roscohio’s AchillesBlog

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Great uplifting blog. Great to hear positive things from those further down the recovery road. Happy healing , take care and keep us posted on progress.

Congrats! Might want to post your foot size.

Yes, normofthenorth, I meant 5″. My OS said my rupture was further down towards my heel and was more difficult to repair. It sure made a difference when I took the first 1″ wedge out if the boot. I “walked” quite a bit today, (used a walker, not crutches) wore me out. I hope I don’t regret it tomorrow.

@sittinginthestands, thanks for the encouraging spin info. I look forward to getting back to cycling. Fortunately, my injury is my left leg. Once I feel a bit more stable, I will go to the gym to get some cardio in.

Thanks, everyone!

Vicki, for most of us walking PWB — with crutches but otherwise as normally and straight as possible — is the best way to get to FWB. And it’s important to build up your “good” foot so it’s as high off the floor as your injured one.

Did you really mean 5 INCHES?!? Even 5cm is a lot of heel wedge — lots of very successful studies used 2 or 3 cm — even non-op without sutures to hold the ends together. (Post-op, you should logically need less not more.)

@john @ron - thx for the uplifting post. cheers to continued improvement and getting back to 100% gym shape! \

@beardedmurray - the past 4-5 weeks have been tough, i was just there. but this next month is going to amaze you with how resilient your body is, how it miraculously heals, and how much progress you can make daily. i have been surprised by how far I’ve come in the 2.5 weeks since i got my cast off at 6 weeks post-op and i’ve taken a very methodical and conservative PT approach. because i hadnt been able to drive, i havent been to the gym but have been working out daily at home. let your body guide you, just listen to it.

@vickiN - I got back onto a stationary bike as soon as i was able to get into a shoe, at about 6.5 weeks post-op (6 weeks in cast). never felt so humbled by a routine physical activity. good luck and keep up the positive approach!

I just started reading everyone’s blogs. I ruptured my Achilles on Dec. 16th leaving the gym after a 5am spin class. Tripped on a parking bumper and my foot landed on the curb. Ouch! I had my surgery on NYE. I was in a splint until a week ago. I have the walking boot now. I can’t put hardly any weight on it but it is easier to get around on the crutches. I also use a walker sometimes when I need to go somewhere. I feel much more stable having 4 legs on the ground.

I started out with 5″ lift in the heel. I don’t even wear 2″ heels in real life! Very awkward for me. I can take a 1″ wedge out every week. What a difference 1″ makes! I go back to my OS on the February 27th for my next checkup.

I started driving this past week. What a sense of freedom! I can get in and out of the car just fine, using the walker. I use a knee scooter a lot during the day at work because I am up and down a lot. I just looked at the icrutc that someone else had mentioned. Do any of you use that? Can you sit down with it on?

I’m sorry to ramble on here but it’s nice to share with people who are going through the same thing. I need to get myself

Great post and energy.

I must admit, the first month or two went by like a snail, but after I went FWB, time flew. I know one thing, the first 3-4 weeks are terrible (mentally and physically). LOL.

Good luck and keep posting.
Ron

This is great to read. At 8 weeks out, I’m looking for posts like this to see where I might be, down the road.

It really is true, being laid up like this has made me appreciate my formerly mobile self. Just seeing people walking their dogs in the park makes me wistful for the days when I could do so too - and look forward to getting better shoo I can do it again!

It’s aways good to hear “it gets better” because someone is always farther down the road. Cheers to your recovery!

Beardedmurray: Regarding the gym membership - I kept mine and began using it right away. It got me out of the house and back to a routine, of sorts. Like you, I could do the upper body weights and core at home, but it was nice to do it at the gym, too. The gym also had the Windjammer cardio machines, which I used before weight bearing and then treadmills once I was off crutches (safer than the snowy, icy sideswalks). Lots of bike options, too. Just a thought:)

John, maybe I’m weird — OK, I AM weird, references on demand! — but I see double-edged swords in some of your statements. “Follow and trust your health professionals, but my leg almost got destroyed by one of mine!” How about “Follow and trust your health professionals UNLESS they make a mistake, get distracted, haven’t been keeping up on the literature, or are still doing things the way they learned them a decade or three ago”? There are a LOT of people posting here who have gotten bad advice or been actively harmed by their health professionals. It helps a lot to have a good smart Health Advocate, and for ATR patients that’s usually us, the patient.

I couldn’t agree more with your new sympathy for the permanently disabled. Have you heard physicist Stephen Hawking’s (Homer Simpson: “the wheelchair guy”) calling people who walk and run “the temporarily able-bodied”? Food for thought.

In addition to sympathy for the less fortunate, this injury could easily make you more thankful for how well the rest of your complicated body works, and how well THIS part will work soon, too. Keep healing!

John this is very uplifting. How soon did you end up going back to the gym and to what capacity? I am not sure if I should keep my gym membership or not, I am 1 month post op. I workout at home right now upper body and core as limited as I am, has PT kicked your butt enough where you dont need the gym in that stage or if you didnt end up going for 5 months then not worth paying?

Hi Jen
Sorry to hear that. You could drop the Oped Hq a line. They are a pretty forward leaning organisation and may find a solution for you.
Other options could be to buy online and get delivered to a friend in the UK or US. They then send on to you.
Or post the request on your own blog site (easy to set up via Dennis)That way should get seen by a wider community!
That said, there are many in other boots who have posted on this site and are happy with their foot ware! Protocol probably being more important than type of boot.

Second that comment on OS not having a scoobie, hence this site is so useful!

Hope that helps - regards to the rainbow nation!
Hoppy

Hi Hoppy
Thank you for the info, am waiting for someone to call me back from ASA, Prius doesn’t stock them. Only pre-owned one I can find is wrong size.
Hope your recovery going well.
Jen

Jen
Hi Jen Welcome to the club!!
U can get vacocast in RSA, although each country comes up with their own costs! As a comparison, £250 incl pp in UK and $300 US. Best of luck. It’s a good boot if you do go for it! + U can swim in it! See below for RSA options (from Vacoped Internet site).
Or you could go he 2nd hand route, if someone is selling one on eBay, or you could ask on his forum!! - they are pretty sturdy and normally come from “one careful owner” and then you just buy the liner

South Africa
ASA Medical Supplies cc
+27 215516976

South Africa
Prius Healthcare Solutions / Claveguard
002783 309 2342

All the best Hoppy

Hi am 11 days post surgery following rupture of left achilles and in a moonboot which I think is the same as an aircast boot. Does any ATR recoverer (?new word) know if I can get a Vacoped/Vacocast in South Africa. My OS doesn’t answer my questions, blah.

Good to hear things are going well for you! If you’re looking for more compression socks or different colors, those designed for people on long airplane flights work pretty well and look like regular socks.

Thanks everyone for the responses and thoughtful comments. My thinking is if Kobe’s using it, it must be top notch, right? Comfort to me is as physical as it is mental - having confidence w the different stages of weight bearing, no rubbing on the wound, no fear of re rupture, etc. Though my OS said ‘a boot is a boot’, I think the peace of mind, positive responses and knowing I’m doing the best possible thing for my leg wins out. Will post once I have it and by all means additional comments welcome!

Thanks all and God bless.

John

As you’ve seen, most Vaco users love it (though there have been a coupla exceptions here). And I think a hinged boot like the Vaco (& others) has therapeutic advantages, maybe especially in the transition from boot to shoes. BUT, (1) UWO got excellent results with a simple non-hinged AirCast, and (2) most boots can be adjusted or adapted to function properly on most legs. The basic jobs are simple and few: a) clamp the ankle so its immobilized at the righ angle, b) protect the leg, c) be snug enough and stiff enough to support the patient’s full weight on the ball of the foot/boot, transferring that force through the boot to the front of your shin, relieving the AT and calf of its usual job. And d) avoiding friction sores and pressure points and general discomfort. Everything else — even hinge-ing — is an optional extra, IMHO.

Yet another vote for the vacocast. The aircast irritated my incision and/or achilles after only about 30 minutes (my OS doesn’t want me wearing it unless I’m up and about), even though I was using a knee scooter and teaching while sitting down. No such problems with the vacocast.

Hi fellow Chicagoan. Vacocast is the best. I’ve tried the Cam Boot the Air Cam and the VacoCast. Kobe also has it as well. I teach golf and tennis here in Chicago and need to get back out ASAP, so I picked the VACO because I can walk in it and work in ti. No brainer, spend the $300, and GO BEARS! Great game yesterday.

I reruptured in the aircast because my wedge wasn’t affixed and it moved under my foot arch and thus my feel went down.

I can’t say enough good things about the vacocast. I bought it thinking I was going to use it for 3 weeks, but my doctor prescribed 5 weeks just to be on the safe side.

Besides the comfort, which there are several different ways to adjust the fit, there are no wedges, and there are no pain/pressure points. I am glad I shelled out the extra $$$$.

Good luck.

Whoops, I should have said that they published their report abstract, not the protocol itself. I’ve included the protocol separately as has Suddsy.

Spacemonkey

Something not right here surely. I was treated at Royal Devon & Exeter acouple of years ago (NHS and with one of the leading ortho centres in Europe) and, after 2 weeks in a fibre glass cast, was given Vaco’s Achilles Pro boot. A few months ago, the Exeter team published its rehab protocol and shows just about the best disclosed recovery rates to date - for surgical and non-op. Fascinating stuff.

Check Suddsy’s 2 week achilles blog at suddsy/2013/06/24/end-of-wk-2-wow-progress/ to see the Exeter protocol and the rehab schedule web link. Suddsy’s own rehab treatment was very similar to mine, although a surgical case and I was non-op. Suddsy was a UK patient too.

Get your guys to speak to Exeter’s Princess Elizabeth Orthopaedic Centre. As for “UK trials” - really?

Oped (makers of Vaco) also published info on its Facebook page showing Exeter Chiefs players with the boots - fortunately the boots can mostly be recycled with new straps, liner, etc, especially useful for gear that was apparently ‘tested’ almost to destruction at the training ground. Also, call Oped in Devizes for the names of NHS hospitals wh

I’m a Vaco fan having used the Achilles Pro for 6 weeks last year.

It is a great boot, lighter than some others, cool to wear, easy to adjust, good customer service. However, if I were you, with only another 4 weeks or so of boot wearing, I’d probably stick with the boot that you already have but bear in mind that I have never tried an Aircast boot and I don’t know the spec that you have - I’m assuming that it is at least the most appropriate in the range for an atr.

Alternatively, you could blow that spare cash, buy the Vaco boot now and sell it in a couple of months’ time at a loss. If you do buy one, and intend to swim in it, ensure that you have the spare (dry) liner to hand. An ‘Even-up’ for the good side will help to avoid wear and tear to the hips and knees too (whichever boot you wear).

I have been using the Aircast for about 4 weeks and get around in it no problem, however I don’t bother pumping it up and anything other than walking is probably a non starter. I have tried cycling and it is possible you just would not want to go too far.
I had looked at the Vacocast, as £240 to keep cycling for 6 weeks would have been well worth the money, however my PT could not work with it as the prerequisite trials in the UK have not been completed, and the Surgeon would therefore not sanction it. I now wish I had bought a vacocast as the lack of exercise is driving me mad, (not a fan of the gym) however only 2 and a half weeks of boot wearing to go….
You are a young guy to be rupturing your Achilles? at least you should heal faster All the best and enjoy the ‘Football’….

There are a bunch of comparisons on here, but one that sticks out is…

http://achillesblog.com/pboltonmd/2011/05/26/vacocast/

“So I was charged $300 for my standard issue air walking boot. The air bladders put pressure right on my wound and did not restrict my heel from rubbing against the boot. The air bladders also lost their pressure after 30 min.

So I spent another $300 and ordered the Vacocast and got it yesterday. Holy shit, what a difference. This thing is comfortable. I went swimming and did pool therapy (even though I am still NWB at 9 wks) and it was easy to dry.

I am going to my ortho tomorrow and will tell him this boot is amazingly comfortable and versitle. It’s got a little adjustment for just about everything.

As a patient and physician I can say this is a superior boot. Does it help you heal faster as they claim. Probably not, but it’s comfort and ease of use make your mobility an easier experience.”

lefty, my OS had me start PWB at the same time I went into the boot (2 weeks post-op); at 4 weeks, he gave me the okay to transition to FWB and to start PT. He didn’t want a PT anywhere near my achilles until now. As @roscohio says, some OSs are more aggressive than others, but they also vary depending on the injury, nature of the repair, the patient, etc.

At two weeks when you went into boot did you use crutches or able to walk somewhat? My surgeon also told me that he would place me into a boot at two weeks.

I have seen numerous options for your first post op appointment 10-14 days after OS. I was lucky enough to have my incision heal very well and went right into a cam boot with plantar flexion. I was NWB in the boot at that setting for 4 weeks. At my 6 week appt. (this past Friday) the OS adjusted my boot back to neutral and was allowed to start PWB and was told I could go to FWB at my leisure and confidence. I had my first PT visit today and the therapist got me comfortable walking FWB and walked out of there at FWB and no crutches. No tow people are the same but that is how I have progressed and was pleasantly surprised at my progress. Good luck to you!

TX - thanks for the response. Where are you now progress wise? What was the transition like from NWB-PWB-FWB? My OS is aggressive and so am I but simultaneously want it to heal right. Thanks for your insight!

After my surgery I had a 2 week check up where they took out the stitches and put me in a hard cast. Wore the hard cast for two more weeks and then on my next check up I got my walking boot.

Thanks for the response. Absolutely would be great to compare progress/notes. Glad first day post op went OK. After a few days kick the meds and you’ll be fine. Will feel back to ‘normal’ mentally, despite being laid up watching bad movies. Message me back if you have any difficulty - I likely experienced it in some form over the last week or so. Take care, John

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My surgery done yesterday. My doc says it will be at least 4 weeks NWB. Pain is not as bad as I expected. Keep updating, I’d like to compare our progress if you don ‘t mind since we’re close to the same surgery date. My first follow up is Tuesday 8/26. Keep in touch.

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