Introduction

This is my first venture into blogging.  Here is my background:

  • I live in a small market town in Oxfordshire, UK.
  • Early 60’s, male, average build and weight.
  • I suffered my Achilles rupture in late October 2013 at a barn dance.
  • Unfortunately it wasn’t diagnosed as ATR until early December (by my chiropractor).
  • Near complete tear of AT was confirmed by ultrasound scanning on 17 December.
  • At end-December met consultant who advised I needed reconstructive surgery.
  • Operation on 16 January (timing influenced pressure of work) - private rather than NHS through my work.
  • Worked from home 19 to 31 January.
  • NWB cast replaced by PWB cast on 30 January.
  • First day back at work today, 3 February.
  • So far all going well.

As I’m some way along the path I intend to write some more reflective and specific posts over the next few weeks.

I found this site from Google and it provided a lot of useful information and reassurance immediately following my operation.  I’m very grateful for the site and to the many people who have offered their insights and knowledge.  This has provided considerable reassurance and helped me to maintain a positive mental attitude.

4 Responses to “Introduction”

  1. Welcome! Glad your diagnosis got fixed. Amazing how many ATRs get missed.

  2. I have also just reached the 4 week mark…how time flys!

    The Injury:

    I am 29 year old active male, based in the UK who participates in basketball, cross country running, MTB and road cycling.

    I suffered partial rupture whilst playing Basketball late in the evening on the 28th Jan 2014.

    A typical story of pushing off on my left leg , I crossed over and beat my man (rest assured this is important plot detail…not a frivolous boast) only to experience a feeling that I can best describe as a punch to my left calf (I didn’t experience the infamous popping sound). At the time I was pretty blaise about the injury, there was no pain, no swelling and no bruising, just a limp foot.

    So…I landed face first on the court, crestfallen, looking around to see who had kicked/punched me, only to find my man exactly where I had beaten him…

    Luckily my injury was diagnosed by my team mate who works in Triage at the hospital. He performed the Thompson test which was negative, but advised that I get it checked out at A&E.

    The Diagnosis:

    At A&E on the following morning I again underwent the Thompson test (negative once more) I was then placed in a temporary plaster cast with a follow up meeting the next morning with the consultant to discuss my options.

    The next day I met with my consultant who after performing the Thompson test (negative again) struggled to find the site rupture, it was actually higher than expected.

    We went through the options (my mind reluctantly set on surgery) and I was advised to take the non operative route…fixed lightweight cast moving to Aircast in 2-4 weeks.

    Week 0-4 The Treatment Pathway:

    My consultant suggested 2-4 weeks in a lightweight fibreglass cast followed by aircast + 5 smaller wedges to take me to neutral over 5 weeks whilst performing exercises. 8-9 weeks total before getting into shoes.

    Importantly the location of the partial rupture swayed my consultants mind to keep me in the fixed lightweight cast for 4 weeks in the end…I’m not sure how this fits with the modern protocol…

    Week 4- Out of fibreglass cast and into Aircast

    Over the first few weeks I found the lightweight fibreglass cast surprisingly light weight and comfortable even with my foot in the customary “ballet point.”

    My only discomfort during the first two weeks was some increased sensitivity around my exposed big toe. Which found would come and go.

    During this time I became quite adept at getting around on crutches and a knee scooter (comedy value!).

    I have just been fitted with my Aircast….hmmmm….the ironically named Aircast (it weighs a bloody tonne). 24hours in and I’m struggling to bond with this monstrosity! The weight of the thing is killing me!

    My dislike for this lead lined Wellington is furthermore increased by my consultants insistence at my fitting for me to remain non weight bearing for a further 2 weeks in the Aircast (wk 4-6).

    Can anybody provide tips on sleeping / moving / generally living with this thing when you can’t weight bear?!

    All comments welcomed!

  3. It’s common and sensible for high ATRs to be treated non-op - not because it works better than average, but because surgery there works worse than average. There’s no evidence that an extended NWB time helps, and lots that it hurts, e.g. increasing rerupture rates. I wouldn’t submit without a fight.

    The AirCast is probably lighter than most boots. (”Air” for the bladder, not the weight!) Once you’re PWB, you’ll be resting it on the floor so the weight won’t matter much. And the other advantages are huge. You got lucky with your cast!

  4. Check out bit.ly/UWOProtocol for one protocol that has demonstrated low rerupture rates with a large number ofATR patients. Exeter has done as well with a slightly faster protocol, but nobody has demonstrated good results non-op going slower.

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