Bet you thought I’d abandoned you!! Smoley is back!

Yes I’m still here and a bit shocked to see that it has been over a month since I last blogged. But that is a good thing because it means I have been getting on with my life. I can best summarise it by saying that now, five weeks after I came out of cast, the whole achilles ‘thing’ is just something there in the background, a bit of an irritation, rather than the dominating feature of daily life. I haven’t tried running yet although I did break into a short trot the other day in London when I was about to get squashed by a black cab!

I’ve been having some NHS physio (they give me exercises and have a quick feel but no massage or anything) plus private on top (lots of TLC plus more exercises). The NHS gang have now moved me into a group session called ‘ankle class’ which is a good wheeze as there are only two of us plus two physios. They have lots of kit to play with and even a Wii Fit. Rock on NHS! Progress has been good, and could probably be better if I was a bit more dedicated with the daily routine. However, I can: walk without a discernable limp if I concentrate (I can feel it though, even if an observer can’t see it); put my toe to the wall (heel down) and then push my knee forward to touch the wall; go up and down stairs normally; double heel raises are no problem and I can do a single heel raise, but that is a bit of a squeeze. And, ‘Yes Sir - I can boogy! But I need a certain song’.

It was my 40th a week ago (which is how I know the song referenced above - you youngsters didn’t even notice there was song lyric above, did you?) and I was able to wear my new red ‘pump’ shoes rather than trainers. Haven’t been brave enough to try heels yet, bit concerned that my ankle is still a little weak and don’t want to risk twisting it. We had a big bash and all got absolutely blotto, ate curry and played ski jumping on the my new Wii Fit board till the wee small hours. Boy, we Brits know how to party!

Two days later at a routine check up with the consultant he warned me about Wii Fit:”Be careful because I’ve had lots of people who get a Wii Fit and then they have a few glasses of wine and get on it and do something silly and reinjure themselves.” I assurred him that there was no chance that I would ever be so foolish!

The scar is still a bit tender which is annoying because it makes it uncomfortable to wear boots. But I’m sure that will wear off over time.

Went back to driving about two weeks after I came out of cast (I didn’t get a boot - just 9 weeks NWB in hard cast then straight to two shoes) and it was fine. That was a huge morale boost, to get my independance back.

And the ‘work from home’ thing that I’ve been hoping to get going for a year finally took off a couple of weeks ago, so dreadful timing because now I’ve got loads to do to get ready for Christmas and a 50 page report to write! If anyone has worked out how to press ‘pause’ on time, I’d love to hear from them!

I’m still planning to write up my account of the night I spent in the geriatric, sorry, orthopaedic, ward. Hopefully I’ll get round to it in the new year. I promise it will amuse and offend in equal measure.

I doubt I’ll get much time to check in with you all before Christmas, so I hope you all have a very merry one. And to all you newly injured folk out there I say DON’T DESPAIR! Time passes and things will get better and pretty soon you too will be hardly thinking about your stupid tendons, hard though that is to believe right now.

May the force be with you!

Smoley

xxxx

First physio - or was it? Advice please!

Hmmmm. What to say about my first physio session? Well, it has raised a question on which I’d appreciate some advice (although I have a pretty good idea what you will all say!)

Turned up at the NHS day hospital about 20 mins drive from home (hubby still doing taxi duty) having taken a couple of ibuprofen in preparation for a good pummelling. And I was looking forward to a good pummelling in a healthy masochistic way.

(I’ve ditched the crutches altogether now, having decided they were more of a trip hazard than a help.)

Didn’t have to wait (v. good) and was scooped up by Mandy who was very pleasant and explained to me that she’s a trainee physio (not so good, but then they have to do their training on someone I suppose) . We then spent ages going through a full case history (dull but necessary) and medical record.

Mandy assessed my leg in various different ways (push against her hand this way and that etc etc, taking copious notes throughout) and seemed happy with what I could do. She nipped out of the cubicle from time to time to check things with her supervisor. Then she gave me a printed out sheet of 3 exercises (the basic initial stretching stuff) and said that they’d normally say come back in about 3 weeks but could I come back in just over one week because her training posting is only 5 weeks and she’d like to track my progress.She advised me to get used to standing up straight barefoot which is still a bit of a challenge.

And that was it! I asked if she wasn’t going to do a bit of manipulation/massage/pummelling that day and she said (and this is the bit I want your comments on), “No. We wait until 12 weeks after the surgery before we start working on it because that is the golden healing time and we want to let everything get really well healed first.”

Now this was news to me. I’m sure I’ve read blogs from all of you in which the physios got to work on the ROM and flexibility as soon as the cast came off (or a load sooner for folk with ‘aggressive’ doctors).

I have found a private physio based at a medical centre about 30 mins away and had a good chat with him over the phone a few days ago. He has plenty of ATR experience and works out of a very snazzy centre with all the kit (with a price tag to match). His advice was to go and see how I got on with the NHS and then give him a call if need be. He certainly didn’t say anything about some magic 12 weeks.

Suggestions please!! (Although I think I know what I’m going to get!!)

Smoley

24 hours later - Goodbye “Ironside”, Hello “House”!!

Dear all,

Thank you so much for all the messages, really encouraging, so thank you all.

Am feeling just a little bit proud of myself so at the risk of tempting fate, here’s an update 24 hours (ish) after the cast came off. Things are better than I had hoped so here’s hoping this encourages some of you still chalking off the days in cast.

I can (very slowly and carefully) walk in my trainers (with heel cushions) with no crutches and I can pretty much transfer all my weight onto the injured side. But this sort of walking is very stiff and with a very flat foot. If I use both crutches I can get more movement through the foot and ankle because, obviously, it’s not coping with weight. One crutch is somewhere between the two. So at home I’ve more or less dumped the wheely office chair I’ve been sliding around on and I am mostly using one crutch. Hence my new matrimonial nickname - House. Hopefully I won’t develop a pain killer addiction or a strange transatlantic accent .

Had a fantastic sleep last night without the cast. You could have grated parmasan on that thing, so I needed to have a pillow between my ankles and that meant reorganising myself every time I rolled over, I’m sure you all know what I mean.

And this morning I had a shower for the first time (albeit sitting down) which was lovely. Up to now I’d opted for the ‘bath with one leg hanging out’ route to cleanliness.

Job for this afternoon is to find a physio, preferably one with ATR experience and preferably one I can walk to in our little town. Not sure which criteria should take priority. I think I have learnt enough from all you guys who are further along the path than me as to what I should be looking for. I feel I know the exercises, but I could do with a bit of massage etc to boost the ROM which is still limited.

Onwards and upwards, ey chaps!

Smoley

Out of cast!!!

Finally, after nine long weeks I’ve got my leg back and it feels….um….good! Weird, but good. Consultant had a feel and seemed happy. He gave me the golden rule for the next few weeks - keep your heel on the ground. So walking and especially stairs and kerbs, make sure there is solid ground under the heel and keep the heel inserts in my shoes for the time being (looks like I’m going to have to wait a little longer to get back in the Jimmy Choos!). Pushing too hard through the front of the foot could be potentially disastrous. It’s fixed but it is fragile, and I need to treat it as fragile up to the 4 month mark (Christmas).

As regards weight bearing, I can move towards FWB as feels okay (in theory I can FWB now), and I can move from two crutches, to one, to none as I feel capable. Cool - I think! Bit scary. The ROM in the whole ankle isn’t great after nine weeks in plaster, but I’m sure a big chunk of that is psychological. He advised me to sit and slide the foot out and back until the stretch got too tight and then to move to doing press-ups against a wall with feet together. “Your resolve will give out before the tendon does.” Fair enough!  He also warned me to expect some ankle swelling and pain in the sole after weeks of non-usage.

As we were leaving, the plaster room lady reminded me to be very careful: “We’ve had people leave on the Friday and be back on the Monday re-ruptured because they overdid it!”. So with those words ringing in my ears we headed home…..

……..and straight into the obligatory bath which was gorgeous! After about 30 seconds I was sitting in a broth of my own dead skin, but I really didn’t care! It was so nice to scrub and massage and wiggle and then de-fuzz! That’s better!

Scar looks okay - a little bit reddy/purple and a couple of spots where the skin didn’t quite pull back together and some scar tissue has formed, but I doubt it’ll give me too much trouble. Although it is dead centre down the back of my leg, it ends above the point where shoes tend to rub.

I’ve been referred to the physiotherapy unit, but I don’t know how long that will take to come through, so I think in the meantime I’ll cough up the money and go private to get cracking sooner rather than later. Bad calf is 13″ at widest point compared to 14″ on good leg, but the difference in muscle tone is rather more pronounced!

But already I can stand up with both feet side by side in shoes - didn’t fancy trying it bare foot!

So generally I’m a happy bunny. I keep having to remind myself that bodies aren’t like cars - you can’t just drive them into the garage when they break and then drive them out again a few hours later, good as new.

I’m off to shuffle round the house a bit and remind my leg what it is there for!

Best wishes to all,

Smoley

Oh la la! Paris on crutches

So after a bit of humming and haaing about the wisdom of a trip to Paris in hard cast I did decide to go and I’m so glad I did because it was great!

We flew from Luton airport and when we booked the flights we ticked the box for special assistance. This was the best thing ever because we were so well looked after. A whole army was mobilised to get me onto the plane with no problems whatsoever. I felt like a one woman employment creation scheme! I might not be able to walk, but by golly I can jump, queue jump that is!

Wheelchair was waiting for me at Charles de Gaulle and they pushed me past all the immigration queues etc to the train station. After that we were on our own and I was slightly nervous the first time I jumped onto an escalator (!) but I soon got the hang of it and all was well. We did cars/planes/train/underground train/bus/luggage trolley!

We had the most awesome lunch which I wouldn’t have missed for the world - 10 course ‘degustation’ menu (ie. hit us with everything you’ve got, monsieur le chef) which took 4 hours!!!! Then hubby and I strolled/crutched around in the evening before collapsing into hotel for the night.

Next day we went to some of the sights, including some more outrageous queue-jumping at the Louvre. I was totally knackered by the time we got home and two days later my shoulders are stiil aching like mad, but it was really worth it.

So if you are planning to travel while recovering, just call for help (even if you think you can probably cope) because there are loads of people employed to provide help and if we don’t use them then they’ll be taken away. And why just cope when you can smile and wave and glide past all the other poor tourists who have to queue for hours!

Amazed to see the explosion of new people on the site after just a few days away. Have ATRs suddenly got trendy or something?!

Smoley

7 weeks post op - Fainting in the plaster room!!

God, I feel like such a sissy!

Turned up at plaster room today for the fortnightly plaster change and foot repositioning. Feeling happy that this will be the last plaster and I’m rounding the bend into the home straight (of the plaster stage at least). Remember I’m on the UK NHS stone-age track where they still think the best plan is to have you NWB in hard cast for 9 weeks!

Then suddenly I’m surprised - “If we can get your foot to 90 degrees we can put you in a walking cast,” says the nice lady. This was unexpected - cool! She doesn’t mean a boot or anything, don’t get too excited, just a hard cast set so you can put your foot down. So they cut off the old cast and, oh dear oh dear oh dear . What a sad sight emerges blinking into the light. Surely to God that’s not my leg? Yes, apparently it is. I could weep with despair (but I don’t - stiff upper lip ).  I console myself that winter is coming - all long trousers and boots and thick socks.Very, very thick socks.

So then I have a few minutes to give it a little wiggle, which feels okay, but very feeble. The muscle which runs alongside the shin-bone is just non-existent. The other plaster room lady arrives and they stick a prop/frame under my knee like usual and then we have the routine battle of trying to get my leg to just relax and it really doesn’t want to - less than ever this time.  After weeks of nothing, suddenly Mr.Leg is expected to crank into a new position and he says “Foxtrot Oscar!”

We all really want to get my foot to 90 degrees but it soon becomes apparent that it isn’t going to go. They are pushing my foot up and it isn’t exactly hurting but it very tight everywhere and my ankle joint feels just solid, especially at the front bizarrely. Lady no.2 is battling to push the foot into the right position and my leg is refusing to let her. I’m trying so hard to relax and breath and go floppy, when suddenly my ears start to buzz and I feel very faint indeed (I never faint - I’m made of girders). They quickly drop down the back of the couch/table and I lie back which helps the faint feeling and the leg relaxing. Don’t know why I was sitting up in the first place. Eventually the new plaster is on, but we haven’t achieved the magic 90, so it’s another NWB cast. I’m not too gutted because it’s not like I was expecting a walking cast anyway.

We are off to Paris for a 1 night stay next Tuesday and, in an effort to be helpful, the ladies have fitted me in for an extra appointment next Monday to try to get the little bit of extra push so I can have a walking cast. This is very nice of them, but at the moment I think I’ll cancel it, for two reasons. Firstly, I don’t really want to go on a plane in a brand new cast which always feels tight at first so any in-flight swelling, however minimal, really has nowhere to go, and anyway the airline policy says that casts under 48 hours old should be split (although I suppose that could be done as soon as it has set hard). Secondly, I’ve been NWB for so long I am very strong and proficient on the crutches. As and when I’m suddenly allowed to walk a bit, albeit in a hard cast, I probably should not be bounding up and down the boulevards of Paris, but pottering carefully at home. Better the devil you know and all that. But I’ll mull it over in the next couple of days. Of course, if I was in a lovely air-cast boot like my friends states-side none of this would be much of an issue (grumble, grump, mumble).

Despite today not being a total success, I’m still due to come out of cast altogether in 2 weeks. I’ve been told to turn up with 2 shoes, plus heel lifts for the injured side. Blimey!  No mention of physios or anything, just my new bezzy mates in the plaster room.

This process is a bit like climbing a mountain - you battle up a steep slope to what you think is the summit, but just as you get there you see it’s not the summit at all, and there’s a whole load more mountain to come. About time somebody installed a nice cable-car on this damn mountain! Preferably one with an on-board bar!

Love to all,

Smoley

5 weeks post op - Yet another cast!

Haven’t really had much to say recently because I’m just doing time, ticking off the weeks in the hard cast. The good bit is that I am now over half way through.

It’s now five weeks since the injury and the op. Can’t remember what it feels like to just walk normally from A to B! I have developed a really bad habit at looking at people with their lovely “normal” legs and wondering what it must be like to not have to spare a thought for your achilles tendons. Sad or what? I’m forced to watch “Strictly Come Dancing” with my children and by the end I’m seething with hatred for all the dancers!

But today I chalked off another waymaker - it was back to the plaster room for a new cast.  I didn’t need a consultation so it was straight to the ladies in the plaster room. They have a very gently gently approach, so as  soon as I felt the stretch they didn’t push anymore. The fibreglass bandages take a few minutes to dry and the foot tends to relax down again while they are still soft so the ladies held it up gently until the stuff dried hard so I’d fix in the right position. That was about it. Hubby came in this time and agreed that the scar looks very neat and didn’t think my calf had withered too badly.

I was able to flex my foot quite well by myself which was satisfying. It’s a long and deathly dull process being in hard cast but it does seem to be working. I have asked my ortho consultant friend (he works at the same hospital) why they don’t make more use of the boot  and I told him about all the US bloggers who get booted up very quickly. His answer was a bit vague and frankly I don’t think he has an especially high opinion of US orthopaedic practises generally (sorry). He did mention patient compliance as one reason - i.e., we stick you in a cast and you can’t go and do anything too stupid! I thought this was a bit of a lame (sorry again) excuse.  His argument really boiled down to, “Look, this way works so just shut up and get on with it”. Fair enough.

Feeling a bit detached from the rest of the world. I do miss the stuff I’d previously have said was quite dull, like taking the kids to and from school, but that’s when you meet the other Mums and have a natter and find out what’s going on. So have been making the effort to crutch down the road into the village occasionally. But this week is very wet and cold so there hasn’t been too much of that. I’ve been making curtains and cushions etc like a mad woman so at least I feel productive. Still really miss walking the dog in the woods but that is still a long way off.

I have just re-read what I’ve written and if you’ve got to this point with out dying of boredom then you are made of strong stuff! I will try and get round to recording “My night in the orthopaedic ward” soon because that’s much more entertaining (as long as you’re not easily offended)!

Smoley

I just want to walk!

Nothing fancy you understand.  Just stand up on two legs and walk across the room.  Still getting around downstairs on my wheely chair which is infinitely better than crutching, but I’m not even one third of the way through my predicted cast time and I’m bored of sitting down. Don’t know when I’ll be able to PWB but it’s a way off however I try to frame it in my mind.  Will never take basic walking for granted again!

Off to a Christening in Wiltshire this weekend which I’m really looking forward to, but it is going to be hard work! And I’ll have to go easy on the champagne.  Ventured out last week and came within a hairs breadth of sticking a crutch down a drain!!!  (One of the big ones on the side of the road) Imagine how much of me I could have broken like that!

Smoley

Zoom! Watch me go!

Had total and utter brainwave last night! I’ve been reading various comments about knee trolley things and thinking they look quite cool, but have had a look and they just don’t seem to have caught on in the UK.  Then last night I was helping my daughter with her homework at the dining room table where I’m hoping to set up my own little office before too long.  It occurred to me that the dining room chairs were just too low for comfort working on the laptop and that I would have to get myself………an office chair!!  Then the two ideas collided and now I am zooming around the house on my snazzy new wheely chair!  Fortunately downstairs is all on one level with laminate floor everywhere so I can get about easily, using door frames and other furniture to ’sling shot’ myself around when I’m not pushing with the good foot.  I can raise myself up and down for different things and even use it as a knee rest if I have to stand up for some reason.  So - bad leg happy because not doing anything, good leg happy because job easier, shoulders really happy!  I’m happy because can get about a bit indoors at least. Happy Smoley = Happy Hubby = Happy children = even happier Smoley!

But I promise I will still be doing lots of resting and elevating too!

Ten days post op - Frustrated and confused..?!

Was feeling bright as a button yesterday. Had seen the doc on Tuesday and all’s well.  I told him I had been squeezing the calf muscle inside the cast to try and prevent withering and he seemed happy with that as long as it felt okay to me .  So, no pain, no swelling, wound fine, posh new cast and feeling well and lively in myself.  Terrific! So I started getting around a bit more and trying to do a few things around the house as far as my crutches will let me.

Which is all great and I was feeling on top of things, but then hubby comes back from the pub where he’d gone because he knew a physiotherapist mate would be there (or at least that was his excuse!).  Physio mate was indeed in the pub and the message came back: “During the initial period (didn’t say how long this was) you need to do NOTHING.  Even just moving around NWB will use the relevant leg muscles to some extent and you don’t want to be doing that.”

So I’m not sure what advice to follow.  Of course I have to take it easy and I am.  But if my body tells me it is happy for me to be a bit more active occasionally, and it hasn’t reacted badly when I have, and if the surgeon seems happy that I’m deliberately tweaking muscles to keep the blood pumping, isn’t that okay?  But I’m not a professional and pub physio is (he’s a sports physio so he does know plenty about ATR, I assume) so if he says Get Thee to the Sofa then…..what?????

I think partly I’m frustrated because we’ve got parents coming for the weekend and I normally make a big effort to get the house looking nice for them.  Can’t help it, it’s just me being house proud. Hubby gets chippy and defensive if I say anything about it being a bit messy. I think he’s fed up because he’s having to deal with all the boring domestic crap and it doesn’t exactly excite him. Can’t blame him, it has never really excited me either.

Guess this is how it’s going to be for the foreseeable - some days you feel okay, other days you feel fed up and frustrated.

Oh, and I’ve just been pushed around the supermarket in a wheelchair with a special wheelchair trolley.  Felt about a million years old.

Hurrumph.

Smoley