nicky’s AchillesBlog

Just over 6 months. I have not posted for a while because like a few other bloggers, I don’t think it is helpful to blog when things aren’t going too well.

6 weeks ago, I felt that all was pretty static. Still very painful rupture site unable to do much in the way of PT. Possibly getting worse, huge lump over achilles and a physio suggesting going back in the boot!I could not imagine ever getting better.

I had an ultrasound scan, which showed an intact tendon with a fair amount of fluid around it.

I did put the boot on, but then took it straight off. (I could not bear it) But I stopped stretching out the tendon and tried to walk without pain which meant slowing down the pace big time. I stopped doing any physiotherapy apart from walking and swimming.

It is still sore but much improved and the fluid filled lump has gone. I have slowly introduced PT and have attempted a single heel raise! OK its only 3mm off the floor, but it is off the floor  :0)

I am making good progress, back to work, but I am still really tender at the rupture site which is really thick and seems to be continuing to get thicker by the day. Its pretty tender to massage and  leaning forward on the ball of my foot in preparation for a heel lift is really painful. This is not in the calf but at the rupture site. My physio has said that most people do not have any pain at this time.

I am a non-op so can’t blame it on surgery. Anyone else this sore at 20 weeks? Am I the only one?

Also has anyone else managed to make their way through the 5 series of breaking bad during their recovery and rehab?

Nearly 13 weeks and physio gave me the all clear to go on a cross trainer. I had looked at these but felt that perhaps not quite yet. I am still really tight at the back of the calf. But she was right. All good.

Then I caught site of the back of my calf in one of the mirrors in the gym when I was doing 2 heel raises.

I was pretty impressed until I realised that I was looking at the wrong calf!

1. Where I am up to?

12 weeks really does feel like a milestone in many ways. Although I still have a bad limp, I have now recovered my lost independence. I am in 2 shoes, driving a car with a clutch and slowly stretching and moving to double heel lifts and a static bike. I was back at work 3 weeks ago and feel ok. In those dark NWB days, 12 weeks seemed such a long way. I appeared to specialise in self pity and kept staring at peoples intact achilles with envy. I feel a bit embarrassed by it now.

2. What did I want to know from you all and what actually  happened?

All the stories here were very helpful to be able to gauge some of these milestones.  I know we all heal and rehab at different rates but it was really helpful to get a feel for things like: taking off the boot at night at 5 weeks, back to work at 9 weeks, driving at 11. I am still hopeful that I will be able to ski next year but I know that is something I may have to wait and see.

3. What all the orthopods thought?

As I work in the medical sector I am lucky to have access to corridor conversations with orthopaedic surgeons. Some are pro surgery, most are equivocal but all were keen on the importance of physio and encouragement to get the scar tissue to act as a new tendon as soon as it is safe. That is, gentle plantar flexion, but remember, it is a bit like glue, you do need to wait until it’s dry before you pull the ends apart. So early mobilisation without going crazy.

We all heal at different rates. Healing depends on blood supply (it is terrible at the back of the heel, compared to other parts of the body) but also tension of the tissues and many other things like smoking, diabetes, and things we don’t know about.

4. Why does the website work?

Like so many other people who use this website, I have found it invaluable. I feel like I have collected a new set of friends that I will never meet. I have been encouraged by many kind words and kellygirls photo’s. I think it works for many reasons. Being NWB sucks and the rehab is so long.  Many of us are similar as we are all seeking information and support by looking for the site.  Also many of us are at that time of life where loosing 6 months is incomprehensible: work, children etc. But also, I think the information here is really excellent. We are all lucky to have norm, whose information gathering and interpretation is fantastic. Sites like this can be subject to misinformation and misinterpretation but I have yet to come across that here. Dennis, you must be very proud.

Finally, I hope I will never have to cook another meal on my knees! ( fingers crossed)

I am not sure that climbing over a 5 ft wall was in my protocol at 9 weeks but the gate to the kids football training was locked!

I know that acting like an 18 year old got me in this mess and a number of cars got an eye full of my rear end, which is relatively unpleasant, but needs must!

It is still pretty sore and I walk with a significant limp, but being off crutches is an all time high!! and its nice to be a bit naughty sometimes.

So moved to 0 degrees and FWB.

At first I could not imagine FWB, definitely not in a normal walking position. It felt like another set back. But towards the end of the day I gave up on trying to perfect the perfect gait and have adopted the ATR shuffle. I expect many of you ahead of me know what I mean. Feeling more positive and think I just need to slowly stretch out my calf/ scar tissue and I’ll get there.

Did a practice drive in to work today in my friends’ automatic car. All good.

Having spent the last 7 weeks addicted to this site, I felt the need to contribute and to say thank you to everyone that blogs.

As the time frame is so long, I have been eager to know how I will recover and by reading everyone’s stories seem to have some sort of picture of how the next 6 months might pan out.

My story began like many of the ones I have read. I seem to be in the main cohort : Middle aged, recreational sport. In the second quarter of a netball match, whistle blew and I was really angry that the goal shooter had thrown a stone at my heal with such force? Like many others, I looked around and noticed that I was on my own and had a pretty good idea what had happened.

The experienced nurse that applied my cast told me that after a few days I may feel like I need some diazepam. I ask if that was for muscle spasms but she said it would about the time I might start going nuts! Yup, quite correct.

I choose the non-operative option (hope you are proud normofthenorth!) partly because my consultant thought that may be the better option for me. I have an unstable knee on the other side without an anterior cruciate ligament, achilles bursitis on the other side and probably the time has come for me to take up a less aggressive sport in the future (knitting?). Also as a surgeon myself (although not orthopaedic) I have seen the consequences of surgical complications.

My first request from my patient better half was for a pair of cycling gloves (I have been on crutches before and have suffered with the blisters). Then I put my foot up took my heparin injections and said a prayer to the god of DVT and re-rupture.

( A bit about DVT: In the first 2 weeks (and when you can within reason after)  keep your leg up! preferably above the level of your heart (this reduces the risk of DVT and encourages blood supply to the bits that need to heal). Getting a DVT is a right pain the the backside. Risk of life threatening PE, Warfarin for 6 months and DVT’s stop the delicate valves in the veins from working properly forever. The risk of a DVT with this injury was 34% in one of the articles I read.)

Next step: I took to the internet. There seemed to be a consistent theme:

Isolation, frustration, tupperare and flasks, bags, upper body and abs strength, listen to your body, patience, time, humour and normofthenorth.

The protocol that I am on is 6 weeks in a cast or boot NWB altered degrees of angle, I am currently PWB at 10 degrees for a further 2 weeks and will move to 0 degrees on wednesday (8 weeks) and FWB.

Moving to PWB was a bit of a disappointment. I had been waiting so long for the day to come but when I did put my foot to the ground, it felt so tight. This has improved alot over the past week and a half but it has reset my mental recovery to realise that the FWB will be a gradual process in a similar way. One of the blogs here described building up the height on a shoe to match the height of the hinged boot. I found that very helpful. I am also trying my hardest to walk in the most natural way.

My confessions include:

1. I have not managed to sleep every night in the boot. With my injury occurring at the start of the first British heatwave for 7 years the heat and feeling of entrapment was unbearable.

2. I have been doing some gentle range of movement exercises out of the boot. This seemed sensible to me.

Questions to bloggers

I have been told that I can go back to all aspects of work when I can stand pain free for 4 hours. I know you are all different but anyone have an idea when that might be?

Also, having had the injury at the end of June does anyone think I may be able to ski next February?

Does anyone else have dreams that they can walk again without crutches and wake up disappointed?

Is anyone else really jealous of the people who have updated their status to "2 shoes"?

Finally

I have been asked by a few friends what good has come out of this? I have struggled to answer this. But so far I think it is always a good reminder to doctors to know what it is like to be a patient. I have caught up with paperwork. That friends are amazing.  That I realise that I do too much for my kids. Now they are used to tidying, washing, picking up their towels!! and making me tea, it WILL continue.

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Dennis