It was a Friday, June 10th, at midnight, alone in a big old hillside house, that the shotgun pop changed my active life. Dancing to Harry Belafonte, the noise made me suspect I’d broken a wooden floorboard. No pain - but the foot could not go down, only hopping and hobbling began.
Now, one year later, the long scar is still there, and I have been exceedingly careful in not running or taking a risk on a rerupture - partially because I followed these blogs and saw what could happen. Not sporty to begin with, it was no sacrifice.
Now I walk without pain and full strength - in spite of no p.t. - EXCEPT:
1. Now and then both Achilles’ tendons ache a little, such as right now as I sit. This warns me that not all is well. Neither hurt before the rupture.
2. In the injured leg, about once a week, while simply walking, a strange twinge can give me pause - if I were running, jumping or dancing, I fear that such a weak or painful moment would make me have another rupture.
I report these two concerns because I am sure others may have the same. Let me know if you do.
Turning 50 this year - the new 30? - means I would be more careful anyway. Some weight loss since last summer!
A whole tourist summer passed me by as I sat thinking, reading, blogging, DVD’ing, etc. With a right ATR, I was afraid to risk driving, and spent a lot of time at home, often considering both of my white, white legs. Now, as of this week, it’s over! I can drive, I can go back to work, I can be a human again. After such a long disconnect, almost monastic in its peace and contemplation, I have to thrust myself back into the frenetic world of tourism - at least to catch the dribs and drabs of 2008 tourists. September and October are beautiful months here, and the Europeans keep coming, while our dollar stagnates.
My doc advised that no PT was necessary, but I saw one through a friend privately. She mentioned that my feet appear to be flat - not very flat, but somewhat. This she reassured me was something that could happen from birth. However, research on the Net brought up articles that say flat feet are often a SYMPTON of shortened Achilles’ tendons, so that if a person knew this, he/she could be more on the ball about trouble ahead. The only real prevention is stretch, stretch, stretching, staying fit, and staying within a proper weight limit. Orthotics can provide arch support.
Has anyone else run into this from their docs or PT’s? Is it something worth discussing as a part of prevention?
One night, watching TV and “spelling the alphabet” with my toe, it dawned on me that the jolting between the strokes of an A or E was mildly annoying. Suddenly, a stroke of genius! My old Gregg shorthand skills, which I had learned 30 years ago in a girls’ Catholic high school, would be perfect for toe-writing.
The inventor of Gregg shorthand, an Irishman by birth, believed that the slowness of the 1880’s shorthand methods lay in their disjointedness, namely, lifting the pen away and back again. He developed Gregg as an “elliptical” system where the pen would flow constantly, never lifted up in creating one word. His system is a pleasure to use, and infinitely useful in the real world, in spite of all our computers and answering machines and so on. Every day we have to write things down, sometimes quite rapidly, at work, on the phone and from TV and radio annoucements.
So here we sit, we miserable ATR victims stuck at home on couches, with the perfect thing to learn: Gregg shorthand by toe writing! We need something to engage our minds, and we need the time to repeat and repeat the strokes to drive them into our minds. Normally, adults busy with real lives never have time for this, but WE DO!!!
Instead of writing the alphabet with your toes, check out this website: www.geocities.com/shorthandshorthandshorthand, which explains some of Gregg shorthand’s history. BAsic “shortforms” are the best to learn and practice, e.g. “we have”, “I have”, “in the “, “at this time” and other frequent phrases.
There’s even a movement afoot (no pun intended) to make such “short forms” applicable to ipods, since it would speed up the writing there, too.
You may all consider me crackpot, but just try it! Gregg shorthand is fluid and beautiful, a flowing style similar to Arabic writing. We have to sit and exercise our ankles, so why give the brain some meat to chew on, too!?
I am curious to know if we are all under some strange compunction not to name our doctors. I know that I hesitated myself at first, and have refrained from it throughout my postings. Is there some kind of unspoken rule in the medical world generally? Even when we’ve had a fabulous experience with it?
Second question: If I do not attend to the now healed wound, since I am doing no PT, will it be alright? Does one really need to massage it or anything else? Can’t it just heal by itself?
My final post-op came at 8 weeks, after 2 weeks of walking in two-shoes, heel lifts and crutches. My doctor felt that I could be released to slowly walk properly on my own, that I could be trusted to be careful in the following four final weeks, to simply walk around for recuperating the ankle and calf. I am still supposed to be flat-footed, with no push off on the right tendon. No PT necessary, in his view; I am at 10 Degrees of dorsiflexion. I was elated while there, but then, back at home, the worries begin: when will I know that I can walk properly with push-off, or to remove the inserts?
He also made very clear that he considered driving for the next four weeks a very risky, maybe-rupture thing to do. Only exception: drive an automatic, use left foot for breaking, but even that could be risky. Furthermore, I have no automatic, and love my Toyota Celica convertible stick.
If I felt I wanted to come back in six weeks for any reassurance, I could call and do so, but he thought it unnecessary. The scar is pink and straight, not painful.
I remain happy at this progress yet frightened of any potential problems.
Finally, I have to admit it to people who know the fear: my other AT is hurting now since July 10th, not everyday, but quite unmistakeably. WHen I told the doc, he said he hoped it was only because more pressure had been put on that leg these weeks; but otherwise, nothing to be done, it’s also just wear and tear and aging.
The tour business is in full swing, and I can work as a lecturer (”step-on” jobs) as well as a busdriver. However, when colleagues call me with last-minute city or wine tours, I realize that I would be taking a very big chance to walk around, even with a crutch, at only 7 weeks post-op, all to get some money. Every time someone calls - and it’s hot and heavy in August - I feel terrible to say “No”. But it’s always complicated with this job: one must get one’s self to a hotel or convention center, usually with public transit, because no one wants to drive me into the hub of San Francisco’s downtown chaos, or all the way to Fisherman’s Wharf. I am not yet allowed to drive my own car, so that’s no go either. In the end, I find myself almost going emotionally numb about it all, in order to get through this: read, read, and read; or write, write and write; there’s always more DVD’s and chores to do.
But what I really want to is to get out and live, not stick around the house all day. It’s ironic that in my teens and 20’s, I never wanted to be a “housewife” and “mother”, because it looked like the most boring and stifling of all occupations, to be stuck in the house. So I never did choose it, and I always had work and hobbies involved with lots of people. Travelling, driving, meeting people: can’t be done with an ATR very easily.
Many here write about their despair at seeing their muscles deteriorate with enforced passivity, but to me the worst of this (or any other debilitating injury) is simply being cut off from people and life. Since my mother was religious, she considered “getting stuck at home” a kind of martyrdom, a penance, or a sacrifice, but it was clear she was not happy with it. Now and also years back, she is riddled with feet trouble, so I get insight into how very, very important mobility is for mental health.
One topic always interested me: WWII. I’ve read every book in the library on the subject, and I learned German and then some Russian to get different points of view on it. But my latest read about a man’s older brother, fighting in Russia with the Waffen SS, losing his two feet, becoming an invalid, and ultimately dying, hit me hard. Perhaps my detached view of the war will change with my own temporary handicapp.
Meanwhile, I baby this tendon. I am still not FWB, but I walk around the house without crutches in sportshoes with heel inserts. When I go outside, I start getting a bit scared about rerupture, tripping on sidewalks (San Francisco - you gotta love Gavin Newsom’s ineptitude!), or getting jostled - anything inadvertant, a common problem on public transit and imported immigrants’ attitudes.
So it’s stay at home - something I purposely avoided all these years.
Well, no pain! No pain, big gain: that’s my motto in the ATR world.
I had just been getting used to 3.5 weeks of a FWB walking cast. No driving or anything, but going places, including the library and shops, clumping around with no crutches, even in the redwoods with the nephew.
Now it’s back to crutches, although no cast. No one had warned me, but I did remember to bring the crutches, and of course, a pair of sportshoes with heel inserts. The shoe is a Reebok Ultralite trainer, black and blue, bold and bright, and personally, shoes I would never wear in my “real life”. Sportshoes are something I’ve kept in the back of the car “just in case” for years, but never use.
These Reeboks were very very on sale ($10) and comfortable, with room enough for the inserts. Appearance, in the California slob lifestyle? Natch!
The orthopedic clinic has two time blocks: mornings, more urgent cases; afternoons, less so. This was my first afternoon visit, much quieter and less crowded. One feels one has “graduated” by not coming to a morning appointment! Since we’re jammed together waiting, I always learn about other injuries, such as arm, hand and finger problems, which gives a person pause: which is worse, our ATR or other leg injuries, or hand and arm problems that also essentially disable you, your driving, etc?
The young surgeon teases me about being his favorite IRish dancer. I did tell him it was due to dancing, but it wasn’t Irish stepdancing. Never mind, my hair isn’t really red, either, but it makes him think “Irish”.
He wanted me to walk with PWB on crutches for two weeks in the shoes, and never remove the shoe unless bathing or sleeping. No driving, because it could be that emergency breaking comes up, and he personally would never do it himself. Come back in two weeks, then possibly FWB, or who knows? I found myself once again awkward on crutches, thinking the progress one step forward, two steps back.
The senior surgeon came to check the wound, which was clean and neat as the cast came off. Two seri-strips, but no scabs, were still hanging, and lots of very dead skin flaked all over the lower leg. The calf and foot were thinner and felt weak. Here’s the kicker: he thought driving would be okay, but not my professional driving because it’s too long to hold the foot down; it would hurt.
He was not so stern as the younger one, more nonchalant about danger. He also mentioned that PT won’t start yet, and a lot of it I will do for myself simply by walking on it, doing what the PT would do. He measured the angle of the foot: 90-degree dorsiflexion; 30-degree plantarflexion. Is that good? He’s a man of few words and too many patients, that’s how it is.
It is now two days of hobbling again, and I find that I can manage on one crutch in the house, with railing plus crutch on stairs, and that there is no pain at all. All the dead skin came off in a mess on the carpet, and I shaved the hair. The greyish skin tint is coming back to its proper Irish pinkish-white. A few times, especially getting the pants off for the toilet, I have been FWB on the shoe for a second. The scar is pinkish but very smooth.
So it’s two more weeks of “taking it easy”. If I carry on with this lifestyle of unemployment too much longer, I may never wish to return to work at all! Poor York is getting a real workout with me around. He’s doing the cooking with fish and risotto’s, or else pasta. Tea and coffee - no alcohol for now.
I am in fact missing all the European tourists that I could have this summer, but they’ll still be there in the fall. We in tourism consider the August tourists the “elcheapo’s”, the lower-income tourists who have to take their vacations in August. Higher- income tourists come later, when the crowds are gone; people with more flexibility, e.g. people with no kids or whose kids are grown, or professional conference people.
Germans in particular are very numerous, the language I specialize in, and my boss NEEDS me!
Better not to phone the office too often, or I get “worksick”. On the other hand, remind them I’m here!
The niece and nephew are still in town, 4.8 and 11 respectively, in desperate need of entertainment. Prior to my ATR, their Aunt Mary was their main transport around and a big chunck of their entertainment as well, since I could let them come on the local bustours with me. Alas! No driving!
I decided to take the Muir Woods (Redwoods) bus tour with another driver/guide from my company, and I have to say, that after weeks of hanging around, it was fun to go on the foggy ride over the Golden Gate Bridge and let someone else drive and give the lecture. Buddy, a fellow with 20-plus years’ experience as an international guide, was super informative. My nephew thought that he was better than me! Well, gee, thanks, kid!
In the redwoods themselves, I didn’t walk far, but sat in the cafetaria yakking with the other drivers and guides I hadn’t seen in about two months. My nephew was mainly interested in the Jumbo Dog, soft drink and Skittles, all junk food his own parents won’t let him eat at home. Only Aunt Mary will let him eat this junk on vacation. I seriously doubt that I am the only source, as he is a genius at earning a bit of money here and there. Last year, he scammed the tourists coming out of the Redwoods to buy buckeyes from him at 25c/each, although they were lying all over the ground. European tourists in particular seemed to find it amusing and called him (in German and Dutch and French, I could understand it): Typical American businessman!
Back on to the bus, there were exclamations of surprise coming from the back. Apparently we had someone famous back there! Yes, it was Katey Sagal, the character Peg Bundy on MARRIED WTIH CHILDREN. She was with her own two teenage children, ages 14 and 18. All three were thin and dressed down; one would never notice them at all. Once she was spotted, she was low-key but generous in talking about her work. At the moment, she’s doing a FX show called ANGELS OF ANARCHY (watch for it!) about the Hell’s Angels; she is the wife of the head honcho in the film.
That’s the link to her photo if you cannot place this person.
I and the kids took the ferry back, then BART, then called their mother for a ride to the house. Public transit does take a lot of walking, or humping, or whatever we call our Department of Silly Walks.
Tomorrow is the big day back at Ortho: cast off, and straight into two-shoes. I bought an Aircast Walker Boot directly online at E-Bay to have as a backup, $22 total incl. shipping. For the price, I thought it might be a good thing to have some of the time. The doctor said bring a sportshoe. Digging into the old closet at home (parents’ basement), I swore I had once had some sportshoes, but when WAS the last time I was ever sporty? Just plain could not find them! Found a bunch of really old and nice ones I had forgotten I owned! But when to wear them? Not for months, apparently…
I stopped at a superelcheapo outlet and got some sport shoes, price on Reebok Ultralites knocked down to $10. In addition, got the Dr. Scholl’s inserts from Walgreens, and also brought from home some other lace-up shoes, such as Mephistos, that the doctor may prefer to the superlight Reebok’s. A real shoe-bag lady is coming his way tomorrow. York will accompany me (my senior friend, great help and happy chauffeur) to be my “uncle”; first time I have brought anyone with me to an appointment. A nurse I know told me it would help; he can clarify questions; doctor might talk more. What do you folks think? Do you bring your friends/partners/relatives or chauffeurs in with you? Does it help or detract or not matter at all?
Six weeks in a cast, out of work, with no driving: yes, I am getting used to lots of books, DVD’s, telephone yak and Internet surfing. Work can wait. I have mountains of books to go before I sleep. The Napa grapes will be ripe and harvested before I can really get moving workwise, it seems. I do miss the Wine tours the most!
Yesterday was my second post-op appt, after 2 weeks in the splint and 3 in a cast. First came the young resident ortho, who said that it was time to go to the second cast.
I asked, “Will I ever be using a walking boot in your protocol, or just casting?”
He answered that it was too soon to go to a boot, or to consider PT. He also thought that I was a model in compliance for keeping the cast in such good condition, not crumbling or cracked or wet. Here I thought that would be the minimal level of compliance, for one’s own sake? I said, “I would never take a risk and go through this again!”
He said, “YOu’d be giving all of us a lot of work if it happened again!”
Suddenly, he looked at the file, then the cast, and excused himself. He was gone for some time, then back, after consulting the senior surgeon, who had done the operation. Apparently the boss had some news: I could go straight to shoes.
I nearly fell off the exam table, after having read so much of what happens to all of you folks here.
Not to mention an enormous fear of rerupture permeating my every cell!
I asked, “Is that safe? What about a rerupture, with no protection? Not even a boot?”
“No, we don’t think you need it, although we could order it, it would take time. It’s heavy and hot, and we don’t think you need it. Of course, it used to be that everyone was kept in a cast a very long time, no matter his progress, but now the thinking has changed. You had a good tight wound, sewed up clean.” (I think that is what I heard from him!)
Unfortunately, I had not brought a shoe. I was to come again on Tuesday, bring a sports shoe, and two wedges (inserts) from Walgreen’s, to make about 5/8″ size. No need to see the doctor, go straight to the ortho tech, have cast removed, and bring the shoes.
Although of course I was thrilled at this progress, a wave of confusion hit me. It seemed I did have some say in the matter, and certainly, this website has shown me the profusion of protocols on the planet. I trusted the senior surgeon, and he has done millions of them, he said. BUT! He had not even seen the scar in these three weeks, since they did not take the cast off.
This bothersome appendage suddenly felt wonderfully secure and binding as I drove home with York.
So here’s my question to you folks: should I insist I would like to stay in a cast or boot longer, or do as he says? What would you do with such an announcement? I have until Tuesday to think about it!
Also, have any of you had doctors talk to you about your compliance? Or are we all “well-behaved”?
BTW, four new ATR’s have happened at their clinic in the last two weeks, as the surgeon said, “They come in bunches”.
Well, it takes an disability-based websurfer to find these things! In India, most ATR’s are caused not by sports but by slipping off squat toilets, or as they call them, “Indian-style toilets”. Physical therapy is almost never really done because of the living situation of these people, and they regain 50-70% of their former tendon use.
So if you are sitting here thinking how hard things are, think about how people in the Third World would deal with such an injury - IF they could get help or pay for it; or would they just become lame, disabled, or beggars. One fellow here online was mentioning travelling there to India, so I wrote a comment that he should consider the toilets he’ll be facing.
An entire article about improving our Achilles tendon length through using squat toilets is here: http://at.dodman.org/discussion/48/alexander-technique-and-the-full-squatting-posture/.
They also get ATR’s from dropped sharp knives, kitchen implements, etc, but because they use squat toilets, they have LONGER tendons than ours.
My own life sometimes seems like a small death - a death to all my tourism, to all my colleagues, and to my self. How much reading, websurfing and so on can one do? Or perhaps it is a short precursor journey to old age and infirmery life, when a person can’t do much but watch TV, etc.
Back in Oakland today, after weeks with my folks in San Francisco, immediately I had a problem I’d forgotten: the heat. It’s been weeks of cool, grey and blessedly foggy weather in the city, so our house was never hot. But back here, it’s cool at night and in the mornings, but not the afternoons. My cast got very overheated for the first time in these two weeks, with the toes quite hot.
Many tourists complain about the summer weather in San Francisco because the fog and wind is such a disappointment. But if you have to recover from an ATR in a cast or boot, it’s the place to be!