::: my husband’s short basketball season :::

From a caregiver’s perspective

Recap of week after surgery

Filed under: Uncategorized — shortseason at 10:46 pm on Saturday, November 21, 2009

The surgical staff emphasized that the patient should stay ahead of the pain after surgery — be proactive about taking pain meds; do not wait until the pain has set in.  So, I was pretty faithful about shoveling pain meds into my husband.  He took two before bed for several nights (3? 4) but did not take many during the day after about the second day.  He did take Tylenol, though.   He never once complained about pain.  He did grumble a bit about being uncomfortable sitting in the same position, but, not related to his leg.

He kept the leg elevated for the first 48+ hours on two bed pillows; even while sleeping in bed.   We iced it every 20 minutes except while he was sleeping.  I truly feel that helped — no swelling; minimal pain. 

On the evening of day 3, we went to a local tavern with friends for dinner.   We plopped a pillow on a chair and he kept it elevated.  We didn’t linger long after dinner, but, it was nice to get out in the world for an hour.  The only other outings were sitting in the car while I ran errands.

The doc said no driving for at least six weeks.  He is remarkable calm about me driving (not his norm!).

The surgical staff suggested some exercises to keep him busy and try to maintain muscle tone. 

  • While sitting in a chair with legs outstretched and supported, clench the leg muscles and hold for 10 seconds.  Release. 
  • While sitting in a chair with legs outstreatched and supported, raise each leg (one at a time) about 10″ and hold straight for 10 seconds.

He had a few fleeting moments of nausea — they didn’t last long, but, he described feeling hot and nauseated.  It seemed like they happened after he was in bed, and got up to use the restroom.  We kept a large bowl by the bed — just in case (but it was never needed). 

Showers are an adventure.  We have a walk-in shower but a toilet is somewhat in the way.  Luckily the shower has a seat, so he is able to manuever over the “curb” and get in and sit down — the entire thing makes me very worried, but, so far so good!  The cast cover works great – it’s one of the jobbers with the neoprene “collar.”  $13 or something along that line.

The pain pills had the predicted side effect — constipation.  (Men and constipation…my goodness!)  So, he took Metamucel (sp?) each day; and I cranked up the fiber in his diet, and kept giving him pitchers of ice water. 

Ice water had another effect — the surgical staff said he should get up and move every hour.  So, all that water made for regular trips to the loo. 

All in all, the week went better than we each expected.  Whew.

Day of surgery 11/11/09

Filed under: Uncategorized — shortseason at 12:32 pm on Saturday, November 21, 2009

Surgery was one week after the injury.  Neither of slept well the night before — nervous, I suppose.    Surgery was at a local out-patient facility; his check-in time was 6:30 a.m.  Whooee, did all those women have fun teasing him about playing basketball at his age.  They said almost all the achilles surgeries they see are related to basketball.

They did the usual stuff — blood pressure, a zillion Qs about his health history, hooked him up to an IV, the doc spoke to him for a bit, then the anesthesiologist appeared on the scene and more questions about his teeth, snoring, previous experiences with surgery.  She gave him a choce:  1) general anesthesia or 2) a block of some sort which would allow him to remain awake.  The down side of the block was he would have to remain at the surgery center until it wore off (5-6 hours).  He opted for the general.   She gave him an antiobiotic shot (not sure if it was a real shot, or in the IV — I was talking to the nurse at this time), and something to make him relax.  The relaxing med took effect almost immediately.  I could tell by his silly grin that he was gone.  Later, he said he did not remember anything after she gave him that shot.  They put him in a silly-looking cap and off he went.   By 7:30 a.m., I was in the waiting room. 

The doc said the surgery would take 45-60 minutes; he came out at about 9:15 to say all went as expected.   A tech took me back to see the patient around 9:45 (ish) — he was sleepy but seemed comfy; a bit goofy from the meds.   They took him by wheelchair out to our car and we were home around 10:30 a.m.  

The scariest moment of the whole day was getting him from the car to bed (which was where he wanted to go) — two stairs and about 50′ of travel.  He sat in the passenger seat with his feet on the garage floor for several moments to clear his  head and off he went.   He made it the entire way fine — a bit wobbly but no  incidents.  Whew!

The post-op directions were mixed regarding icing:  they told us 20 minutes per hour; but the written sheet said 20 minutes on, 20 minutes off.   So, I did the latter.   The doc said even though it seems silly to ice while wearing that big ole cast, “humor me…do it.”  The cold apparently radiates through the cast.  They said to ice anywhere the length of the lower leg (front of calf, back of calf, ankle, whatever) — the exception being the toes and directly behind the knee (some big artery lives there). 

 They also said when he first had awareness that something had been going on down there, take a pain pill which they anticipated would be mid-afternoon.  He slept most of the afternoon; he took two pain pills around 3:00 (though he protested he did not need them) and wobbled to the living room around dinner time.  To my surprise, he was hungry so had a pretty big but bland dinner.  No nausea at all from the general (whew); no pain to speak of. 

He kept the leg elevated on two bed pillows the entire day — the goal is above the center of the chest when elevating.   They said to not have a “bridge” under the knee area — support that area, too.  Also, as much as possible have the pillows end just before the heel.  I think her exact words were “to prevent breakdown of the heel, thought that is unlikely.” 

I did ask someone to sit in the house while I dashed to the pharmacy to get the meds:  1) pain pills and 2) valium (to reduce spasms).

He missed the fiberglass splint — after surgery he sported a large, heavy, cast.  He was surprised at the weight of the darn thing. 

All in all, the day went well….better than we hoped!

Crutches, immobility, and chaos…oh my!!!

Filed under: Uncategorized — shortseason at 8:21 pm on Friday, November 20, 2009

I dashed around the house to make accommodations to meet the needs of him to:  1) be entertained; 2) have his foot elevated; and 3) be comfortable. 

We rarely use our living room, but, now was the time to use it — there’s a big comfy chair with an ottoman; perfect for elevating his leg on two bed pillows.  I dashed to the store and bought one more pillow.  I also bought an inexpensive ottoman at Bed, Bath & Beyond so he could be comfy in the family room (read:  the room with the BIG TV) in case he wanted a change in scenery. 

I also ran to a local discount place and bought cheap sweats to go over the splint — I scored one pair at $6.99; another pair for $11.99.   The $6.99 pair were a bit snug so we hacked them off at the knee which made them more comfy and easier to get on over splint. 

Socks were out of the question for the injured foot, so I pondered what to put over  his toes to keep them warm.  Clever bunny that I am (grin), I took the hacked off leg from the above sweats-turned-into-shorts and gathered up one end with a big rubberband so it looked a bit like a hat.  Then slipped the open end over his foot.  Warm toes! 

A friend loaned us an end table so that became his “bedside” table for water, glasses, phone, cell phone, tv remote, book, Tylenol, etc. 

Mr. Husband is 6′2″ — his crutches seem to go forever in our small house.   I went around hrough and picked up hazards — throw rugs; scattered shoes; a small trunk; things that were in the way of his passage. 

Luckily, I read about cast covers so I scampered to the store and bought one.  Best $13.00 we spent!

1st doc visit — day 2 of injury

Filed under: Uncategorized — shortseason at 8:06 pm on Friday, November 20, 2009

The ortho doc said my husband’s achilles tendon was indeed ruptured — confirmed by the exam, and squeezing his calf while my husband kneeled on the exam table  (again, no twitch in his foot).  He gave him two options for repair:

Option 1 — surgery.  According to the doc, this would likely prevent further problems with activity in the years to come.  Possible downfall would be general anesthesia; infection at incision site (apparently due to lack of tissue at that location).

Option 2 — casting.   The cast would be replaced each week and gradually the angle of the foot would be elevated as the tendon healed. 

The “down time” would be about the same.  My husband briefly thought about it and opted for surgery which was scheduled for 6 days later.  They replaced the splint which had been removed for the exam; firm instructions to stay off the foot;  no work;  elevate the foot/leg above the center of his chest; and apply ice to reduce the swelling and pain (20 minutes every hour).    The PA emphasized the importance of keeping the swelling down prior to surgery; apparently there were a few strands of tendon that were still hanging on; preserving those strands would make the surgery easier. 

The PA said the splint can be removed, but, he recommended that only when my husband was stationary — taking it off to shower would be risky in case he slipped and put weight on the injured limb.   Ditto sleeping — he suggested leaving it on to sleep. 

My husband’s outlook is good — he’s surprisingly good-natured about this ordeal.  Whew.  He seems relatively free of pain which is a surprise to me.  It seems to me that an injury like this would hurt like hell.

Day 1 after injury

Filed under: Uncategorized — shortseason at 7:53 pm on Friday, November 20, 2009

The pain wasn’t too bad (according to the patient).  The only bad moment seemed to be when he got out of bed in the morning to hobble to the bathroom — he felt a wave of heat and nausea and felt dreadful.  It passed, and from then on the M.O. was to sit up in bed for a bit before lurching to a stand and walking. 

Slow is good.

Short basket basketball season

Filed under: Uncategorized — shortseason at 7:40 pm on Friday, November 20, 2009  Tagged

This is the story of my husband’s achilles tendon rupture (rupture…what a ghastly word!).  He’s 50 and decided to start playing basketball after a 15-20 year lapse in playing.   It was a very short season — 20 minutes into the first half of the very first game of the season, he felt like someone kicked the back of his leg, and he found himself on the gym floor.   He looked around to see who else was on the floor, and was surprised to find no one there. 

We were in the emergency room at around 8:00 p.m. with scores of H1N1 sufferers.  We had a long wait (4 hours) to see a doctor.  Luckily, we found a wheelchair in the corridor away from the coughing horde.  It dawned on me about an hour into the wait that ice might help, so I scrambled for an ice pack. 

The exam was relatively short — the doc used an ultra sound machine to look at it;  then he had my honey lay on his stomach.  When the calf of his injured leg was squeezed, there was no reaction in the foot. 

They put him in a fiberglass splint; bound it in an bandage; gave him some crutches, 6 percocet pain pills, and direction to not put any weight on the leg,  and sent him home with the name of an ortho surgon for the following day.   Five hours later he took a pill, crawled in bed and sulked.

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