thelifechangingpop’s AchillesBlog

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“You Can Make Me Dance, Sing or Anything (Even Take the Dog for a Walk, Mend a Fuse, Fold Away the Ironing Board, or Any Other Domestic Shortcomings)”

Filed under: Uncategorized — thelifechangingpop at 4:33 am on Saturday, November 16, 2013

Longest song title on the UK charts, Rod Stewart and the Faces.

Spent yesterday at a symposium on osteoarthritis in dogs and cats. All very interesting especially the hip replacements that they do in dogs and most interesting was the discussion on pain management.

I do a lot of sterilsation work for animal welfare and am always amazed to see how quickly these animals seem to recover from surgery. A dog that is spayed will be up and walking, admittedly they all receive a pain killer injection, within 30 minutes of surgery and the next day will be running around as if nothing has happened (obviously my post-op instructions stress that exercise is to be limited but try telling that to a labrador!).

However, when the same surgery, an ovariohysterectomy or usually a hysterectomy, is done for a human patient there is an extensive 6 week recovery period and even at the end of those 6 weeks many patients are still in pain at the op site.

So studies were done on dogs post surgery  and this showed that the body was having a pain response with all the associated responses in the body for at least 3 weeks post surgery even though these dogs do not show any signs of pain or discomfort.

So applying what I learnt yesterday to my achilles surgery, there will be a pain response from the tear in the achilles and from the surgery that was done to repair the achilles which also involved cutting through skin and subcutaneous tissue so therefore even more pain. Because we are in pain, we guard certain muscle groups and because we are initially not weight bearing we are underusing some muscles and overusing others. This results in myofascial trigger points developing in these muscles (basically a knot in the muscle fibres that further impairs muscle function which in turn creates further knots………..). So these myofascial trigger points create a constant path of pain impulses that then leads to referred pain, pain in another part of the body. So then the body starts guarding these areas where the pain is which leads to further changes in muscle use and flexibility which leads to more myofascial trigger points which leads to more referred pain……..I think I’ve painted the picture.

My pain management post-op was extensive. I was asked to score my pain on a scale of 1 to 10, initially I was moaning 11 and it took a huge amount of medication to get me comfortable and for the whole time I was in hospital I received pain medication every 6 hours, even when I said that I felt fine. I took anti-inflammatories and painkillers for the first 3 days at home and then just took anti-inflammatories as I didn’t have any pain from my ankle.  I just accepted that my other muscles would be sore, part of the healing process I thought but actually I was just winding my body up with pain triggers. A very vicious cycle. My treatment plan will now include drugs for the pain and a combination of acupuncture and trigger point massage from a physio.

In a nutshell, your body will heal better if you keep it in a pain free state.

10 Comments

17

Comment by CliveC

November 16, 2013 @ 6:28 am

Hi Jen

Following on from that, for an ATR, doesn’t the mostly pain-free state of non-operative care, never mind the lack of surgery risks promote even better healing (and peace of mind)?

18

Comment by normofthenorth

November 16, 2013 @ 12:43 pm

Clive, the data on op-vs-non-op outcomes is published, and “It is what it is.” Your theory would predict significantly superior outcomes for the best non-op treatments than for surgery, and other logical-sounding theories would predict significantly superior outcomes for surgery. In fact, the reported outcomes are comparable and statistically not different with only a couple of outliers. (The NZ non-op group was statistically stronger than the post-ops in ONE test, and the UWO group was weaker in ONE.)

For “human” reasons, it makes sense to restrict these comparisons to the blog threads where we concentrate on that choice. Jen made her choice a while ago, and her current “job” is following that path to full recovery, while asking and answering questions that arise. Our job is to help. I’ve hijacked a few post-op threads myself in the past to present op-non-op facts, but it’s the wrong place for it.

19

Comment by CliveC

November 16, 2013 @ 1:04 pm

OMG, did I get it wrong? Fooled by some of the text boxes in blogs, not just achillesblog, when they are headed ’speak your mind’. It’s all protocols I guess. Recovery protocols, exercise protocols, blog posting protocols. Explains why I was so bad at school too.

Suitably chastised,

CC

20

Comment by normofthenorth

November 16, 2013 @ 2:25 pm

Clive, I am the King of Unintended Offense myself, and now I think I’ve offended you. Sorry! But most of my unintended offense around this site has been along the lines I outlined above, and I was just trying to avoid having us both offend Jen or anybody else who has already made their own op-non-op decision and isn’t logging on to this site to re-open that particular can of worms.

Me, I’m happy to discuss that issue until the cows come home, but helping people to make that important early decision is only one part of the huge and multi-faceted benefits this site provides.

21

Comment by alanweibel

November 16, 2013 @ 4:04 pm

Hey Jen,

I’m not big on pain killers. I try to avoid them at all costs. My body doesn’t react well to them.

To get around pain killers, I’ve found that leg and calf massages to work very well. I rub and massage my calf constantly.

You could also try foam rollers. They do wonders to rub out aches and pains.

Good luck!

22

Comment by hillie

November 17, 2013 @ 5:32 am

Hi Jen

That is a very interesting piece that you’ve written, and what you say comparing humans with dogs is so true. We can sometimes be wimps in comparison.

Clive and Norman - having a little tiff? Reading between the lines it seems to me that while Norm is seeking, understandably, not to get Jen et al stressed about decisions made, Clive is looking at the facts in isolation and trying to present future ATR victims with a few theories or options
.
As with you both, I had posting issues in the past and still don’t know if I should just speak my mind or be more conciliatory - maybe the answer is somewhere in between if not sure.

Alan - agree with the foam roller. Excellent at getting right to the spot although my visiting hairdresser wondered what it was when she saw it. Rolling a tennis ball up and down the back of the leg helps too, or a small bottle of icy water.

Jen again - have a great recovery and keep posting. Great stuff, and you generated some interesting follow-up posts from the ‘old guys’.

H

23

Comment by normofthenorth

November 17, 2013 @ 11:07 am

Hillie, I feel
No restrictions on what I say about op-vs-non-op or how bluntly I say it. But I’ve slowly learned that Where and When I do that blunt speaking is important. Nobody assailed me with that evidence while I was immediately post-op, and that’s a Good Thing. As in ATR Rehab, there’s a time and a place for everything. The “right” exercise or stretch or boot setting at the wrong time can cause a disaster, and true statements that are positively life-changing for some readers on this site can be the opposite for other readers.

Bottom line is that you and Clive and the rest of us who are keen on the latest evidence on treatment choices should feel free to duke it out, maybe on one of my pages that’s dedicated to that subject — how ’bout “The case for skipping ATR Surgery”? But hijacking a thread about post-op pain control (as we’re STILL doing — sorry, Jen!) is cruel and rude, and needlessly so. (People who speak their mind are great. People who always say the first thing that comes to mind…)

24

Comment by Hillie

November 17, 2013 @ 1:11 pm

Cruel and rude, Norm? Jen, I have never had any intention of being so, and have always meant for the best and certainly thought that I had conveyed that above. If that is how some feel that it has come out, then I apologise. And Norm, with your last sentence above…

25

Comment by normofthenorth

November 17, 2013 @ 5:34 pm

Sorry to you too, Hillie, if I’ve offended again. I do stand by my basic point, buried somewhere under the unintended offense. . .

26

Comment by thelifechangingpop

November 18, 2013 @ 6:26 am

My, there’s murder on the dancefloor. I have not felt offended or had the sense that anyone has been cruel or rude. I value every bit of info that I can get, thank you to you all.
Jen

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