Pop goes the achilles

I was waiting to post until I had some news, then our computer crashed, hard (who knew Mac’s aren’t perfect?).  In summary: it had started to freeze up occasionally, then over the course of a few days got to the point where we were constantly restarting.  I tried a few different things which didn’t make much difference, then I found a post by someone that said they had similar problems which were caused by the same back-up drive that we have - the solution is to update the firmware on the drive.  So I download the update.  The instructions mention a couple programs that you have to make sure aren’t running or you can lose all your data.  I can’t find them, but I figure I’ll do a restart and then copy everything from the hard drive to back up - I don’t care if I lose the back-up data.  Try to re-start, and it won’t!  Do some stuff which leads me to believe that the hard drive has crapped out.  So now I have no hard drive and a questionable back-up drive!  To keep it short, it turns out the computer had a burnt out power supply and the back-up drive worked fine, so we’re back in business.  The restoration with Apple’s Time Machine program was impressively easy and complete - all our preferences and settings returned as well. 

So, on to achilles news.

Kate and Zander returned, and that took some adjustment on all our parts - me no longer being able to worry just about myself, and Kate realizing I’m not as capable as her mother right now in helping with Z-man.  Once we settled back in to our routine it was good - the days go by quickly taking care of a baby (but of course the times that he cries feel like an eternity).

I got the Cam Walker boot from the place my doctor recommended.  It’s a new store opening up beside his office.  The ladies in there previously worked at a home health store, but they seemed pretty clueless about the different boots.  The prescription only said “Cam Walker”, so I got them to pull out the catalogue from their distributor and picked out the  Range Of Motion boot because early movement makes sense to me.  They said the rep was coming in the next day, so I told them to tell him that it was for an achilles injury, just to make sure it was the right one.  They weren’t sure of the price - one of them checked the price list and then guessed at around $300.  I knew my benefit coverage was up to $500 so I didn’t care.  When I picked it up it turned out to be $235.99.  She wasn’t set up with the electronic banking equipment yet so she had to use the old style carbon-copy imprint machine (which I had to show her how to use).  When’s the last time you saw one of those?  And it was new too - fresh out of the box.

I asked the lady if she could show me how the walker works.  It was apparent that the supplier had given her an overview but she didn’t really remember.  I was pretty sure I would figure it out on my own but I was hoping they might have some helpful tips.  ”Oh the doctor will know how to adjust it”, she says.  Yeah, but he’s not going to be at my next appointment, and I don’t know if Archie know how to use one of these.  At the last visit the Doc gave me an appointment card for a check-up in two weeks which I took to the receptionist to schedule.  When she checked the computer she said she had to go talk to him because he wasn’t going to be there on this day.  She came back and said that he said to come in and Archie would check the wound.  So I knew the cast was coming off, but I wasn’t completely sure if they’d want to put another one on or put me in the boot.  

Between the 1st week appointment and the 3rd week I don’t think I touched my crutches, just relying on the iWalk.  My mom and brother came back to help install the kitchen counter.  Very nice after living with a temporary set up for a little over 3 years - the old counter pieced together to fit the new layout, with some gaps.  Spending most of the day on the iWalk and lugging the counter around did a number on my back - very uncomfortable for a few days.

I found a new method to get down the stairs, so now going down is quick (hopefully not too quick).  Instead of going down on my bum or backwards, I’ve been holding myself up with one hand on the railing and the other on the wall, taking the stairs two at a time.  I don’t think Kate has realized this yet - I’m waiting for her to notice handprints on her new paint job on the wall.

The only time that I felt anything in my achilles region was when I tried to pick up one of Zander’s blankets with my toes.  It was strange because I had been moving my toes all around without feeling anything.  It was brief and sharp.  At first I couldn’t tell if it was the tendon or the incision, then I was worried that I could feel blood dripping.  When the cast came off it was all OK though.

The day finally came for the 3 week post-op appointment.  I put the Cam walker in my backpack and headed to the hospital.  I was excited about getting the cast off, but also a little anxious about how the appointment would go because I knew the Dr. wasn’t going to be there.  

After a short wait Archie comes and leads me to one of the two examination/casting rooms - not the one that I’ve been in every previous visit.  ”So what are we doing today, do you know?” Archie asks.

Hmmm.  I’m not sure if he’s asking so that he can tell me in case I don’t know, or if he doesn’t know why I’m there.  ”Well, I hope you’re taking this cast off and I hope you’re putting me in this boot” I reply.  I had taking the boot out and laid it on the bed.  He looked at it quizzically, mumbled something about checking my file, and left the room.

He came back and again looked strangely at the boot.  I was thinking that either he doesn’t know how to use it or the Doc’s instructions don’t mention it.  ”Where did you get that?”  I tell him, and he asks how much it cost.  I tell him that too, and he says “I was wondering because I have them here” and he nods towards the far side of the bed.  At first I just see a bunch of foam liners, then I notice the box that they’re sitting on, and I see the exact same boot inside.  EXACTLY the same, and it’s a full box of them - maybe 6?

“How much do you charge for them?” I ask.  He doesn’t want to tell me at first, but I tell him I won’t be upset because I’m getting reimbursed.  $140.  So, I ran around town dealing with people that had no clue so that I could pay $100 more for something they had in the next room.  I try to joke with Archie that the Doc must be getting kick-backs from the store, but he doesn’t laugh.  Then he tells me that he might be working there part-time.  Awkward.

At the last visit the Doc had asked Archie if he knew how to adjust a “Cam walker” that controls the amount of dorsi and plantar flexion, and Archie looked a little puzzled.  Now Archie says that the Doc should have asked him about a “Range of Motion ankle brace”, then he could have told him that there were some right there.  Confused by terminology, I guess, but it’s pretty surprising that 1) Archie didn’t make the connection, and 2) that the Dr. didn’t know what they had right there.  For me, I think any boot that has a not-flat or curved bottom is a Cam walker.  Though it seems like some manufacturers use CAM as an acronym for Controlled Ankle Motion.

Archie cleaned up the incision and said that there was a still a small opening that had a piece of suture sticking out of it, which is probably why it didn’t close.  He pulled that out and put some gauze over it with a light wrap.  I asked what angle he would set me at.  He checked my file again to see if the Doc had given instructions for that, but it didn’t seem like it was specified.  He said probably 30 degrees (as measured away from 90).  He started getting the boot ready by taking the pins out that lock in the angle, then he started to try to rotate the uprights.  He had to use quite a bit of force and he was looking at it like it was too stiff.  I said “I think those move easier if you loosen the locking screw”.  Maybe Archie doesn’t know how to use the boot.

He checked how far my foot could flex before I felt some tightness in my achilles, which he said was 15 degrees, then set the boot and put it on me.  When I got home it was actually set for 22.5 - I don’t know if he changed his mind or if he wanted it set so that there would be no tension on the tendon.  I asked about when I would start physio, and he said it would be after I get to 90 degrees - maybe after the next appointment in 2 weeks.  He told me not to try to bring my foot up to my shin but I could point my toes down, but he locked the boot that angle, which seems to defeat the purpose of a Range Of Motion boot to me.

I got home and headed outside to enjoy the nice weather.  Here’s what the leg looked like, with Roxy in the background.  The open part of the incision is at the very bottom.

3 Wk Post Op Leg

I was pleasantly surprised when I saw my leg because it wasn’t as withered as I thought it might be after 5 weeks of immobilization, but when I started feeling around it actually seemed rather hollow - not much muscle inside.

Here’s my range of motion:

Dorsiflexion

Plantarflexion

And just for kicks here’s one of Zander getting ready for St. Patrick’s Day: 

Zander - St. Patrick's Day

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