Foot_Fault

My achilles tendon repture & recovery blog.

Doc Visit & Pic - 10 wks, 4 days

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10wks, 4 days

7 weeks ago I’d visited my doctor in an effort to get my foot out of a cast (and his 3 month cast plan) and into a boot.  He said no, but when I went back a week later, he put me in the boot and said I was basically on my own since this isn’t his protocol and come back in 6 weeks. In the 6 weeks that followed, I regularly did my exercises, kept the foot in the boot unless sitting or taking a bath (which of course still involved sitting! :) ).  I did the ROM excercises, but nothing that forced or pulled on the foot.  And before I stood, the boot went back on.  I started sleeping with the boot off after 3 wks, and only the last 2 weeks or so have I started taking the boot off at home, but still put it on before walking out the door.   And last week, I began “water therapy” with a friend.  I got a walker and used it to help balance myself in the pool and concentrated on walking heel-toe, heel-toe.  She’s also helping me learn to swim, something I had not done before.

So this morning was the big day - the 6 wk follow-up after getting what I thought I wanted.  :0  The foot has felt great, minimal soreness (basically only when I press firmly on the scar), good ROM,  minimal swelling, and even the scar tissue had thinned out (maybe in part due to the massages?).  But, i didn’t know what was happening inside, so I had no idea what to expect from the doc. I wore the boot, but took no crutches with me.  When they called me into the back, the tech said, “WOW! You look great!” as I walked (with a short stride, I can walk almost normally, even in the boot).  I took the boot off, she saw the foot and was impressed.  She said she understood why I wanted it as he is very conservative. They had to move me to another room,  so she asked if I needed help carrying anything, but I picked my backpack and the boot up and walked barefoot down to the other room.

My doctor came in and immediately said, “OK, you were right, I was wrong!”.  I appreciated the comment, but I told him I didn’t see it that way - I was determined to be cautious in large part because i didn’t want to have to limp back into his office with a re-rupture!  So, we came to an understanding and appreciation for one another’s position.  He said the it look exceptional and asked if i was doing PT.  I told him about my stretches and the work in the pool and he said those were great. He said he wanted to put me in a brace that would limit the movement of the foot up, but allow full range down, and then he hesitated and said unless you want to argue with me about that.  :)  I told him no, I was good with that.  :)   I took the scrip for the brace over with a shoe and was fitted and will pick that up on Weds.  I started PT Tuesday afternoon.

So, all in all, I feel great about where things are for me.  The foot looks and feels great and my progress has now been approved by my surgeon.  I owe a huge thanks to so many of you here for sharing your treatment experiences and protocols to help me create a plan that worked for me, and of course the priceless emotional support this site provides.  Thank you all!!

Letting It Grow

I’m hanging out with a group of girl-friends from high school this weekend. We’ve gotten together once or twice a year since graduation 22 years ago. While talking with one on the phone last night, her husband joined in on the conversation offering to play me in tennis now that I had the ATR. We always had competitive matches back in school, so it would be great to be back out there. Anyway, he mentioned his brother ruptured his AT about 5 years ago (at around age 40) … and 5 months later he ran the Houston Marathon and finished. He’s always been athletic and active, but I can’t imagine pushing to run 26 miles within 5 months. I’m going to call him and find out more about his post-op protocol and the degree of damage he had. I’m not interested in meeting that goal, but I’m curious how he got there. :)

Anyway, somewhere on this forum yesterday I came across the analogy of hair growing & patience. It is hard to be patient in recovery from an ATR with so much going on around us, most of us were injured being active, and we start to feel good and want to keep going. Recovery, even the little milestones, seems to happen as fast as hair grows at times.

But here’s the thing about growing hair: You don’t see it growing minute by minute, or day by day, but one day you wake up and you need a hair cut. Being able to stand w/o feeling any discomfort , seeing my scar had finally closed completely, and realizing I could dorsiflex with my foot easily were all “I Need A Haircut” moments. I hadn’t been focusing on making them happen, but had been doing the little bits daily to get me to those points - which in the beginning (for me) meant being NWB, keeping it elevated as much as possible, icing to control swelling, and all the other babying steps needed when it is so tender and vulnerable.

So, hang in there those of you just starting off. It will get better. Enjoy (as much as possible) the down time. Rest your body and focus on taking care of yourself physically and emotionally. Ask for help. People want to help - it makes them feel good. Just be appreciative and patient with them when they help in their own way.

Tell me about some of your own “I need a haircut” moments. When did you wake up & realize you’d passed another milestone in ATR recovery? Other than when the casts get changed and you see how long the hair on your leg is. :-P

Me and my girls. That’s me far left.

25+ Year Friends

7 weeks post op - tomorrow

Well, when I took the pic I thought it was Thursday. So this is 6 wks, 6 days. :)

Not a great pic, but I’m pleased with the progress of the scar.Can see some rubbing on the back of the foot /scar from the boot (yet another annoyance with my doc - with scar on the back like that).

Been in the boot for 2 weeks now and doing gentle ROM exercises. Not sure when to call doc and request a scrip for PT (as was suggested by one of the orthopedic clinics I called who couldn’t take me but wanted to offer a suggestion), but maybe will do that next week. I wanted to see what my transportation situation would be like before picking a place and I didn’t want to request the scrip unless I had a place in mind, in case I needed it.

Considering my doc wanted me in the cast for 3 months, I’m pleased with where I am at 7 weeks. Not looking to break any speed records, but I feel much better about being in the boot and able to keep the ankle lose and foot clean, especially in this heat. ugh. I’m still PWB, using 2 crutches is I go any distance, but use 1 crutch at home where I can lean on something or have a short distance to go.

I took my first lift out today and have two others still in. If I don’t have any pulling on the tendon by tomorrow, I’ll remove another lift. I have enough ROM that I may not need them at all at this point, but moving slowly, just in case.

With the rift between my doc and I the last thing i want to do is have to limp back in to his office with a rerupture, so taking it slow and cautious. :)

Spending the weekend with my high school girl friends at a beach house (yays, lots of steps!!) and we had a hurricane just make landfall a little ways down the coast. The beach will be filled with all sorts of wash up junk, but i don’t think i dare venture that far. :) And ugh - sand inside the boot! I’d really be rubbed raw!

Hope everyone’s recovery stays smooth!

5 Wks Post-Op - in boot

As I mentioned elsewhere, I asked my doctor last week about getting into a boot sooner rather than later (to allow better mobility and the ability to do ROM exercises) since his protocol involved 3 months in a hard cast, then moving to the boot (!!). I went in yesterday to get a medical release (I’ve been working from home but before I could return on site, I had to have a note) and the next thing I know, he’s telling me he will put me in the boot, but that I will be on my own for the treatment since it isn’t his protocol.

I called around last week trying to find another doctor who would take over and no one would see me until at least 3 months post-op. So, I have under this doc’s “care” and am seeking out a qualified PT to help me determine the best way to proceed from here.

I am 5 wks (as of today) post-op, PWB, 1 day in a boot. My doc wouldn’t even provide lifts, which I stopped and got on the way home from his office to better protect the tendon. Maybe this is a huge mistake, but I feel that if I proceed cautiously and carefully, I can safely create a plan to get me healthy again.

Ok, off to call PTs.

If anyone has any words of wisdom/advice/caution/encouragement, feel free to post. :)

My 2 week post op pic from 6/19/08

Inspired by Marianne, here’s 2 wk post op photo. :)

This is with original cast removed before staples were removed and 2nd cast applied.

Ugh. Relatively minor discomfort, I think, considering the degree of trauma in there. I was on demirol the first few days after surgery - maybe 4-5 days - then reduced to hydrocodone, then just tylenol . After the 2nd cast it was aching for a few days and these last couple of days the swelling has remained low and I haven’t had the ache. So, all in all, the wound isn’t so bad - the logistics of mobility are a much bigger headache. :)

5 days after 2nd cast (post from last week - just found it today!)

Hi all -

The aches from the cast don’t seem to be as bad today as they have been since this new cast was placed on it Thursday.

However, I have noticed my foot seems to swell to the point of discomfort rather quickly. I think this cast is a bit tighter than the original plaster cast was and therefor it has less room for swelling and becomes uncomfortable when it does swell. I have a call in to my doctor to see if this is normal or if they can replace the cast. I am having to keep my foot elevated pretty much all day to avoid the aches and swelling.

Hello world! - My Story!

Hi All! What a great forum to find during this time.

My ATR story starts with the decision to play in a tennis tournament over Memorial Weekend. I was going out to San Francisco to visit a friend and we both play (or did in our youth) and we thought it would be fun to participate. I hit a couple of times and practiced serves, but was still quite rusty when the first day of play came up. We decided to go hit on our own to warm up and practice serves. So we hit for about an hour then walk back up the STEEP hill (this is SF after-all) to the truck and drive out to the tournament. There we sit for 4-5 hours watching matches and waiting for ours. When I’m finally called, I go down, start hitting and begin my doubles match.*

We were tied at 2-2 when I had to turn from the net and race back to hit a soft lob that had gone over my head. I hit the shot over my left shoulder, turn and planted my feet to charge the net again when I heard the pop and hit the court. My team mates assisted me off the court, found a doctor and began icing it down. I don’t recall the doctor ever saying anything about the tendon. The best I recall he felt it wasn’t broken, and it was a pulled muscle or strain, and I just needed to ice it down and be gentle with it. I asked if there was anything to be done in the ER (since I was from out of town/state) and he didn’t seem to think it would help much.

So my friend picked up a brace/support from Walgreens with laces and velcro straps which provided a lot of support for the ankle. I was able to continue to walk on it, with a limp and of course, only walking on the heel. During the course of the remaining week I was there, it seemed to get better unless I stepped on uneven ground and my heel dropped, then I had shooting pain up my calf.

I flew home 8 days after the initial injury and my leg was throbbing the entire flight. The flight attendants gave me an icebag and Advil to help, but I couldn’t wait to get home, elevate it and ice it down. Since it was hurting so badly at this point, I decided I needed to have it checked out so went to my regular doctor the next morning.

She looked it over and within 10 minutes said she was referring me to an orthopedic specialist. I was a bit stunned, still thinking it was a pulled muscle - not realizing what the note “ruptured tendon” mean on my paper work. :)

5 minutes into the visit with the orthopedic surgeon, he said, “Oh yeah, you’ll need surgery.” Once I realized what they were able to visually see (or rather not see) I understood why it was so easy to be able to tell the nature of the injury.

That was Monday, my surgery was Thursday (June 5th). Fortunately my office is letting me work from home these first few weeks, so I’m able to keep it elevated as much as possible and rest when needed.

* Oh, I included the bits about tennis earlier in the day before the rupture, because I suspect having warmed up my muscles through hitting and that elevated climb to the truck caused a lot of tightness in my legs and had I stretched a bit before the match, I may have avoided this problem. Won’t know for sure, of course, because as my brother likes to remind me, “We’re not 19 anymore.” :)