Wayne’s Achilles Blog

My third follow-up appointment with my orthopedic surgeon went well as expected.  According to my doctor I’m progressing quite well.  The incision area is clean and the level of flexibility is on schedule, if not just a bit ahead of schedule.

My doctor wants me to push a little harder on my stretching exercises so that the angle behind my knee is less than 90 degrees while aiming to keep my heel on the floor. And he wants me to stress the Achilles more than I currently do now.  The goal is to provide maximum flexibility so that when I begin to walk full weight bearing (maybe in another 2 weeks!) that it’ll really speed up the recovery process.  I’m also hoping to be out of my boot within the next 4-5 weeks.

I also asked about the numb/tingly area of my foot.  He reinforced that its normal but to keep an eye on it in case it gets worse.  Otherwise, it should subside with time.  I also asked about the residual swelling around my ankle area.  He mentioned that heat followed by ice may help some, but using my ace bandage and elevating are my best bet right now.  He mentioned that wearing a compression sock also helps.  But its still too early for me to begin wearing compression socks.  He even explained to me why there’s swelling in the first place and how the lymphatic system is involved.

I also mentioned that the loss in muscle tone of my entire left leg has been unbelievable.  He said that’s to be expected and that part of the recovery period and physical therapy is devoted to rebuilding those muscles and regaining muscle tone.  On the bright side, my doctor noticed that my arms, or “guns” as he referred to them (yeah, right!), are looking pretty good.  I guess that’s one of the upsides of using crutches.  Your arms do get quite a bit of a workout.

My doctor also wrote out a prescription for me to see a physical therapist to begin an Achilles rebuild program.  The problem I’m running into now is finding a reputable PT that will take on new patients and fit within my work schedule.  One of the recommended PT offices located near my house was booked solid for the next 3 weeks!  So I’ll keep on looking.

And next week I return back to the office.  I’ll miss working from home.

I made a bit more progress this week.  I’m finally partial weight bearing (PWB).  I’m also able to make it up and down the stairs of my house walking upright and using crutches.  I’m still debating which is harder…walking upstairs or downstairs.  Walking upstairs requires me to concentrate on my balance.  I use both crutches to prop me up while walking sideways literally taking one step at a time.  Walking downstairs requires more control from moving too quickly as to not tumble down the stairs.  I use one crutch to balance myself while using my free hand to grab onto the wall/rail.  The secret is just to make sure you don’t let gravity get the best of you, move slowly, and make sure you plant your foot firmly onto each step before taking the next step.

I’ve also been working very hard on my flexibility exercises.  I’m able to successfully get to the 90 degree range between my foot/ankle/leg/knee without any pain or discomfort.  I still have a little swelling around the ankle area.  And that annoying numb/tingly feeling along the side of my foot seems to be status quo…not any better/worse.  I’ll need to ask my doctor about that at my next follow up visit.

I’m also able to drive.  So I’ve made short trips to the ATM machine and even to Pentagon Row to just get away from the house and relax and get a little reading in.  On the downside, I’m noticing that my wrists and “good” leg are starting to take a beating.  So I still have a few limitations as to how far I’m able to walk at any one time.  I just need to keep things short and simple for now.  Although, the biggest downer is that I’m still unable to go to Starbucks and carry a drink out by myself.

My second follow-up visit to the orthopedic surgeon’s office went very well.  The doctor examined my foot for any infections….none.  And he was further impressed with the progress that I’m making with the flexibility.

One concern that I had was the numb/tingly feeling on the side of my foot.  The doctor told me that a nerve may have been roughed up during surgery and that the numb/tingly feeling should subside.  He recommended that I keep an eye on it and gauge it for improvement. He also gave me a new exercise to further work on my flexibility (sliding foot along the floor and lightly stretch the Achilles; goal is to get foot/ankle/leg/knee at a 90 degree angle).  At this time I am still non-weight bearing.

The good news is that I can now take full showers (FINALLY!) and get my incision area wet.  I went out and bought a shower chair which I found very useful.  I also removed the steri-strips from the back of my leg.  The second piece of good news is that my doctor cleared me to drive a vehicle.  Also, one silver lining about my injury is the ability to get a temporary handicap placard and getting the best parking spots everywhere.  However, I’m still unable to go grocery shopping by myself, let alone being able to go to Starbucks and carry a cup of coffee by myself.  Life is rough when I can’t go to Starbucks on a daily basis.

The majority of my time post-op was spent in bed sleeping.  My orthopedic surgeon prescribed some good pain killers (something similar to a Vicodin) that I took about every 8 hours and it made me very sleepy.  I also made sure to keep my foot elevated at all times to reduce swelling.  At times I could feel my foot swell and get a little tight in my splint/cast.  I couldn’t take full showers and was resigned to sponge baths.

My doctor removed the splint/cast at my first post-op follow-up appointment. The doctor checked for any signs of infections along the incision made behind my Achilles.  Everything looked good.  In fact, the doctor was quite pleased with his work and the amount of flexibility, as little as it was, that I already had just one week after surgery.

I was refitted back into my fashionable black boot that the doctor issued to me during my first visit.  My Achilles was covered with two sterile gauze pads and an ace bandage was wrapped around my ankle area.  I was instructed to keep the area dry and change the dressing on a daily basis.  The doctor also allowed me to slowly begin moving my foot back and forth and begin working on further increasing the flexibility in my Achilles.  And of course, the doctor reinforced that I remain non-weight bearing and keep my foot elevated as much as possible during the day and at night.

Some of the challenges I ran into during week one was climbing up and down the stairs of my house.  Since I was non-weight bearing, I was forced to do this on my rear end.  My foot also got a bit sweaty.  So as you can imagine, my boot got a little smelly.  So I ran off (ok, bad choice of words) to Target and picked up a Dr. Scholl’s insole and foot powder to keep the stank in check.

Nothing really prepares you for your first operation.  On one hand, I felt a little scared entering the operating room.  On the other hand, I was anxious to get the surgery over and done with so that I can start the recovery process.  If anything, I felt really annoyed at myself and feeling a bit helpless being injured.  I’ve always been one to fend for myself and survive. Now I find myself unable to do basic things such as taking a shower, driving, walking, or being able to go grocery shopping by myself.

My surgery took place at the Virginia Medical Center’s outpatient center. It was scheduled for 5:00 PM but ended up getting delayed until around 8:00 PM.  While in my pre-op room, I was hooked up to an IV and recall having to pee a lot because the fluids were going right through me. Those plastic urinals became my best friend!

The nurses and medical staff came in and out of the room checking up on me.  The doctor ordered an EKG and the anesthesiologist interviewed me and gave me a couple of choices for anesthesia (general or spinal).  I decided to go with the general anesthesia.  There’s absolutely no way I wanted to hear what was going on in the operating room.  What I don’t know won’t kill me…I think.

The surgery took approximately 2 hours.  I spent another hour in post-op recovery and about another hour in general recovery where I was fed a few graham crackers and sipped on apple juice.  I recall being offered ice chips when I woke up from the anesthesia.  I felt very groggy and my throat was a bit dry from the tube they shoved down my throat during surgery.  It was very close to midnight by the time we left the hospital.  My foot was wrapped in a splint/cast with my toes slightly pointed downwards.

Despite rupturing my Achilles Tendon, I made the best of my vacation.  I was still able to move around the ship using my crutches (for very short distances) and a wheelchair (for moving around the ship and offshore excursions).  This was my first cruise afterall.  I wasn’t going to let a little injury stop me from enjoying my vacation!

While on the ship, I went online and found a good orthopedic surgeon in Arlington, VA.  I made a ship to shore phone call and set up an appointment with the orthopedic surgeon to see me immediately on May 11.

At my first visit to the orthopedic surgeon’s office, the doctor removed the cast and re-examined the Achilles Tendon.  Sure enough, I totally ruptured the tendon.  Surgery was immediately scheduled for May 14.

It was May 6 aboard the Caribbean Princess in what was my first Caribbean cruise vacation.  I was just returning back from touring Bonaire and looking forward to my personal training session in the ship’s gym with Marco.

Marco designed a circuit training routine which involved using steps, light weights, a stability ball, and a Bosu ball. I must admit that the routine was quite rigorous and my lack in fitness really showed as I had to catch my breath a couple of times. It was during my second set when I injured myself on the Bosu ball.  I recall hopping while alternating legs on the Bosu ball when I heard a loud popping sound (like a flat tire). The popping sound was loud enough that everyone in the gym couldn’t help but hear the rupture of my Achilles Tendon.  Then all of a sudden my ankle felt warm and my foot didn’t move off the ground.  I knew immediately that I had ruptured my left Achilles Tendon and I hit the ground in pain.

Marco had no clue what had happened to me. I told him to get me some ice. It seemed to take him forever to get the ice but he eventually found some along with a towel to wrap the ice around my ankle area.  The ship’s medical staff was contacted and they came up to the gym and wheeled me off to the infirmary in a wheelchair. What a day. And this was just the fourth day of our 8 day cruise!

I spent about 3 hours in the ship’s infirmary.  If it was any consolation, the ship’s medical staff was very friendly treating me. The doctor performed a Thomson test on my Achilles and declared my left Achilles totally ruptured. He took an x-ray and placed me into a cast with my toes slightly pointed downwards. I was prescribed an anti-inflammatory and pain killers (Ibuprofen and Codeine). I was also advised to elevate my leg….I found a good use of the ship’s life jackets!