Tag: surgery

Posted on

One Year Later

Today marks one year since I had the Achilles’ tendon repair surgery.  Life has mostly returned to normal and I can do everything I was doing before the injury.  I do get stiffness in the tendon area, but I actually get that on both legs even though it was only my left tendon that ruptured.  And, thinking about it now, I realize that I had had stiffness in both tendons for a while. After sitting for a while, usually an hour or more, when I first stand up I can barely walk for about 10 seconds until it loosens up, and then it’s basically fine.  But I can ride my bike, walk, sprint to catch a train, take stairs two at a time, and have even gone back to the ocean a couple times – which was the real leap of faith, since that’s how I injured it in the first place.  

So for anyone who’s found themselves with a ruptured Achilles’ Tendon, I just want to let you know there’s life after.  It definitely helped that I had a great doctor, great physical therapist, great wife and a great employer (who let me work from home for 2+ months after it happened) and great health insurance for support.  But stick with it and hopefully you can expect a relatively normal life afterwards.

One year ago
Incision scar on my left ankle after 1 year.

Video update I recorded last week in Central Park.

Posted on

Day 63 post-op: back to the office

This past Monday, Sept 17th, I finally returned to the office, after almost 11 weeks being out.  I was on long weekend (July 4th) when the injury occurred, and worked from home the following week.  I then had the repair surgery on July 16th, and spent about two weeks just sitting on the couch recovering – WFH wasn’t really an option for that, since I had to keep my leg elevated above my heart.  Since then I’ve been working from my home office.

First of all, let me say how amazingly lucky I am to have a job and a manager that allow me to work from home.  I am extremely grateful for that.  However, while there are definitely advantages to working from home, it’s not ideal, so I got clearance from my doctor and went back in this past Monday.

I live on Long Island and my office is in Manhattan, which means commuting involves driving to the local train station, parking there, taking a train into Manhattan, and then taking the subway to get to my office. Competition at the LIRR parking lot is fierce, and if you’re not there by 7 AM you likely won’t get a parking spot.  I left the house at my previously usual time of 6:25 and managed to get one of the last spots in the “good” parking lot.  There are no handicapped spots in this lot so I ended up just taking a regular spot, which was about 1000 feet from the stairs.  The stairs weren’t too much of a problem, though I am definitely slower climbing them, and double-timing was not an option.  I got a seat and the train ride was unremarkable.

I got off at Penn Station and took the escalator up to the concourse.  I took another escalator up, and then decided to take the stairs up to street level.  Again, no problem, just slow.  I walked over to 6th Avenue and entered the NRQ station at 6th & 32nd.  This was the first time all day I had to go down stairs, and it was definitely more challenging than going up. The main problem was that the boot was too big for the steps.  I took the subway to 5th Ave & 59th Street, just to take a peek at Central Park before work.  One thing I noticed walking on the sidewalk was that the slight grade of the sidewalk is very noticeable when wearing the boot.  The sidewalks are all slightly slanted downwards, from the building to the street, so rain will run into the street.  Normally I don’t notice this, but having the massive flat-bottomed boot bolted on, unable to use my ankle, it was awkward and uncomfortable.  I found walking on the right side of the street was easier than the left, so that the boot was lower than my good foot.  Not sure if I’m explaining it well, but it was a noticeable issue.

When I got to the office I took the elevator to the 17th floor, where the coffee is, and then walked down stairs to 16, where my desk is.  I managed to get special handicapped elevator privileges with a doctor’s note, so I can at least take the elevator to my floor in the future without having to walk down.

For lunch I walked to a burrito place about 5 blocks away and brought it back to the office to eat.  That was also a relatively unremarkable experience.

At the end of the day, I left a bit early, since there’s no way I can run if I need to catch my train.  Descending the stairs into the subway station near the office I started to feel sharp pains in my right ankle – my non-injured one.  By the time I got off the LIRR and got back to my car the pain was becoming more frequent.  My immediate guess was that all the walking down stairs had caused Achilles tendinitis in my right leg.  I had a physical therapy session right after work and I told my therapist what happened and he massaged the right leg as well as the left, using his roller thing.  He said the right calf was extremely tight, and I need to make sure to stretch the calf out before doing anything, to avoid future injury.

The pain in the ankle continued intermittently throughout the evening, and when I woke up Tuesday, laying in bed, I felt it continue.  It felt like someone had slashed the very bottom of the back of my ankle with a razor.  I decided to work from home rather than exacerbate whatever the issue was.  By Tuesday afternoon it was fine, but I chose to work from home for the remainder of the week.  There are just too many steps involved in getting to & from the office.  I plan to go back in either tomorrow (Friday) or Monday, and see if I can take a different subway route that has escalators or elevators the entire way.

Posted on

Day 45 post-op: started physical therapy

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.

Posted on

Day 38 post-op: no more wedges

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.

Continue reading “Day 38 post-op: no more wedges”

Posted on

Day 25 post-op: walking again (sort of)

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).

Continue reading “Day 25 post-op: walking again (sort of)”

Posted on

Day 10 post-op: got the stitches out

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”

Posted on

Day 4 post-op for Achilles’ tendon repair surgery

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:

Posted on

The results are in

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

1.3.12.2.1107.5.2.50.175625.30000018070914070686000000142.jpg

 

 

 

 

 

Posted on

What the hell happened to my leg?

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.

img_1591

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.

img_1594