Five weeks and a cast change
So it was back to the Fracture Clinic on Friday, for a cast change. I was expecting to see the doctor again and was a bit disappointed to find out that the ‘NLC’ written on my appointment card meant ‘Nurse led clinic’, or no doctor present.
So the old cast came off and while the nurses left me for a few minutes I took the chance to feel the tendon and move my foot up and down a bit. I couldn’t find evidence of any gap in the tendon and I could lift my foot up and down easily and without any pain. I’m not sure that actually means the tendon is healing, but hope so!
The nurses came back to fit the next cast, moving the foot into ’semi-equinus’ position. So at last, a visible sign of improvement, in that the foot is now not pointing pretty much to the ground. This cast is to stay on for two weeks before back to the Nurse Led Clinic for the the foot to be moved close to neutral and another cast put on for the final two weeks. The nurse told me I would be PWB’ing on that final cast, which is good to hear.
I also presented a pair of shoes to be sent off for a raised heal to be added. I’ll wear them for six weeks, which seems like a lot to me. I can’t say I am looking forward to the high heels!
The nurse also said I would be ok to go to France, to attend my cousin’s wedding, the flight being a day after the last cast is removed.
I’ve also been reading about a clinical review which talks very favourably of the results of conservative treatment for patients seen within 48 hours of the injury occuring. I am taking some comfort from it, despite it being some twenty years old.
I also liked the introduction to it which quoted Hippocrates, the Greek ‘father of medicine’ who’s view of a rupture of the achilles tendon was…
“that this tendon, if bruised or cut causes the most acute fevers, induces choking, deranges the mind and at length brings death’
Another reason to consider ourselves lucky, that we weren’t living in Ancient Greece when our ATR’s happened.
Anyway, the review paper is here.
May 12th, 2009 at 3:25 am
Hi Simon,
I believe i am getting a heel wedge for my shoe as well but didn’t realise you had to have it in for six weeks.
Does that mean you will have to wear it when walking around the house and if you have to get up in the middle of the night, will you have to put your shoe with the wedge on?
Cheers.
May 12th, 2009 at 4:49 am
Hi Cactus
I didn’t ask those questions. I guess my assumption is yes, that the shoe will need to be worn at all times.
Simon
May 13th, 2009 at 11:08 am
Hi. I’m glad to see another non-operative experiment in the works. I’m a bit concerned about the report you posted, though, because I am currently undergoing conservative treatment, but I went 2.5 weeks before seeing a doctor… Health costs are so oppresive in the U.S. as to actually fear us out of doctor’s offices. After that 2.5 weeks, I began to realize that the injury was serious enough to take the financial loss. So I saw a doctor and he planar flexed me in a cast. I voiced my concern about doing it so late in the game, but he said that tendons are so slow to heal that it should be okay. I don’t like the idea of losing 25 percent of my strength… but alas, what can I do? I wonder if they can still do surgery by cutting the tendon? Hmmm… Well, I look forward to hearing about your progress. Thanks.
May 14th, 2009 at 1:14 am
Hi Ipfristensky
Surgery would still be an option for you, I understand. I went to see a second doctor around three weeks after my ATR conservative treatment had begun to get a second opinion that surgery was unnecessary and the surgeon would have been happy to operate. Luckily for me, my rupture is right at the calf muscle and both surgeons agree this position means conservative treatment is likely to be successful, due to greater bloodflow around the injury.
There are actually quite a few people following conservative treatment blogging their recovery on the site. I have found them in a couple of ways (using the list of bloggers on the group marathon tracker page (http://achillesblog.com/atrpt.php) and looking for those recovering in the UK where surgery is less common and by searching on the term “conservative treatment” or similar in the achilles blog search box.
Good luck with your recovery. Hoping it goes well for you.
August 12th, 2009 at 7:08 am
Dr.Harry W. Diehl was the discoverer of Cetyl Myristoleate. Best known for his Award winning research of CM8 and its great effectiveness in the treatment of osteo-arthritis symptoms.