late joiner: surgery 7/31; now PWB

I wish I’d known about this site before I had my surgery; I almost certainly would have saved myself several months, if not years, of pain and hassle.

I’m 19 days (7/31/13) post-op — debridement, Haglund’s excision, and FHL transfer. I originally injured my achilles in 1994, carrying a backpack and laptop up a long, steep hill. I was in grad school at the time, and had limited health insurance so didn’t seek treatment. It’s flared up periodically since that time, and I underwent weeks and weeks of PT over the years. It finally got to the point where I was unable to wear any kind of shoe with a back to it and had quit doing a lot of the activities that I enjoy.

The first OS I saw this most recent flare was a sports medicine guy who is really a shoulder expert so when I “exhausted his bag of tricks” he sent me to one of the foot and ankle specialists in the same practice. Aside from ordering an MRI, seeing the second doc was a waste of time — had I known what I know now, I would have sought a second opinion much sooner — the 2nd OS did not want to do surgery, even as a last resort. Instead, he suggested PRP injections (platelet-rich plasma), though admitted that he had little experience doing the procedure himself. I read every study I could get access to and decided that, while the procedure may have potential, there were still far too many questions and far too little convincing data to go ahead with it, especially as my insurance wouldn’t cover it. Besides, it wouldn’t have treated the Haglund’s deformity.

I got the name of two more foot/ankle OSs in the area and tossed a coin as to which one I’d try first. The 3rd OS, also a foot/ankle guy, looked at my MRI, and immediately started talking about what kind of surgery I needed. While I wasn’t thrilled about having to have surgery, I knew he was right. He also confirmed what I’d already learned about PRP and I felt very comfortable with him, so scheduled the surgery at that first appointment.

And not quite three weeks out, I’m so happy I did. Within a couple of days, I was having less pain than I did pre-surgery. I’ve gone through major joint rehab before, so I know that there will be soreness, etc. to come, but based on pain (none) and ROM (not bad!) so far, I couldn’t be happier.

I was lucky in the anaesthesiologist who was assigned to my surgery; apparently not all the anaesth. around here are willing to do this w/o general anaesthesia, which I did not want to have. “My guy” did a saphenous nerve block and a popliteal block; they filled me full of versed and topped it off with a little propofol and that was that. I woke up, completely alert, while the surgeon was dictating his notes in the OR after the procedure.

Pain medicines and protocols have improved dramatically in the 30 years since my last orthopedic surgery. I was off the meds two days later and except for preventative pain relief following a slight fall, haven’t had any since that time.

I had the spint and sutures removed on 8/12 and went into a boot with about a inch heel lift — smaller than I had anticipated. I had more plantar flexion in that ankle than I expected, too, though my ROM pre-surgery was normal. The OS had told me in the spring that I’d remove one layer of lift every week, but on Monday he said to do it every 3-5 days. He also said — and this was the best part! — that he wanted me to wear the boot ONLY when I was “practicing my walking.” I was surprised, and just to make sure, asked if that meant I didn’t have to sleep in it. Absolutely not. Having slept in the boot for several weeks over the last couple of years, I was thrilled to be told *not* to do it. I’m hoping that when I see him next, on 8/30, I’ll go to FWB in the boot.

I’ve also been given permission to start working out again; before the surgery, he had told me I could not ride a recumbent stationary bike, even with my injured leg propped up on a chair. At Monday’s appointment, though, he not only gave permission to ride that way, but said I could even use my right foot, as long as the resistance was set to zero. I worked out with my trainer at home on Wednesday, and at the gym on Friday. Being able to exercise again has definitely made a difference in my outlook!

I’ve been PWB for 6 days now, and am pleased with how it’s been going. I had thought that I wouldn’t be PWB until 4 weeks post-op; now I’m revising my timetable for being able to drive (it’s my right foot) down, too.

I’m also lucky in that, as a college professor, I’m on a 9-month contract and didn’t have to take sick leave for this. Meetings and classes start this week, though, so I’ll be putting more demands on my ankle than I have yet this month. I do have a knee scooter that I plan to use at work and a extra set of crutches a friend lent me so that I don’t have to carry them back and forth to school.

The one disheartening component of this is how quickly my right calf has atrophied. I knew it would happen, and happen quickly, but I was still shocked at the extent of loss. I don’t known when I’ll be allowed to start PT; I’m hoping the doc will write the script for it at my next appointment, so that I can start rebuilding that leg.

I’m sure I’ll have periods when I’m frustrated with the progress I’m making — or failing to make — but I’m much more optimistic about returning to normal activities now than I have been in quite a while. I just need to try to remember my state of mind now when I hit those plateaus.

4 Responses to “late joiner: surgery 7/31; now PWB”

  1. Sounds like you are doing great–PWB at two weeks. Pretty impressive! I wasn’t WB until 5 weeks.

    I can sympathize with the atrophy. It’s pretty shocking, isn’t it! Hopefully with the early PWB, you won’t have as much atrophy as me. Good luck getting PT!

  2. Great account, upstate! Your pre-op suffering gives you a psychological edge now! I bet your “frustrating plateau” won’t be that bad either — though the worse you expect it to be in advance, the more likely you’ll be pleasantly surprised! :-)

  3. Thanks, kellygirl and normofthenorth. Support and advice from people like you and others on this site has and will be helpful as my ankle progresses.

  4. Upstate. Thanks for the infor. I have a call into the doc’s office now. I am so glad I decided to go with sedation and the nerve block rather than general anethesia. I, like you, woke up refreshed, no nausea or other side effects from the anesthetic. Hoping to be PWB after appointment on the 5th. Good luck with your appointment on the 30th.

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