Non Surgical Treatment

Male Age 64. ATR 8th Jan 2020 Non Surgical Treatment

Surrey UK

2020 started so well. On NYE my wife and I danced the night away until dawn and then a week later we flew over to Spain to make sure things were tickety-boo. We had a cruise planned for January and February. 2020 was going to be a great year.

Back to my story. So I’m in Spain in early January. Thought I’d pop down to La Marina to play Padel and see friends. A short while later after lunging for the shot of the match (okay, slight exaggeration!) and a sudden ‘pop’ came from the bottom of my leg and I crashed to the ground. That was Wednesday the 8th of January 2020 - a date indelibly engraved on my memory.

Ooops I’ve done something there that I should not of? Oh, it doesn’t feel too bad - I can still walk! Yes, I know with a bit of a limp and my toes started to slap when I walked about, but I had little or no pain?

So Wednesday and Thursday came and went. I carried on driving and exercising, oblivious to the gravity of the injury I had incurred. I even flew back to Blighty on the Friday. But I wised up and saw the GP (NHS Doctor) that evening who sent me off to the film set for WWlll, otherwise known as the Accident & Emergency at East Surrey Hospital.

There I was seen by a knowledgeable nurse (no doctor) that I had done something a wee bit serious. You’re ahead of me - she said I had COMPLETELY snapped my Achilles Tendon. I then retorted ‘What about my cruise and trip to India next Wednesday?’………

The next thing I know is that my right leg from the knee down is in a plaster cast with my foot in a downward prone position with a prescription for blood thinners. I think I knew then that my future holiday plans were going to change. That was the Friday night. I left the hospital after a couple of hours on crutches and was told not to allow my foot to touch the ground. I also left with an appointment for the Fracture Clinic on the Monday.

The weekend came and went. Slight discomfort but no pain to talk of. I got myself a 3 wheel travelator because I felt it was easier to move around. I used a black bin bag for showering with elastic around my leg above the cast with a small stool in the shower. Put my feet up as much as possible.

On the Monday I saw a consultant at the hospital and he cut off the plaster cast and did the same test as the nurse - Thompson Test. He diagnosed a complete rupture of my tendon, 7-8cm above the heel. He gave me a conservative treatment plan. At no point did he mention any alternative treatment ie surgery. I left him and then got fitted with a plastic boot with side bellows.

The next appointment I was given was in 6 weeks time.

My treatment plan was:

  1. Walker boot immobilisation with 3 wedges
  2. NWB for 2 weeks and then
  3. PWB (with one crutch) for 4 weeks and then
  4. FWB until week 12
  5. Removal of wedge at end of week 6 and then removal of subequent wedges each fortnight
  6. Clexane injections for period of NWB
  7. Referral to physiotherapy for treatment after week 6

In hindsight I thought 6 weeks was a long time so I went to see another surgeon at week 3 for second opinion. Unfortunately he sent me off for an MRI which has yet to be done and I have not seen him since, but more of that later.

The boot has not left my foot for the 6 weeks. I even sleep with it on! I think I could go on Mastermind and choose Achilles Tendon as my specialist subject. And perhaps more ashamedly, I’ve come to the conclusion that I’m not a very good patient.

I’m in week 6 and use a crutch ‘off and on’, but I really don’t need it now I have a pair of Even-Ups for my shoe/trainer on the other foot. I now use a Cross Trainer and Rowing Machine every day. I massage my muscle on my right leg and my wife uses cream on the leg and foot and Athlete Foot powder on the toes in the boot.

I’ve tried to find out how to test for whether my tendon is melding back together but to no avail. I guess the consultant will tell me on Monday or whether I will need surgery?

REFLECTION

  1. Should I have paid to go private and got a more interactive Initial Assessment? The fact is these surgeons see a lot of ‘victims’ of this injury and should be fairly knowledgeable perhaps they even become a bit blase - well I’ll be in a better position to say whether my treatment has worked for me in a few weeks.
  2. Going on the internet is really good. I have visited a number of blogs and YouTubes. They have all been excellent sources of information. However there is a bias to surgery and that is not the current trend in the UK.
  3. Get a knee scooter rather than crutches! Also buy a pair of Even-Ups for your good foot’s shoes to reduce the limp/hop.
  4. I haven’t got to the bottom of my lack of pain - perhaps I shouldn’t moan!!!!
  5. I usually work out each day and I have not stopped but I changed my work out to doing exercise around a bench and leg extensions. Recently at week 6, I have moved onto a cross trainer and rowing machine.
  6. The main change has been to my social calendar! It has been a great insight to a life experienced by a lot of disabled people and I feel really humbled by the difficulties they must go through each day.
  7. The one question I haven’t answered is: how do I know whether my tendon has started to meld back together? Anyone got an answer?

My next appointment is onĀ  Monday and I’ll let you know how that goes.

Nicholas

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