Second opinion; Into a cast; Itchy all over

This’ll be ┬árecap of developments from the last week.

On Tuesday, I had an appointment with a podiatrist from the medical group I’ve been using from my primary care. I was trying to get an appointment before my surgery, but this was the earliest they had. I figured it would still be worthwhile to get a second perspective on the reinjury and the recovery process.

I actually quite liked his approach: Pretty much all of the doctors I’ve had appointments have left me feeling like they’re willing to answer my questions, but are in rush to get to the next patient. He seemed less like that than the other doctors I’ve had recent experience with.

In any case, he didn’t really come up with anything significantly different from what I’d already read elsewhere, but he did mention a couple of things of note:

- In his experience, it’s not unusual for a rerupture to happen higher on the Achilles

- The location of my rerupture is actually where they would normally do an Achilles lengthening procedure - so it’s not a bad place to work on.

- For recovery he mentioned that there is some evidence that being in a cast (vs. going directly into a boot) improves outcome

- He mentioned that he lets his patient ride a stationary bike with a cast (heel on the pedal)

In general, he gave me some things to think about, but I didn’t hear anything to make me think that my current path is incorrect.

The good thing about this appointment is that he wanted to take a look at my leg, so he cut me out of my torture device of a splint; It felt great to be able to hold my ankle in a somewhat normal position again!

Unfortunately the pictures of my splint didn’t turn out that well, but here’s a picture my wife took when I was out of the splint - Even though I was more relaxed, you can see my foot is still stuck at an angle from being contorted for close to a week.

Here’s a shot of the new incision from the same appointment:

In any case, that was pretty much it for the second opinion. I left feeling reassured, but not necessarily much more enlightened.

Wednesday was the day of my appointment to get my splint looked at and adjusted.

I called half an hour before my appointment to see if the doctor was running late, and much to my chagrin found out that I had no appointment! Apparently somehow the appointment had never been recorded despite the fact that the PA confirmed the time with me.

I was nearly panicking - the idea of more days in that splint was sending cold chills down my spine!

In any case, cooler heads (my wife) prevailed, and we decided to go down to the outpatient center anyway.

As it turns out they were very accommodating. They said that they’d find a way to fit me in, and as it turns out, it was my shortest wait to date!

The doctor saw me and said that this time they’d like to put me in a cast (agreeing with the other opinion), and would like me to stay in it until four weeks after the surgery. Coincidentally, that means my next followup was to be scheduled at the same time that was supposed to be my 8 week follow up from my first surgery, so I didn’t even need to make a new appointment.

In any case, I get to be in this thing for the next 3 weeks:

(My follow-up is on March 29th).

The cast is still at a very plantar-flexed angle, but it’s putting no strain on my foot/ankle anymore, so I’m much happier.

Unfortunately, it seems like the fates are conspiring to make sure that I don’t get too comfortable, because the most recent new development (it actually started shortly after the last surgery) is rashes that have broken out all over my body. Basically the spots I’ve found are: Both ears, both forearms, my lower belly, both knees. My right ear was particularly bad - it swelled up to look like grotesque caricature (no pics, sorry).

I had already read up a bit about this, and it seemed to me like I had some kind of systemic allergic reaction. I contacted the doctor’s office and they agreed with me. I told them I was taking anti-histamines and applying corticosteroid ointment when necessary. I agreed to let them know on Monday if things hadn’t gotten any better.

As it turns out, it does seem to be getting better (slowly), but based on the rate of improvement, I’m going to be fighting the urge to scratch for a while yet. The one thing I’m thankful for is that the leg under the cast hasn’t been that itchy (yet?).

I’m really looking forward to getting a comfortable night’s sleep; Hopefully things will continue on their current trajectory.

3 Responses to “Second opinion; Into a cast; Itchy all over”

  1. If you escape from a cast WITHOUT going a bit bonkers from itchiness, you may be the FIRST!

    I’d love to get a reference to the evidence that shows better healing with a cast than a boot. The best-results studies I keep citing AND the good-results “early mobility” post-op studies that are on this site’s “studies and protocols” page, all did as well or better with boots.

    Mind you, most studies (and OSs) put post-op patients in something absorbent (splint or plaster cast) for the first 2 weeks, but that’s mostly so they don’t mess up the boot (and they’d probably have to wrap the incision area with gauze and stuff anyway).

    One guy here recently broke out in hives/rash on the trip home from surgery, after eating 2 jalapeno chips. He thought it was a reaction to the anaesthetic, IIRC.

  2. Hopefully, the reaction is to something temporary (drugs, or something else (possibly latex?)) that you were exposed to during your surgery. In rare cases, some can even be alergeic to the internal sutures, which is a real bummer.

    My wife had surgery for a broken tib/fib - including metal plates and screws. She had an allergic reaction to the (probably the alloy nickel content) hardware. It all had to come out as soon as the bones had started to fuse- 2nd surgery, and longer recovery. The original intent was to leave the hardware in there permanently.

  3. Trifecta Health and Psychiatrist Dr. Fruitman offers Adult ADHD, Depression, Anxiety, Substance Abuse, Weight Management and Transcranial Magnetic Stimulation (TMS) for depression in New York City.

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