9 Week Update - Two Shoes

January 4th, 2015

I haven’t been writing much but have been checking in on this site often to see how others are doing in their recovery. It’s been encouraging to see others progressing along and going through all the same things as I have.

I just had an appointment with my doctor at about 9.5 weeks and it was all good news. I was okayed to move into two shoes and given a small brace to wear on my injured foot (the Achillotrain - which seems to be made by a German company). I’m supposed to wear my boot any time I feel uncomfortable, but can’t see myself wearing it too often going forward as I’ve found it to be really uncomfortable since I started walking in it.

A little update on the last few weeks:

Weeks 2-4 post op were pretty uneventful. I was in a cast until the middle of the fourth week at which I point I moved into a CAM boot. I was NWB for weeks 4-6 in the boot, only allowed to rest of my injured foot on the ground but was not supposed to walk. I didn’t push it much, but definitely tried a little partial weight bearing on my crutches toward the end of that time.

At six weeks I was given the okay to start FWB as much as possible with the boot still on. It definitely took me a few days of PWB with the crutches to convince myself to put my full weight on my bad foot. But I was eventually able to do it. I haven’t found walking in the boot to be comfortable at all and feel pretty confident that I should have been given a smaller sized boot. I was right on the cusp of two different sizes and having the larger boot has really limited my ability to roll my foot completely. I’ve gotten by with it, but haven’t really been able to walk for a sustained period of time, which has been frustrating. By about eight weeks post surgery, I started walking around my apartment in bare feet. Mostly an awkward duck walk not really pushing off with my toes, but more comfortable than boot walking at home.

I started PT at week 6 when I was allowed to start FWB. My PT has been good and started with a number of range of motion exercises (ankle alphabet, toe clenching, seated stretches). It has since progressed to stretching with resistance bands, balancing on my bad foot, and for the last few sessions riding the stationary bike. Last session (yesterday) I biked 1.4 miles with the resistance at 4 of 10. I’ve also been using a balancing board/disk to stretch my ankle.

My PT has been astonished that I have almost no swelling after our hour long sessions. He hasn’t even felt the need to give me ice after most sessions. My range of motion has certainly improved since the start of therapy and I’m starting to regain a little bit of strength.

I’ve spent this weekend walking around my apartment in two shoes. I started with a significant limp but it has improved all weekend to the point where now it is just a minor limp. My PT said we’d work on that this week though.

My doctor said I could start driving again when I feel ready for it. I think I’ll feel comfortable after another week or two of PT. I’m not in a huge rush, and frankly the ability to walk is generally more useful for me, but I look forward to driving again when I’m ready.

I spent last week graduating from showers that started seated and ended standing to just standing showers all the time. Between having two shoes on and the standing showers, it’s been a nice mental boost after a few frustrating weeks trying to walk in the boot.

My incision has healed very nicely for the most part and just has a little bit of scabbing near the bottom, but I figure that has to do with the PT exercises pulling on the scab. My doctor said it looked really good when he saw it on Friday. I’ve been using regular skin lotion on the rest of my foot and haven’t put anything on the scab yet. I might invest in some Vitamin E or a specific scab treatment from the drug store when I get around to going later this week.

/home/wpcom/public_html/wp-content/blogs.dir/0f1/34163879/files/2015/01/img_6934.jpg 9.5 weeks post AT surgery

First Post Op

November 12th, 2014

I had my first post op appointment with the doctor on November 6, nine days after surgery. They cut my very bulky cast off (freedom!) and unwrapped my ankle to see how I was healing. The doctor said he was very pleased with how things looked. They cleaned up the wound a little bit, rewrapped my foot, and were quick to put another cast on it. I would say I only got to enjoy 20 minutes without a cast. Though at least the new cast is significantly smaller and lighter, which is really nice.

Photo Nov 06, 9 36 31 AMMy incision 9 days post op

The doctor told me that I should come back in two weeks time. At that point, I will be getting the stitches out (about 3 weeks post surgery) and hopefully moving into a boot to start partial weight bearing. I was warned that 3 weeks might be a little fast to move into the boot and that it might come after 4 weeks instead. From what I’ve read, this is a decently aggressive protocol. The goal after getting the boot is for me to walk with crutches until I’m comfortable without them.

I’m writing this 15 days post surgery and I’m feeling okay. There isn’t a lot of pain, though my foot swells and throbs just a little bit if I don’t elevate it most of the time still. I’m sticking with the crutches, though I considered a knee scooter. I’ve already been on crutches for 3.5 weeks, what’s another two at this point? I get fatigued very easily, which has been frustrating. I didn’t have much of an appetite for the week before surgery or the week after. Though it seems to be getting back to normal. Going up the steps to my apartment is very tiring and I try to avoid having to do it more than once a day, and there have been quite a few days I haven’t gone out at all.

Photo Oct 23, 8 11 20 PM The second staircase in my apartment building. Going up two flights to get home is the bane of my existence right now.

A few things I am really looking forward to, knowing that some are still far off:

*not having a cast
*not having crutches
*being able to walk up stairs
*being able to wash my foot
*being able to stand in the shower
*being able to drive again - with a right foot injury, I’m so dependent on getting rides to places or taking cabs
*wearing two shoes
*and of course getting back to my usual activities of biking, hiking, and playing soccer

Successful Surgery

November 12th, 2014

I had the surgery on the morning of Tuesday, October 28. I arrived at the hospital at 6:30 am as I was told to, and was called in around 7:15. I met with Dr. Shapiro, his resident, and a few students that would be watching the operation. There was then a quick talk with my anesthesiologist and I was wheeled into the operating room. I remember them putting the mask on to put me to sleep and then woke up in the recovery room. My surgery took about 2 hours.

Photo Oct 28, 8 06 24 AM My foot the morning of surgery.

I was groggy when I woke up and took my time getting my wits about me in the recovery room. The doctor came in and told me that my surgery was successful and they were very happy with how the tendon came back together. After a little while I was awake enough and my parents were brought back. My mom was able to go down to the pharmacy while my dad fetched the car, and soon we were off to their house in NJ for a few days. I live alone, so it would have been impossible to stay in my place without assistance for the days after the surgery.

I felt okay for the rest of the afternoon and evening, but the pain block they gave me seemingly started to wear off as I tried to go to sleep on the night of the surgery. My foot throbbed a little bit and I couldn’t seem to get comfortable. Things were not made easier by having to pee every hour or so. Apparently they put a lot of fluid in me during the surgery.

I took the percocet that was prescribed to me the morning after the surgery. My foot was still throbbing, I was tired and frustrated from not getting much sleep. It helped with the pain and allowed me to fall asleep for a little while, and only made me a little bit groggy. I took two more in the six hour increments that I was prescribed that day as the pain was present, but not terrible.

Photo Oct 28, 2 48 23 PM My very bulky cast after surgery

I didn’t take any more of the percocet after that second day. I had a little bit of discomfort but nothing that the 800 mg ibuprofen they gave me couldn’t handle. By Friday I was feeling okay enough to crutch around the house a little, even sitting outside around my parent’s fire ring for a little while in the evening. My foot would swell and it was a little uncomfortable when I wasn’t elevating it, so I tried not have it down very much.

By Monday I was able to come home to Philadelphia and my house. I was glad to be home and to see my cat, who had been home alone for the week. (Thank you Cindy for stopping by to feed him and hang out! Charlie and I both greatly appreciate it!) Being home alone is a little bit of a pain in the ass, but I’m getting by. I’ve got some routines worked out for fixing food and getting drinks. I carry my messenger bag around a lot to move things between rooms.

About Me and the Injury

November 12th, 2014

Hello everybody. I’ve found this site to be incredibly helpful in learning about my achilles injury so I figured I would share my story here as well.

A little about me…I am a reasonably healthy 32 year old male. I bike 6 miles per day to and from my job and my bike is my main mode of transportation in Philadelphia, weather permitting. I play soccer twice a week most weeks, a Tuesday night fustal pick up game and in an over 30 recreational league on Wednesdays. I am an avid hiker, hiking often in remote parts of Pennsylvania in rugged terrain. (You can read about that here.)

I ruptured my achilles on Wednesday, October 17 while playing soccer. I wasn’t near anyone when it happened and was simply going to pass the ball with my right foot when I felt the sudden pop that many others on this site have mentioned. I was pretty sure of what happened right away, and needed my teammates to help me off the field.

Photo Oct 15, 11 29 11 PM Still in my soccer shoe at the ER the night of the injury.

I stopped at home after the game and picked up some dry clothes (we had been playing in a pretty drenching rain) and headed over to the ER at Hahnemann Hospital. The ER doctor (who happened to be the podiatry resident) performed the Thompson test and immediately knew that there was an achilles problem. They gave me crutches and told me to make an appointment with their Foot and Ankle Center. I made the appointment for Friday morning with Dr. Howard Shapiro.

The doctor and his resident confirmed what the ER doctor had told me and that I had a complete rupture of my achilles. He said that surgery was the best way to correct my tear and that it would give me the best chance to return to the activities I had been doing. Surgery was scheduled for October 28, eleven days from the injury.

The days between the diagnosis and the surgery weren’t bad. My parents were kind enough to drop off some food for me to cook easily. I minimized how much I went out, as I live in a third floor walk up and the stairs are not easy on crutches. I can luckily do most of my job from home, so that wasn’t much of an issue. I had an MRI and some pre op testing and soon it was surgery day…

Photo Oct 19, 10 38 58 AM My first cast - pre surgery