The Achilles tendon is a wrap – six months post surgey

It was the expiration of the temporary disabled placard that struck the female DG: That meant it had been six months since surgery to repair her partially torn left Achilles tendon, even though she keeps thinking  five months. So it was fitting that she also had her final appointment with Dr. Oloff today and was told “you’re too healthy to be seeing me any longer.” While at SOAR she also ran into master caster Joe, so was able to give him a final round of thanks, too. Now if only the right hamstring was less cranky. It’s always something…

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

It 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.

Getting a quick cast patch

Just a day short of six weeks post Achilles tendon surgery – and seven days before she’s due to get her latest and last cast off – the female DG stopped in at SOAR to see master caster Joe Bulcao for a cast patch. The walking she’s been doing – pretty much pain free – had broken down the cast padding and her toes – well her big toe – was extending beyond the end of the cast. With a boot underneath the cast, that in itself wasn’t a problem but rubbing against the fiberglass was. Joe added some strips of soft tape around the perimeter, and she was on her way in just minutes

Green is for go – time to start walking

The female DG wasn’t sure exactly what to expect when she went for her appointment with foot surgeon Dr. Oloff and master caster Joe Bulcao today at SOAR, five weeks post surgery on her left Achilles tendon,  She was fairly certain she’d leave with her left leg still in a cast from below the knee to foot. She was right about that – and opted for day-glo green.

But she was also cleared to start walking – not all at once but to slowly but surely become less reliant on the crutches. Great news  but a little bit scary, even though her hands hurt and her shoulders ache from the stupid crutches. But she can’t really imagine putting full weight on her left foot even for a few steps. She takes encouragement, though, that she’s been doing just that, going up and down the few steps leading in and out of the DG’s garage  the last couple of days.

So, she’ll just keep faith that Oloff is following a prescription that’s worked countless times before and that Joe has given her, as he termed it the “Cadillac of casts,” to make it (that being walking) happen.

Ready for 25% weight bearing

If the female Dual G (gimpy and grumpy) is being truthful, she’d admit that she’s been on the look out for members of the local sports teams who take advantage of the all star cast of doctors at SOAR (Dillingham etc, and of course, her surgeon, Larry Oloff) – especially “her” San Francisco Giants. There seems to be a greater chance of an encounter since her appointments have been in the “cast room,” which shares three treatment tables. But it really was just as delightful to walk in yesterday morning and find  friend Marty on the next table – who later demonstrated what it’s like to be almost crutch free.

The female DG’s milestone was more incremental. She graduated to a new cast (all pink again) that allows her to be 25% weight bearing for the next week and 50% weight bearing the following week. She’s always been clear about “no weight bearing.” That means  “don’t you dare take a step or even touch down on the foot that’s now supported by a surgically repaired Achilles tendon.” And thanks to master caster extraordinaire Joe Bulcao (pictured), she now understands that 25% means you use the afflicted limb as one of three prongs,  the other two being crutches. Fifty percent means that foot/ankle takes a bit of weight as you step – but only if pain free.

On the pain issue, there was some today. Still mild – 3 on the “during childbirth” spectrum but more than the almost zero she’s had beginning the third day post surgery. To get the clearance to start some weight bearing, she had to get her foot in a 90-degree angle, which it hasn’t been for three weeks. Joe was good enough to reinforce thatwhat she was feeling wasn’t pain but a “stretch.” And the motivation was easy – start some weight bearing and continue on the path to recovery.

There is a downside to the new regime. It puts her on crutches, a slower form of navigation than her scooter and one that requires use of both hands/arms (a challenge when you’re already down one arm in the household; being down three out of four makes things tougher). There’s also a new bootie around the foot of her cast that elevates that side, so her legs are now uneven. She thinks she may have one shoe that has a bit of a platform – otherwise it’s back to the shoe shop.

All of this orthopedic news happened on the same day that the male DG had a conversation with his neuro-oncologist and decided another treatment round requiring infusion was the prudent course of action. That decision was fairly straightforward. Making it happen – with the necessary insurance authorization, blood work, and UCSF office visit –  takes time and patience.

Photos by Chris Gulker

“Looking good” 11 days post surgery

The 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).

It’s check up time with the surgeon

With the blue tubing of the Polar Care 500 hanging barely in place and the surgical bandages starting to unravel, it was clear that the post-op visit with Dr. Oloff was coming none too soon. But when you’re a two gimp household, the prospect of getting dressed, into the car, out of the car, to doctor’s office and the reverse is a bit daunting. (We promise to forever spare readers the details off the sponge bath procedures currently in effect .)

It was also to be the most activity the female dual G (gimpy and grumpy) has had since Friday. She’s feeling good – clear headed and pain free as far as her Achilles tendon is concerned. She’d feel almost normal if it wasn’t for the reminder of the dreaded walker at her side and how much it hurts her hands and arms moving from one place to another.

Having reached the SOAR office, they were quickly ushered into, for lack of better words, the fitting room where there was three (or four) examining tables separated by curtains and every kind of orthopedic device you could imagine. A certified orthopedic technician by the name of Joe removed the bandages. And there, surprisingly, was something approximating her  pre-injury foot/heel. There was no discoloration to signal the sniping that had gone on and  minimal swelling.  The male DG could see the four-inch long incision knitted together with sutures. Soon Oloff appeared to pronounce “looking good,” to encourage the daily injections that ward off blood clots (giving yourself a shot isn’t all that bad) and to give the go-ahead on the application of a cast. She’d never considered that getting a cast would be good news.

Nor had she known that today’s fiberglass casts come in a multitude of colors. She couldn’t resist day-glow pink. Mission accomplished – next visit in a week