Day 10: 1st postop appt

Dec 4:  on the day of my diagnosis, the doc said “set up an appt for 10-14 days from now”.  So his office set it up for the 4th, 10 days after surgery.   On the day of the surgery, the nurse said that he said “set up an appt for 14-15 days from now”.  WTF?   So I just kept my appt for day 10.  I had left the outpatient surgery suite with my foot in a “half-cast”, which I can’t describe adequately.   It wasn’t plaster, or plastic–it fit around the back of my calf and foot, was rigid, and most importantly kept my foot angled sharply downward–so as to eliminate any need for the tendon to stretch rather than compress.

If you haven’t seen the videos on teh intertubes of what the surgery does, I urge you to watch them–it makes perfect sense, once you see that they have shortened your tendon and sewn the ends together, that you DON’T want to exert any pulling force on that stitch for some time.   So I welcomed my non-weight-bearing requirements.  Also because I was pretty good on the crutches–you can be fast if you have  uninterrupted space.  Just don’t ever ever do anything, anything, to put weight on it in the first couple of weeks.

I attribute part of the speed of my recovery to just lying around with my leg up on the couch for several days after surgery.   Fortunately my surgery was the day before Thanksgiving.  So, while I was very sad we couldn’t drive down to see my daughter and grandchildren, I am glad that I could just lie around for days.

They gave me LorTab for pain–which is just vicodin, which is just acetaminophen and hydrocodone–and I took some during day 1.  Mostly I just lay around with my foot up.  Didn’t eat much.  Day two, i took some Lortab in the morning, drank some coffee, and promptly threw up.   So no coffee.   Fortunately for me, there really was very little pain–mostly just where the incision was.   So by day 3, i was taking only one Lortab and using Tylenol.  I think on day 4 I stopped the Lortab and switched entirely to Tylenol.   I just lay on the couch, eating sparingly.  Of course, I am very fortunate in having a Significant Other who could help me and do nearly everything–basically making me keep my butt on the couch.  I think this five days of recuperation was essential for my future progress.

The following Monday I could go back to work–because I work from home.  All I do most of the day is sit at my desk, do email, call people and be on conference calls.  So I could do that.   I put a chair with a pillow next to my desk (again, fortunately, it was my left leg that was out of commission), propped my leg up on it, and put my wireless keyboard in my lap.   Every couple of hours I’d get up from my chair and lie down again.   Keeping the leg elevated a lot is critical.  This went on for a week.  I spent most of my evenings with my foot up.

Anyway, on day 10 i went to the doctor.  They unwrapped my foot.  I took a picture of my heel, which was still all stitched up.  Too early to take out the stitches, they said, but it’s healing really well; so  come back in a week and we’ll not only take out the stitches but put you in a boot!

Which I had read about, but didn’t expect to happen until four weeks after surgery.  This would be 17 days, a little more than two weeks.

Recap: Injury to Surgery

I’m starting late, as usual.  My niece in the Navy said “why did they forget, again, to dip that second heel into the river?”   Hence my blog title.

Recap:

Nov. 21:   It’s 8:30 am, and a Saturday, and we’re about to leave for the farmer’s market.  I am leaping up the step from our family room to our hallway, when suddenly our cat jumps underfoot.  I madly avoid stepping on it, when the infamous pop! happens.  A sharp pain, and I quickly sit down.  An electric shock passes throughout my body.  I say to my wife “I’m in shock!  This is shock!”  And I’m thinking “I could pass out!  And I can’t do anything about it!”  But I don’t.

I choose to stay at home and not go to the market.  While she is gone, I think “this is at least a bad sprain (although inside I fear the worst), and I need R.I.C.E.”  My PT aide training from years past kicks in, and I lie down, wrap my leg in the ACE bandage we have in the bathroom, put ice on it, and keep it elevated.  Time passes.  I discover that I can hobble, even bearing weight (just a little).  I get out the sword cane I’ve been saving for 15 years for just such an occasion, and flee to my laptop to look up Achilles tendon injuries.

WELL!  At the very least this is a partial injury.  It’s hard to tell, I tell myself.  My wife says “don’t you want to go to the ER?”  And I say “why?  they can’t do more than I’m doing already.”  As the day goes by, and I read more, I worry.   It sounds more and more as if I do in fact have a total tear.  I try to convince myself that maybe I don’t, but the soft gap where my tendon should be above my heel suggests otherwise.  I fight this because I want to go to my daughter’s house for Thanksgiving, and we’re supposed to leave Tuesday or Wed at the latest.

Sunday, Nov. 22:  As the swelling goes down a little bit, that soft gap becomes more prominent, and my further researches suggest that oh yeah, it’s probably a total disaster.  Damn!   As the day does by, I think oh maybe I should see the doctor tomorrow.

Monday, Nov. 23:  Sunday night I left  a message for my PCP (am in an HMO, in which i wholeheartedly believe) that maybe they should try to fit me in today (Monday).  And they do!   She seems dubious (”what makes you think you’ve hurt your Achilles tendon?”  as if I have no ability to self-diagnose), but arranges for me to see an orthopod the next morning at 8 am.

Tuesday, Nov. 24: I see the orthopod.   When he says “ok, lie face down on the table” I say “oh, are you going to do a Thompson test?”  That’s when you lie prone, bend your legs at the knee so your feet are up in the air, and press your calf–if your Achilles is working well, then your foot will involuntarily jerk.  I tried this myself, and when my left foot didn’t move it reinforced my thought that my injury was bad bad bad.  He does one, and lo and behold!  same result.   We discuss my options–the favorite of his being to do surgery the next day.  I press a little to see if there’s any realistic chance that I can be in the car for nine hours the next day.   He seems dubious.  I ask him to send in my wife.  (I am reluctantly coming to the conclusion  that I should have surgery the next day, but I want her to participate in the decision that we don’t get to see our grandchildren for another month+. )

She has already heard us discussing loudly.   And immediately agrees that the best thing for me is immediate surgery.  Sigh.  I call later in the day to see what time it’s scheduled (they were thinking afternoon might be a possibility) and it’s at 7 am!  So I should arrive at 5:30!  AM!

Wed, Nov. 25: Bright and early in the outpatient surgery department, nearly deserted.  Various cheery hospital people float by.  The anesthesiologist helpfully says, upon hearing how I did it, “have you ever successfully stepped on a cat?  Why try so hard to avoid it?”   Thanks, pal.  The good news is that he thought maybe I could get away with having only a spinal anesthetic–always to be preferred to a general.  And indeed, so it was!

I’m talking to the anesthesiologist, and next thing I know I’m on my back, sitting up, but my lower left leg is completely wrapped in a couple of ACE bandages, and my foot is immobilized.  I can’t move my right foot either.  My lovely wife is there.  We start talking.  I say “look!  I can move my right leg!  Can we go home now?”  She gently suggests that maybe the anesthetic has not worn off completely.    I say “but I can wiggle my foot!  Cant’ we go home now?”  Reason prevails.

Finally, everyone agrees that I can start the going-home process.  PT is called to discuss with me how to get around on one leg.  FINALLY they arrive–with a walker!!    I scorn this (possibly they think that because I’m 59, I’m weak and feeble.  Little do they know that I am a terror on crutches, from my PT training and the races down the corridor we used to have.) and ask for crutches.  After some thought they agree that maybe they can find some.  They do, and I learn that the latest technique for going up stairs, if you have a bannister, is hopping.  I hop magnificently.  I race down the halls.  They are impressed.  I show that I know that with a bad leg and crutches, you put the bad leg first going down and the good leg first going up.  Bad down, good up.  Get it?

I go home, and start a two-week session of NWB activity.  Luckily, it’s Thanksgiving weekend, so I don’t have to do anything for five days.