Tommo’s Tendon Tribulations

hello there AT brethren,

I have now re-entered the lofty heights of the 2-Shoe world, and as a reward went out to buy myself some new shoes (naturally). Pity everyone in China has tiny feet, couldn’t find my size! Bloody hardship posting….

So the world of 2 Shoes is very different to that of Das Boot. I was a bit ginger at first, but you do find your stride pretty quickly. What I do notice is that now I am using a whole bunch of muscles in my foot and calf/shin that haven’t been used for some time (even in the boot), so they do get pretty sore by the end of the day. Here are my main observations:

• I have, like, ZERO power in the bad leg. This has improved a tiny tiny bit since I started in 2 shoes, but you can tell it’s going to take forever to get my foot-mojo back.
• my ankle swells up big time after exercise and walking around in a shoe a lot. I am guessing this is from under-use over the past 3 months.
• I still have a pronounced limp. I seem to use my toes to try to compensate for the lack of strength in my calf, and the resultant overcompensation causes me to limp like Kevin Spacey in The Usual Suspects (ok not quite that bad).  Whatever that muscle is that runs down your shin next to your Shinbone - that’s the one that is sore at the end of the day.
• I have a little lump that appears at the point where my AT meets my heel. My guess that the AT and the heel are partying on like crazy in there and just needed some extra room was pronounced INCORRECT by Willy the cool physio, who tells me it’s just extra strain on the connection as the AT is quite tight after surgical repair - boooring. It’s not there in the morning, only after I have been exercising or walking a lot do they seem to crack out the champagne.

I am doing my 2 legged calf-raises 3 x daily like a good lad and am seeing the physio once a week. Am guessing I’ll need to be right on top of the exercises in order to get the old leg working normally again, you can really notice when you slacken off the stretching that the AT gets super tight (like, in the morning when you get out of bed).

Hope everyone else is getting along ok.

For the past week and a half I have been FWB in the boot outside the house and nude-foot in the house. I am now spending as much time as I can at home, trying to walk around and get used to walking “unaided” by the boot and crutches. Unfortunately this also means I have run out of excuses to avoid housework, so spent most of yesterday doing laundry and dishes while my wife sat on the couch barking orders in retribution for the 11 weeks of BS I have put her through so far! Fair play….

So getting around nude-foot is frickin scary at first people. Even at home. The first few steps you take you are convinced that every pop you hear is your tendon rupturing again. Thankfully it’s mostly just the bones and ligaments in your foot crying out something like “heeeeeeeere’s Johnny” having been unused for months. The progress from gimpy hobbling around to reasonable gait is actually very fast though, I got back to walking with a slight limp around the house within about 3 days. By slight limp I mean I am concentrating like George Bush at a Spelling Bee on getting my technique right, it’s just that there is no strength in the calf/ankle to allow me to walk normally. I mean seriously, NADA in the strength department, meaning you cannot possibly walk normally and without a limp.

Am doing as many exercises as often as possible, even at my desk at work. It seems to me that the more I can do on flexibility and strength at this point (without overdoing it of course), the better off I’ll be gait-wise. I have regained a tiny amount of my bad calf, but am still He Man on the left and Steve Urkel on the right if you know what I mean. This will be the hardest part I reckon, can envisage months of painful exercise to bring the bad boy back.

Scarus Maximus is healing nicely and is not painful at all, except if it gets rubbed by Das Boot a little too much. I have also noticed that my injured leg is a different colour (slightly darker, perhaps suggesting different blood flow to the leg?) than m y good leg, anyone else have this?

Over and out!

Hey there Achilles people,

I have officially gone to FWB now, very stoked about that and am thinking about getting myself a trophy.

At physio the guy was doing some very full on stretches on my Achilles in various positions (knee bent, straight leg, foot behind ears - just kidding…) which freaked me out a bit as I don’t imagine I’d put that much strain on the tendon since I did the injury - wild stuff! Fortunately the tendon didn’t snap, meaning I WILL have to pay the physio fees (damn) but that I now have good ROM (sweeeeeet). Apparently I can “dorsiflex” to 20 degrees. Seriously, when, other than after getting an ATR injury, would you ever use the word “dorsiflex” in normal life? It’s like how every 4 years when the Olympics rolls around we start talking about how so-and-so would be thrilled to “podium” this year…

Anyhoo, I took about 3 steps in the physio with no shoes on at all. I was feeling dizzy from the thought of doing this, I actually thought I might just pass out. I took 3 zombie-like steps and then backed off, didn’t want to do anything further.  The tendon was ultra-tight despite my enviable “dorsiflex”, but given I have been FWB the past week I am expecting it to feel slightly better/less tight this week.

Any pearls of wisdom from ATR folk out there who have gone past this stage? I am really tentative on the foot and can’t imagine what it would take mentally to just start walking…

On another note, my calf now resembles a toothpick. It’s like a bag of jelly hanging off my shin bone, shorts will be out once the boot’s off! My career as a foot model is over!

hit 8 weeks on Monday, and have been PWB for the past 2 weeks. When I say PWB I mean it loosely as I have been cruising around a lot without the crutches (eg. to the kitchen, to the bar!) and seem to be really comfortable with this. Saw Physio yesterday who tested everything (dorsiflexion +15 degrees, can put about 50KGs of pressure/weight on the bad foot with boot on etc) and is keen to get me away from crutches asap - good man. Only problem is his suggestion was to GET A CANE. I mean, seriously, a cane? I am a 30 year old white dude in Beijing, I don’t think a cane is going to work for me here…..I had horrible visions of looking something like this:

Fortunately, the physio has instead suggested I use 1 crutch, which instead makes me look like a cyborg pimp who the Terminator has come back in time to kill (I have the Aircast boot), or someone who escaped a battle scene from Star Wars after being roughed up by Chewy. We are hopefully moving me onto FWB this weekend so that Beijing and I can leave this whole horrible episode behind us.

Did a day trip to another city on Saturday, which was fine. Took 2 flights and had no issues with swelling or anything else that would be a bit of a worry if you were stuck in a pressurized steel tube at 10,000 feet, glad I could road test that for everybody out there!

My scar now is looking very neat, which is disappointing as I really hoped for something jagged and mean-looking to show off for having to go through this whole damned process. I keep telling the physio to stop massaging it as he’ll rub it completely off and I’ll be left with nothing to prove that I did the injury. Here’s what it look like now:

Scarus Maximus

Last but not least, here’s a new Engrish pic, my new favourite nappy brand:

There must be something about Chinese babies that I don't know?

I hadn’t really thought about this since my ATR, but was cruising through the site the other day and read this article (among others): http://www.cbc.ca/health/story/2008/07/08/cipro-fda.html.

At the time I did my ATR, I also had a ruptured eardrum from a snorkelling trip in The Caribbean….seriously, I had 2 ruptures at the same time - boo. Anyway, guess what the doctor gave me for my ear:

That’s right people - Ciprofloxacin. I know you were all thinking that. Turns out this little bad boy has been linked to tendon ruptures and now has an FDA warning int he US about the risks here. Pity I didn’t know! Also explains why, with no history of tendonitis, tendonosis or even pain in the tendon I managed to do a full rupture while running around at age 30. Or does it? Who knows, but very intresting stuff.

I wonder if anyone else was on these kind of antibiotics when they ATR-ed?

Tom

After 6 weeks I finally got approval (yesterday) from my specialist to get rid of my grotty splint/cast thing (small but very unsafe and smelly) and get into the boot. While I had initially expected this would be life changing, I now know that this is only the next step and comes with its own set of challenges, namely:

• I cannot get my pants over the boot (see pic), meaning my pants need to be all scrunched up around the knee (very uncool here in trendy Beijing);
• the boot is waaaay heavy;
• the boot is not as comfortable to sleep in as the cast was (I have t deflate it a bit to stop my foot aching around the ankle)

Aircast Boot

On the good side, I can start PWB (sweeeet) and ROM exercises on the foot now that the cast is off. This all starts Thursday so I am pretty pumped for that. The Doc says I’ll need to be in te boot for about 4 more weeks, and has basically released me to the Physio now. He was really not keen to see me again, hahah, I think he has had enough of me actually wanting to know about my injury.

The coolest part of all of this was, as anticipated, getting rid of all the dead skin on my foot. There was HEAPS of it! It was pretty gross as the foot has n’t been washed for 6 weeks, here is another gross picture of the foot sans-boot:

6 weeks in a cast - I'm a long way off being a foot model.

Last but not least, here is the scar at 6 weeks. again, has healed nicely and appears to be going ok. My ankle is pathetic though, and the lower calf muscle is almost non-existant, as you can see:

Scar at 6 weeks

That’s all I have time for now. Will update with more PWB-news next week.

Tommo

Got the good news yesterday from the Specialist that I haven’t damaged my tendon when I slipped and fell on it the other day. I can’t believe it given the weight I put on it and how much it hurt for 2 hours afterward, but anyway….The doctor felt around the tendon asking if it hurt anywhere, specifically at the spot where it joins the heel and where it connects to the calf. Felt a little achey but not painful so he gave me the thumbs up. He also did the Thompson test for the 80,000th time and is was all good, a huge sigh of relief. I literally begged him to put me in a boot, not to weight bear, just to offer more protection than my flimsy half-cast. Of course he said “no”, but he did give me the good news that I can start using the boot and commence weight-bearing next week. So now all I need to do is not fall over for the next week and I can move onto the next stage.

On a side note, how awesome is dead skin?? I saw my foot only briefly while the Doc inspected it, but I have loads of it, particularly around the scar. Will be kind of grossly fun to get rid of it I bet…The scar, incidentally, has healed over and is now looking very cool. Forgot to get a picture, so instead, for everyone’s viewing pleasure, I will include some great ENGRISH from Beijing. Systematic abuses of the Englsh Languages, another reason to love this place!

Right outside my house, how convenient!

So I was walking out of my office building today to go and grab lunch when I slipped on the shiny marble surface in the building lobby. My right crutch literally came out from under me and I put a lot of weight on my bad foot…..S^%***@#. It hurt like crazy and I felt a strong burning sensation in the tendon. I freaked out and jumped in a cab (skipping lunch, conincidentally) and flew to the ER to get it checked out. It later turned out that the metal in the frame of the crutch had come all the way through the rubber foot on the bottom, henc eit was easy to slip….The physician took the cast off and felt around, he said I Ishould see the specialist on Monday but that the tendon was still intact, Thompson test showed little, but definite movement etc. He mentioned that as I was 5 weeks post-op it would take a lot of force to re-rupture. 3 hours later it still throbs a little but no pain, man I hope I didn’t screw this up….

I thing I thought of when I was sitting in the ER, wouldn’t it be safer in a boot (I am still in a fibreglass cast down the back of my leg)??? I mean surely, you can’t move your foot past a certain angle in the boot without breaking the thing, it’s got to be more sturdy than this damn cast? Will be bringing this up with the specialist on Monday, needless to say I am pretty nervous about seeing him again!

so I had my 3 week post-op consultation with the Doctor last Monday (it’s taken me a while to get around to writing this post, what with all the TV watching and sleeping I’ve had to do). He took off my old “slab” cast that went on the top of my shin (I will miss that big rig) and replaced it with a svelte new fibreglass number that goes down the back of my calf and under the foot. Ground-breaking! Here are some sexy photos of the cast and the incision wound after 3 weeks:

Svelte new fibreglass cast going down the back of the leg

GROSS!

So the next bit of hilarious news I have is that my neolithic Doctor has NEVER USED A BOOT BEFORE. From what I gather he just keeps casting until you can get to 90 degrees, then puts you into 2 shoes. I am no orthopedic surgeon but that seems pretty archaic. My physio and I are double-teaming him at the moment, trying to get him into the 20th Century before he realises it’s actually 2009. I have another appointment at the 6 week mark at which he will look at the injury and make a call then. If I go into another cast I suspect I may reflex kung fu kick him, so my next post may be from a Chinese prison.

Cheers!

Hi there Achilles People,

thoguht I would update quickly on my progress to date and also include some pretty gross pictures of my stitches and wound - be warned! 

I am now 2.5 week post-op and am still in a NWB cast with my toes pointing down. This position is pretty nasty as it makes 1 leg longer than the other while the cast is on, meaning you almost always need to hold your leg up with your hip/quad muscles when on your feet - very tiring. It also makes me look like a flamingo, as my colleagues are loving reminding me.

Had my 2 week post-op appointment with Dr Shrug-a-lot 3 days ago, where he took out my stitches (OUCH! Anyone who says this doesn’t hurt is on drugs - hard drugs) and re-applied the cast. Initially he had thought about putting on a smaller cast that only came halfway up my leg (yes please!), but he went for safety firat and delayed that until the end of week 3. Fine with me I guess.

Still no talk of the boot, and I found out from my hilarious physio Willy that they only have ones without wedges, so I need to be able to reach 90° ROM in my bad foot before I can use it. Beijing - truly a hardship posting.

Anyway, wound is healing nicely apparently, and my rupture, while complete, dfid not damage any surrounding tissue (is this even possible?) so as far as ATRs go it is not too severe. This gives me a good prognosis for recovery time and effectiveness-wise. Yay. Now if only I could find a doctor that lived in 2009 and not 1789.

Here are some cool shots of my surgery wound week-by-week since the surgery:

24-hours post-op, you can see the swelling around the wound and cankle

Cheers

Tommo