Slato’s Achilles Blog

After being discharged after a 14 hour stay in hospital and returning within 10 minutes I was about to face 12 nights in Medical Short Stay, a ward that normally has a 72 hour limit.

During the 12 night stay I had further pain attacks during the nights, further chest x-rays and ultra-sound.  With the further chest x-rays it revealed I had developed around 1 litre of fluid on my lung and my lung was partially collasped.

This then meant I had to under go a procedure to drain my lung, not once but three times over the next few days. Entering through my rib cage with a large needle from my back they drained 200ml of partially blood stained fluid the first time, nothing in the second and a good 300 or more the third time. This was clearly not in all but they stopped and sent it away for testing. 

I’ve now been out of hospital for 5 days taking warfarin for the DVT and PE plus 8 day antibiotics for the inflammed and possibly infected remaining fluid on my lung. Overall a very stressful time but glad to be out on the mend and now concentrating on my ATR recovery.

After being discharged I walked out using my crutches but only made it half way down the corridor before having another pain attack similar to the three I had early morning at home. My wife rushed back to get a doctor and I was put back in bed with an ECG machine and oxygen. The recovery time was about an hour and my wife had never seen me look so ill. My Mum and Dad who had left just before me to get the car returned to my bedside with my wife and looked pretty concerned as my breathing was deteriotating and only the oxygen could stablise me.

This was to be the first of a twelve night hospital stay.

Day one in EAU I had more needles, drugs and tests than hot dinners. I had blood removed from various parts of my body, injections for blood thinning and pain killing.

I was rigged up to an ECG machine several times, had chest x-rays, a CT scan, an echo scan on my heart all done within a few hours of being there. Several doctors spoke with me and confirmed I had a DVT and that this had climbed into my right lung. My right lung had a forest of clots known as a Pulmonary Embolism.

Eventually at 1800 I was told I could go home but first had to see another doctor about my medication I would be taking for the next 6 months. Another couple of hours passed and I was given a yellow book and an explaination on the drug Warfarin. I then waited a further hour for my discharge paperwork and eventually walked out at 2200.

Just under three weeks ago I had a very scary setback with my ATR injury. During the early hours of Thursday morning whilst sleeping I woke up three times with massive stabbing pains in my chest and right side. The pains lasted for around 20 minutes each time and were extremely painful. I rang NHS Direct who advised me to call an emergency doctor or 999 but I held out to the morning.

First thing as soon as my Doctors opened I walked in for an appointment. I had to wait an hour but soon the doctor concluded I had DVT and the blood clot had travelled to my right lung. The blood test was positive and I was rushed into hospital. Luckily because I had seen the doctor I was booked straight into EAU (Emergency Assessment Unit). At this point I was becoming very concerned and my wife was in tears - I think we both realised this was pretty serious.

Since finding the Vacocast link on the achillesblog site I thought this was a worth while product so I contacted them this week. They’ve been extremely pro-active and already visited my consultant and plaster room. Luckily my consultant is supportive of the product and they are joining me at my next hospital visit, next Thursday.

If anyone has used this boot I would be interested to hear your comments, good or bad and if you did use this boot what week did you get fitted with it after the injury.

Friday 19th August, the morning after the scans I wasted no time and rang the Consultant. Spoke with his secretary and luckily for me he had  reviewed the scans shortly after the scan had been done. I was advised that the consultant thinks a non-surgical option is best and I need an appointment in two weeks to have the cast changed.

With this now being the 13thday since my injury, (I had obviously had plenty of time for research, reading blogs and talking with my friend who is still recovering from his rupture) I was curious as to why an operation was advisable. I made it clear that I would prefer an operation as I believed my age and active life would benefit from an operation and challenge this decision. Obviously his secretary wasn’t in a position to comment further so had to pass on my comments.

I was now beginning to think the delay getting home, the incorrect cast position for 4 days and the huge delay getting scanned had hampered my chances for a decent start to recovery. Why does the consultant prefer no op when clearly the rest of the world say an operation is the only approach.

Within 5 minutes I received a return call from my consultant. Firstly he wanted to know why I preferred to have an operation and I explained based on research and friends experience an operation was advisiable for a complete rupture especially when I’m still young and active. I wanted the best chance for a good and strong recovery. The chances of a re-tear were alot lower as well.

He went on to explain that surgery isn’t always the preferred route and comes with it’s own complications like infection being one of them but more importantly he said that surgery for my particular injury wasn’t possible.

Putting the partial tear to my inner calf muscle aside, apparently the complete rupture to my achilles tendon was higher than normal just above my ankle bone and there wouldn’t be enough good tendon higher up to use to stitch into. He said my achilles has ruptured away from the muscle and it wouldn’t stitch well.

I’m no expert and this advice seemed to be logical so what could I say. My only concern now was ’How big is the ‘Achilles Tendon’?’. Answers please…..based on images I’ve seen on google the achilles tendon travels right up to the large calf muscle so why isn’t there enough tendon to use.

Well to say I had been let down by the NHS was an understatement. Despite phoning the X-Ray department and my Consultant daily my URGENT scan appointment was on Thursday 18th August in the afternoon. So that was 7 days since my initial consultant appointment and 12 days since the injury. I was beginning to think that I had been neglected of a service I needed and if I needed an operation I was too late.  Since I had been in full time employment since the age of 17 paying NI I was not amused. If only I had private cover or had the cash lying around for a private scan and operation I could have been seen the following day by another hospital 7 miles away.

I was told the ultra sound scans required expertise to read and this was the cause of the delay. Only certain people are trained to read achilles rupture scans. No idea if this is true or not.

Anyway, I had the plaster removed in preparation for the scan and my leg felt so weak and delicate I could barely rest it on the bed. They proceeded to scan my achilles and calf and this %!!*^& hurt - I was gripping the bed so hard at this point. Being inpatient I asked what they could see. They told me I had completely ruptured my achilles tendon and their was a 2cm gap, I guess this was what I was expecting ….however there was more, I had also partially torn my inner calf muscle. Great, but at this point I knew an operation was called for.

Luckily my insurance company arranged for wheel chair assistance at both departure and arrival airports and purchased me a further two seats on the plane. Having three seats to myself on a full flight lasting four hours was very much appreciated. Only downside was I couldn’t help my wife with two suitcases, hand luggage and two young children.

We eventually landed on time at midnight on Wednesday 10th August so an hours drive home, a few hours sleep before a visit to A&E in Luton. Luckily because I had paperwork from the Hospital in Fuerteventura I could go straight through to the Fracture Clinic to see an Orthopedic Consultant. Only an hour went by before I eventually saw him - plaster cast was removed then he examined the injury. No idea what they call these tests but grabbing the calf muscle didn’t move my foot so indicated a complete rupture. He couldn’t feel a gap in the achilles so the tests were not conclusive. An ultra sound scan was required to get exact extent of the injury.

During this consultation period, the consultant seem to be in favour of the non surgical route. Not only is there no risk of infection but he mentioned new research showed that a non surgical route was just as good as the surgical route. This went against everything I had read and all the advice I had been given from the private doctor in Fuerteventura and a good friend who had completely ruptured his 18 months ago.

Anyway, I couldn’t be scanned today but was told they would get me an urgent scan, so go home and stand by the phone. They re-plastered my leg from knee to toe with the correct foot angle and told me to only take aspirin while keeping my leg elevated above my heart.

Since it was made clear I needed an operation I thought I would try and get myself and my family home asap so I started to check out alternative flights and touch base with my insurance company. Flights in and out of Fuerteventura to the UK are not that frequent so I ended up waiting three days for my original scheduled return. The next few days were going to be uncomfortable.

The following day on Monday 8th I hired a wheel chair, spent €30 on further pain injections. I also found out that the airline wanted a fit to fly certificate and since the Hospital don’t supply them I had to spend €115 getting one from a private doctor - visiting the private doctor proved to be worth while in the end for many reasons. Not only did he provide a fit to fly certificate but he had just recovered from the same injury. Sharing his expereince and advice I had a good foundation for the injury and my road to recovery.

Having spent all the previous evening surfing the web and reading all about achilles ruptures I was beginning to regret not taking the option of an operation in Fuerteventura especially when the private doctor mentioned the surgeon had a good reputation for this type of operation. The private doctor mentioned two things that did concern me. Firstly, the hospital had put me in a plaster cast with my foot at the wrong angle and that an achilles rupture should be operated on asap to aid a good recovery.

So after the game briefly stopped to get me side lined, the hotel managed to get hold of a wheel chair and pushed me to reception. Being in a foreign country on holiday I knew this was not a good start. My wife rounded up the kids, my passport and some cash while the hotel called for a taxi. I was advised a taxi would be quicker than an ambulance. The nearest Hospital was only a 15 minute cab away and luckily A&E wasn’t too busy. After booking in and waiting for 10 minutes I was seen by a nurse who took some details and pushed me along to see the Doctor.

The Doctor didn’t speak any English but it didn’t take too long for him to see my achilles was ruptured and wheeled me into another room which just contained a table, a chair and a phone. He made a call, spoke alot of Spanish and passed the phone to me. An English speaking lady then asked me if I wanted an operation or would prefer to go back to the UK and have the operation at home.  After asking the question I was told they could operate in two days, I would then be in hospital for another two days and then couldn’t fly for a further two days. Seeing as I was due to go home in four days I was sure going home would be the best decision. They then completed some paperwork, put me in a half cast from knee to toe, gave me an injection for the pain and sent me on my way.