Into the boot

Well - last Friday was the big day!

I finally got out of that (insert adjective here) cast and was transferred into the boot.

While the cast was quite light compared to the cast, the psychological aspect of not being able to get out of it was starting to wear on me. Because of scheduling issues, I was actually in the cast two days longer than the three weeks the doctor suggested. Those last two days really dragged on!

This was also the appointment that my sutures were removed - this time by the Medical Assistant instead of the Orthopedic Tech. I have to say the MA was quite a bit more gentle - despite the fact that there were considerably more stitches to remove, I was quite a bit more comfortable than the first time.

The surgeon didn’t spend much time with me at all - she looked at the sutures, said my wound was healing well, and basically told me that she’d like me on a four week schedule to come back (for a total of 8 weeks post-surgery - so pretty much the same pace as it would have been without the extra two weeks in a cast). She suggested that I start at 20 degrees of wedges as I did last time.

I did express my concern that my calf/tendon felt very tight last time and I was concerned about being able to make it to that angle, especially given the fairly plantar-flexed position I had been in for the last four weeks. She told me that it would be ok to start at 30 degrees, but to work on getting to 20 degrees at home.

When the orthopedic tech came, I pretty much took charge. I explained my prior experience to him, and he was willing to let me do all the work. He did provide an extra wedge for me (since we had left our extras at home).

When I first tried to get into the boot at 20 degrees I felt a very familiar feeling - quite extreme tightness in my lower calf and tendon down to my heel. This time I fortunately knew better than to try to push things. I decided to start at 30 degrees, which was a comfortable angle for me.

When I got home, I experimented with taking the extra wedge out again. I found that if I inserted a folded sock under my heel (about half the width of the wedge I would feel a stretch but still not be to the point of pain - so that was my compromise for the rest of the day.

Contrary to doctor’s orders (actually choosing to follow my doctor’s original answer rather than her most recent advice) I chose to sleep in a half-splint that I had from my pre-surgery appointment. I found that to be quite secure-feeling - i.e., I don’t think I’m likely to put any strain on the tendon, and size-wise it’s much more pleasant than the boot in bed.

This was also the day of my first complete shower since the second surgery - it felt great to get some of the dead skin off my leg (I didn’t get it all in the first try, though).

The following day, I went into the boot without any additional “shims”. I couldn’t quite get my heel down in the morning, but during the day, it got closer and closer. By evening it was making light contact with the wedge.

By Sunday morning I was fully in the boot at the 20 degree angle. I’ve started going through walking motions while I’m crutching around the house - not really applying weight but just letting the boot lightly rest on the ground as I move around. I’m hoping that this movement will increase the blood flow in my leg a little bit to keep the swelling in my ankle and foot down (This is the interesting thing, by the way - I’d say the swelling is about as bad as it has been - even worse than it was after the first surgey and the rerupture - I’m guessing it may be because I’m not elevating as much anymore).

One thing that’s really obvious now that I can see my leg is how much it has atrophied.

Here are my upper legs at the appointment on Friday:

And my lower legs - can you tell which one is the “bad” one?

And for the surgical junkies a picture of my healing incision prior to removal of the sutures:

The plan is to remove the next wedge on Wednesday.

2 Responses to “Into the boot”

  1. 1) ELEVATE! Control that swelling!
    2) my fave way to change ankle angle is with the boot, at bed-time, and “sleep on it”. That way you can separate the “stretch” from the “load”. Even when you’re NWB, it’s dangerous to go around with a gap below your heel, because a small slip could close that gap and send you back to the OR. And when you’re PWB or FWB, making the stretch and load together feels obviously scary, and probably is.

  2. Hey - thanks for the advice, Norm! I like the idea of the night-time change and agree with you on the danger of the gap - To be honest, I don’t understand how they came up with 10 degrees as the increment of change - it seems like quite a substantial switch each time. If they would provide just one 5 degree shim in addition to the 10 degree shims, it would let you make 5 degree adjustments, which seem much more easily doable.

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