Entries from October 2012
October 24th, 2012 · 4 Comments
So it was finally time for another cast change. I was taken to the cast room per usual and was greeted by my cast tech. Honestly I love this girl, she is so nice and encouraging. Full of information. I must remember to send her a Christmas gift/card! Back on track, naturally my mother accompanied me to this appointment. The cast tech began to saw off my cast and I was afraid my mom was going to pass out. Seriously? It just tickled! I laughed ridiculously, she removed the cast and I stared at my leg. It was amazing to see how much my leg had atrophied (lost muscle). My leg was considerably smaller and considerably hairy. They still wont let me shave and told me to get over it. The surgical site looks great! I wasn’t able to see the doctor since his wife had a baby during the night! Congrats to him lol. The PA who saw me was worthless, she couldn’t answer my questions and said to wait to see the doctor. Whatever! My main question was whether or not the first week post op counted as part of my 6 weeks in a cast, and the cast tech said of course! Thank god!
It means that I will be put in the neutral position for 1 week before placed in a boot and PT is started. I can do this! The interesting thing was that my cast tech warned me that the change in position was going to be extremely painful and that I would most likely cry. She warned me at the last appointment to take pain meds before coming. I forgot of course and took one in the cast room. SURPRISINGLY I didn’t feel any pain!!! It was amazing! She said this was a great sign! If I continue to progress this way she said definitely the cast would come off at the week 6 mark. But there is always a risk of the cast not coming off then if its not ready. Honestly I hate reading others’ blogs and seeing people in a boot and weight bearing so quickly! It’s not fair that my surgeon is so damn conservative!

This is my new red cast
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October 11th, 2012 · 3 Comments
Well, after 1 week (6 days) from surgery I had my first appointment. Physically things had been going well, I felt as if I was heeling okay and was nervous about my first appointment and cast change. They took off my splint and had me lay on my stomach. The doctor saw my leg and was impressed, said it was heeling well. I wasn’t prepared for this but they took out my stitches. It didn’t hurt too bad, just kind of like plucking a hair, maybe even not as bad! Next they put me in a new cast (full plaster) but didn’t change the angle of my foot. Two weeks of this position! I can do this…

This is my leg. I’m proud that the scar looks so good! Very clean edges and good approximation of the incision. Please don’t mind how hairy my leg is, I’m horrified! The bruise is from the hematoma where I tore my muscle as well. I’m concerned that my actual heel is so red, the pressure I’ve had on my heel worries me about a pressure sore. Must monitor it closely!

My pretty new purple cast! She’s a beauty!
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I was so excited for this day to come. To me it was finally the beginning of my healing process. I arrived at the surgery center at 7 am.

This is what my legs look like on the surgery day, I want to do a before and after to see how bad my leg will atrophy
Anyway, Shortly after I arrived I was taken to pre-op holding room. I changed into a paper gown and was allowed to leave my underwear on. The pre-op nurse started an IV and began my pre-op antibiotics. My mother was allowed back and we waited for anesthesia to come. The anesthesiologist called me the night before and explained that he wanted to do an anesthetic block on my leg to help control pain. Why not? Shortly before surgery the anesthesiologist came and prepared me for my block. My mother left at this point since she can’t handle medical things too well.
The anesthesiologist had me lay on my stomach, he gave me some medications to help me relax and not get nauseated (Versed, Fentanyl, Zofran). He then used an ultrasound to find the sciatica just below the back of my knee, he poked me once and I felt what was like pins and needles all along branches of my lower leg, he then poked me again and inserted the anesthetic to numb my leg. Next I was taken off to the actual operating room.
In the OR I was wheeled in and remained on my stomach. Being an ICU nurse I’m quit familiar with surgery, anesthetics and such. I asked if he planned to intubate (put the breathing tube) me while I was lying on my stomach and the anesthesiologist said yes. This is not normal. I’ve never heard of patients being electively (or even emergently) intubated in this fashion. Not concerned I said kudos. He next approached me with a syringe with milky fluid, the last thing I remember was telling him,"Ooh, that’s propofol" and lights out.
I woke up out of surgery and saw my mom by my side. I was pain free but groggy. Very clearly (to me and to my mom) I said, "The last thing I remember is the propofol, good job!" and then continued to repeat Good job, Good job multiple times.
What was surprising and yet disturbing to me was that my leg was paralyzed. I couldn’t move a thing below my knee. I knew they were going to numb it but I’m not sure why I didn’t think that it would be paralyzed too. There’s different things with numbing agents. For the most part you can take away the patients ability to feel pain, but not pressure. Surely this had to do with him injecting it into the nerve and not just the tissues. Anyway…
Within 30 minutes I was discharged with my mother home. She set me up in my room and I took a good nap. She also spent the first night with me, although I’m sure she didn’t sleep for fear of me trying to get out of bed on my own. I took a pain pill (Norco) and began my recovery…

This is My first post-op cast, I had a lot of pain with pressure at this weird spot on my heel, it started to concern me. so I ended up calling the surgeon and he said I needed to have my cast redone in the ER. So below is the next new cast…

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Three days after my injury, the following monday, I struggled with my insurance. After much advice from fellow healthcare professionals I finally was approved to see an orthopedic group. I was amazed at the difficulty I experienced in getting authorization. Didn’t they understand I was incapable of living life this way? I’m sure this is being dramatic but it’s how I’ve felt this whole time. After some sobbing and being kind to strangers I finally got my approval. The office called me and had an appointment for me that afternoon! What a relief.
Naturally being the incapable person I was at that time and having the over-bearing mother I did I was picked up and assisted by my mother to go to the surgeon. Our consultation was interesting, they first led me to the "cast room"where the removed my splint. In case you didn’t know a splint was, a splint is a sort of soft/hard cast, it is very padded but provides support in the area needed. Basically there was plaster along the back part of the leg and up both outer sides of my leg with padding everywhere else. I’ll post a picture soon. In the cast room my splint was removed. The doctor came in and assessed my leg, did a Thompsons test and we discussed my options.
He explained that I could take a conservative route of healing, which involved serial casting and allowing my tendon to regenerate naturally, or I could have surgery with the serial casting. He explained that each method would keep me immobile the same amount of time and that the only bneefit to the surgical option was a decreased risk of re-rupturing my achilles. I chose surgery. My main concern was returning to work as soon as possible. You see, my work is everything to me. He expalined that I would be out for at least 12 weeks. 6 weeks of serial casting and 6 more weeks of PT (physical therapy) and a walking boot. Surgery was scheduled for friday.
They sent me home with some rinky-dink make shift cast. The doctor didn’t think I needed a cast since surgery was so soon and he said there was no way to injury myself further. However, when I attempted to crutch out, the pain from my foot flopping around was too much so I had an interesting splint.

This is my rinky dink splint
The ladies at the doctors office helped me fill out my disability and said they’d send it out once the doctor completed it. Now it was time to head home and "patiently" wait for friday.
I did decide that I couldn’t do crutches any more. I had a friend who used a "Kneely", it’s a scooter for leg/foot injuries. I rent it for $100/month and it’s made my life SO MUCH EASIER!! Check it out! I highly recommend it. Honestly, I can go distance now and move around without becoming tired quickly. The only down side is you cannot do stairs with it.

This is my scooter, it’s amazing! I call it scootie

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