nico76’s AchillesBlog

I had my first post op appointment. I was able to check on the scar which is 3 points and no longer than 10mm due to minimal invasive surgery and use of Achillon. The doc told me that heel pain is going to last for a while but totally normal.

I had a new cast yesterday with a new inclination. It was quite strange when the doc pushed my foot to change the angle, well… quite scary I should say. But he was so confident in what he is doing. For this time, he told me let’s not insist too much but next time I will trust him blindly.

Other than that, nothing to report…

I have spent the entire week at home, trying to keep my leg elevated. So I turned couch potatoe very quickly. Luckily I work in financial markets, so I can do some stuff for work from my home. I also asked my IT to install a system at home to work in order to stay in touch with my coworkers.

Pain was easy, except on one occasion where my heel felt like burning for quite some time, like a few hours. But except this, everything is ok. Fighting against boredom.

I read a lot of stories where people complained about swelling. That never occured for me. Maybe the reason is the size of the scar (15mm) compared to larger scars when open sky surgery is performed. But I am no expert, so maybe another external factor, who knows.

I was admitted at the Clinique de la Colline, where Dr. Assal works, for a surgery exactly a week after my rupture. Surgery was very quick, approximately 30 minutes plus another 10 minutes or so to build the cast.

The pain was manageable, just the first night was a bit difficult, but afterwards it was ok.

I was required to spend one night at the Clinique which was ok and was then able to return home the next day.

The clinic:

http://www.lacolline.ch

As mentioned in the previous post, I spent the weekend doing research on this injury in order to learn more and be well informed to take the right decision with the help of the surgeon. As a former researcher at University, I am used reading academic papers and research, so I started to dig into the wonderful world of ortho research…

The first thing that struck me is that apparently there is no consensus between the quality of the recovery using non-surgical and surgical option. Most of the studies have been performed on, in my opinion; relatively small cohorts (read a study with 40 patients only). Sorry some of the articles are in french.

The first article I came through was this one:

http://www.ncbi.nlm.nih.gov/pubmed/20802094

in which the authors have a sample of 79 patients and compare the two options. They conclude that the difference at the end of the recovery process is not statistically significant between the two options. They do however note that risk of re-rupture is bit higher in the non-surgical group.

However, the authors in this other article http://rms.medhyg.ch/numero-286-page-595.htm#rb24 do note that the non-surgical option could pose issues in the quality of the recovered tendon.

After more articles, I came across a nice one written by Dr. Mathieu Assal, a surgeon in Geneva.

http://www.sgsm.ch/fileadmin/user_upload/Zeitschrift/55-2007-1/RuptureAigueDuTendond_Achille.07-3.pdf

This surgeon has also designed a surgical instrument called “Achillon” which avoids to make a large incision, hence decreasing all risks associated with surgery.

http://www.weil4feet.com/research/presentations/achillion-system-tendon-repair.pdf

After more research, I became very confident that this method was promising and I decided to opt for the surgery process and chose Dr. Assal to perform the surgery.

One last article, in French though.

http://www.weil4feet.com/research/presentations/achillion-system-tendon-repair.pdf

The injury was very straightforward. I checked in at Crossfit GVA for the daily training (Friday), started to do some stretching and basic pre-training exercise for about 10 minutes. I then took a rope and started double unders just to get the cardio ready for the training. Suddenly I felt like someone kicked the back of my right leg and hear a “clap” that sounded pretty much like to jumping rope hitting your leg. I looked behind me and there was no one.

For a minute, I thought it was something in the calf that was wrong but for some reason deep down I knew it was worse than that. Went straight to the emergency of a private clinic (public hospitals are excellent in Switzerland but the wait line can be horrible unless you are covered in blood..).

Had a Thompson test from an ER doc who diagnosed ATR. Was send then to echography to confirm, and it was confirmed. Unfortunately there was no ortho on that day, so the ER doc told me to wear a boot at 30 degrees and reconvene in a week as she was suggesting the non surgical option.

Did my homeworks during the weekend and finally found another brilliant surgeon in Geneva specialized in ATR and I was able to get an appointment on Tuesday afternoon. He told me about my options (surgery and non surgery) and the point he mentioned that was important to me is that he told me that with non surgery there is a greater risk of losing propulsion in the injured leg.

As an avid sports guy, I chose surgery.