Had my first physical therapy session today. The doctor’s prescription said nothing past 0 degrees planar flexion so there wasn’t a lot they could do, but they did a pretty good massage on the calf and worked the scar tissue a bit, and gave me some basic stretching and exercises to do. Rocking the foot front to back, side to side, and around in an orbital motion, as well as scrunching up the toes. Nothing really special, but I guess it’s progress.
Had my “6 week” followup with the surgeon today. 38 days isn’t really 6 weeks, but due to some scheduling issues this is as close as I can get. He took off the last strip of tape on the incision and declared that healed. Most of the scabbing has fallen off and it there’s just a scar there right now.
He had me remove the last wedge from the boot, and also had me stand on the floor without the boot on for the first time. It felt a little weird, but no pain. It definitely felt tight if I bent my knee a bit, and he said it looked like there was noticeable loss of muscle mass in the left leg as well.
He said I can stand in the shower now, which is a relief, but I can’t move the ankle past 90 degrees. He wrote me a prescription for physical therapy and said to follow up with him in 6 weeks, so I won’t see him again until October.
Pic from this morning (pre-doctor) below.
Had my second post-op followup today (August 10th, 2018), 25 days after having Achilles’ tendon rupture repair surgery. The doctor took the tape off the incision, said it was all closed up but there was still a part that was “soft” so he put a strip of tape back on.
He told me I could now get the area wet, as in “run water over it,” but not rub or scrub it. So showering is slightly less of an ordeal now, since I don’t need the cast protector.
The big news though is that he had me remove one of the pieces of the wedge in the boot, so it’s only about 1.75″ tall now, and said I should start walking on it. Obviously with a big wedge in there, I can’t walk normally, but it’s a huge improvement in quality of life to be able to walk up the stairs versus going up butt-first or on crutches.
He also said I should take the ace bandage off when sleeping. I told him I had found another boot on Amazon that’s much lighter – it’s for plantar fasciitis – and I’ve been using that to sleep. He said that puts the foot in the wrong position, and I told him I rigged it up so the wedges were by the heel rather than the toe and he seemed slightly impressed. He said, “you’re an engineer, aren’t you?” I laughed and said yes, and he said “I love it when my patients solve their own problems.” This boot weighs maybe 1/10th what the heavy duty boot weighs, but can’t be used for walking at all. I use it only for sleeping – it’s way more comfortable than the big boot. My sleeping boot is the “Plantar Fasciitis Night Splint by Vive” and comes with two wedges. I’ll add a couple pictures below showing the Vive boot vs the heavy boot (the heavy boot was provided by the doctor, and appears to be this one: Procare MaxTrax Air Walker).
I have some more pics below of the incision with the tape off. Apologies again if it’s gross (it is).
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.
I’ve always been a big fan of hot showers. I used to use up all the hot water every day when I was a kid. Not being able to take a shower post-op has been one of the more harrowing aspects of this ordeal. Fortunately, there’s the Curad cast protector. Basically, it’s a plastic bag you slide over your leg and cast, enabling you to take a shower without getting the thing wet. It’s not easy, but at least it’s possible. Also, highly recommend a shower stool or something similar. I don’t know how else you can possibly shower with only one leg. It’s enough of an ordeal that I don’t know if I’ll be able to do every day anytime soon, but at least it lets me feel like a normal human being.
One thing I don’t (yet) have in my shower, but wish I did, is one of those safety bars. Once you find yourself needing one of these, it’s hard to understand why all showers don’t have one. I find myself doing a lot of unsafe balancing on one leg or holding on to the shower fixture or other less-than-stable things. I can balance on one leg, but balancing on one leg in a soapy shower is a different story.
Today’s Friday, 7/20/2018; I had the operation on Monday. I made a couple Youtube videos before and after the operation describing it. According to the surgeon, it went well. My leg is in a dressing from just below the knee to the tips of my toes, which it will be in until my followup visit on July 26th. At that point I expect to get another full-calf dressing/cast. I can’t put any weight on the left leg at all, which has been fairly annoying so far. After ~3 weeks I should get transitioned to the boot for another 9 weeks.
Here’s the videos I have so far:
Today is a beautiful Saturday. My stupid injury happened a week ago today. I spent this past week visiting doctors and getting ready for the repair surgery. I worked from home as much as I could, but it was hard. I’m not really in any pain but lack of mobility has already taken a toll emotionally. I hate commuting but I like being at work.
I’m supposed to be at the hospital at 12:30 pm. The surgery will begun around 2:00 pm. It takes an hour and then there’s the recovery time, so I should be able to get home around 7 or 8 pm. I’m not too worried about the surgery itself, more the long recovery. I’ve never had a cast on my leg, and even this past week with the boot I’ve been able to hobble around and put weight on it. Post-op I’ll have a cast on for about 3 weeks where I can’t put any weight on it at all. That’s kind of terrifying at this point.
I took a shower this morning, tried to bask in every minute of it, as once I have the cast on it will be difficult or impossible to do. I bought some waterproof cast protectors but just entering and exiting the shower seem daunting one-legged.
Before I got in the shower I took some pics of my foot, to remember what it looked like before it was cut up. A big bruise has developed on the inside of my heel, which seems to be common for Achilles’ tendon ruptures.
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.
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.
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.
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.
It’s been a rough couple of months. I feel like I’m just now starting to feel normal again after the dog died on March 13th. The dread is still there, but it’s more of a whisper than a shout. Every once in a while it pokes its head back out but generally it’s just… like an app you left running in the background a couple weeks ago and forgot about until you get a stupid push alert.
What it’s really reminding me of is one of my favorite TNG episodes, “The Inner Light.” The one where the Enterprise finds this probe floating in space and it hits Picard with some beam that knocks him unconscious. In the 90 minutes he’s out, he “lives” an entire lifetime on the home world of the probe’s creators, who it turns out all died long ago because their sun went nova, or whatever. When he first “arrives” on the planet, he spends a lot of time trying to “get back” to the Enterprise. As time passes, he falls in love, gets married, has kids, learns to play the flute, and eventually dies. All the while, his memories of the Enterprise get fuzzier and fuzzier, though he never really stops thinking about it. Once he “dies,” the people in his new life all come back to explain that this was essentially a time capsule from their dying world, and he is now the only one who knows about their people. The simulation ends and he wakes up on the Enterprise’s bride, with only 90 minutes of real time having elapsed. Sort of like Inception, I guess.
That was sort of a long-winded way of explaining what I’m feeling now. Just like Picard never really stopped thinking about the Enterprise, I suppose I’ll never stop thinking about these things, but hopefully they’ll stay in the background as much as possible.