bilateral achilles ruptures with fracture

Wow!!  I did a double whammy.  I have been active my entire life.  I love sports and in the last several years have been active in triathlons and CrossFit.  Recently I started back gymnastics which I enjoyed in my younger days.  I had tumbled for several weeks when the injury occurred.  I was doing a round off back tuck.  After springing off both feet in an explosive movement I felt both Achilles snap.  Thankfully I landed the tuck but did not have any Achilles for support.  I fractured my right medial malleolus and tore my left deltoid ligament.  It was severe pain immediately.  Worse than childbirth and Ive done that four times. I underwent surgery 36 hours later to repair both Achilles and pin the fracture.

The first two weeks went by pretty uneventfully.  I took pain medication for about three days after surgery.  We had a lot of people visiting, bringing meals, and helping to care for our four small children.  This kept me busy along with doing as much research on this injury as humanly possible.  My first post-op visit was at 13 days in which I was to get my cast off and remove the stitches.  There were so many things that I had lost control over that I was prepared for a long discussion with my surgeon regarding my rehab options.  I wanted my life back and FAST.

My first visit with the surgeon did not go as planned.  I pushed for a boot and asked to do gentle range of motion.  His plan was to recast me till five weeks.  In the end he conceded to leave me in the old cast bivalved so I could shower but nothing else. That is were my life started to fall apart a bit.  Well, maybe more than a bit.  I don’t think I have cried that much since having the postpartum change of hormones after childbirth.  Im usually upbeat and optimistic but this injury had started to unravel me.  I will admit I was depressed and grieving.  Grieving for the things I felt I had lost.  I was looking forward to a carefree summer with our children.  Time on the lake water skiing, going to the pool, triathlon season with my husband and two dear friends.  These things would not be this summer and I got quite pissed about it.

Obsessing about this injury is an understatement!  I think I have read every sports medicine protocol and research article I can get my hands on.  Needless to say I was not pleased with my surgeon’s conservative approach.  I pleaded my case with his nurse practitioner quoting several articles which show that early weight bearing and range of motion do not increase re-rupture rates.  My husband got a text two days later stating I could go into a cam walker boot at thirty degrees plantar flexion and fully weight bear as tolerated with a walker.  I could also do ROM to 10 degrees plantar flexion.  He had stated that he would talk to his foot and ankle specialists so I assume he did his homework and felt more comfortable with the current literature.

Now what?  I got what I wanted but I’m scared to death.  This injury still consumes my every waking moment.  I still grieve over silly things like pretty shoes sitting in my closet.  I miss doing things with my children.  I feel like I’m sitting on the sideline watching life pass me by. Life is just harder right now.  When I’m not rolling around in a wheelchair I’m standing or shuffling around with a walker with great effort.  Each day does get better in small ways but the overwhelming disability seems to shadow those small victories.  When I’m in a positive state of mind I can see my blessings.  It could be much worse.  It could be  permanent.  It could be incurable.  It could be my child.  My family, friends, and community have been wonderful.  As a physician I can now see the role as patient much clearer.  As a person who has never had a disability I can see the disabled in a new light.

Reading research articles and rehab protocols only tell you so much.  They tell you what to do and when, but not how you will FEEL along this journey.  This is were we need each other.

4 Responses to “bilateral achilles ruptures with fracture”

  1. Wow — and OW!! And congrats on the research and convincing your Doc to change his rehab protocol. After all the talk about “it’s YOUR leg, not HIS”, etc., I think only a small minority of us actually make significant progress on that front, even with the weight of the scientific evidence on our side!

    I was discussing the medical profession’s attitude toward “patient Googling” with two sailor friends on the boat ride to our club this evening. One, with an 80-ish mother post-MI with a nasty sore from being bedridden (I forget what they’re called now, pressure boils or some such?) asked the Doc what STAGE it was. It turned out to be stage 4, which is extremely serious, but he responded in anger to the question, instead of answering it!

    The other woman in the conversation had the opposite reaction from a Doc: After he answered one of her questions, she was sure that his expression meant “You know you COULD have just Googled that!”

    Very interesting, your being a patient and a physician!

    You’re only the second person to rupture both ATs at once, since I started hanging around here almost 1.5 years ago! I’m blanking out on the other woman’s “handle”, but I’m sure a search would turn it up pretty quickly. (”You know you COULD have just Googled that!” ;-) )

    Unfortunately, your impression that parts of life are passing you by is well founded — like most of us, you’re a very active person, and you can’t do any of those things for a while. That’s not a choice, but how to deal with that reality is a choice. Govern yourself accordingly, as the lawyers like to say!

    Of course, the absense of a “good leg” makes your rehab much more difficult than ours in the early, pre-FWB stages. As much as we’ve complained about using crutches, NOT being able to use them is clearly way worse.

    The good news is that you should start seeing some significant progress toward “normal” — “ADL normal” more than “sports normal” — any minute now. FWB should be a huge breakthrough, physically and psychologically. And you can be proud that you’ve taken enough control of your recovery that it will come as quickly as reasonably possible.

    BTW, if you haven’t noticed doug53’s blog here, you might find it interesting. He’s also an MD, and he devised a super-fast rehab protocol for himself that worked well for him. If little parts of it work for you, it may save you some disabled suffering time.

    Good luck, and good healing!

  2. It sounds awful. I do know some of what you are saying. I have worked with people who have disabilities my whole working life. Its impossible to be objective when it affects oneself. I totally understand your obsession with reading articles. I wish you a speedy recovery, you WILL get there in the end.

  3. That is some story. I was having a rough day and feeling pretty sorry for myself yesterday then I read your blog and felt ashamed. You have far more right to be feeling blue than I do — twice as much actually: I have two young kids, you have four. I ruptured one Achilles tendon, you ruptured two, not to mention your other injuries. Ugh.

    So I’m not in much of a position to try and cheer you up, but we do have plenty in common. I too, cried over shoes; for my 40th birthday last year I pestered for and got a spectacular pair of Christian Louboutin heels. Most of the tears I shed in the emergency room were over fears that I wouldn’t wear them again! And summer plans: I won’t be riding and hiking with my kids, hitting the trails on my new dual suspension mountain bike, paddle boarding, surfing . . . the more I sit and think about it, the more activities I can come up with that I won’t be doing. I’m trying to focus on the things that I can still do, albeit in a much less active fashion; I’m working out my arms and core (with a pilates DVD) and I’m looking forward to physiotherapy in 3 more weeks, I hope. I’m going to make THAT my summer plan for this year, and devote all my efforts to it when I’m not working.

    With help, couldn’t you still go the pool? I’ve been waiting to submerge my leg (tomorrow is three weeks since my surgery) because it could reopen the incision. But I have read a few blogs here of people who did swim as part of their recovery, therapy and fitness. I ‘m hoping to add it in starting next week. I suspect it’s going to feel amazing, and I bet even with all your additional injuries, a little floating around and then working up to moving/swimming would be so great for you.

    Most of all, I’m so impressed at the way you have educated yourself, and convinced your surgeon to take a second look at his plan for you. You’re an inspiration. I was doing a bit of reading, but you definitely have me thinking that I should find out even more if I really want to advocate well for myself. Seems like everyone could take notes from you. Please keep us updated regularly — especially with your
    attention to the research it will be so helpful to know where you’re at.

    Hang in there. Cheering you on from Vancouver!

    Deana

  4. You have definitely been sent a challenge! Ripping my AT has been a life changing event for me. I cannot imagine getting both of them. I cheering for you from the WNC mtns! Alice

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