Day of the injury sent home in the cast. NWB. Pretty painful if not elevated. Mostly related to swelling I think. I was lucky in that my kids were in school all day and the job that I just started 2 months ago is only half-days and mostly computer work, so I was able to go back 2 days after the injury. Sat with leg elevated on another chair at work. Felt bad asking co-workers to get me things so often, but they were really great about it. Looking back, those first 2 weeks did go by fairly quickly. I was definitely popping ibuprofen and acetaminophen, but I didn’t have to fill the morphine prescription I was given.
The day after the injury, I figure I should find out what the heck I’ve done and how best to deal with it. Where else but the internet? I find a few medical sites that describe the anatomy and symptoms of the injury. Moderately helpful at that early stage since I don’t know anything about Achilles tendons. Find plenty of info about how long the recovery time is and about how surgery is the only way to go. Am starting to feel like I’m going to have to get it done one way or the other. Then I find this site. Super informative in terms of the surgical vs non-surgical debate, but also strangely comforting just to read others’ stories. Eventually find normofthenorth’s blog, which finally convinces me that maybe it’s just as well they didn’t do the surgery on me and I can at least wait the 2 weeks until my first appt. I’m still worried though that when I get there, they’re going to say “You need to have the surgery” and I’ll just be 2 weeks behind in my recovery.
After 2 weeks I go in to meet the ortho armed with all kinds of printouts from here (UWO protocol, AAOS letter, other sample treatment protocols). The usual waiting, even though I have an appointment. They remove the plaster. My ankle feels like it’s made of glass and I’m afraid to move it at all. A resident comes and talks to me: asks if I’m the guy who needs screws removed. Not. He finally figures out who I am and has a little look-see and a feel. Says: “Yeah, we’ll be keeping you immobile for another 4-6 weeks, that’s the non-surgical protocol”. He quotes most of what I now think of as the old wisdom. Then the actual ortho specialist makes it to me. He is much less gentle with his prodding, but this reassures me slightly that even injured, my tendon is maybe not as fragile as it feels. Then he says he can’t actually feel where the gap is. Not sure what that means, but the he surprises me again by saying: “You know, whether it is a full or partial rupture, I wouldn’t have recommended surgery 2 weeks ago either”. He actually refers to the UWO study and gives the resident a little lesson in front of me. I don’t have to pull out my printouts. So that’s something anyway. He asks if I want an ultrasound, but after further discussion, I figure out the treatment protocol will be the same no matter what the ultrasound might show. Since I am already tired of waiting around the hospital, I opt not to have it done. They give me an aircast saying I can take it off 2 or 3 times a day (i.e. to try to move my foot and to bathe), but not more than that and I should definitely sleep in it. The resident promises to email me their treatment protocol since “…there’s something wrong with the printer here or something”.
They send in a physio who shows me the few little moves I can do (point my toes and then pull them back no farther than 90 degrees and a little bit of supported heel rotation). Then, funny thing: he looks around as though to check if the doctors are still there. They are not. He says: “You know I actually recommend you take off the cast as often as you want, you know if you are just sitting around, and move your foot as much as you want as long as there is no pain and you don’t dorsiflex past 90″. Hm. Not getting a completely consistent message, but thanks to all the extra info from achillesblog.com, I feel reasonably well equipped for the next 2 weeks. The resident never did email me the treatment protocol they are expecting me to follow though…
The aircast is a huge improvement! So glorious to be able to air out/cool off my leg and foot. So nice to be able to move the ankle a bit. Baths are significantly easier, though somewhat scarier without the protection of the cast.
As I mentioned, most of my pain seemed swelling related, near the end of the first 2 weeks, the worst pain was actually in my upper calf, quite far from where I would think any Achilles rupture would be. I thought this was cramping from carrying the heavy plaster around, but it continued and even got a little worse after I got the aircast. I scared myself reading some posts about deep vein thrombosis and resolved to phone to move up my next appointment. Luckily, with some more consistent icing my overall swelling seemed to finally be going down and that upper calf pain has now almost completely subsided, so I will wait until July 9 for the next appt.