One Year Milestone!

Wow, here it is!  I cannot believe the day has come, yet as with most other milestones in this recovery, it is simply incremental!  Nothing magical about any one day - specific event or accomplishment, absolutely - but no magic days to mark ahead on a calendar.  Not much has changed since my last post where I listed many other physical milestones along the way for people to use as they like in terms of comparison.  Mine was a pretty easy recovery, especially early on as I was put directly into a boot out of surgery, which occurred just a few hours after the full ATR while skiing. My OS encouraged me to utilize weight bearing as tolerated (WBAT) after the first week or two, and I was walking around in my boot  after two weeks (incrementally) without much discomfort.

For quite some time now, I’m doing everything that I want to do, cross-training, running, skiing, playing singles tennis full out sprinting for balls, a few times a week - though I’m still not more than 80% in terms of calf strength.  My assumption is that most people would be very satisfied with where I am overall in the recovery, and would likely consider themselves fully recovered.  For me however, I will not be satisfied until that calf is as solid as my good one.  Perhaps not exactly the same size, but it needs to be as solid.  Therefore, I continue to plug away 5-6 days a week at strengthening exercises, jumping rope, Insanity and similar workouts and it keeps getting stronger.

For all of those in the throws of this recovery, as many others have said prior to me, looking back it is not all that bad.  Best of luck to you - and keep it incremental!


8-Months / List of Milestones To Date

It has been quite some time since I’ve posted on my blog.  Amazingly enough, my last post was at the wonderful 3-month mark, where things really started to improve and here I am now 5 months later!  Occasionally I will pop into the site to look at blogs of the others in my time-frame to see how things have progressed for them.  It is wonderful to read the many success stories and to see the variety of ways people have rehabbed their legs.

As Norm constantly drills into everyone on this site, keeping everything incremental has been the key to my recovery thus far.  The tendon having been healed for quite some time now, building back the strength in the calf and supporting muscles is a slow grind.  I figured that since I do keep a brief workout log, I’d go back and provide others a general guideline (obviously this is just me) of the milestones along the way since 12-weeks.  For me, always staying active and working the leg out in many different ways over the course of time has been effective.  There is almost no consistency in terms of which exercises are done when, only that I do serious leg work and/or plyometric workouts essentially every 2-3 days depending on my schedule and/or level of soreness.  The most wonderful feeling for me is an incredibly fatigued leg on the day following a tough workout, and then having it feel stronger and ready to go a day or two after.  The recovery keeps getting stronger.  The following are highlights from my calendar, with the understanding that I do something at least 5 days a week whether cardio or strength exercises:

Week 12 - Walks of about 2 miles.  Started cross training on exercise bike (35 minutes) and now elliptical (5 minutes)

Week 13 - first outdoor bike ride, slow and careful approx 5 miles.

Week 15 - rode 12 miles outdoors at nice pace

Week 16 - up to 30/20 min on bike/elliptical

Week 17 - began plugging in some intermittent light jogging into walks

Week 19 - rode 20 miles outdoors at nice pace

Week 20 - ran 2 miles without stopping

Week 21 - first strong walk over 4 miles.  Started back with my trainer - stretching, leg exercises and cross training.

Week 24 - ran 3 miles

Week 25 - regular walks over 5 miles

Week 27 - jog/sprint intervals on track.  10-mile hike.

Week 28 - Began doing foot drills daily per PT recommendation - huge benefits - really wish I had started these earlier.

Week 30 - did a 45′ ropes course (pic) with my boys with no problem!

Week 32 - ran 3 miles on a track then sprinted the straightaways for 3 more.  Started jumping rope a few times a week.

Week 33 - started doing Insanity workouts again - one of my all time favorite programs.

Update Picture

That brings us current at almost 35 weeks.  The workouts continue to get more intense and the recovery feels great.  I have resumed my membership at the racquet club and will begin hitting balls and slowly getting back to my tennis game.  I have resisted thus far so as not to push too much, but feel that my strength has reached a level in which I can trust myself to get back to tennis incrementally.

Good luck to all - especially anyone who has recently suffered from this annoying slog of an injury.  Don’t use my experiences as anything more than what is possible in the future.  The specific timeframe is irrelevant in the grand scheme of things.  I still can’t do a full single calf raise, but I”m confident that will come in time along with everything else as I strive to return to full strength.


1st Qtr Results - 2nd Qtr Guidance: Increased Strength & Endurance

The initial portion of this recovery is officially behind me.  Even though I was officially in 2-shoes at 7.5 weeks, the change from around week 10 to now at almost 13 has been extraordinary.  Nothing that can be measured in days, but as a whole, I have definitely hit the next level and feel even more energized to begin the real work of building strength and that hidden gem, endurance.  Reading other people’s updates has helped me tremendously.  At times, I would chuckle to myself while reading about activities others slightly ahead of me had reported, thinking yeah right, I’m a looong way from that.  Low and behold, 4-5 days later an entirely different perspective.  And these milestones keep occurring when measured on a weekly basis.  I credit the blog, and newer high intensity PT visits (now once a week) for unlocking capabilities that I had no idea my leg could accomplish.  Things that I am now doing regularly:

  • Going on up to 2-mile walks.  Some days not as much, others no problem.  It simply keeps building.  Overall steps per day are becoming irrelevant to me. There is no problem being on my feet all day and accumulating 13-15,000 steps or +/- 5-6 miles per day.  It’s the focused walking  that remains a challenge.
  • Riding exercise bike with foot properly positioned, moderate resistance, over 80 rpm’s for 30-40 minutes 4-5 days per week.
  • Using a slider under my bad foot, doing lunges while sliding the foot back keeping the heel down, at 3 angles, then switching to full lunges raising the heel and touching the knee to the ground.
  • The last exercise has allowed me to begin using my elliptical machine again with no problem.  Building endurance on this machine as well in conjunction with the exercise bike.
  • Working the quadriceps muscle on the bad leg 3-times as much as the good one.  The muscle is still strong, but has lost some mass.  In order to prevent future knee issues on this leg, this quad must work hard to catch up.  I’m doing a lot of body weight squats and doing one-legged lunges utilizing the TRX.
  • P90X2 - one of my favorite workout regime’s, is a fantastic recovery tool for this injury.  It is all about balance, while training your core and other muscle groups on one foot at a time, exercise balls, foam rollers, etc.  I’ve done all 3 P90X’s, Insanity, T25, TRX training and more.  P90X2 is the perfect for me at this time.  I have no problem with planks, side arm planks, push up’s on exercise balls, etc.  Obviously I’m not engaging in any plyometric’s so I’ll skip or modify something else and move on.  The plyo stuff will come in due time and as advised by my PT’s, likely starting with T25.
  • Kinesio tape has been a constant on my leg.  My PT puts it on each session.  I credit it with significantly reducing the swelling in my lower leg.  I also believe it has assisted in its job of getting my calf muscle to begin properly firing while walking.
  • Calf raises of many types, a few times per day.  What is interesting is that while I still cannot do a single calf raise on the bad leg from scratch, if I am in a plank, or say downward dog position where the calf is already engaged, I can then proceed to do single legged raises from there.
  • Last but not least is the continued visits to my trainer, who is mostly working with me on focused intense stretching and massaging out my quads and IT bands. Also, my chiropractor who specializes in ART, working on my ever sore QL’s, mid-back, neck, and keeps me balanced from the weekly trauma that this injury continues to have on my body.

There is still a long way to go here, but I can say that my experience of the past 2-3 weeks has provided a truly remarkable resurgence of energy and focus.  Another piece of this recovery that was sort of lost on me previously was the lack of endurance.  My PT’s have explained that now that we have moved to this next stage of strength building, marked endurance is still likely 8-12 more weeks out.  Best explained - I’m still a few months out from likely taking a strong 5-mile walk.  More than running, biking, getting back on the tennis court, this is my next major goal.    -Rob

Week 9 Update

So here I am going on week 9 and things continue to be relatively smooth and steady.  I’m solidly in 2-shoes at this point on a day to day basis. Over the past two weekends I have found myself in situations that I booted up for i.e. crowded social gathering, doing yardwork, a day long tour tour on a bus with a lot of walking, and one night with people over I put it on after having a bit too much vodka subsequent to not drinking much over the past two months!  The boot is always a welcome refuge in the face of uncertainty.  As others have noted similarly, my progression in steps has been a bit alarming.  My fitbit keeps my records daily and the steps have really spiked up to averaging 6,400 steps daily from under 4,000.  The past two weekends have all been over 9,000 each.  With 2-shoes comes fatigue and swelling… I continue to work on a proper heel to toe short gait, but when that leg gets tired, it is difficult, and boy does it swell now, when I never really had it while wearing the boot.  After icing a few times per day, but especially at night, every morning seemingly starts out fresh.

My routine remains consistent and I’ve ramped up riding my exercise bike without the boot with decent resistance for 20 minutes now, and then I’ll boot up for another 25-30 at higher rpm’s and resistance for a good sweat.  I’m now able to do planks and pushups without the boot, which is a nice change for proper balance.  I do short lunges onto pillows for my legs and balance, do multiple reps of theraband ROM exercises and now have begun tying weight to my foot and doing those ROM exercises while sitting on a counter, which I really like.  My upper body has really benefitted from the injury, as I’m now able to do many more reps of pushups and pullups than I could do previously and my core has remained as solid as it was pre-ATR.

A few items of note now that I’m in two shoes:  I’ve already mentioned the new, albeit relatively mild, swelling as the day goes on.  To combat this, I’m wearing standard calf length athletic socks (picture) which keeps that area in check.  Next, because I’m no longer in the boot my leg is experiencing more trauma and pumping less blood due to the shortened gait.  Therefore, that leg is always colder than the good leg and usually a nice pink tint! (picture).  At first it was a bit of a concern, but after consulting with everyone on my “team” I’m comfortable that it is normal and will go away.  One tip on walking, actually either in the boot or in 2-shoes that might be helpful for others is:  instead of walking down steps the natural way of bad leg first in most cases and repeating, step with your boot or shoe solidly, but past the halfway point of the foot and step down below with the good leg normally.  This way the bad foot (boot or shoes) rolls over the step and doesn’t place pressure on the achilles - and you can walk down normally.

Last item of note but deserving of its own paragraph is - when you go to 2-shoes, you are ALONE, as nobody knows that you are injured anymore like they did when you had crutches or the boot.  And just like a sore elbow seems to find things to hit, so will your foot - and people, especially kids, will find a way to skirmish right in front of you!  It’s my new biggest unforeseen game changer.  I feel like wearing a bright pinney or a flag sometimes and perhaps occasionally yell, “Stay the *%#^ away from me!!”

To Boot or Not to Boot?

Approaching the 7wk mark and things continue to go well in my recovery.  Another fortunate result of my surgery is that I do not have much swelling at all.  My ROM is essentially fully restored, albeit with some twinges in there, and the leg continues to gain strength as I have been diligent about my exercises.  A week ago, my PT’s told me to start spending +/-90 minutes a day in two shoes using my “sticks” to place around 50% weight on the bad leg but concentrate on the proper heel toe motion.  I have done this at home and at the office as those are very controlled environments (mostly - with 3 kids and 2 dogs running about :-) ).  I have enough exercises that could take me 4 hours a day to complete!  However I do realize that they are a growing variety of options to keep in my quiver.  Riding the bike in the boot for a good sweat and continuing my core and upper body workouts keep me busy at home so time moving slowly has thankfully not been an issue.

This weekend, I ventured out with the dogs and walked a VERY slow 3/4 of a mile around the block with the crutches and finally called my wife to pick us up when it started getting tight.  After icing and some rest, that night we went to a party and I booted up and danced till midnight.  Ended the day at 10,900 steps!  I feel strong enough to go for 2 shoes without the sticks, but today my PT requested that I honor his request and not do that just yet.  We worked hard today and then he really went to town on massaging out the various parts of my leg with the Graston tool.  On one hand it feels great to have reclaimed my leg and foot as my own, but overall it remains so weak that I feel good using the sticks and throwing the boot on when I need to go somewhere or get something done.

I’m not in a race, so labels don’t mean anything.  In fact, continuing to learn from all of you and perhaps helping others is the primary goal.  This is an odd time in this process.  Not as monumental as NWB to FWB in the boot, which was HUGE.  This is both exhilarating and scary simultaneously.  Bottom line is that while continuing to be incremental, there is no magical 2-shoes moment - it simply remains incremental.  Strap the boot on and quickly (walk) circles around this fantasy of  being categorized as 2-shoes!

6wks Post Op - Day by Day

Today marks the 6wk mark since my ATR and surgery.  Since being able to walk FWB in my boot at the 2wk mark, that initial quick progression has given way to the more typical slow and steady improvement.  Some days are easy, others are a drag!  I wear my fitbit every day to monitor my steps.  Most days are ending up between 3,500 - 5,000 steps.  On active days, especially weekends, I have actually come close to 10,000 steps on a few occasions, which is entirely too many, but then I rest, do my stretches, ice, and all is good.

I have been diligent about doing my exercises at home (gentle stretching, isometric strengthening against my other foot inside, outside, forward, back), massaging the area around the incision and gently working out scar tissue and nearby ropey tendons with the handle of a large serving fork as my PT’s have taught me.  The incision is mostly healed and looks great, to me at least (picture).  Everything is going along very well thus far, and I remain positive and encouraged about the future of my athletic life.  The process is slow of course, which is so very apparent as each week seems to just tick by thus far with my routines.  As a side note, perhaps the best move I’ve made was ordering a second boot to keep essentially just for sleeping.  It’s so nice to shower and then wash my foot at night, put on the pristine sleeping boot and get in bed without cleaning the nastiness that is my daily boot!

I have declined many invitations to venture out of my comfort zone i.e. to sporting events, and even some adventures with my family while the kids were on spring break.  It’s difficult to explain that while I’m comfortable doing things around the house and going a bit overboard on steps, there really is no destination in those tasks, and a comfortable salvation is always nearby to take a rest.  Going to, say, a baseball game is a leap of faith.  The amount of walking and relative discomfort of the seats with little room for the boot and especially a stretched out leg, with crowds and the fact that you actually have to get somewhere is something I simply do not need at this time.  My industry’s annual convention is in Las Vegas every year the week before Memorial Day.  I haven’t missed one in over 20 years.  At that time, I’ll be at 10wks post injury/op and I’m not even considering going!  While it is always good to be at the convention and one never knows what might come of any encounter at the show, at a table, dinner, wherever to create a new business relationship - I simply know myself too well, and I’ll overdo it.  No way would I want to be in LV with the boot - not for vanity purposes, but what a pain in the butt that would be!  And, at 10wks and (likely) solidly in two shoes at that point, I’ll arguably be at the most vulnerable stage of my recovery.  Therefore, I’ll man the office this year, no problem, and not put myself at risk of a setback.

PT continues to be beyond my expectations.  I’ve gone twice week for the last month.  They continue to work on my foot, and we have gotten into balancing exercises, 360 degree strengthening, gentle recumbent bike riding without the boot and the usual stim, ice machine wrap, and more home exercises.  My ROM has improved every week and is now just slightly off of my good foot.  They now have me working on walking in crutches, no boot, at about 35-50% weight on the bad leg for ±30 minutes twice a day.  They want me focusing on good heel toe action to slowly wean off of the boot in the coming weeks.  I’ve learned to never ask much about their future plans - as it really is day by day.  I don’t want them thinking that I want to be any more aggressive than their plans for me.  In fact, both guys have separately commented that they are the ones that need to remain conscious of where I am in my recovery because my strength, balance and ROM have progressed well to this point.   These exercises along with my continued upper body and core workouts, with now ±30 minutes a day on my exercise bike in the boot at higher resistance and rpms have kept me busy and sane on a day by day basis - it’s a long race!

3rd wk post op - Begin PT

My blog has now caught up to speed and joins me here live in my 3rd week post injury/operation.  I returned to the local doctor that has taken up my case at home in Cleveland to have my stitches removed.  Aside from the odd feeling of the stitches actually sliding out of my foot, the process was pretty simple.  Already being FWB, I walked into the office accompanied by my wife so we could both ask questions and grab lunch afterward.  We verified with the doctor that once again, as long as the foot was securely in my boot, he encouraged me to continue to walk about but not to go too far as to get fatigued because that’s when other things go wrong and accidents happen, such as hyperextending my knee.

I began wearing my Fitbit One again after keeping it pretty much dormant over the winter.  I’m so used to it now, I can pretty accurately guess how many steps I’ve taken at any point during any given day.  While my old goals used to be aggressive at 15,000 steps daily with ±2hrs of very active time, I am now monitoring my steps for the opposite reason, so as to limit overdoing it.  I have found that when I’m in the 3,500-4,000 step range, my leg is getting fatigued and the heel is sore.  I’ll then give it a rest by using the knee scooter or sitting down with my feet up, taking the boot off and gently flexing toes and gentle ROM movements since I haven’t been to PT yet.

There was nothing thus far in my process that I looked forward to more than meeting my PT getting to know the most important person that will help me in the recovery process.  I was excited for the day.  Yesterday, at 3wks, 1 day post op, I met Paul.  Any fear of having to visit a few different facilities evaporated after the first 15 minutes.  This guy knows his stuff and has numerous accreditations in physical therapy, including my favorite - ART (Active Release Techniques), and over 25 yrs experience.  He’s completely up to date on the latest protocols, most of which I’ve learned through achillesblog members!  He did the standard ROM and push, pull tests and then began to actively knead and work both the achilles and then my calf.  If I wasn’t so accustomed to visiting my regular chiropractic physician who specializes in ART, I would have been in tears.  Instead I was cherishing the feeling of getting those areas worked on and feeling the blood flowing freely through the repaired achilles and calf muscles.  He followed up with the low voltage stim and some ice and gave me some exercises to gently stretch the foot back and release, over and over about 40 times.  I peppered him with questions, which he gladly answered in great detail.  He and I were on the same page.  It’s a long road, but I am thrilled that by having essentially no pain, and being able to walk around freely in the boot at an early stage, I have effectively curbed the atrophy in my calf and thigh.  He reiterated the basic rule of thumb for PT, that for every week of immobilization, add another 4-6 weeks of rehab.  Here’s a snapshot of my movement today (video).

I’ll start attending PT twice a week, and fully understand that I’m still extremely early on in this process.  My solid progress to date notwithstanding, baby steps - in fact I am extremely cautious with everything I do, including how and where I step, I’m in no hurry to get out of the boot.  Overall, I’m in NO hurry to do anything!

Wk 2 - Startling progress

During the 1st week, I was able to continue my schedule of taking it easy in the morning and making my way to the office using my crutches. By the second weekend I had begun placing some weight on my left leg when standing still with no pain.  Within a few days of that I became able to easily balance while standing using perhaps 80/20 weight distribution.  Then I began moving my leg while walking on the crutches and gently adding additional weight to simulate walking, albeit slowly.  There simply wasn’t any pain when gradually adding more and more weight each time I would move somewhere else using crutches.  At 2 weeks, 1 day, I found that I was able to go FWB with no pain (video).

This was startling progress for me, especially considering the general statistics here on the achillesblog database where the average time to FBW is 6wks 5days.  I’m filled with ongoing thoughts about the incredible differences between people that have suffered with this injury.  Certainly, the nature of the injury itself i.e. location of the ATR, comes into play.  Also, the surgeon, the procedure itself and their particular method of immobilization subsequent to surgery might perhaps be the biggest wildcard?  Different philosophies on even wanting the patient to place weight on the repaired leg while in a boot or not also seem to differ.  I’ve become a big believer in the faster you are able to work any muscles previously immobilized, the better.  The general rule of thumb I’ve been told is that for every week of immobilization of any particular limb per se, add a month of rehabilitation to get back to normal.  Certainly, with an ATR, the healing process is a slow one because of the complexity of the tendon and because of the general lack of blood flow to tendons as opposed to muscle and bones.  This seems to be a 7-9 weeks time period in which one really needs to be cautious, but the faster you can walk around and do ROM exercises and work that calf muscle, will hopefully shave significant time off of the later months of rehab in order to get back to an optimal level of performance.  This is certainly yet to be seen and just a current observation.

So, in reading through achillesblog it became apparent that the Vacocast Pro Achilles is THE boot for this injury and is a device to behold. Once I became FWB so quickly, I couldn’t resist getting my leg into one of these things to hopefully make the walking process that much easier!  I ordered one from the company with expedited delivery.  Upon arrival I marveled at the box and the drawings of people wearing the device while walking dogs, swimming, and doing handstands!!  Wow, I was going to be doing handstands when I put this on :-)  So I opened it, read the directions, tinkered around a bit, and noted immediately how much higher the profile was compared to my Tracker EX, which is about the same height as my hiking shoes that I regularly wear.  Also, I noted that the device weighed at least 4-5lbs, compared to my Tracker EX at 2lbs.  Hmm, let’s see what it’s like.  I quickly deduced the proper angle of my existing foot to be equivalent to 10 degrees on the vacocast, locked it in and put the boot on.  The fit is very nice and then the vacuum seal makes it very snug and comfortable to have on your leg.  It comes with two bases depending on what angle your foot is set to.  At 10 degrees, that seems to be the mid-point for either base.  First I tried the lower base and found it almost impossible to walk.  So I switched out the base and tried the even higher profile wedge base.  This was a bit easier to walk due to the forward angle, but was still very difficult, especially because of the disparity in height vs. my shoe.  Very quickly I realized that this device is likely a fabulous option for someone in a more severe condition or as a true cast replacement for the first few weeks.  As for walking in it, I’d compare the vacocast to a cement block with straps on it to my Tracker EX being a court shoe!  There was absolutely no comparison.  With my foot well protected at the correct angle, my boot has the same height profile, less than half the weight, much more maneuverability, and is only $55.00!  I immediately ordered another one to use essentially for sleeping so I don’t need to clean it off every night before getting into bed.  The vacocast pro achilles will soon be for sale on Ebay as the company has a formidable return policy.

I’m actually surprised that there hasn’t been more discussion on the blogs on which walking boot, or aircast, however you choose to describe them, is easiest for walking in once going FWB.  I would think that it would be a top topic!  However, in thinking about it, my assumption is that people simply don’t know any better than either what they were provided by the hospital, or through insurance - or they go for the dominant device in the category, the vacocast pro achilles because of all of the wonderful things people have to say about the product and its own marketing and claims to assist and reduce recovery times.  In no way do I want to disparage the vacocast, as it is clearly a great product.  For my condition and compared to the boot I was originally provided by the PT department at the hospital in Steamboat, it simply was no comparison for me.

Drive! - 1st Week Post Op

As many others have similarly posted, it is amazing what you take for granted in our normal active life, such as walking and carrying things in your hands at the same time!  I took to my crutches very quickly and utilized assistance where necessary, such as in the airports during my commute home 2 days post op.  I was feeling strong and lucid since there was no need for the heavy painkillers after the first and second night with slight discomfort.  Once I returned home, much to the dismay of my wife who is simply watching out for me not to overdo anything too soon, I began a cautious routine of core work, push-ups, and using dumbbells for curls and presses while seated.  I had clearance from the surgeon and my trusted chiropractic/ART physician friend, who is very active in athletic training and himself with multiple Iron Man competitions under his belt, that as long as the boot was in place and no stress was placed on that leg, I was free to do upper body and core work.  Even with some great upper body workouts completed, using crutches to get around can certainly take its toll on the shoulders and neck!  Luckily, a acquaintance from our children’s school heard about my injury and brought her Drive steerable knee scooter to school and gave to my wife.  I’m not sure who got a bigger kick out of my using the scooter between myself or each of my kids? This was such an incredible life saver for use in the house, as I didn’t mind ever getting up to go anywhere.  It kept me moving around as much as possible as it is difficult for me to sit still for longer than an hour or so.  I could help around the kitchen with my knee resting nicely on the comfortable pad.

Upstairs, I would use my crutches.  Obvious challenges occur in the middle of the night when nature calls.  I’ve read where people used different devices to urinate without having to leave the bed.  While that certainly held some appeal, I was determined to maintain as much normalcy as possible and cautiously use the crutches to go the the bathroom.  This would wake my wife at first, but we both started to sleep a little more each night.  In addition to working diligently on my lowering my caloric intake, I was not drinking any alcohol, for the most part because I wanted to be as sharp as possible at all times.  Having an accident while crutching to the bathroom at 3am was not something that I was prepared to have happen to me - therefore all precautions are being taken to avoid something like this happening.

Since this was thankfully my left leg, I saw no reason why I could’t begin driving to the office after the weekend.  Of course, there were certain others in the household and extended family that disagreed.  If I was going to rebel on one thing (without permission from Dr’s, family, etc.) this was it.  Getting to the office proved to be as easy as I had anticipated, and was beneficial for my mental and physical well being to maintain as much normalcy as possible without placing the repair at risk.  Using the Drive scooter while at home really provided much needed energy to do other things out of the house if necessary.  Needless to say, I did spend a lot of time resting by reading and watching some TV (Breaking Bad), as I typically don’t sit still to watch anything.  I’d rather take the dogs for a walk.

Toward the end of the week (9 days post op) I visited the Dr. recommended to me by many people in the medical field.  The visit was interesting mostly because it was the first time the boot came off and I saw my leg (picture).  The incision sort of freaked me out, but not too badly.  It was too soon for the stitches to come out, so the boot went back on and I peppered the doctor with questions.  The most important thing for me was that I left with the assurance that placing weight on the boot was solely a function of my personal comfort, and that as long as the boot was securely on, the repair was safe.

Uh oh!

Hello all - this is my first post, but I have been browsing many blogs here on achillesblog for the past 3 weeks since my ATR.  Let me start off by simply thanking Dennis for creating this fantastic, knowledge filled environment for people who have had or are currently suffering through this injury.

My story started on the morning of 3/11/14 in Steamboat when I was heading out for my 1st day on this trip, but having skied ±25 days so far this year both out west and near home in NE Ohio.  A storm had come through that morning and had already dumped 5-6″ of powder on the mountain.  On the 4th run of the day we were skiing the first tracks in some pristine glades near the top (picture) and during a turn my left ski hit something hard under the powder.  A brief glance of pain in my calf, the ski released, and I somersaulted to a stop so as not to run into a tree.  I stood up to retrieve my ski from 30 feet above, and upon placing the first bit of weight on my left foot, WOW, that’s not going to happen!  After standing around waiting for 40 minutes, returning some work emails and advising my wife (back in Cleveland) that I had done something to my calf,  my buddies came back with Ski Patrol and my sled to get down the mountain.

After easily (for me) transporting via sled off of the mountain (picture), I was transferred over to the nearby hospital to be admitted to the ER.  For the most part there was no pain as I was seated the entire time, with my ski boot still on.  At that time, I was only able to guess at what the injury might be as there was direct pain when touching the side of my calf above the boot, and the ongoing uncomfortable feeling of an imminent cramp in my calf.  Massaging that area seemed to keep the cramping at bay.  Miraculously, the highly experienced woman in ER was able to open up my ski boot wider than I thought possible and my foot was able to slip out.  When she began a quick examination of my leg, there was no longer any pain or the cramping feeling in my calf.  Both the tibia and fibula seemed to be intact.  And then she touched the area an inch above my heel,  where my Achilles tendon used to be connected.  With that incredibly sharp pain I now had the answer to the mystery question of “what’s my injury?”  This is where the extremely active, multi-sport, 6-day a week workout, never sit still, always on the go father of three kids under 10 and two Labradoodles that love their nightly 4-5 mile walks, started to cry for the first time in memory, albeit briefly, save for the occasional movie tearjerker…life was going to change dramatically for the foreseeable future as my single biggest injury fear just became a reality.

In what was simply the greatest experience in an ER perhaps ever, I proceeded through essentially a nonstop assembly line of another doctor that had me turn over and did the Thompson test and poked around my leg to my discomfort, over to the in-house PT department where I was assigned my new best friend the DeRoyal Tracker EX walking boot, crutches, and given some ice packs to rest my leg on.  Through the process of moving through the ER with all of the repetitive questions, I became aware that I had not eaten anything since the early morning and had barely had any water since my Camelback had frozen on the slopes early on.  While discussing my options with the PT for travel, timing, and having surgery back home in Cleveland, she too was aware of the current consumption status.  She left the room for a bit and came back to advise me that in her opinion the top orthopedic surgeon in town, and one that works for the US Ski Team among other things, was currently at the hospital.  She had spoken to him about me, updated him on my situation and low and behold, he had time for another procedure, basically right now.  I met him, felt comfortable right away as every employee in the place had either had him operate on them personally or a spouse or similar.  My buddy and I called multiple people in town and back home, and every report came back glowingly positive for this guy!  Ok then, call the wife and tell her I’m going to just go ahead and have the surgery right now… Didn’t go over that well, but this made a heck of a lot more sense than traveling home, choosing a doctor, making an appointment, then scheduling surgery, then fasting for 8 hours, driving to the hospital, and on and on.

I was given a gown to put on, then got an IV, all of which happened right away.  I woke up seemingly moments later with my boot on (two heel lifts) and no real pain to speak of.  After about a half hour and a quick test on crutches, I was heading back to my friend’s condo.  So, after my accident at 11:30 AM, I was on the couch with my foot up at 5:30 that afternoon post op.  Pretty wild day.  The doctor told me that that I had a particularly “shredded” ATR located approximately 2″ above the calcaneus, where the achilles attaches to the heel, but although it took a bit longer (35 min instead of 20) to complete, it looked to be solid repair.  I was told to keep it elevated above the heart if possible for as much time as I could for the first 72hrs, but otherwise just keep the boot on 24/7, go do whatever I felt like doing, keep it dry, and fly home whenever I wanted and follow up with a doctor at home in about 1.5-2 weeks.  After hanging out in the comfortable confines in Steamboat (picture) for a day and half with very minimal discomfort, my wonderful friend ended his trip a few days early to escort me back home to my family.  I went ahead and received courtesy upgrades for the flights home so I could put my foot on the front wall in the bulkhead seats.  Two flights (picture) with a few hour layover in the middle proved to be uneventful and relatively pain free while only taking Toridol, essentially stronger Advil.  My anxious wife and family were happy to have me home!