Sylveeuh’s AchillesBlog

So things are going very well! PT is moving right along, we are really focusing on balance and strengthening my bad leg. I see a lot of people post on here about single leg calf raises. We aren’t doing anything like that. Kind of interesting, I have attempted it and am of course unsuccessful : ( Basically my PT begins with stretching, then I use the blue band for my ROM, then I do leg raises, balancing on the foam, then weight shifting on the Bosu ball. Oh I also do this stupid thing I call the triangle. Basically you stand on your bad leg, then reach out the good leg to a foot in front of you while bending down, then you do it to your opposite side, then behind you. To all 3 points five times without putting your good leg down. Very difficult, but it is getting better. I also do the bike, elliptical, and stair master now! I’m living essentially pain free but I do get some weird pain on the top of my foot in the bones. I’m amazed how strong I’ve become and I really feel ready to go back to work!

I next see the doctor on the 30th. I will be released then, if he doesn’t want to then I plan to throw a fit until it happens. I am ready to stand on my feet for 12 hours a day. I can handle it!!! I want to be a nurse again! I miss it so much… Disability insurance has also been a PIA. I’m so glad to finally have it straightened out again. Other than that, I’m just counting down the days until I go back. I feel great and ready! I did ask my PT what the plan was for the rest of my PT progression, and she said after my next doc visit we will start plyometrics? Running, jumping… ACK! I couldn’t run before I got injured let alone now, but we will see! Take care ya’ll

Wow how things have changed. Walking without the boot is bliss. I honestly believe I’ve had more pain in the boot than out of it. I’ve increased my PT to 3x a week courtesy of a request to my doctor and I’m enjoying going and seeing my progress. I have had some pain in different areas but have had trouble identifying it. By that I mean, is it pain? Soreness? What? I told my PT and we determined that it is related to not being stretched out and the pain subsides with ambulation and/or stretching. Other than that, it’s been a little over 2 weeks of walking and I see progress every day! I used to have an antalgic gait and now my gait has normalized. I can through step on the stairs, I’m able to walk 1.5 miles without rest and minimal pain. What more can you ask for?

I’d love to go back to work. After talking to my employee health NP at the hospital where I work, we determined that it’s best to wait until the end of the month (which is what the doctor wants) before returning to work. Since I’m getting stronger each day there’s no reason to rush back. I have been having issues with disability insurance but that’s what savings is for.

I have began to exercise on my own as well. Basically practicing what I do at PT but at a gym. I ride a stationary bicycle for 15 mins (I’m building up to more time) and lots of arm exercises. No leg exercises aside from what I do at PT just yet. That’s about it!

So yesterday I went for my 11 week post op, 6 weeks in a boot visit with my doc. What a frustrating yet exciting visit I had. I somehow am no longer seeing the physician but the PA. Not too thrilled about this. So I hand her my information given to me by my PT. According to my PT, my ROM degrees are quite impressive. Near perfect on my plantar and dorsi flexion, perfect on inversion/eversion. My PA asked me how I was feeling. I explained that it’s been pretty great, no pain, minimal swelling, great ROM. I asked her all my questions I’ve been saving up, and finally got my answers. I got a prescription for adding stretching and strengthening to my PT. I asked her about ditching the boot (as I thought was the plan) and she seemed reluctant!!! She questioned how I was feeling etc and I explained I felt great and felt ready. I promised I wouldn’t over do it and attempt to run a marathon so she finally agreed. How ridiculous! I then ask about returning to work. I acknowledged that I didn’t feel it would be in the next couple weeks, but as I was told at my last visit, I could be released when I felt ready after 12 weeks post op. This PA disagrees (WITH THE PHYSICIAN WHO SAID THIS TO ME) and said we can discuss it at our next appointment (18 weeks post op). UGH!!!

Granted, this is putting me back to work about 2-3 weeks later than I anticipated. I’m so frustrated. This is not at all based on my response to PT but based on some random amount of time that she feels needs to pass. If the case was that I wasn’t progressing and my fuction was limited I think I would be more understanding. But the fact is they have this number in there head of weeks they want to pass, but why didn’t they ever say this in the beginning?! So ridiculous. Any way, I am finally at terms with this, but truth is, at my next appointment if they try to pull some crap and say I need to wait (provided I feel ready) I’m going to blow a gasket.

So more about being out of the boot. Umm, it’s amazing. Wore 2 shoes for the first time in 3 months! It’s a bit ironic that I chose the same nikes I got injured in, but they’re practically brand new! I am now on day 2 walking and it’s going quite well. I was at first walking like what I call, peg legged. I was using my bad leg more as an anchor and not properly heel toe walking. With some assistance of my PT I have to remember to walk the right way. I have a tiny limp, noticeable when I attempt to walk “briskly” (briskly in my opinion was probably my natural pace). I have no pain, and minimal swelling. It’s funny because I had more pain in the stupid boot than I do on my own.

Well, I did ask to increase my PT to 3x/wk. I like it that way, I do other exercises and it makes me feel like I have a routine. I started with some very light resistance bands (yellow) and my PT says she wants to see how I tolerate and we will increase the resistance if I feel up to it tomorrow. I feel up to it! Yay! All in all, it’s great to feel more normal. On a side note, I do need to find all my left shoes now. haha… Merry christmas everyone!

Sylvia

Well, I continue to be bad (in my opinion) and walk around my house without the boot. I know the protocol as mentioned by normofthenorth states that this is acceptable at my stage in healing but I still feel guilty. I’m not good with breaking rules when it comes to this injury even though I’m pretty non-compliant (or complaint as I see fit) in my other health issues. I think it has something to do with being accountable at PT every week… However, My gait (walk) is getting really good! No real limp when walking slowly, I don’t attempt fast walking or much other than around the house type things. I am 10 days from legally being out of my boot!

I can’t believe this whole experience is moving right along. I remember in the beginning each day was dragging but now that I am ambulatory my life seems a bit brighter! I do have a bad day here and there. I’ve progressed in my Physical Therapy to where my AROM is essentially perfect, my PT no longer even manually stretches my foot out because it’s pretty worthless. I honestly feel like she’s just playing with my foot. I do my own ROM, leg exercises and upper body exercises without guidance, honestly, I feel like PT is a waste of time at this point!!

I’d give anything to be at the strengthening phase of PT. I hate going and feeling like I’m just getting checked off without being able to see any further results. December 19th can’t come soon enough. I am worried about coming into PT when I’m out of the boot because I know it’s going to be obvious that it’s not my first time walking! Maybe I should get back in the boot and stop practicing walking… but is it worth saving face at PT and delaying my return to normal function?

Things are going well! I’m walking in my boot with a normal looking gait, pain is pretty much a 0/10 99% of the time, and PT is going smoothly. My PT remeasured my degrees of plantar and dorsiflexion and apparently my plantar flexion is 20 degrees shy of normal and my dorsiflexion is 3 degrees shy of normal. I’ve made great progress! I have a little less than 3 weeks in the boot left until I am out of my boot and I’m getting a little anxious.

It’s hard because I am starting to feel stronger so I notice myself getting a little ballsy. For instance. When I bathe, I step into the tub rather than slide in. Am I allowed to do this? I’m not sure. The doctor did say I could shower normally which would include standing sans boot so one could assume I could do this. Also, I find myself taking a few steps without the boot sometimes. Never more than 5 feet but still. It was crazy because at first when I tried this it felt like my leg was not apart of my body, and now it’s feeling more natural. Also, I should add that I don’t do a normal walk when I do it without the boot, it’s more of a place foot on floor, walk with other leg type thing. I really need to stop, but I’m super careful.

19 More days!!!

So I’ve been out of my cast for 1 week and 4 days and so far it’s going much better than those first few days. After about 2 days I was able to wean myself off of the crutches, now it’s just me and my boot. For a short time I continued using my scooter during the night to go to the bathroom but I ended up returning scootie and so now those mid sleep bathroom trips are dreaded, but doable. Showering is still the same obstacle except now I’m able to get my injured leg wet and clean! I do not shower standing up. I’m too afraid to chance slipping and re-rupturing so I stick to baths and my shower chair.

I’ve been doing PT 2 x a week and I’m pretty bored with it. Range of motion seems pretty tedious but I understand it’s the foundation to strengthening. My PT is wonderful!! She is young like me, has her doctorate, and we get along quite well. She’s even got me doing upper body strengthening to occupy my time. Why not?

Other than that, my quality of life has vastly improved. It’s amazing and wonderful and so many other adjectives to be able to walk without crutches or my scootie. I don’t get around very fast, but I get around. I’ve even stopped using my disabled parking placard except in extreme cases when I’d have to walk very far to get somewhere.

I have been a little bad…. I did take about 3 steps on my own in my room (very carefully) to see what it would be like. It’s disheartening to feel how weak my leg is. My tendon feels weak and/or stiff (not sure) as well. I’m pretty scared to be out of the boot in about 4 weeks, but I’m sure I’ll feel a little better when that time comes. I just wish there was some way to strengthen my calf without really using that tendon. Anyone know of exercises that are minor but will help build your calf?

All in all, things are going well, I’m less depressed and back to being independent again. I’m eager to go back to work, but realistically I know that it won’t be until after at least a few weeks of strengthening PT. I’m HOPING for week 15 post op to “feel ready” to go back. I get worried because FMLA runs out early December and my exact position/shift at work will no longer be protected. I LOVE my job, and the thought of not getting to do it when I recover terrifies me.

Well yesterday I had my cast taken off and my first PT session. To be quite honest I was very discouraged after not being able to walk with 1 crutch. I began to realize the true gravity of this type of injury. I’m not sure why I thought that this was really no big deal, cast for 6 weeks, then 6 weeks of PT and bam, life is like normal. Truthfully, I didn’t think learning how to walk would be this difficult. But it is, if not more so than I could have imagined.

I’ve been quite fortunate, I’ve maybe only experienced pain once or twice during this whole journey. Granted there’s just generalized aching and I understand when I need to rest, but now that I’m learning how to walk there is some real pain happening.

First my bones ache. I have pain in my heel and most of my foot. While walking, the first few steps are the worst, probably as bad as a 6/10. After I get going and have walked a few feet, the pain continues at about a 4/10. My biggest concern is when do you know it is acceptable/expected pain vs. warning pain? This is something I’ll be asking tomorrow at my 2nd PT.

I guess I finally understand the magnitude of this situation. I do have some questions… I return back to my physician saying I’ll be doing 12 weeks of PT first 6 are ROM then 6 of strengthening… is this normal? Anyone else with jobs where you stand for 12 hours or similar survive and are telling the tale? Help a sister out. It seems extensive compared to what I’ve read around on other blogs…A total of 18wks for recovery….?

Thanks!
Sylvia

What a day. Got my cast off (shockingly early) and called to set up an appointment for PT. My PT actually got me in the same day! I arrived to the facility and began filling out pages of questions. This facility also does fitness training and I’m actually a member here so it’s nice to see familiar faces. Well the Therapist finally gets me back and starts evaluating me further. We get to talking and we make a plan that today I will be measured to see my degrees range of motion (ROM), stretch a little, ice, and practice walking with 1 crutch.

She evaluated my gait and felt that I could easily do 1 crutch. Funny… Well she started by having me put myself back to the neutral position, it was hard, but possible, she then further pushed my foot to just past where she said it felt “leathery”. Basically she said it means it needs to be stretched. Okay… Then we tried flexing the other way (pardon my lack of knowledge on correct terminology), then side to side. All went fairly well. I did feel 1 sharp pain when trying to move my foot to the left. Overall, not too painful! Next they iced my leg for 10 minutes to try to bring the swelling down. Basically I have a cankle right now (no distinction from calf to ankle, gross). It’s honestly not too bad but I’ve never seen my leg or foot swell before. It’s kind of interesting.

She then demonstrated how to ambulate with 1 crutch. Funny, the crutch goes on the side of the good leg (I had it on the bad leg). I attempted, no success. It’s very painful to put full weight on my foot. I feel my bones (metatarsals) hurt, then pins and needles throughout my foot when I truly put weight on it. I probably did this for 10 feet, then 10 feet back. It was honestly exhausting! She then did some passive range of motion (PROM) and I was done.

Goal is to work on 1 crutch ambulation on friday at my next PT. I’m pretty satisfied with how it turned out. I feel a tiny bit stronger and I’m looking forward to going back.

Well Today was my 3rd post op visit, 5 weeks post surgery. I was expecting to go in and have my cast changed to the neutral position. I even had it in my head to convince the doc to let me go into a boot this week but talked myself out of it thinking that another week wouldn’t kill me. Funny how things never go as we plan.

I went into the cast room and was chit-chatting with another patient. I told him I had been in a splint and/or cast for 6 weeks, then the doc came in an over-heard me say that. He left but didn’t examine me because my cast was still on. The PA came back shortly and said, well we are going to put you in a boot!! I was over the moon ecstatic! Happy and grinning like an idiot! They came in, sawed off my cast and started fitting me for a boot. I had so many questions but never really talked to the doc.

He came back in after I asked them to ask him to and he explained things, he said that I can start ROM PT and begin walking FWB in my cast. I was completely shocked! He then said in 6 weeks I will start strengthening at PT for 6 more weeks. That’s where things got iffy. I asked him when I was supposed to go back to work. He told me 12 weeks!! What the heck?? He told me on my consultation that it was going to be 6 weeks of casting and 6 weeks of PT. I was in such shock and disbelief.

Here I was under the impression I am half way through my disability and he comes out saying he’s adding an additional 6 weeks. I wasn’t emotionally prepared for that. He swears he warned me about this during our consultation but my mother and I never heard him say that. I understand that I don’t have a desk job and I have to be able to stand on my feet for 12 hours but I thought this would happen by 12 weeks!

After many tears he explained that after 12 weeks post op I can make the decision when I’m “ready” to go back to work. I’m not sure how I will know this but he said he will release me when I’m “ready”. So I get the boot on and they say okay, “Walk”. HAHAHAHAHA

Not funny actually. I can’t walk. The pain in my bones is awful. I can’t put all my weight on it. I haven’t used my leg in 6 weeks. How do they expect me to do this?? I feel defeated. I used my scooter and left the office. After I got home I began trying crutches. Using 2 crutches and weight bearing is possible, but EXHAUSTING.

Well, I start PT in an hour, just ROM. I’m nervous. This has been such a bad day…
Here is my boot

This is my super hairy leg, you can kind of see the difference in the size of the calf

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