Tag Archives: Achilles tendon surgery

First Blush: more clouds in the future

Clouds over Hoover Tower on the Stanford  campus
Once upon a time it was all about jogging at dawn. Then life interfered – things like glioma and an Achilles tendon injury that required surgery. Now the female DJ is up and jogging at dawn again. The thrill is still there but not the passion about blogging – at least as pertains to the dawn experience. Some good things have taken its place. But what to do about jogging at dawn…

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One stride forward, another back – 7 weeks post Achilles tendon surgery

boot cast_0910It was with much excitement that the female DG strode (yes that really is the correct word for it) into the cast room at SOAR this morning so that master cast Joe Bulcao could remove her fourth and last cast. What emerged was – as others have reported post surgery – an ever-shrinking left calf but an ankle/foot that showed little swelling (not surprising due to the morning hour).  Following an inspection by Dr. Lawrence Oloff, the path was cleared for the walking boot stage.

The ugly and somewhat bulky black boot came with caveats.  Ok to remove for shower but no weight on an unbraced ankle, so the shower chair stays in place. Expect a bit of adjustment, including increased pain and swelling, over the next couple of days.  Watch overdoing, e.g. it may feel fine to be walking for longer period but bad result – pain – could show up hours later. No physical therapy during the ‘boot adjustment’ period of the next two weeks because, in Oloff’s view, if you start boot and PT at the same time and pain ensues, you can’t determine what the cause is.

What the boot isn’t – at least initially – is quite the liberator/emancipator the female DG had hoped. Her ankle is barking, more typical of how it feels at the very end of a long day as opposed to during the day. The more rocking bottom requires her to get re-balanced. But as a number of people, aka cheerleaders, have already said to her today, probably better to look at the boot as a sign of  recovery  than yet another annoying obstacle to normality.

Meanwhile, the male DG is weighing in that she’s grumpy.

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Four weeks post Achilles tendon surgery

cast#3_082109Prior to her surgery to repair her partially torn and severely deteriorated left Achilles tendon, the female DG did a lot of research on the internet, although most of the first person accounts she found were from people who had ruptured their tendon completely. She recently went back to one site that featured a lot of post surgery reports and was struck at how differently various doctors approached the post surgical recovery – especially as it pertains to non-weight bearing activities and boot versus cast.

The female DG is in her third hard cast, from just below the knee to foot (with opening for toes). This latest version is at 90 degree angle and is fitted with a bootie that has a rolling tread. Beginning yesterday, she started 50% weight bearing  at the instruction of her surgeon Dr. Lawrence Oloff, which seems to put her in the “aggressive” recovery approach post surgery. On the other hand, the fact that she’ll be in a cast for another three weeks (apparently) seems to be on the conservative side.

What she knows is that she’s a lot better off than even one week ago, at least mobility wise:

– She can stand on two feet – and boy is that handy for all sorts of activities.

-She can walk (rolling heel to toe) with aid of crutches – renewed independence as she doesn’t have to rely on the male DG and colleagues to get her scooter in and out of the car.

-She remains relatively pain free – just little twinges here and there.

Showering is still a big hassle due to keeping the cast dry but she has the routine down. And she will for the rest of her life remember how heavy most swinging office doors are when your trying to open them with one arm while balancing on crutches.

She won’t know what’s next in the recovery manual until she visits Oloff and master cast maker Joe next Thursday. Until then, it’s quite literally one step at a time.

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Scooting into the office

officeStating the somewhat obvious when you’re a gimp, it’s not doing the work, it’s getting to work – meaning the office. The female DG took another step on the normalcy spectrum by getting herself and scooter to the office for the first time since her Achilles tendon surgery. (Thanks to neighbor Kay who helped her into the car in the male DG’s absence!). It really was good to see everyone, and she felt warmly welcomed back. Thoughtful colleagues offered help and post lunch chocolates were delivered. But boy is she tuckered – much more than she thought likely. It was also her first time driving a car.

Meanwhile, the male DG was up at UCSF’s Milberry gym for a session with physical therapist extraordinaire Heidi Engel, who was extolling the Gospel According to Heidi. Today’s commandments: “Thou cannot be a train wreck” and “Thou shalt buck up and get at it” – “it” being her regimen of exercises.

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“Looking good” 11 days post surgery

old cast off

Dr Lawrence OloffThe Dual Gs (gimpy and grumpy) headed back to the SOAR offices today for the second post op visit with sports podiatrist Dr. Lawrence Oloff (the guy in the tie). With the surgical site exposed after the pink cast got sawed off (the word “removed” is much too timid and far from the truth), he pronounced “looking good” and gave the go-ahead for the sutures to be removed (clipped not sawed). More encouraging, he said to come back in nine days and he’d consider putting the female DG into a cast that would allow limited weight bearing. Meanwhile a new cast was put in place; she opted for pink with a swirl of purple, just to liven things up a bit. Anyone curious to see an account of the whole process, can do so here, thanks to on the spot photography by the male DG. Warning: there’s one shot of the incision (although it’s reallly not that awful).

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Some milestones pass with the prick of a needle

Yes, being a concerned health consumer is a noble goal but oh-my-goodness there’s a lot of information out there, particularly as pertains to perscription medications. There seems to be a distinct website for every drug imaginable. This is the case for the drug the female DG said good bye to today – Lovenox.  There are two major risks to Achilles tendon surgery – infection and blood clots, or as the Lovenox site says, deep vein thrombosis (DVT). Her surgeon had recommended Lovenox, which comes as a single injection, although admitted not all his patients are willing to give themselves a daily shot. She couldn have opted for a baby aspirin a day but decided that a shot a day for 10 days isn’t the end of the world. She was, nevertheless, happy to pull the last syringe from the box this morning and know that tomorrow she would be starting her day injection free.

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Thoughts on the one week, post surgery mark

Leading up to her surgery, the female DG spent considerable time on the internet trying to get a better idea of what she faced in her recovery from surgery to repair an Achilles tendon. (Looking back, she is somewhat glad that she didn’t spend as much time researching stage 3 glioma when the male DG was first diagnosed; she might have been more inclined to fold the tents – even in the good hands of the top-of-their-game UCSF neuro-surgery and neuro-oncology team.)

She found a ton of material about recovery from surgery following a Achilles tendon rupture – and it all sounded grim – but little about her less serious injury (severe deterioration and partial tear). So in the hopes of someone, someday, finding this post, she’s offering eight things she’s learned in the week since surgery.

1. Plan for pain but don’t be surprised if it’s more discomfort than real pain. That has been her experience.
2. Surgery takes the wind out of you – even if you’re fairly fit. She’s unclear if it’s the assault on the body itself or the anesthesia – or both. Don’t try to be a hero and do too much.
3. Do everything possible to make sure your spouse (or other caregiver)  knows how really helpless you’ll be. Being restricted to non-weight bearing activity necessitates balancing on one foot and not having the use of arms/hands (if using crutches or walker).
4. Ask your surgeon very early on if he orders cold therapy following surgery – and don’t leave the surgical center without it. More about this here.
5. Order a knee walker. There are different models.The female DG ordered hers through RentAKneeWalker. It arrived as ordered, and the customer service staff has answered two basic questions with courtesy. The knee walker allows you not only get around easier and more quickly. You can literally do more. The female DG can stand at the kitchen sink and kind of toggle between the sink and refrigerator to put a salad together, for example
6. Be ready to say no and yes. No when you’re really not feeling up to it and yes when people offer to help.
7. Spend the money on an wedge pillow to make it easier to keep your leg comfortably propped up in the “toes above the nose” position. No combination of pillows would have produced the same results.
8. Hope for temperate weather. The rarely too hot, summery temperatures of Menlo Park have been a boon.

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