oscillot’s AchillesBlog

Entries from June 2015

week 7 update: first PT appointment

June 24th, 2015 · 1 Comment

There was a cancellation at the physical therapy clinic, so they were nice enough to squeeze me in for my first appointment, 7 weeks post-op. There seems to be a lot of mysterious “cancellations” when you’re recovering from surgery and the nurse calls on your behalf. I suppose that makes sense.

The first thing my therapist did was have me raise my leg from a seated position, and demonstrate “toes up, toes down” range of motion. It was the first time since my injury that I tried to do this, so the foot was non-responsive and quivering as long-neglected neurons shook off the rust. After ten minutes or so, I was able to demonstrate ~10 degs of ROM. The calf twitched / pulsed for the first time in nearly two months, and I quickly regained more stable control of my foot. He prescribed the usual exercises until I see him again on Friday - writing the alphabet, picking up marbles, flexing my arch, light self-massage, etc..

At week 4, my surgical wound was deeply scabbed, so I’m roughly 2 weeks behind where most people are at week 7. Of course I wish I was 2-shoes now, but patience is a virtue when avoiding re-rupture is priority #1.

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request for PT advice

June 23rd, 2015 · 7 Comments

Good news - I finally stood on my own a couple days ago, and am walking with one crutch (instead of needing two) today. It feels amazing to start checking off milestones after so much time without any progress.

Now I’m 6 weeks 5 days post-op, and my OS *finally* sent the order for physical therapy. Unfortunately, all the clinics in my medical group are booked solid for a month, meaning I wouldn’t start PT until week 10. This seems unusually late compared to the protocols I’ve seen.

I am thinking of paying out of pocket with another therapist until the one my insurance covers has availability. For those who are ahead of my timeline, does this sound like a good idea? If so, how often would you recommend going (e.g. 2-3x/wk)? I’m happy to pay for my recovery, but prefer not to be excessive since the cost is $80 per visit.

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indoor elevator shoes

June 20th, 2015 · 6 Comments

Searched online for elevator shoes to even out my hips while wearing the boot indoor. Why can’t I find any in size 13? Oh yeah, short people don’t have big feet.

In the interim, I removed a thick insole from a pair of Crocs mocassins I had, and placed it into a right Croc. It gives about 1.5″ of heel raise - enough to alleviate my good Achilles while PWB around the house. It could use more height, but Even-ups require the back of a shoe to stay on.

7/1 Update: Even-ups DO fit on Crocs, after all! Raising my good foot up those 3″ really does make a huge difference.

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week 6 update - PWB @ 20 degs

June 19th, 2015 · 2 Comments

Went to the doctor on Wednesday for my 6 week checkup. The surgical wound had scabbed over and mostly fallen off, except for a square-centimeter chunk by my ankle. To speed up the healing process, my OS carefully removed it with tweezers and scissors. He sanitized the pink skin underneath, put a band-aid on it, and told me to keep an eye out for any sign of infection.

Sadly, he said to hold off on swimming until I see him again in two weeks. By then, the skin should be 100% healed, and I’ll be nearly FWB (full weight bearing).

He had me drop my boot from 30′ (degrees) flexion to 20′. Every two weeks, he wants me to drop it another 10′. I asked if 5′ every week would be better, but he said “no, let’s stick to the protocol.” That’s fine. I’m really in no hurry if going slow will allow me to avoid pain and wait out the timeframe when I’m at my highest re-rupture risk (first four months) from within the security of my turtle-shell boot.

I’m also allowed to start bearing weight on my heel while crutching around. 40 lbs to start, adding 10 lbs every day. I use a scale every morning and night to test what the prescribed weight feels like. Being able to bear weight in your second leg after a long layoff is a pleasant, unexpected treat. It’s a fourth limb to stand on, and provides relief to my painful “good side” Achilles, which has been barkin’!

Every day, I feel a tiny bit stronger. My wife is due to deliver baby #2 in four weeks, and her doc says it could happen as soon as two weeks from now. I should be losing the crutches around then, and regaining the use of my hands. Perfect for holding our new baby girl! =D

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Kobe documentary + “good side” sneaker

June 10th, 2015 · 17 Comments

Do you remember young Kobe Bryant? 19 year old, high school to the NBA, taking Brandy to the prom, unstoppable, buzzer beating, throwing lobs to Shaq, pre-scandal Kobe Bryant?

I was in college in the early 2000s when Young Kobe was THE MAN. He was the best young player in the NBA, and clearly assuming the mantle as the best in the game when Michael Jordan started to show signs of mortality. Safe to say, I was a huge fan, and hugely disappointed when he was accused of rape in Colorado, while a married man and father no less.

Kobe went on to have a great career in basketball, but everyone outside of Lakers fans hates him. Problem is, as documented in the recently released film, Kobe Bryant’s Muse, his upbringing and psychology embraced this image.

I considered myself in this group of Kobe-haters, but his 2013 ATR and well-documented recovery recently gave me something to identify with. I think everyone on this site can relate to the Facebook post he wrote the night of his injury:

This is such BS! All the training and sacrifice just flew out the window with one step that I’ve done millions of times! The frustration is unbearable. The anger is rage. Why the hell did this happen ?!? Makes no damn sense. Now I’m supposed to come back from this and be the same player Or better at 35?!? How in the world am I supposed to do that?? I have NO CLUE. Do I have the consistent will to overcome this thing? Maybe I should break out the rocking chair and reminisce on the career that was. Maybe this is how my book ends. Maybe Father Time has defeated me…Then again maybe not! It’s 3:30am, my foot feels like dead weight, my head is spinning from the pain meds and I’m wide awake. Forgive my Venting but what’s the purpose of social media if I won’t bring it to you Real No Image?? Feels good to vent, let it out. To feel as if THIS is the WORST thing EVER! Because After ALL the venting, a real perspective sets in. There are far greater issues/challenges in the world then a torn achilles. Stop feeling sorry for yourself, find the silver lining and get to work with the same belief, same drive and same conviction as ever. One day, the beginning of a new career journey will commence. Today is NOT that day. “If you see me in a fight with a bear, prey for the bear”. Ive always loved that quote. Thats “mamba mentality” we don’t quit, we don’t cower, we don’t run. We endure and conquer. 

In the Muse documentary, Kobe is shown rehabbing his Achilles in Nike basketball sneakers he calls his “medical Mambas” (Kobe nicknamed himself the “black mamba” years ago). I went onto Nike’s website and promptly ordered myself this year’s model (Kobe X Elite “rose gold”):

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I think they look really cool! Note the red stitching signifying his ATR on the left side. From my first wearing, the shoe feels like a $200+ shoe, the upper stands noticeably tall, and it is extremely supportive of the ankle. One downside is the toebox is narrower than I normally like, reducing comfort, so I chose to remove the insole to free up some room. But the upper is pretty much an ankle brace built into the shoe; a welcome feature that provides pain relief and loads of stability to my barking “good side” Achilles.

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Once I start PWB, hopefully next Wed, I’ll try rocking these with EvenUps on my right, and my Vaco cast on my left - just like Kobe!

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fear and intermediate goal setting

June 7th, 2015 · 1 Comment

Brendan has a great discussion on his blog about how fear can be healthy, protecting us from re-ruptures in the same way it prevents us getting hit by a car. But it can also overtake us irrationally, holding us back from living life to its fullest.

I’m four weeks post-op (five since the injury), and too early to gauge “realistic” goals, as I haven’t even healed enough to put weight on my foot, experiment with range of motion, or start strengthening exercises. Once I do, I know I will follow my rehab protocol religiously, but there will be setbacks, even if it’s just minor soreness or scar tissue that’s tough to break up. Undoubtedly, I will be held back not only by my physical deficiencies, but psychic ones, too. While I can’t wait to ditch the knee walker and crutches, the protection and security of the boot will be much harder to give up. But to live a normal life and fully recover, I need to.

The Death Valley Trail Marathon was the pinnacle of my physical accomplishments, having completed it in just over 5:00:47 in December 2012. This race consists of climbing 1500 ft of steep elevation up a mountain, bombing straight down 5000 ft of loose gravel, then running another 15 or so miles on packed sand. I live within driving distance, love being in the desert, and Furnace Creek is a nice resort, so it’s actually a nice way to spend a family weekend. I was 2.5 years younger and 15 lbs lighter than I am now, but if everything goes according to schedule, I could conceivably work myself back to that level of fitness. It’s a significant amount of time to commit to training and recovery, but the warrior in me feels compelled to pursue that path and conquer my ATR. That’s my ceiling.

Short term goals are also easy to set - I am going to entrust my surgeon and physical therapist with monitoring my body and dictating the healing and strengthening process. I’ll be told week by week what angle to stretch my Achilles, how many miles to walk, what strengthening programs to follow until ~6 months post-op. But then what? Should I immediately pick up running and train for a 5k? Should I take time off of running, and experiment with something lower impact, like cycling? When will I become comfortable enough to go bowling (my ATR was on the left, and I am right handed)?

After the emotional trauma of rupturing an Achilles, I’m going to be shell-shocked for a while, and am going to have to re-learn what it means to push my limits, while being safe and self-aware.

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#firefighterninja + 4 week checkup

June 3rd, 2015 · 1 Comment

Wow! Dennis Lappin, a 39-year old firefighter from Michigan, completed Kansas City’s qualifying course on the obstacle course TV show, American Ninja Warrior. Dennis is a second time contestant who DOUBLE ruptured his Achilles exactly one year ago at the same event. Congrats, Dennis, on slaying the warped wall, and your injury! I’m feeling inspired…

Today was also my four week followup appointment with my OS. I was hoping he would start my long road back and prescribe me PT, but he is more comfortable with a total of 6 weeks NWB post-op, and wants to keep me fixed at 30 degs plantar flexion, to boot (hehheh). I guess I am okay with that. My heel is still tender, and I’m more concerned with avoiding re-rupture (which seems to have some correlation with aggressive PT) than returning to sports quickly.

On the bright side, he did give me a copy of the rehab protocol I’ll be placed on:

Of particular note, it says there is “major risk of re-rupture between 6 weeks to 4 months, especially when unprotected.” I’m thinking of continuing to wear my boot for a full month after I achieve parallel, and setting ROM to swivel between 30′ plantar flexion and increasing dorsiflexion from -5′ to -20′. We’ll see if I can bear the weight, bulk, and sweaty foot during the summer, but I am going to have a hard time giving up my turtle shell VACO cast. It’s become a part of me.

It was kind of fun to schedule goal dates for some personal milestones into my calendar. If I don’t encounter any setbacks, I’m hoping to:

  • Aug (month 3): lose the crutches; start walking flat, easy, longer strolls; bring my daughter to day care unassisted
  • Sep (month 4): ditch the boot
  • Oct (month 5): lose the limp
  • Nov (month 6): walk on the beach
  • Dec (month 7): hike up hills
  • Jan (month 8): try alter-G treadmill running
  • Feb (month 9): start jogging
  • May (month 12): take the training wheels off - no more restrictions!
  • December 2016: San Diego Holiday Half Marathon

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safety tips for getting around

June 3rd, 2015 · No Comments

This is my first time using crutches and a knee walker, and have had three nasty falls. Here are some tips I’ve picked up along the way:

  1. When NWB, try standing with the good side’s knee slightly bent and push off using the ball of your foot while crutching / scooting to preserve your good Achilles.
  2. Sit or kneel in chairs when washing by your bathroom and kitchen sinks, and while dressing at your closet and front door, to minimize fatigue.
  3. I choose to scoot up and down stairs on my butt while NWB. A friend suffered a re-rupture when he fell down his stairs.
  4. Keep the wing bolts on your crutches facing backwards, so they don’t get caught in your clothing.
  5. Go slow, and beware of slipping hazards. I went flying after placing a crutch on a non-sticky door mat.
  6. The knee walker is nice to have, but when going over uneven pavement (seams, ramps, warped sections), slow down and use the brakes to “walk” the front wheels over or through the obstacle. Even small seams can stop the walker in its tracks, sending you flying.
  7. Knee walkers aren’t very stable while turning. Try to go over seams in the sidewalk head on, rather than at an angle, for maximum stability.
  8. If falling (mine felt like they were in slow motion), raise your bad foot to the sky to try and prevent it from impacting the ground. Land on your butt or side, and if at all possible, “roll” through your landing rather than crashing down.

If there are other good tips I missed, leave them in the comments!

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inspiration / best case outcome

June 2nd, 2015 · No Comments

If you haven’t already, you really need to see Brady Browne’s video demonstrating his return to football shape 9 mos after ATR. He skipped the surgery, to *boot!*

I’m going to make it a point to watch that regularly for inspiration. His channel also looks to be a useful resource, showing the progression of the exercises he did.

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