I’m in a boot!

May 24, 2012

My first office visit post op, 10 days after surgery, went well.  I’m off the pain meds now and ready to move on with this process.  I was  looking forward to having the splint removed and giving my leg a chance to breathe while the doc examines and decides what to do with me.  To my surprise I didn’t have have any stitches.  I had 15 staples in my ankle instead.  The PA asked if I had ever had staples removed before.  I said no, and she says “Let me know if you need to take a break at any time while I’m removing them.”  Not what I wanted to hear.  I asked for the anesthesiolgist and she thought I was joking, so I laughed and pretended I was joking.  Took her all of 30 seconds to remove the staples, and I felt no pain.  Got me all worked up for nothing.

Doc comes in and in 15 seconds says, you’re healing well.  Let’s put you in a boot.  For reals?  YES!   And only 10 days out.  Can’t decide if this is a good sign for me, or if my doc is just crazy.  Doc says he thinks it’s better to be aggressive  in my situation.  Although my rupture was considered total, the tendon was actually hanging on by a thread.  The tear happened closer to the calf muscle, so there is good blood flow in his words.   I also didn’t lose the sheath that surrounds the tendon.  Lucky me, I guess.

I was given the physical therapy referral form so that I can start searching now for a good therapist.  The doc says I can do some home therapy now, which would include simple flexing and extension as pain will allow.  I can walk in the boot around the house, but need crutches when I go out or go to work.  In another two weeks I can start seeing a physical therapist.  Doc thinks I may be able to be off crutches by that time and maybe in two shoes a few weeks from then.

Anyone else working on an accelerated program like this?  I’m grateful and fearful of a re-rupture at the same time.  Doc says that since the suture was attached to my calf muscle, there is a risk that I would pull the suture through the calf before I tear the achilles again at this stage.  Thanks doc.  I feel better now.

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6 Comments Add your own

  • 1. kimjax  |  May 24th, 2012 at 10:31 am

    Wow! Letting you walk in the boot at 10 days? Let us know how it goes. My doc says no PWB until 4 weeks. Maybe since you had an easy repair?

  • 2. joss1799  |  May 24th, 2012 at 1:52 pm

    Glad to hear of your progress. I too was on a bit of an accelerated program. I was PWB 4 weeks post op, FWB 4 weeks 5 days post op and in two shoes 9 weeks post op. Started formal, full fledged PT the day after I got out of my boot and into my shoes. I am now 6 sessions of PT down and notice improvement every day. It is amazing how different everyone’s treatment plan is. It depends on the doc and it depends on you too. Just listen to your Achilles. It’s a long road to recovery so no need to push too much and start all over from square one. Keep it up!

  • 3. hillie  |  May 26th, 2012 at 6:18 am

    When I look at blogs from only 3 or 4 years ago, and read how long the plaster period and NWB took, I’m pleased that, if I had to have an ATR, it was recently. I’m on an accelerated program, non-operative/non-infection, and had the adjustable vacoped boot at my week 2 review with FWB as much as was comfortable. Started simple exercise then. Barefoot indoors at week 8, and no boot outside at week 9.5.

    Have had more swelling as I became more active, limiting wearable shoes, and I can now drive. ATR was right leg. Exercises increasing steadily which is helping me to lose a bit of weight too - good thing too!

    Good luck with the boot and weight bearing. It should all get better from here on.

  • 4. normofthenorth  |  May 26th, 2012 at 12:23 pm

    +1 to hlllie’s! It’s good to see that the new evidence is penetrating the medical world, including the NHS. But several aggressive treatments mentioned her (incl FWB @10 days) aren’t supported by evidence, at least not yet. Of course they could turn out to be the standard of care in 2020, but I think I’d keep an eye on the well-tested and highly successful UWO protocol for today’s standard. No hotkey here on the iPod, but I think it’s at bit.ly/UWOProtocol . And linked from the end of the full study, which is on this site.

  • 5. tpj25  |  May 26th, 2012 at 7:10 pm

    Thanks for the input and advice everyone. I was a little surprised at how quickly I’m being pushed along as well. However, my surgeon and his PA are both athletes themselves. Their office handles surgery for one of the professional sports teams in the area, so I would like to trust that they are up to speed on the newest methods for handling sports related injuries. My surgeon seemed really encouraged with my procedure and healing and likes the fact that I’m very healthy. I’m definitely going to remain cautious and listen to my body. I do not want to go through this again.

  • 6. normofthenorth  |  May 28th, 2012 at 1:02 am

    tpj, FWIW, my first OS (in late 2001) was an avid skier but ultra-conservative and ultra-slow in his rehab preferences. The evidence was already pretty clear then that fast rehab and boots produced excellent results, but he liked slow rehab and casts. I finally became his first “booted” patient ever, starting maybe 12 weeks post-op(!). The only way his athletic interest affected my schedule, was that I had to stay in my last cast for an extra week, until he got back from Aspen!!

    Good luck and good healing!

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