that knows the Wallace stuff and/or I have to educate them. But thanks again for at least bringing it up.

2) That’s good to know. Maybe I’ll feel comfortable enough playing low intensity basketball once I’m fully healed again. It would be great if it wasn’t gone from my life completely.

3) I had antibiotics back in August, I assume that’s long enough for any effects to have worked themselves out of my system?

herewegoagain– Quitting basketball was part of my reaction yesterday. I may change my mind, but to be honest every time I went out and played a little voice was whispering, “You’re going to blow your Achilles again.”

Also BTW, I hope you’re not really SICK, along with being injured! One at a time is enough!

Sorry you joined our tiny club of two-timers.

First things first:

1) You can still skip the surgery this time, you know. Check out the great results — and Wallace’s great “trick” to perfect non-op treatment — at achillesblog.com/Cecilia/Protocols. Rerupture rates are either totally identical or virtually identical, strength and ROM are maybe virtually identical, complication rates are quite different, wounds and scars can make life hard, Wallace got 100% return to sports among almost 1000 non-op patients…
I think it’s worth some serious thought. If you can educate an Oakland OS to do Wallaces tests — to determine exactly what ankle angle just gets your torn AT ends to apprximate — and to immobilize you initially at THAT angle, you should be on your way to recovery in a hurry.
1a) If you do consider non-op, and you negotiate with your insurer, you may get them to apply some of the $ they’ll save on the surgery, to extra PT (which will be mostly in 2015), or to carrying over the deductible to next year to cover PT. Maybe. (If I were the insurer, I’d negotiate to save us both some $.)

2) One of the guys here, maybe 3

I am really sorry to hear this. I got 15 years in before the other side went. You are absolutely right though the second time is not nearly as scary- nothing beats prior experience.
Have you chosen to retire from basketball or is this the advice you have been given?
All the best

Norm: Interesting— good to know. Let’s hope I’m in the 49/50.

In the sports-med-clinic waiting room for my second ATR, I met a guy who used to work in a similar clinic. He said that when they discharged ATR patients, they’d say “See you soon!” because so many ruptured the other one.
The stats in the one study I’ve seen - posted in the Studies & Protocols page, look for Contralateral - don’t support that attitude, though the risk is way higher than for a random person who hasn’t ruptured one AT (~200X higher during the first few years). If they just studied those of us who ruptured “normally” in sports or similar, I bet the risk would be a bit higher still, but still not exactly “likely”. I don’t think 1 in 20 of posters here are working on their second ATR like me, MAYBE <1/50.

That’s great news. Congrats and good luck.

Congrats! Great to hear of another successful recovery!

Flex-leg…funny. An old friend of mine sent me a video of him walking on something similar - a knockoff he had made on his own. I was floored by it, didn’t realize something like that already existed in the world. Oh well, I was already in two shoes by then, but I’d have given it a go, had I known about it. I was one who *really* hated my crutches with a passion, though. Kudos on the Manhattan tolerance!

We’ve also had a few folks here with alcohol-enhanced injuries and reruptures, so Be Careful!

Funny!!! When I was in “protective custody” there was a take “Anne” out once a week chore assigned to someone in my family. I think I had 2 martinis with lunch once and I couldn’t crutch out of the restaurant. I started sweating profusely and went into a mental fog.

I sweated so much using my crutches when I was in the cast that stopped using the crutches and started walking on my cast so I didn’t deplete all my electrolytes just getting to the bathroom.

Congrats on your success! Take care.

Ok I’ve got it all configured now, thanks norm.

Sounds good! Install the ATR Timeline Widget (Main Page) if you can, to answer our FAQs.

In the UK we mostly use forearm crutches. After 3 or 4 weeks, if I needed support at all, say for uneven outdoor surfaces, I would use one on each side or, more often, only one. One advantage of this style of crutch (and they are available in US, etc) is that they will just hang off your arm when you stop and use both hands for a chore or whatever. That way they don’t fall on the floor either.

Because I was fwb by 4 weeks, good surfaces meant no crutch and my little, ‘turn on a sixpence’ knee walker was completely obsolete - I had bought it because it seemed a good idea at the time and it was nice to have for the first 2 weeks, after which it was simply a leg support while I sat watching tv or washing the dishes.

I know that I was lucky with my rehab which meant that 4 weeks was a real milestone. My boot was now set with a ROM which would steadily increase over the next 4 weeks, I was able to do more exercise, didn’t need the boot on in bed, mostly did without crutches, and so on - it was simply, sorry about the pun, a great step forward. Any atrophy issue began to go as I was able to flex my ankle and calf more, and just mov

I got by with a backpack and several well-placed mesh bags that i could carry while crutching. And a few stools for kneeling (in front of sinks) and a wheeled office chair in the kitchen.

Those things are all helpful. I’m not a big fan of crutch alternatives, mostly because crutches are about the only way to get a good transition from NWB back to FWB. But standing on one foot while washing dishes or brushing teeth (&c, &c) is torture, so you’ve got to kneel or something.

If your crutches hurt your armpits, they’re very likely adjusted too tall, or the distance between the top pad and the handle is too big for you. The top pad should be clamped between your bicep and your side, maybe 2″ below your armpit. And you’re allowed to add padding to the handles and the vertical parts, if they scrape your hands and wrists. . .

The knee scooter is great! Used it while I was in a cast as well as the boot. My boot was set in a neutral position, and I was able to bear full weight in 3 days, but I think it just all depends on the person. It also didn’t feel extremely awkward because my foot was set neutral. I can tell you that you will progress daily even if you don’t notice the improvements you will find yourself being able to do more. Good luck, it only gets better each day

Did you have a total rupture?? Can’t believe you are weight bearing already….

A backpack worked for me for carrying things around when I was on crutches.

FWIW, my husband can’t do most of the things on your list with the exception of 2 and I’m the one who blew out the achilles ! Joking aside, sounds like you could use one of those knee scooters. I used a chair for unloading dishwasher (rest my casted leg on.) I tried a camping chair (3 legged variety) and found it most unstable.

yes they call me peg leg at the office, and is absolutely necessary at home with 2 kids and post pregnancy wife. The iwalk2.0 is so much better than crutches. check out iwalkfree.com you can also find on amazon.com which is good if you have prime for 2 day shipping. cost $150 but well worth it.

That is normal at your stage, but it will get better every week. Many on her rented or bought a knee walker, which fees up your hands. That would allow you to do those things without a problem and give you some mobility.

Good luck,
Ron

Haha i told my wife that i will continue using the bottle to pee in after i heal! so convenient

Heh– FYI I did have a ‘floodgates-are-open’ day on Monday. It was like a giant chocolate ice-cream toilet-cone!

Oh this is a good giggle. I lost 18 pounds the first 4 weeks because after 4 days of being full of it, (literally), I decided I too would limit my intake. I thought about asking my doctor to catheterize me.

After this experience, I would never develop an addiction to these type of meds. I started taking aspirin once the good stuff was gone and it worked fine. There were some painful days here and there though.

Good luck!

LOL, you seen to have a grip on things.

I did not eat enough for the first week to worry about it and lost about 10 pounds in the process.

Good luck,
Ron

Continuing the TMI…
Did they tell you to take stool softeners (like Colace) with the pain meds? Opiate pain meds are very constipating.

I found that Advil helped my pain much more after the block wore off, too. I would sometimes take the prescription pain med “to sleep” and found sometimes even that didn’t work so I switched to benadryl at night.

Thanks… Hopefully moving to the boot so early will be OK…!

I had the same nerve block and it worked great. Almost no pain after surgery. I only had to use pain meds for a couple of days, and within a couple of days I wasn’t taking any meds at all. It’s nice you get to move to a boot so soon! I will be on week 4 when I go to my boot which will be next Tuesday, and that’s also when my stitches will come out. Good luck with your healing. I can tell you everyday from where you are to where I am gets a lot better.

I had the popliteal block too. Mine lasted over 24 hours. I had very little need for pain meds and actually Advil worked better after the first day. Good luck!

SittingintheStands–
Thanks for the welcome. I’m in Oakland… I agree, nice to be in the warm dry weather, and I’m thankful that the recovery is happening in the winter. Hopefully will be able to kiteboard come summertime!

Welcome to the club and great attitude! I hope surgery went well and you’re recovering comfortably. I’m with Norm on this one…warming up likely wouldn’t have prevented it. My ATR was within the first 15 minutes of hoops as well, after having stretched and warmed up on the other end as the other guys already started playing.
I’m 38 as well in San Francisco. Where in CA are you? Old age and a bit of bad luck catching up to us. At least in CA we have a warm and dry winter…it was 72 degrees today. I’m 7 weeks in and just started PT. You’ll get there soon too. Hang in there!

Seasonal variation in ATR frequency would be pretty easy to check for on this site’s database. Tuning out the Aussies and NZers would be the only tricky part, and we NH types so outnumber them that it might not be necessary.

I tore both of mine around Dec. 1, but I think that’s got more to do with my volleyball season than the weather. (INDOOR vball, too, so I was toasty.) In the Summer I bike and sail/race — all pretty ATR-boring. In the Winter I ski and play competitive vball. Now it’s almost 100% indoor beach, but back then there was lots of court ball, which is definitely NOT ATR-boring.
Fitness and strength probably aren’t good predictors either, since it’s the rel between the muscle strength and the AT strength that probably matters, and that can probably be off-kilter at high or low levels. We do see lots of ATRs among those who throw some intense ATR-risky sports into a recently-sedate lifestyle, but there are also lots of us like me, who stayed consistently active and ATR-risky.

Good luck today! Sorry that you are in the ATR club. Happens to the best of us

Re: normofthenorth: Warming up —
My surgeon said the same thing. He said the only correlation he’s seen in his many years is weather… he sees more tears when it’s cold.

BTW, LOTS of us tore our ATs after fully warming up and/or late in a long sports session, so don’t be too hard on yourself or your pushy pals. {}##€£¥ happens — including ATRs!

Love the style! Keep posting, we can all use the smiles!

Love the “last meal” menu! Good luck with the surgery. Let us know how everything goes!