Month: July 2018

Today was my first followup visit with the surgeon after the surgery.  Apparently everything is going well.  He took the stitches out, but said the wound isn’t completely closed at the very bottom, so no getting it wet for a while. He gave me the Thompson test again and a couple other evals and said the tension was back in the tendon. Still can’t put any weight on it for another couple weeks.  He took the dressing and cast off and wrapped it in an ace bandage and then had me put the boot back on.  Not much to report, but I guess it’s good news, all things considered.

Some pics below, sorry if they’re gross.

Continue reading “Day 10 post-op: got the stitches out”

MRI-3T LEFT ANKLE NON CONTRAST

HISTORY: M25.672 Left ankle stiffness M25.572 Left ankle pain

TECHNIQUE: MR imaging of the left ankle was performed without IV contrast on a 3.0 Tesla high-field wide-bore magnet.

COMPARISON: None

FINDINGS:

TENDONS/MUSCLES: There is moderate Achilles tendinosis with a high-grade tear at the myotendinous junction. There is no full-thickness discontinuity however fibers there is marked laxity of torn fibers at the myotendinous junction. Additionally, there is a second site of interstitial and superficial tearing comprising 30-40 percent of the total tendon surface area along the course of the distal tendon spanning a length of 4 cm up to the calcaneal insertion site. There is no muscle atrophy or intramuscular edema.

LIGAMENTS: The syndesmotic, deltoid and lateral collateral ligament complex is intact.

BONES AND CARTILAGE: The talar dome and tibial plafond are intact. There is no evidence of tarsal coalition. The cartilage of the tibiotalar, subtalar, calcaneocuboid and talonavicular joints is preserved.

JOINT FLUID: There is a physiologic amount of joint fluid. No loose bodies are identified.

PLANTAR FASCIA: Intact.

NERVES: Unremarkable.

TARSAL TUNNEL: No masses.

SINUS TARSI: Fat signal within the sinus tarsi is preserved.

SUBCUTANEOUS TISSUES: There is mild subcutaneous edema laterally and posteriorly about the ankle.

IMPRESSION:

High-grade tear of the Achilles tendon at the myotendinous junction with markedly lax fibers but no full-thickness discontinuity. There is a separate site of partial-thickness tearing along the distal aspect of the tendon.

ICD 10 –
Achilles Tear, S86.012A

Signed by:  MD
Signed Date: 7/9/2018 2:17 PM EDT

 

 

 

 

 

Yesterday, Saturday, July 7th, 2018, I went to Flying Point beach in Southampton. I went by myself because my son felt like he had swum enough during the week, and I didn’t feel like convincing him, and my wife also didn’t want to go. The weather was gorgeous, and I’d been in the ocean a couple days before at Tiana in Hampton Bays.

I got to the beach around 3 PM. All I brought with me was a towel, my phone, and a Gatorade. I dropped them off about 20 yards from the water and walked down.  The only people in the water were a couple of teenage boys, despite a pretty big crowd on the sand. I figured the water must be pretty cold to keep so many people out, but when I got my feet in it felt pretty nice.

I decided to just jump right in. After about a minute of looking, I found a good opening and dove in.  As my feet left the sand, I felt a huge boulder or something hit me in the back of my left calf.  I turned around to see what the hell it was, but there was nothing there.  When I surfaced a couple seconds later I realized I couldn’t put any weight on my left leg at all. My first thought was, holy shit I tore my Achilles’ tendon.  I tried to make my way out of the water but it wasn’t happening.  I managed to get upright but a wave knocked me down, and then the lifeguards ran down to help me.  Me, a 39 year old guy being helped out of the water by a 90 lbs 18-year-old. I told her “I think I broke my Achilles’ tendon” and she looked at me like I was insane.

Anyway, two of them helped me up to the lifeguard station and gave me a chair to sit in. They got me some ice packs and an ace bandage to attach them to my calf.  There wasn’t really any pain in the leg at all except when I put weight on it.  They offered to call me an ambulance and I begged them not to.  It was embarrassing enough that I couldn’t even dive in the water.  They also offered me a wheelchair, which I also refused. When I felt like I was good enough to leave, one of them helped me to my car.  She said she was a first year physical therapy student and she figured it was probably a pulled calf muscle that would heal in a couple weeks.  I was able to drive home without any issue since the thing happened on my left leg, and the car is an automatic.

I had fully briefed my wife on the situation as soon as it happened and she made an appointment at the urgent care in Hampton Bays. As soon as the doctor saw me he had me lay on my stomach and started squeezing the calf muscles.  He said it was probably a partial Achilles’ tendon rupture and would probably require surgery. I guess the test he did was called the Thomson test and is a standard way of diagnosing Achilles tendon tears.

He put a cast on it and gave me crutches and said I’d need to find an orthopedic surgeon ASAP.  According to Dr. Google, treatment for Achilles tendon ruptures ranges from surgery+6 weeks recovery to 12 weeks. We just got home today (Sunday) so it looks like there’s going to be a long road ahead, and I’ll be out of commission for the remainder of the summer. I’m more pissed off than anything. Mostly at the fragile nature of the human body.  Stupid meat bags.