Kathy's Achilles Tendon Adventure

Post Op 5

2009-04-05T12:44:00.000-07:00

Post Op #5 was Wednesday, April 1... no fooling! All in all, I continue to do well - although I am not ready for dancing lessons yet...

Hmm... I never was ready for dancing lessons...

3 major steps - literally and figuratively - forward as a result of this appointment. First, I start physical therapy [PT] tomorrow [4/6/09]. I need to build strength in the lower left leg as well as "re-learn" how to walk. My gait has been off, so that the opposite [right] hip hurts. So much so that I went to my regular doctor because the pain keeps me awake at night. Hopefully PT will have multiple positive effects.

The second big thing is that I am allowed to walk, with really good shoes, without the boot for a bit each day. I wear Skechers [Skechers Sport or sport-style insoles, to be more specific], which are fabulous shoes for my feet - they feel they were made for my feet. What is lacking, in this new walking experience, is strength in the lower left leg - which the PT will hopefully help improve. I don't take too many steps at a time and those I do take feel very weird. All in all, it is nice to get out of the boot for a little bit each day. I think the goal is to be out of it completely by May 1.

The third thing is that the length of time between post op appointments is expanding. They have been about every 2 weeks, but the next one will be in 4 weeks. It has become habit to go every 2 weeks - sort of a social medical experience. It's okay, and by then I think we will see some real progress from the PT.

Soon to come - pictures [before and afters of the leg... trust me, the afters from right after the surgery will not be pretty - consider yourself warned]. I will also review PT.

Post-Op 4

2009-03-20T17:45:00.000-07:00

Wednesday, March 18 was my 4th post-op appointment. In short, I continue to do well. I am full-weight bearing [FWB]. I have "graduated," if you consider that term appropriate, to no crutches. It is somewhat amazing to move about with no additional equipment to tote. I had started with 2 crutches for a week, then one crutch, then pretty much none. Today is the third day I have gone without even bringing a crutch along for as-needed support.

Back to the post-op... The incisions are healing, although they look a bit red. I infer, from the doctor's info, that this could be because I am so fair-skinned [in other words, pale]. The incision from the tendon lengthening feels like it has a lump underneath. This may be due to the tissues healing and becoming fibrous. Massaging the area should help with that.

During my appointment, I had to point and flex my foot pushing against the doctor's hand. After 6 weeks of not doing that [and I did it maybe a whopping 3 times], I have been "feeling it" since then. I think the tendon needed to be reminded of it's job, and it's reminded me it had 6 weeks off. Clearly, I am not ready for physical therapy, but we will revisit that in 2 weeks at the next post-op.

I'm not dancing yet, but I should be moving better and better as time goes along!

The Things People Say

2009-03-07T14:48:00.000-08:00

People are funny. Sometimes in an amusing way, and sometimes in an endearing way. As I am motoring around on my knee scooter, others seem amused. Here’s a review of some conversations…

* “Oh my gosh – what did you do?” “I got mad at someone and kicked butt a little too hard.” [hey – it’s shorter and funnier than the real explanation] “Really?” “Ummm… Nooooo…” [real explanation follows]

* “That looks like fun.” “It’s for mobility.” [oh yeah… this whole experience has been a load of laughs].

* “You should put a motor on that thing.” “Are you kidding? I have enough trouble maintaining control with it under my power.” [I’ve had a couple guys offer to build/attach motors. Ummm…. No thanks]

I have been called endearing little names. “Zippy” come from how I can go pretty quickly on a smooth, flat, non-carpeted floor. “Speed Racer,” I think, comes from how well I can make it across a parking lot and into, say, our favorite restaurant [Billy McHale’s in Renton]. The most common nickname seems to be “Scooter.” Even the doctor calls me that. I guess it’s a common nickname for people using the knee scooters. Now that the balance is getting better, and I run into things less, people aren’t renaming me “Crash.”

Third Post-Op - Graduating to PWB

2009-03-06T17:02:00.000-08:00

I had my third post-op Wednesday [3-4-09], and I am recuperating pretty well - I even told the doctor I strive to be considered a "good" patient - following directions, having a good attitude, and not whining too much [I save that for the dog - if I scratch his head, he loves it, lol].

I have "graduated" to partial weight-bearing [PWB]. We took the crutches to the appointment and I was shown how to put my foot down and put some weight on it. After a month of NWB, it actually made me quite nervous. I have a very patient and nice doctor - who didn't laugh when I managed 3 steps with the crutches to come face-to-face with a wall. My question was "What do I do now?" Honestly, I couldn't figure out how to turn. Eventually I did. I scootered out to the lobby where there was more room. With practice, I think I'll be okay.

Walking could be as early 2 weeks from now. I am to practice with PWB and crutches and when I think I can handle it [at least a week's practice] I can walk with full weight. I will keep the boot on for a while - I think at least 2 more months.

On a much lighter - and less successful - note, my leg is itching like crazy. One incision is a tiny bit red and still healing... I get that. But my lower leg is so dry [and I drink water like crazy!] and flaky. I think I need "Head and Shoulders... and legs" - well, I would think about getting it if they made it. The doctor said the skin flaking/peeling is normal. What helped, last night, was gently exfoliating with a washcloth and using a body cream after. Another suggestion was to try an olive oil and sugar scrub, which I will try this weekend [being very careful to avoid the incisions - yowch!].

Happy Friday - nurse puppy Max is home from day care and entertaining Mommy!

Back to Work

2009-02-28T21:07:00.000-08:00

I went back to work this week. I find that preparation is important, but you can’t always plan for everything. First – although I’ve gone out a few times on my own, 4 falls and potentially icy mornings made me nervous. I was lucky to have Jay [the hubby] follow me to work to help get the knee scooter out of the back of my car. Friday, Dan [the son] came up to work and was able to help me get the scooter into the car after work.

Second – I am trying to learn how to travel lightly. Generally, I pack too much into a tote bag. Several days this week I managed to only take a small paper bag with a handle. It helped. The heavy tote bag came home on Friday.

Third – I underestimated how tired and sore I could be. Sleep is essential, but especially so when you come back to work after something like this. You are using your body in different ways. After work activities consisted of resting with my foot up, playing with the puppy, normal evening activities, an occasional nap, more playing with the puppy, and bed.

Soreness comes from the ways one goes up and down stairs. Scooting down on the bum uses/stresses the shoulders and elbows. Kneeing up stairs uses/stresses the shoulders and elbows, as well as the knee that is on the scooter. It is, however, the kind of soreness that one might get from an exercise program… so I expect to be able to crack walnuts open with my arms by the time this is over, lol

So – what is the lesson in all of this? Plan as much as you can, but expect the unexpected.

On the agenda this week… meetings & hopefully no more snow. Less soreness and tiredness as recuperation continues. Post-op #3 & maybe learning how to use the crutches without putting my foot down or losing my balance. Definitely playing with my personal nurse, AKA Max!

Second PostOp - Progress!

2009-02-22T15:13:00.000-08:00

I had my second post-op visit with the doctor [Friday, 2/20/09] - it appears I am doing pretty well, both physically and in my ability to follow her directions. It was VERY nice to have the plaster splint off. What was also really nice was that she let me just sit for a couple minutes and enjoy airing out my leg. The stitches came out and, in case you are wondering [considering my aversion to pain], it wasn't too bad. She did not take another x-ray, which I expected after the most recent fall.

I got the black walking boot, which will be part of my attire for the next 2-3 months. It is a little taller than the first splint and I think the weight distribution is different, so everything I figured out how to do before I am relearning. Some of these include standing/sitting, getting on/off the floor [to scoot up/down my stairs], where to put/how to position my leg for comfortable car rides, etc.

Perhaps the most exciting thing to me was the opportunity to take a shower. I had purchased a shower stool, but we quickly figured out that I couldn't figure out how to balance enough to sit on it from outside the tub. Jay [husband] to the rescue - he went to the nearest medical supply place and got one that extends outside the tub for transfers. A much better option, considering my poor sense of balance. If you find yourself in a situation similar to mine, I highly recommend the transfer bench. You should know that it cost approximately twice what the stool did [$110 versus $50]. It was all worth it - I took my first shower a couple hours ago & it was very nice. I am happy and refreshed.

Numbers

2009-02-18T10:21:00.000-08:00

4th fall…

Yep – fell AGAIN [2/16] – I’m not feeling too coordinated. I can hop to the rear driver’s side door. As long as I sort of lean on my car, and take short hops, I’m okay. I somehow managed to lose my balance getting the scooter out of the car. So much for doing what I thought I wanted to do. I called the doctor and she asked if it still hurt [because it sure did when I put weight on it and I wasn’t supposed to] – that pain appeared to have passed, so things are probably okay, but we will be taking another x-ray at the 2nd post-op.

Apparently, putting your NWB foot down, for balance, is quite natural if you feel you are losing your balance. My challenge is to figure out how to maintain my balance better before getting to that point. I’ve noticed 3 things that seem to help – the first thing is just plain slowing down. That’s not easy. The second thing is asking for help – another thing that’s not easy, lol. The third thing is to be more aware of balance issues – and what has helped with that, around the house, has 4 feet – Max. He hovers around when I move through the

house, which makes me move more thoughtfully and deliberately,

and keeps me safer in the house.

Amazing – a dog that is less than 6 pounds and under a year old

keeps me safe. Thanks Max!!

Observations

2009-02-12T17:08:00.000-08:00

Crutches – should not be attempted after general anesthesia... at 3am… when you’ve had or need pain medication. You can get a really interesting rectangular bruise from the top part… ugh…

Knees – are underappreciated. So let me just apologize to both of mine… I have to sort of knee my way up stairs. It’s tolerable, although the hardwood landing halfway up is, well, hard wood.

Grocery stores – scary places on a knee scooter. Have you seen the way people “drive” shopping carts? Scooters, crutches, and maybe even wheelchairs don’t have a chance.

Falls – I’ve had 3 of them, which is enough thankyouverymuch… The first one [using crutches] was more of a flop – thank goodness the bed was in the way. The second one [using crutches] was onto the knees about 3 am – the rectangular bruise as rather decorative. 3rd fall was transferring from a chair to the floor so I could scoot [on the bum] downstairs to get to the car. I put the left foot down – no lasting pain, but I’m sure I’ll get chewed out by the doctor when/if she finds out.

Aerobic activity – can be done while NWB [non-weight bearing]. I believe it’s called getting into and out of the car. Or up/down from a chair. Or picking up dropped items from the floor. I believe I mentioned I was sedentary – you wouldn’t believe what causes me to break out in a sweat, LOL.

Max – is a smart puppy. He knows how to stay out of the way of the knee scooter. He also knows when Mommy needs kisses – which is apparently any time I’m in a reclining position and can’t get up easily.

First Post-Op Visit

2009-02-09T15:29:00.000-08:00

I am, apparently, a “good” patient and have been following doctor’s orders/directions. These include: no weight on the left foot [well, duuuuuuuuhhhhh……], not sticking a hanger down the splint to scratch a remote itch [I laughed – but the doctor said she’s known people that have really done this, and keeping the foot elevated and the puppy away from it [5¼ pounds of dog, at the right angle, does NOT feel good and is weight – and I am to be NWB].

Any side effects, or symptoms I have are pretty typical. I get calf pain when I want to sit upright with my feet down. The pain is from the blood rushing downward [thank you gravity] and is the reason the foot is to be elevated. A little “pumping” of the leg, similar to the leg motion when riding a bike, helps. So does swinging the leg gently from side to side, using the knee as the pivot point. I have a little itching by one incision, and there is some redness, so the doctor put me on an antibiotic as a precaution.

Some may accuse me of TMI, but if you are in a situation in which you need prescription pain relief, there are certain side effects you need to be aware of. I am trying to refer, hopefully delicately, to constipation [or the “other kind of congestion,” a “back up on the old Jersey turnpike,” or whatever funny euphemism you’d like to use]. Fiber will be your friend; so will water. Ground/milled flax meal can add a yummy, nutty flavor to food – I like to add a tablespoon to a cup of oatmeal, salad, or side dish. Fruits and vegetables are good choices. Please check with your doctor on the choice to use and timing of when you take fiber supplements.

Disclaimer... I am NOT a medical professional, therefore anything I say should not be taken as medical advice - it is merely my experience. If you have a question about your medical condition, or that of someone you know, please consult a doctor that knows you and your situation.

Home from Surgery

2009-02-05T17:53:00.000-08:00

We left for the surgery about 6:45 this morning - 'had to check in at the St. Francis hospital outpatient center [https://fhshealth.org/location/sfoutpatient.asp] [in Federal Way, WA] at 7:30. We got home about 2 pm. There have been few surprises, and even those have been minor.
* Nausea - I don't do nausea... or so I thought. I'm doing that now. Nothing severe & thank goodness for compazine.
* Pain - I don't do that either. Thank goodness for percocet... although it's challenging when 2 [yes, they gave me 2 at the hospital] only take the pain from a 7 to a 5.5 or 6. I'm down to a 3-4 - maybe being home and relaxing helps.
* Crazy puppy - he was really "energetic" from when we got home to about half an hour ago. He seems all tired out now. I love him, but my face is REALLY clean from all the kisses!

We have a split entry home, so getting up to the main floor, where the bedrooms are, was interesting. I put the good knee on a step and pushed up with the good foot/leg. That was WAY easier than crutches. I also think it was better than the backwards "butt scoot" that was recommended. At the top, I stood with the help of a good, solid chair and then "crutched" it into the bedroom.

Thank you all for the good thoughts!

[The first cast/splint]

Good News/Bad News

2009-02-03T17:24:00.000-08:00

So, I trying to be a "glass half-full" kind of person and be optimistic and positive. So I'm turning to my sense of humor and trying to look at all sides of the situation...

Bad news - my left foot still hurts
Good news - I can still drive [I am not a 2-footed driver]
Bad news - My dancing career is over
Good news - I never had a dancing career
Bad news - I will be off work for a bit
Good news - I have a really cute puppy to amuse me at home
Bad news - I'm nervous
Good news - I have a massage scheduled for tomorrow to help me relax [at Touch of Excellence in Renton, WA - http://www.bodyhairandskincare.com/]

I'm sure I'll think of more good news - I'll be sure to add it ASAP

Pre-Surgical Efforts

2009-02-03T17:02:00.000-08:00

This experience started about 8 months ago. Here's a brief list of interventions that were tried before deciding on surgery...
* Acetominophen - it did nothing. Okay, maybe it dulled the pain 1% - which wasn't really enough to make me happy.
* Aircast/boot - it sort of worked at first, but after a month or two, I still really couldn't go more than a few days without it and not feeling some pain. Add to that 2 cross-country trips - the boot is not comfortable on an airplane. Considering the possibility of DVT and circulation, I took the book off on the plane so I could do stretches. Added motrin and added some serious heartburn within a week.
* Topical NSAID patch - 'seemed okay, it dulled the pain a little
* cortisone/anethetic injection - I was so happy when this happened - I hadn't been pain-free in months. It was effective for maybe a week? I think for it to be considered successful it should have worked for a month.
* prescription NSAID - [generic for Voltaren] - It sort of worked well at first. It still dulls the pain when it's severe. I eat before I take it and I haven't noticed any tummy upsets. The foot still aches - considerably - so...

... Here comes the surgery - and here's what's being done:
1. Resection of the posterior heel spur
2. Debridement of achilles tendon
3. gastroc recession

The "Track" to Surgery

2009-02-01T15:46:00.000-08:00

How did I get to where I am - Achilles tendon surgery on Thursday? I wanted to help chaperone a group of young people in Relay For Life [6/7-8/08] - an awareness/fundraiser activity for the American Cancer Society. As a 7+ year survivor, I not only wanted to do this, but needed to. I wanted to walk with these wonderful young people. Spending time with others at this event is one of the most meaningful things I have done.

I walk at work, and I have also done 6-mile Volksmarches in the past. I figured I could handle walking on a nice, even, well-maintained track overnight [with intermittent breaks]. My goal was 25 laps - on a quarter-mile, that would beat my previous walking recond by a .25 mile.

... And if I was doing 25 laps, why not try 30? And then I thought I'd do 2 more laps to make it an even 8 miles. If I was doing that, I might as well do 10 miles. Well, at 10, I decided to go for 12 miles and double my previous "record."

Can you tell where this is going? At 12 miles [and no sleep], I figured I should do 4 more laps, which would make 13 miles and a half-marathon. Then I sat for a bit and realized my feet were numb and I didn't want to move. After the Relay ended, I got breakfast and went home - after a warm shower and ibuprofen I knew I was a wee sore, but proud of what I had done.

On Monday and Tuesday, my calves were a bit tight. I am plus-size, but the legs are reasonably muscular, so I figured the calves just got a good workout. Thursday, I was noticing less tightness, but more of a sharp pain around/above my left heel. This did not seem good, but I thought I'd take it easy and wait a few days to call the doctor.

Oh my - did I start getting an education about Achilles tendons when I finally called and visited the podiatrist.

About Me

2009-02-01T15:32:00.000-08:00

Hi! I'm Kathy, and I'm having Achilles tendon surgery this Thursday, February 5, 2009. I wanted to make a blog of my experience, to help/inform others - as several other blogs have been very helpful to me.

Here's the disclaimer... I am NOT a medical professional, therefor anything I say should not be taken as medical advice - it is merely my experience. If you have a question about your medical condition, or that of someone you know, please consult a doctor that knows you and your situation.

I am the married mother of young adults. I am a teacher and a student and generally keep a pretty busy schedule. We share our home with a Rosy Bourke parakeet, 3 cats [ages 8, 10, & 12], and a 9.5 month old Chihuahua. I suppose I should mention the polar bear dip I did on January 1st - can shivering be aerobic? Otherwise, I am pretty sedentary [channel surfing, apparently, is of no value, lol]. I'd say I do enjoy walking....

... Which kind of leads me in to this Achilles tendon saga...