After my 8 week visit to the glorious UK Health Service its this site that has given me the advice and help I need. Yet again the NHS has left me wondering what purpose they actually serve.

 

8 weeks down the line and back to the hospital yesterday. All excited and nervous about the prospects of losing the boot, and stepping into the first stages of rehabilitation. So after waiting for 90 minutes passed my scheduled time I’m led into a cubicle and asked to remove by boot.

 

The doctor, who I have seen twice before, is not there so another Dr reads my notes and then does the Thompson test. He turns to his 2 trainee’s he has with him and explains what he is doing. I overhear him say that although there is still a marked difference between my two legs that there is definite signs of improvement and the good news is I can lose my boot.

 

I smiled ready for the next set of instructions but simply got, ok now you can go, I will get the physio team to contact you about your rehabilitation. That’s it. I was dumb struck, not knowing what I can do, how much I can do of it or even how long to the physio starts.

 

Thanks to this site I do manage to ask a few simple questions but it is clear he wants to go off and see his next patient.

 

So now I am FWB after coming out of the boot yesterday after 8 weeks and 1 day, although my leg felt as if I had just ran a marathon. The first step was if I was walking on a jelly floor, I kept hold of my crutches to give me a little stability while I walked the mile looking for the car in the car park but around the house am moving, albeit, very slowly and carefully around the house.

 

The Achilles is very stiff and feels tight but I’m guessing that is normal, although the pain in the heel I had while walking in the boot has gone, so that is good.

 

I guess I just sit and wait now wanting the physio letter to arrive. I’m biting at the bit wanting to start the next phase and really push on but not sure what levels I should be trying to attain. There had been no mention of ROM or anything or how good / bad my recovery has been so just dare not start without the professional advice

 

I look forward to updating you all when the physio letter arrives and the hard work begins but for now……

 

All I can say if Thank God for Achilles Blog.

15 Responses to “Thank Gods for Achilles Blog”
  1. Hala says:

    Hi smiler

    We must be on very similar timelines - I got out of my cast today after 9 weeks - and had the same type of encounter with the NHS, although they have now phoned to say physio on Thursday so all in all I’m quite pleased. After 9 weeks in plaster my heel was a mess - skin quite gruesome! - but I suppose since you have been in a boot, yours is OK?

    Like you I am walking gently around the house in the shoes with the two heel lifts I bought (£22!) at the hospital, and have been out and about with crutches this morning. I asked about cycling on stationary bike (he said no) and driving (he said when I can press the brake enough for an emergency stop - for me to decide). he also said a bath and a glass of wine would help the stiffness - is this good medical advice??!! I am now starting to draw the alphabet in the air but my writing is very poor so far!

    Any tips anyone?

  2. smiler says:

    I keep hearing all the good things on here that the doctors / trainers have told people to do and was left very frustrated at the lack on anythign to do while waiting for physio.

    Have to say after the first 4 weeks in the boot when i had to have it on 24 / 7 the bottom of my foot was a mess but since week 4 where I could take it off in bed and get plenty of air to it seems to have recovered a bit. I wasnt even offered any heel lifts (Im in Coventry) but fortuntely had a fairly fashionable pair of shoes / boots with a bit of a heel on so am now wearing them to work.

    The writing the alphabet in the air also seems a good practice so might take that up this evening although have to say it still feels unnatural to walk on and the achilles area is very tight. There is an area on it which seems to a defined lump and is also very hard, I’m assuming that is the area where the rupture occurred and unsure what I can be doing in the mean time to improve this

  3. Nathan says:

    Hi Smiler,

    I haven’t started a blog yet but intend to do so in the next week. I had a very similar experience to you - snapped my achilles playing football, into A&E, and then into the NHS system in the West Midlands. I am two weeks in post operation, and have had two interactions with consultants at the local hospital - the first when deciding whether to operate or not, and the second when I had my first cast off. I, like you, have been amazed at how little information is forthcoming from these guys, and therefore before each visit I write down a list of questions and ensure they get answered by showing him the list which seems to generate some grudging obligation to answer them! For example - in my second visit yesterday I had the original splint cast removed and then entered into a discussion with the consultant who was seeing me about what next (he wasn’t the senior guy officially dealing with my case but I guess was the first Ortho guy available). I love the NHS and thinks the service is generally fantastic, but with these consultants I think you have to be pushy as my few short experiences have shown. My conversation yesterday went along these lines:

    Consultant: OK, your wound is healing fine, now into another cast and no weight on it for 4 weeks.
    Me: Any chance of getting into a boot?
    Consultant: No, my protocol is 4 weeks immobilised, then into a boot.
    Me: Hmmm..but can you check this with Mr.x (senior consultant guy owning my case)
    Consultant (slightly grudgingly): Wait a minute. (Disappears and comes back). Ok, yes, that’s fine, into an aircast with 5 heel wedges, one wedge out every 2 weeks. Different protocols in this hospital for different consultants.
    Me: Ok, good. Do I have to continue with these Clexane shots?
    Consultant: You’re on Clexane? Err, hang on a minute (off again). No, I want you to move to Aspirin, 75MG per day. (doesn’t write any of this down for me or tell me how long for - and I forgot to ask that last bit!)
    Me: Don’t you need to check platelet levels etc on these blood thinners?
    Consultant: No, don’t worry, the dosage is so low it and the half life is short
    Me: what about clots - anything to look out for:
    Consultant: Do you have any pain?
    Me: Not really, just a stretching feeling in the calf when I extend my leg
    Consultant: Oh that’s normal. You only need to worry if you have a lot of continuous pain and swelling in your calf
    Me: Can I weight bear in the boot?
    Consultant: No,not for another 4 weeks
    Me: Should I sleep in it
    Consultant: Yes
    Me: Well, can I move my foot around?
    Consultant: Yes, wiggle your toes but no dorsiflexing.
    Me: When should I take the bandage off this scar:
    Consultant: Give it 3 days
    Me: But I can’t wash the scar, right?
    Consultant: No, not really
    Me: Do I need to keep my leg elevated?
    Consultant: No, not any more
    Me: When can I start physio
    Consultant: I’ll refer you to the physio now
    Me: Now? But if I can’t weight bear yet….
    Consultant: Yes but the physio will build a plan for you.
    Me: err, right, ok (at this point I thought I would get more from the physio so happy to get a referral this early in the process)
    Consultant: OK, thanks, see you in 4 weeks.

    So at the end of this session, although I didn’t quite get all my questions out, I did get a reasonable outcome as a result of having all the questions sorted out in advance. However no proactive info on wound care, use of the boot, what to look out for, do’s and don’ts etc. What made me laugh is when I went to see the othortics people, I asked them just out of curiosity if I should wear the boot in bed and they said no! Anyway, really hope your next few weeks go well, and might be worth you bringing your own list of questions to the first session!

  4. Hala says:

    There’s some good exercise diagrams on the site if you look under physio - these are just stretching etc so think would be a good start before physio.

    The underneath of my heel on the outer side is really hurting now after a day of two shoes - anyone had this or know what it might be?

  5. dizmarkie says:

    Sounds very similar to my experience but at least the Dr looked at your leg. When I got my cast off, 8 weeks post surgery, he didn’t even glance at it. Your tightness sounds the same as mine is. I have been going to therapy for 2 weeks now and its still very tight, especially in the mornings.

    Hala- I had the same pain in my heel and outside of my foot. When I was putting weight on the foot I was setting my foot down on the outside. Once I realized this I tried to set my foot down flatter and has helped. I have heel lifts too and I am not sure if that is why or I was just not thinking about foot placement and more about the weight. Hope that helps ya.

  6. Hala says:

    Hi Dizmarkie, I’ll try it, thanks!

  7. smiler says:

    Just a quick update on Day 1 with no boot.

    Last night as expected by foot / ankle area was very swollen, could definately feel a tightening in the achilles area but to be honest very little pain which was a positive, However I had a lot more twitching and pain in the calf area, more than I would have hoped for

    This morning again the Achilles was tight and I was a little nervous after getting out of bed as it felt ready to pop but this has eased off in the first hour. However the ankle is still swollen and calf is killing me.

  8. Hala says:

    Hope you don’t mind me updating my Day 1 on your page too!

    Mine was very swollen last night - ankle about the size and shape of a tennis ball - so perhaps I overdid it?Is this similar to others?

    Lovely night sleeping in sheets with no cast though - it was so soft. This morning my ankle was not swollen but very stiff so I lay in bed and did some stretching which did help to loosen off but the best thing seemed to be walking with crutches. I walked about half a mile with crutches, and I started to get a more normal heel to toe action and less pain in my heel, so will be trying this again later.

    I have also done two quite naughty things! Last night I shaved my leg, which apparently is not recommended for 7 days after cast removal, but I couldn’t bear looking at it any more! No bad effects fortunately so I got away with that one. So emboldened was I this morning that I thought I might just sit in my car and see if the pedals would move. They did - so I drove a hundred yards up our road (a cul de sac and very quiet!) and it seemed fine. I am going to try a short drive tomorrow at a quiet time of day but very excited that I may soon get my independence back. How are others approaching driving once in two shoes?

  9. smiler says:

    No problem update away

    I would say my swelling is of a similar size to yours so I wouldnt worry to much although mine doesnt seem to have gone down much this morning. They let me take my boot off at night for the last couple of weeks but as much as losing the boot is good I was, and still am, very consious of it getting caught in the sheets and it is still quite stiff

    Have to say your very brave driving….. I want to desperatley, but with the lack of real assesment from the doctor am waiting till i see the physio so they can give me a green light. That being said I may get the wife to drive me to a car park so I can have a little go. Although I have to say I wont be shaving my legs !!!!!!

    Also I dont know about you but frustrated at the speed I can walk without the crutches, Around the house is fine but there is no way I could go far or do much with at least 1 crutch. I could be gone for days if I wanted to do any shopping :-)

  10. dizmarkie says:

    Sounds like we are all about the same stage and similar treatment. Have either of you started physical therapy yet? My cast came off on 6/25 and I started PT on 6/28. So at almost 2 full weeks and my ankle will still swell up if I push it but my therapist says this is fine. I will still elevate it and ice it if it gets painful after a lot of activity. I was elevating my foot in bed for the first week after cast was removed and then slowly went to nothing. I pushed myself yesterday and last night I wanted elevation for some relief but by morning the pillows were on the floor. So i guess what I am saying is that what you are experiencing is perfectly normal.

    I only started driving with my foot 2 days ago. I have been driving with my left foot for weeks, so I drove a little with the right then switched to my left again. My fear is having to brake hard so I definitely keep my distance and my eyes peeled.

  11. smiler says:

    Only had the aircast removed Monday and as such am waiting to refered to the phsio (UK Physical therapist) have to say I was disappointed they did not arrange it while I was there so am still waiting to hear, I’m really desperate to start doing something as after going to the gym 5 days a week for the last 2 years am finding the withdrawls symptoms are not going away but I know getting back to the routine again will be soooooo soooooo hard :-(

  12. Hala says:

    Won’t it be fun to start up exercising again and actually see some progress?

    Have you thought about calling the physio department and seeing if they have any cancellations? I am only in tomorrow due to a cancellation and you might just get lucky - don’t thuink it could do any harm…..?

  13. smiler says:

    Thats not a bad idea Hala, I’m off to Budapest on Friday for 3 days on a stag do so would be nice to get moving before I go. Will give them a call asap

  14. Hala says:

    …and you said I was brave driving! How are you going to manage a stag do in Budapest??!! ;-)

  15. smiler says:

    lol :-) . Doctor has made me promise to wear the boot the whole time I’m there, Cobbled floors and beer not a good combination apparently

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