Road to Recovery

Baby steps…
I was in and out of the surgeons office in a matter of minutes. “Buzz”, and within seconds my first hard cast came off as I layon my front with cast leg held upright by the physicians assistant applying her buzzing scissors. Intentionally lightly plucking the cotton padding off my foot, I couldn’t help but burst into hysterics due to the only ticklish part of my body being constantly teased. Within another matter of seconds, the doctor said “looks good”, “let’s pull out some or maybe all of these stitches”. I asked, “didn’t we use dissolving stitches” (as the surgeon had done in my last ATR surgery 8+ years ago), to get the quick retort, ” you don’t want to risk additional infection in this very delicate part of the body”. Again, goes to show, every surgeon has a different protocol.  A few pin-prick stitch extractions later, another hard cast is then quickly applied back onto the foot. I’m told to keep doing whatever I’ve been doing (i.e. nothing), and come back in two weeks.  I also had some quick back and forth about cancelling a trip to China at week 8 post-op, to which the surgeon suggested no long vacations (or rather, active vacations) for at least 3 months.  Bah.

Very unexciting, but I’m now back on the couch with leg held high. Other than some mild swelling and pain from being jostled around in the cab, to and from meetings and the doctors today, overall I’m feeling (or perhaps, sensing) some improvement.

Onwards and (leg) upwards…

I am now one-week post surgery and am beginning to feel the extra pounds around my mid-riff. While being fairly active prior to the injury, I resigned myself to a week of bed rest post surgery. Despite the limited movement around my apartment on the crutches, I did not risk (or will) any further exercise. Needless to say, comfort food was part of the recovery protocol for me — sadly, now I’m feeling the pain of having to lug around my extra weight on these crutches!

Speaking of lugging extra weight around, the biggest physical and psychological issue at this point of recovery is the inability to use your arms/hands. As I mentioned in an earlier blog, I am an unfortunate second-time rupture’r (last time right leg, this time left, and both playing squash!). My hardest memories from the last injury, over 8 years ago, was being unable to take care of myself. At the time, I was at business school and relatively independent/infallible prior to the injury, so the psychological effects of having to ask for help and crutch my way around campus were tough. This time round, despite being in much different personal circumstances now (not living in a dormitory, family to help, my own apartment, etc.), the psychological dependency issues still remain. So, what have I done about it? Since, my last injury I noted a number of new “inventions” have emerged that supposedly help people in our unfortunate situation. I refer specifically to those crutch-less crutches. After some research (primarily on these blogs), I dived in and bought the following two items (I didn’t get a wheely crutch as I didn’t want to be too lazy spinning around).

1) one-crutch (www.onecrutch.com)
and
2) i-Walk-Free (www.iwalk-free.com)

I plan to use these to help me bide the time at home and potentially find a way to get around more conveniently when I am outside.

I’m only one week post surgery (and still in a hard cast), so I’ve spent most of the week on pain-killers and with leg elevated, but my initial reactions from my limited use of these crutches have been mixed:

The one-crutch while simple in design, is a heavy piece of metal, that I feel I could have put together in a metal-work shop. It screws onto your (under-arm) crutches and supposedly you put the weight of your injured leg onto the one-crutch and have no need for the other. So far, I’ve found it to be a heavy crutch and very awkward to move around. It was $50, so I suppose it was good value for money, but I think I’m going to need a lot more practice to be as smooth as the guys on their web-site cruising around.  At least, it is easy to take on and off and is does not look like an alien-attachment….

I had high hopes for the i-Walk Free (especially since it retails at $400) and the web-site speaks wonders about it. If you watch the media video on the web, you I had to believe a young-ish athletic man can at least walk as well as the lady presented in their video?! Well, I have failed miserably on this belief to date. There is a lot of time and attention needed to alter the i-Walk Free device to your personal dimensions and perhaps I have not yet got mine correct. While liberating me to balancing on both legs (or one real leg and one peg-leg), I have found when walking, I need to move with a very wide stance (western style) and over-exaggerate lifting my good leg to move forward “smoothly.” Anyway, it’s early days yet, and despite some lower back pain from the awkward jagged movements, I have at least had some luck doing basic tasks with my i-Walk (e.g., making bed myself, getting stuff from the fridge, making tea/coffee, organizing my closet!). Normally, I wouldn’t do any of these tasks when I had both good legs, so I’m glad to say this injury is already making me into a better person!

More to report on the crutches and my improvement/practice in future posts.  Wishing all other ATR’s a continued successful recuperation in the meantime.

The "crutchless" crutches!

The only thing that was different than I had expected was that the anesthetist recommended I have local anesthetic (as opposed to general).  I came in assuming I would want to have general anesthesia, and have had no issues with this in my past operations.  In any case, I came around to the anesthetists recommendation and I lay out below (what I see) as the pros and cons of weighing the decision.  I was also commenting on Bennet’sblog page on the same topic earlier today, so I assume this is a topical subject for all of us:

General Anesthetic:

Practical Pros — Knocked out cold and little/no recollection of entire surgical procedure

Practical Cons — Possible medical ramifications on other bodily organs (minimal though if you have no history of problems or in your family history); Potential nausea post-op; Likely to be doped up for the remainder of the day

Local anesthetic:

Practical Pros — Awake soon after surgery; Pretty much mentally fully functional after surgery; Leg numb for 12-15 hours 

Practical Cons — Have to listen to/see initial wheeling into surgical room; Local anesthetic blocker applied to specific nerves (minimal complication risk); Numb leg for 12-15 hours feels like you lost a limb

I’m sure there are many other pros and cons, but these were the one’s that were top of mind as I write this.  Going back to my situation, I was hell-bent on GA.  My mother is a retired anesthetist and she wouldn’t recommend anything but it.  However, today, for some reason, the anesthetist encouraged me otherwise indicating for this “standard” procedure local will be more easy to administer and I’d feel much better for it.  He was right (or so I think at the moment) — I was wide awake a couple of hours after surgery while everyone else in the post-op waiting room were sound asleep (another surreal experience). 

The toughest thing about the local was being fully aware as I was being rolled into the operating room and seeing all the doctors around me (felt like a bad dream).  The subsequent psychological damage, if any, was having to listen to the anesthetist and his junior anesthetists poking around my leg with a needle and ultrasound imagery to find the “nerve” to block.  This was a little uncomfortable with a couple of mildly painful shots, but soon subsided.  Within minutes, they hit me with some strong sedatives (anesthetist said they were “valium like”) and I didn’t wake up until the post-op room.

So, here I am at home, almost 10 hours after surgery with my leg up on a chair buffeted by a big pillow.  The advise to raise your leg above heart level is pretty unwieldy, so I asked my dad about this (who is a plastic surgeon) and he said try to keep your leg at least above groin level… this is a little more comfortable at least.

With that, I’m going to go back to watching some more dumb TV, reading the papers, and having a nice glass of wine (not too much though, as I’m likely going to need the heavy pain killers as soon as this local anesthetic wears off!).  Good night all.

Better get used to this leg-up position...

First and foremost, thank you for this amazing blog. I have never blogged before and am not very experienced at this, but for such a great cause, I felt I had to get involved and share my story.

So, here we go again…. yes, sadly this is my THIRD achilles rupture. I have ruptured twice before on my right leg and, this time round, it’s unforunately hit me in the left leg. I guess I saw it coming, as they say, those that have a tendency to rupture in one leg, will equally likely do so with the other. Having said that, it’s been over 8 years since my last rupture so I at least had a good run in between.

So, how did I do it? Well, like many others on this site, I am an avid squash player. Last time round in 1999, I was in a tournament and heard the classic “pop” and didn’t know what it was. I even walked (or limped) my way to the railway station to head back to my parents home to get some care and attention. The second time round was also on the squash court again, but I blame myself for jumping back into the game way too soon (I was probably at around 14 weeks) even though I was only practice hitting.

My first injury was treated “conservatively” by the surgeon - i.e. there was no treatment whatsoever other than natural recovery in a boot. At the time, I was just starting business school, so it was a psychologically traumatic and humbling experience. The hardest thing was having to fly to the US (from the UK) alone and arrive at school not knowing anyone. Having to rely on others, make new friends, and still do well at school while jumping around on one leg was not enjoyable to say the least. To add insult to injury, it was the middle of winter at a New England school — ice and snow everywhere. I won’t share the horror stories of falling in the ice, but as you can imagine there were many such unfortunate situations. The upside of this whole story was that, by peddling myself all over campus non-weight bearing for 8+ weeks, I was in great shape — even getting up and down steep staircases (looking back I was crazy to do that given a fall could have resulted in much more severe injury).

After the second rupture, I went back to the original surgeon (who felt terrible) and surgery was decided for the next recovery.  This time round, he stitched my tendon up good and tight. The healing process went well and I was back on my feet in a matter of 3 months, though didn’t play competitive squash again for at least a year .

So, it’s over 8 years later now, and this time round I was just recreationally playing on a Thursday morning. While I have been good about stretching and taking care of myself, I knew I was pushing myself for: 1) playing first thing in the morning when my body is naturally stiff, and 2) playing every other day in training for a club tournament where I was in the semi-finals. While stretching in the morning, prior to the game, I felt my left tendon being a little tight but foolishly thought it was nothing serious. As a right handed player, most of the stress is on my racket foot (right leg) so generally, I have not worried as much about my left foot. To all other squash players, don’t make the same mistake I did — stretch both achilles religiously!

While in the fourth game, I heard the tell-tale “pop” again so knew instantly what it was. This time round though, I went straight to ER. After 4 hours in ER, even though I knew what the diagnosis was, and 3 medical Residents poking at my leg, they told me the inevitable — go see the ortho. I was able to get an appointment to see my orthopedic surgeon the same afternoon. He was understanding and suggested I go into surgery the following Monday (5 days post injury). While my inclination was to get surgery asap, he informed me that there are only possible surgical difficulties after 7 days. He did however encourage me not to fly before the surgery as I was planning a trip to Miami… now cancelled.

Tomorrow is the big surgery day. I’m a little anxious but having been through this before am hoping the day goes by quickly, and that i’m drugged up on percoset before I know it back at home on my bed. I’ll report back in in the next day or two to let you know how it goes.

Here’s a picture of the scar from my previous right foot achilles surgery. Come next week or the week after, I’ll no doubt be looking at a similar looking scar on the other foot. At least, I can keep using the shark-bite story from my Scuba diving trips (claiming I now got bit on the other foot coincidentally).

8 years later still looks ugly!

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