New to the club - 1 week post surgery
I would start by complaining about how much being in this situation truly stinks, but it’s a moot point because, if you are reading this, then you most likely know what I’m talking about. Let’s just say that this is not how I wanted to spend my summer. Big thanks to Dennis and the contributors to AchillesBlog. It has been a huge help.
The Injury
My story is fairly typical, as I’ve discovered. I was doing some kickboxing drills with a partner in class, when I stepped back with my left foot to load up and felt I had been kicked in that heel, immediately falling to the mat. Of course, no one had kicked me. It was the force of my AT snapping that I felt. I was taken to Urgent Care and then referred to an orthopedic surgeon that afternoon. He put me in a boot and briefly discussed my options - surgery vs. conservative non-operative approach.
Decisions, decisions
I struggled a bit with which approach to take. The OS said that he would opt for the surgery if it were his ATR, but he didn’t push me either way. I could tell that didn’t feel that comfortable with conservative treatment. I read all of the published studies on the topic, and read the information on this blog. Despite the data showing similar outcomes between surgical vs conservative, the surgery appeared to be more of a sure-thing in terms of re-rupture risk and AT strength. My mind was made up?
My follow-up/pre-surgery visit was a week later with a PA and another OS. I had been referred to a different OS (who was the foot/ankle specialist in the practice) from the one I saw on the day of my injury because he didn’t have any OR time in the near future. The PA discussed the process a bit more and said that surgery was definitely the way to go. My surgery was scheduled for the next week. I didn’t get to meet the new OS until the next week (2 days before my surgery) because he was running behind. I really didn’t want to go under the knife without first meeting the guy who was going to do it. During that visit, I was looking for reassurance that surgery was the best option in my case. To my dismay, he seemed non-committal with either approach. He also scared the hell out of me by informing me about the risks of surgery. Those being infection at the incision, skin-tethering, and deep infection. That last one was particularly frightening due to the fact that it could result in complete loss of the AT. Not to worry though, he could replace it with the tendon that connects to the big toe to get some AT function. Again, this is 2 days before my surgery. He was doing the right thing by informing me of the risks, but I came out of that visit with a lot less confidence in my decision.
Don’t get me wrong, I think that patient preference has a place in medical decision making, but the physician, who is the expert, should ultimately drive it. I just wanted him to tell me what to do, but it seemed like a coin-toss would work just as well.
So I called a buddy of mine who is an OS looking for some advice/reassurance. He’s a good friend that I unfortunately hadn’t spoken to in a couple of years. True to form, he made some great points. Yes, there are risks to surgery, but they are very small. Not to brag, but I had none of the risk factors for infection or poor wound healing. Secondly, be skeptical about the studies. The subjects in those studies were under a rigorously controlled protocol. Would I be able to get that same level of therapy? Did they know how to do that? Also if the OS thought that the conservative approach was just as good, then why does he even do the surgery? Why are they equal options? His advice was to just get the surgery. After that, I’d be on auto-pilot and I wouldn’t spend the next several months second guessing myself. My mind was finally at ease and was once again gung-ho for the surgery.
The Surgery and the Aftermath
Let’s do this. It’s been 15 days since the injury and I was looking forward to getting the recovery started. My OS spent a few minutes with me during pre-op and explained the whole process. His demeanor made it was clear that he enjoyed surgery much more than in-office patient interactions. I got the nerve block and heavy sedation. Woke up feeling great and not feeling my leg from the knee down. I recommend the nerve block. It helped with the trip back home and allowed me to get settled without being on heavy painkillers.
Things got interesting when the block wore off at 3 in the morning though. I was on oxycontin, but needed to pop a couple of vicodin for the breakthrough pain. I was on those drugs for the next 2-3 days. Everything was mellowed out by then.
I’ve basically been on my back with my leg elevated for the last week. I can get upright for a few minutes here and there, but the blood rushing downwards is really uncomfortable. After a few minutes, my toes turn blue. Needless to say, with the exception of being able to binge watch shows, read, play Xbox, nap, and work a little, I’m useless.
I knew this going in, but I’m an incredibly lucky man that I married the woman I did. She has done everything; taking care of our 2 little boys, making sure I have all that I need, all while working a full-time job without complaint. In return, I’ve tried to be a good patient. I would elevate her stress level if I tried to pretend that I didn’t have a debilitating injury and was hopping around the house doing things I shouldn’t. So I remain in bed and accept her good will. Being useless has been the toughest part of this adventure so far.
Next, steps
I have my first follow up visit in 4 days (11 days post surgery). With any luck, my incision will look good, I’ll get the stitches out, and put in the boot. I’ve already ordered the Vacocast thanks to the recommendations on this blog. Looking forward to trying that bad boy out. If all looks good, then PT starts the following week. My OS isaware of the benefits of early weight bearing, so I think I’ll be on a fairly aggressive PT schedule, again, if all looks good. Fingers crossed.
Wow, has anyone made it this far? Regardless, writing my story has been therapeutic for me. This is my first blogging experience, and I haven’t written anything that wasn’t work-related in quite a long time. Might as well make the most of this situation, right?
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Sounds like you are on the right track and have gotten good care. I am just past week 12 post-op and in two shoes…seems a long ways away for you, I’m sure, but it went pretty fast in retrospect. I tried to focus on what I could do as much as possible, without doing anything to risk re-rupture.
I had the same sensation you report whenever I didn’t elevate, but that went away for the most part after a few weeks. That said, elevation was my friend and I’d encourage you to elevate as much as you can.
I’d also recommend renting a knee scooter, way better than crutches, and I was able to do a lot around the house (and outdoors, too) on the scooter. Your OS will know where you can rent, and you can always find them used on Craigslist or whatever. You are not too far from being much more mobile, I would guess.
I never thought I would be excited about wearing two shoes. And I did get powerful perspective from cabbing to the grocery store and riding around in the electric cart. It’s still early in my recovery, but that will be an enduring memory for sure.
Anyway, hang in there, and know that it does get better. Good luck with your recovery!
Thanks for sharing your story outlaw. My story is very similar only I was playing basketball when I was injured. I just had my surgery last Friday June 5th. For the first 4 or 5 days, I kept my foot elevated as much as possible. I felt the same way after putting my foot down. All that blood rushing down was a bit weird. I’m scheduled for my first post-op appointment on June 18th and I’m hoping to get the cast off then and move over to the boot. I hear the recovery time can be anywhere from 4 to 6 months. I’m highly motivated to keep at 4 months. I know it’s going to be a long recovery but all we can do is be patient and listen to the Dr.
Good luck and thanks for sharing your story!
You guys will be up and at it before you know it. You both had surgery and I didn’t, but I’m at 17 weeks and moving along very well. Walking without limp and can even run a bit. I was in shoes and walking at 9 weeks. Just find the beauty in the journey and let it teach you lessons that will springboard you forward. Good luck and lots of prayers!