Getting the Plaster Off - Tuesday the 13th of August

Three weeks after the second plaster had been put on, I was on my way to hopefully get it removed and replaced with some type of plastic boot referred to as an AIRCAST.  Official name a Rebound Airwalker in a fetching two tone grey shade.

It was great to get the plaster off, although it looked like some sore of scaly stick had been grafted on to the bottom half of  my leg.  I left an embarrassingly large pile of flaky skin on the hospital chair.

The Consultant Surgeon advised I would be able to get the boot off and have a bath, once he ad gone the person fitting the boot advised to treat it like a cast and never take it off?  I pointed out my trousers would not fit over the boot.  That was my problem…..

Back to Work - Monday the 29th of July

Back to work, a bit later than planned or hoped but the potential threat of someone suing someone had got in the way.  The dangers of someone with a cast sitting at a desk had to be assessed before I could return to work.  (I will maybe create a separate page to rant about this later, purely for my own therapy, for now I’ll leave it alone :-))

Those difficulties behind me I was delighted to be a part of society.  While signed off you are just a number, no one will speak to you for the fear of it being construed as work at a later date.  Who made life this difficult? lawyers?

It felt great just to be useful ‘ish’ again.  After 3 weeks of sitting around the house I was properly ’stir crazy’.

Day 1 of worked passed by without any incident, the expected level of japes were levelled at me as I moved around on my crutches… nothing humorous enough to report, altogether a good day, with the exception of getting to and from work I felt like I had made a big step back to normality.

The big plus was there were no issues with the cast at all, I was fine, no swelling, irritation … all good….

First Followup appointment - Tuesday the 23rd of July

I arrived at 9:30 for my 9:45 appointment, checked in at reception and took a seat.  My wife had given me a lift and had dropped me at the door before going to park the car; it was raining quite heavily with a bit of thunder and lightning too.  I had barely sat down when I was called along with a bunch of other people to go and sit in another waiting room, it reminded me of school.  It was encouraging as it was only 09:33.  I sent my wife a text to tell her I was now in the Green waiting room 20 yards down the corridor.  I noticed a sign as I walked in to the Green waiting area, “PATIENTS WAITING AREA ONLY” as if you are going to sit for the ‘hours’ 20 yards away from a friend, partner, child or whoever was kind enough to give you a lift to this ‘arse end of nowhere’ hospital. What is the point of that sign? As I sat there waiting in the window less environment surrounded my miserable injured people (of which I was one) I obviously once again had too much time to ‘think’, for me it is a dangerous time, however I harmlessly fixated about the stupid officious sign, the dreariness of a windowless waiting room and the fact it did not have a clock.  No doubt it would only highlight the inability of the NHS to stick to a timescale.  Thank god my wife turned up at that point and saved me from overthinking more crap!

10 minutes after my scheduled appointment I gave up and went to the toilet without even an ounce of fear I would be called for my appointment while MIA.  It was well past 10 when out of the blue a plaster technician quietly walked past me and said come with me.  The most personal touch I had received in the NHS, someone who worked out who I was and came and got me other than shouting my name across a waiting room.

As I got myself in to the plaster room another man who introduced himself as a registrar started talking to me and said he was going to look at my stiches.  It quickly became clear I was not going to see the consultant and once again I had to ask to see him.  It would be much better if the NHS could do what they say, if my appointment was for a registrar to check my stitches and wound end of, then don’t tell me I am going to see the surgeon again!! And I wouldn’t come armed with a bunch of questions for him.

My plaster was removed at this point I had to call on all my self-restraint to stop myself swearing like a docker.  I remember clearly being told by Miss Phillips they would make an incision of a couple of inches in around the Achilles, the reality was a large incision up the back of my leg, around one and a half times the length of a TV remote control.  A device I had become too familiar with.  It was worse than I had imagined, I almost did not notice the other scar “where they went looking for the Plantaris” as the main one was so “*******” big! #pissedoff!

Anyway he very kindly came to see me and attempted to answer my questions.  The main element of my concern was the difference between pre and post op explanations, I remembered his assistant telling me it was worse than they had expected.  However he seemed to think I had been pre warned about everything and told me I was in ‘shock’ and ‘in denial’.  I do not doubt that, however the shock was not as great as the one when I saw my leg with the plaster off.  Regardless of what he said he was obviously aware that this would be a shock to me and I was not aware, something is failing there.  The fact if I did not have the operation I would have a limp was the overriding authority to carry out whatever operation, and rightly so, It is me who has the massive issue dealing with it.


The Repair:          Where the original ends of the tendons joined together?  Yes, once the leg was opened there was a gap of around an inch they had to bring back together. Great care was taken to protect the membrane around the tendon. (Paratenon) despite me being unconscious it was still very difficult to bring the two ends of the tendon together and a lot of muscle manipulation was required.  ***I think he said it was stitched together with a vycerl suture ( suggested these would dissolve in the body over an 18 month period.

What was the issue with me having Thin Tendons? – what does that mean?

Yes I have ‘weedy’ tendons, the right leg is the same.  Smaller tendons will break easier.

Why are they thinner? Would a thicker tendon changed the approach to Surgery?

The fact they were thinner made no difference to the surgical approach………………..hmmmmmh

Was there any signs of longer term Tendon Degradation?

No could not tell, you get no warning the tendon just breaks..

Recovery:             What would be normal pain? What would be a problem?

No pain

Best pain relief (if needed)


When will I be able to put weight on the foot?


Re-rupture:         Would the treatment a second time be the same?

No….  some kind of graft would be used to treat a rerupture.

Physiotherapy:                   Could he give me any insight or recommendations for an Achilles specialist?

Good Question, no recommendations.  (to be honest in todays ‘not my fault’ society I did not expect one)

In this orthopaedic dept, an Achilles rupture is usually treated by surgery in sporty people under 40.  If my ‘presentation’ had been earlier I would have most likely avoided surgery.

Anyway, the staples were removed from my leg and a new Equinus plaster put on my leg and I was sent of to continue my recovery for another 3 weeks…

The Operation - Thursday the 4th of July

It may well have been independence day in the USA, however it was the day I would lose a lot of my independence for a while, how long? ‘unknown’.

I had followed all the instructions and eaten nothing since 6:30pm the previous night, drunk nothing since 11pm.  I arrived in the correct place in the hospital before the requested 7:30 am, having got up very early to shower and get ready.  With ‘Day bag’ packed and no unnecessary extra’s and been driven there by my wife.

On arrival at the main reception I received directions from a man at reception, I thanked him and turned to head off and he wished me ‘good luck’ I now think he knew something I didn’t.

On arrival in the Day Surgery reception, up the stairs, the reception nurse advised I was not on the list for surgery.  My heart sank, physical and logistical preparation aside I had gone to some effort to get myself in the correct frame of mind.  The key to this was being able to plot out the schedule of the day in my mind.  This failed at the first hurdle and I struggled to keep it all together.  I sat in the waiting room with my wife, not certain if I would be operated on or not. I was left for an uncomfortable length of time, with my wife getting agitated.  When I asked I was fobbed off saying she was waiting to hear from the ward sister.  About 90 minutes later a nurse asked me to go through to a little room to check my details, and suggested my wife did not come with me.  I asked her if I was getting an operation that day and she did not know.  So I did not see the point in proceeding if we were not certain, at this stage she went and got the ward sister who came and advised I had been put on the list for surgery but they had not had it confirmed by the surgeons as they were in a meeting.  She had not spoken to me as she wanted to wait until she had definite information to tell me.  I advised that it was not pleasant to feel ignored when you are anxious about an operation in the first place, on top of being told on arrival you are not on the list.  I was feeling very anxious and close to being annoyed, but the fear I was going to be ’shoehorned’ in was more overwhelming.

I got my name tags on my arms and went back to the waiting room and my wife had to go home as we had not planned on this taking this long and she needed to get back for the kids.  A few minutes later one of the surgeons team came along to get me to sign the consent form, she was very quick and was adding risks to the form even as I was trying to sign it.  This did not fill me with any confidence at all.  It seems the primary concern of a surgeon is to not get sued ( I am sured this applies to more than just Surgeons).  After a further 10 minutes I was moved to the Day Surgery Ward waiting room as the seats were more comfortable.  I was there for over 5 hours … sitting … with out anyone even coming to check I was ok.  Around 3pm someone called out my name, what a fright.  It turned out to be the anaesthetist, he was very pleasant and asked a lot of the questions I had already been asked that day.  He tried to show me a type of pain relief called a ‘blocker’ but the windows xp computer took for ever to start up so he showed me on his phone.  It looked like some kind of mini epidural so I promptly turned this down as soon as it became clear it was optional and I think went for the more ‘traditional’ Morphine if needed after the operation.  Among my questions I asked if I would still get home that evening, to which he replied yes, this was a minor boost in an otherwise awful day.  During my 5 + hours of solitude I seriously contemplated going home.  Thinking time in situations like this is always going to be dangerous for me.  I kind of felt I had been rolled in to this situation.  I could not remember the surgeons name on Tuesday night and was therefore unable to research him, he advised me against going private, however the way I had been treated that day was making me seriously regret following that advice.  I was seriously considering getting a referral and going elsewhere for the operation, the only thing that stopped me, is that course of action would mean preparing myself for surgery again.  However, I kind of wish I had……  and conceptually I do not like the idea of private healthcare, but it became very clear that ‘in my opinion’ the NHS has had it’s day.  From what I had seen it it more about ‘political vanity’ these days as it was not at that point in my opinion anything to be proud of.  From memory the NHS was set up to provide “Free medical care at the point of need?” This does not seem to be a good fit for today’s ‘exceptional customer service or I’ll sue you culture’.

I had a splitting sore head by the time the anaesthetist called me, probably due to the fact it was around 3:30 pm and I had not eaten or drunk anything that day.  Shortly after I sat down a nurse appeared with some pills for me to take.  I asked what they were and what they were for and she advised they were paracetamol and some anaesthetists preferred to get some pain killers in your system beforehand.  Given my headache they were quite handy, although given my personal dislike for painkillers I was not overly keen to take them.

Around 4pm another nurse came to take me to get changed for surgery.  I got on with it an sat in the room awaiting a further call.  I sat there so long the automatic lights went out, I was expecting the surgeon to come and see me at any point, however when the nurse came back it was clear this was not going to happen, I had to ask, and even then they were not keen.  However he came to see me, and was initially mildly confrontational before I think he realised I was anxious, this is something there is no time in the process to deal with.  He recovered and went some way to putting me at ease.  I could not believe how non-personal the whole process was.  I could have had the operation without seeing the surgeon again.  He left, but not before mentioning I was not getting to go home tonight, any good work instantly undone.  and I was put on a bed in what I initially thought was the ‘theatre’ however I quickly realised it was too small.  I had previously asked who else would be in the theatre and the question was avoided.  I could see several people busying themselves in another room through a small gap in the door, and the anaesthetist started his ‘knocking you out’ process.  A nurse put the little needle thing in my left hand (cannula) and I asked if I could see the theatre, apparently not.  Drugs were injected into my cannula, a mask placed over my face and I was asked to breathe deeply, I remember feeling tired for around 30 seconds, a discussion about how they wanted me face down in surgery with my leg presented, a sharp attack of anxiety, then I must have ‘gone under’.

I woke up in the day surgery ward and my recollections at this time are not 100% clear.  When I woke I was shaking uncontrollably, I then heard someone speaking to me and asking how the pain was on a scale of 1 to 10, I had no idea I only felt uncomfortable from the shaking, stuff was injected in to the cannula and I felt tired again and a bit numb.  I don’t know at what point my wife and mother pitched up or the Dr who was assisting the surgeon, unclear what level of her training she had completed despite her getting me to sign the ‘consent’ form earlier.  I remember her telling me after opening my leg up it was more difficult to repair as I had Thin Tendons, I asked if this would be the same in the other leg, she did not know.  I asked a few more questions but it felt like I was speaking to a politician as none of the answers were clear.  I remember being told there was a 95% chance of making a full recovery.

From then on I was given 2 large paracetamol and 2 Tramadol every 4 hours.  Blood pressure, Oxygen levels and Heart rate were also taken regularly.  With hindsight I should have refused these drugs as I felt no pain and they only led to me feeling continually spaced out and tired, not to mention constipated.  I do not think the morphine after waking up from the aesthetic was even necessary for me….

I know it is a strong word, but I hated being in hospital….. maybe I am a control freak? I hope to never have to go back!  if iIdo notes…..

Avoid drugs such as Morphine and Tramadol, unless I am experiencing pain on a par with medieval torture…..  those things are awful!

Go home ASAP! you will get no rest in hospital….

To the detail, I had had open surgery to repair a completed ruptured Achilles tendon that due to it’s ‘late presentation’ had opened up about a one inch gap that required considerable work to close before joining it together with large surgical sutures.  I am grateful for the skill of the surgeons and medical teams for all their efforts that will hopefully see me return to a normal life….

Consultant appointment - Tuesday the 2nd of July 2013

I had an appointment at outpatients at 15:20.  I got a lift again from my Father in-law and arrived just after 3pm.  On arrival I was advised that the clinic was running around 50 minutes late.  This proved to be optimistic.  After a further time delay update from a nurse also advised that other Doctors from other clinics would come down and help out once their clinics had finished.  I thought I had come to see a specialist Orthopaedic doctor so I found this a little concerning.

After a fairly lengthy wait my name was called, when you have been waiting in a busy room for that long the sound of your own name seems to scare the **** out of you.  I was being called to go and see the ‘Plaster Tech’ to have it removed to allow the consultant to examine it.  I saw this one coming and pointed out to the orderly I did not have a plaster on, he said “but there is a ‘P’ in biro” at a jaunty angle on the front of my file, I could not argue with that he was right.  I pointed out there was no plaster on my leg and sat down in a different waiting area, let’s call it one all.

Now in itself a simple error, however, when you are paranoid and you are in a place where major surgical procedures happen I expect everything to be perfect…..  if someone in here is going to anaesthetise me so someone else can open me up with a scalpel, I need everything to be perfect!   I mean for goodness sake I had a ‘P’ in biro on the front of my file and I didn’t even have a plaster on my leg what on earth is going on? :-)

First words… “Sorry you had to wait so long there is simply not enough Doctors to see everyone” ..  he then proceeded to request I remove my trousers. Reassuring me that the door would remain closed, unfortunately it never.  Normally I would not have cared, but I had been in my least favourite place for too long that day and it was beginning to take it’s toll.

After a quick examination of my leg and having heard the story, where he visibly cringed when I said I had followed the Physio instructions for a torn calf.  He then advised I would need surgery to correct the problem.  Despite the physio on Monday having mentioned this when it was real it came as a terrible shock.  The appointment was so quick and obviously running very late, I was advised if I could think of all my questions and ask them on Thursday, when the surgery would take place.  The operation was scheduled to take place at the ‘Day Surgery’ unit and I was advised this would be early in the day and I would be able to go home in the afternoon or evening.  It was well after 5 when I left the consultation room to sit back in the waiting room to wait for my wife to pick me up.  Once again I could have driven myself.  I left feeling the decision to operate on me had been taken very lightly (of course it hadn’t) and was finding it difficult to find the appropriate level of trust in the medical staff and more so the process.

The reality of the impact this proposed surgery did not really sink in at all, my focus seemed to be on the fact I would have to have an operation requiring general anaesthesia.  I went home very disappointed and suffering a bit from “why ****** me!”

First visit to the Physiotherapist - 1st July 2013

Five and a half weeks after injuring myself playing 5 -a side I was battling through the first day of road works that had just started on the road outside the physio, desparate not to be late, however I was approximately 10 minutes late in the end.  It was not a problem and I saw and explained the issue to the Physio.  I think she knew what the problem was immediately, but she carried out a ‘Squeeze’ test (AKA Thompson’s Test) on the calf which had no effect on the left leg, and she pointed out a palpable break in the Achilles tendon.  She called her boss for a second opinion, which was the same and I was referred to A&E with a letter from the Physio.  They advised me not to drive there as I may get a plaster on……

I went home, called in to work on the way and my Father in Law dropped me off at A&E .  Fortunately there were not many people in A&E on a Monday morning and I only had to wait around 20 minutes before seeing a Physio.  The physio there quickly diagnosed the same problem as the previous two physio’s and referred me to a consultant.  She was very good and was able to get me an appointment the next day.  I asked about using my medical insurance but was advised against it as the consultants are the same ones and she was after all able to get me an appointment for the next day.  I then walked to a different cubicle to get my leg put in plaster.  I questioned this as I had been walking around like this for 5 and a half weeks and I had an appointment the following day.  After a discussion they agreed to put a tubigrip on instead, however on my notes I read later it stated the patient had refused a plaster…. not the case, but let that be a lesson…

In and out of A&E in under an hour #efficient , with a consultants appointment for the next day.  I had been advised by the physio it would require a cast or surgery to repair the injury, however option 2 never really registered with me as a possibility.

My wife came to collect me and we drove home…..

Getting on with it - 23rd of May to 1st of July 2013

Over the next few weeks the pain reduced I became more mobile able to play in the back garden albeit somewhat limited.  I was feeling much better, able to cycle (as long as I did not stand up on the pedals) and driving brought no pain.  I drove to and from Dunkeld with no problem.  I was concerned by the lack of power in my left foot, I was unable to lift my left heel off the ground if I stood only on my left leg.  It was not sore, simply nothing happened.  If I went swimming I was able to lift my self up off my left foot if I was waist deep in water.  I was very busy at work and generally a bit down about the injury, really just wanted it to go away.  I still convinced the Doctor was right and it was a nasty calf injury and I was getting around no problem.  I had decided enough was enough when an appointment came through for NHS physio on the 1st of July 08:45.  I decided to hang on another week and go to that.  I was still doing the rehabilitation exercises from the NHS Physiotherapy website….

Visit to the GP - Thurs 23rd May 2013

I called the GP at 8 am on the dot and after 11 minutes I got through and made an appointment for 10:55am.

When I met with the GP I advised I was fairly sure I have torn my calf the previous evening playing football, but was concerned I may have damaged my Achilles also.

After examination I was advised it was a damaged calf muscle and advised to contact Physiotherapy.  I was given a piece of paper with the contact details and advised the process was one of self-referral.  I was not keen on Physio and asked if just waiting for it to heal was an option.  I was told yes, but advised Physio may still be beneficial as walking with a limp may cause further injuries.

I went home and called the number.  After a 10 minute ‘vetting’ process I was added on a list and advised it could take 6-8 weeks to get an appointment so not to bother them if I had not heard anything before then.  I was advised to follow the link on the piece of paper I had been given by the doctor, it would give me good advice on how to treat my injury.  I think it is safe to assume ‘in my opinion’ Physiotherapy of an acceptable level is not really available in Scotland on the NHS.  I was on the system so I got back to work and on with my day.  walking was a little painful and slow but I could get around.

How it Happened - 22nd May 2013

I was playing 5-aside football at one of those Astro-Turf pitch complexes in a company inter departmental competition.  Preparation had not been ideal, very busy at work the previous two weeks had impacted my ability to go to the gym and stretch and work my calf muscles, I had previously torn calf muscle and was very conscious about stretching them properly.  I also had to miss the warm up match that had been arranged in order to complete a presentation.  Leading up to the tournament, things were very busy!  I was planning going to organise our team and take on the role of manager, however a couple of call off and injuries left me having to play….

Initially the games went well, and apart from tiring quite quickly all was well.  Although I keep fairly active it had been 5 years since I played 5 aside football.

During the 3rd 10 minute match I felt my calf muscle tighten up, in very small localised way, it was like one tight string in the middle on the outside calf muscle on my left leg.  After this match I spend 5 minutes stretching this muscle and it felt better, however I was conscious of it and if we had had spare players would have sat out.  I have felt this way previously during Hockey in the winter and taken the decision to sit out the game.  Against my better judgement, and probably because I wanted to, I continued to play and get involved.  It is impossible to take a ‘competitive’ game easy.  During the 4th 10 minute match I went in to a minor tussle for the ball, I got the ball, turned quickly to set off down the wing and as I accelerated it felt like someone was ripping sticky tape of the back of my leg and then kicking me in the calf.  I knew immediately may game was over and I hobbled over to the edge of the pitch.

As I stood on the side lines the pain began to increase, I waited for about 15 minutes until the games had finished and hobbled back round to the car.  It was pretty slow going.  I managed to get myself home.

When I got home I had a hot bath which seemed to relax the muscles.  I have torn calf muscles on previous occasions and the feeling was similar.  I had never previously had this much difficulty walking before which raised concerns I may have done more damage.  I decided to go to the GP the next day…..