2 weeks post surgery

I had an exciting visit to the ortho today. They removed my splint and stitches and I passed a Thompson's test. The Thompson's test seems to the primary diagnostic for achilles function and seems to require little more than a squeeze on the calf when it is in a relaxed position. Passing this test, the healing of my stitches, and the general lack of swelling seemed to make the doctor (or nurse?) happy. We are a little frustrated with the lack of information about upcoming steps and appointments, but the surgery work seems to have top notch. We just would like better communication about the future so we can make our schedules work.

I have to admit that I was nervous about getting the stitches removed. They put a numbing spray on and it wasn't too bad. Teresa was there and that helped me through the process. Then I went to the connected rehab clinic to get a dynamic brace made. It is basically a custom molded plastic brace with an open back. Seeing my heel again is quite exciting. The picture below is what it looks like (sorry if you don't want to see the surgery area):

I am now allowed to step down on this but the angle it is fixed in doesn't make it very useful yet. And I can remove it to shower and even put a shoe on over this when I go out.

I don't know how much the herbs that I am taking have helped, but everyone seems to be impressed by how I am healing and they certainly haven't slowed me down.

I posted a review of my knee walker last week and here is the requested picture of it. Its interface with my new brace leaves a little to be desired but I think a little padding on the top where it hits my shin should make it manageable.

I decided to take not go to work today as I am adjusting to the new brace but am going to go out and watch some ultimate tonight. It is my 37th birthday on Tuesday and I guess we get to celebrate my excellent recovery so far. Teresa has a busy day at work but we are planning on going out for a fun dinner. For our anniversary last week, I wasn't ready to go out for dinner. I think we'll be double celebrating on Tuesday to make up for the last three weeks of stress and discomfort.

Hygiene and crutches

I have noticed that being on crutches or a knee walker creates an issue with hygiene. Unless you can reach the sink while sitting on the toilet, it is hard not to put unclean hands on support equipment to get in position to wash your hands. Washing your hands after that only partially mitigates this issue. So wiping the equipment has become an additional step in the process when possible, which is not always the case.

Completely unrelated to this, being semi-conscious at home last week and not having cable meant watching lots of internet tv from netflix and hulu. I got frustrated that the only way the writers seem to be able to create tension in thrillers is to have people do stuff that should get them into trouble, like cheating or stealing or abusing their jobs in some way. I guess you can't create a "taut thriller" without stupidity causing the problem. So we fell into watching more "period" movies where the drama comes from revealing an interesting set of events...

I am happy to report over 200 pageviews so far on my blog. I am hoping to make it more entertaining as I move from status updates on the injury into the rehab process and getting back to work concerns.

As an update on my recovery, I was doing great going into day 9 of recovery - starting to work and stopping pain meds. And then as I was heading outside to work and sit in the sun, I tripped, started to fall, and put weight on my injured foot. I am hoping I didn't do any real damage (it is hard to tell but I think it is just additionally sore/bruised) but feel like it took me backwards a couple of days in healing.

Shortly after that, I went for an acupuncture appointment. The treatment showed me how out of balance my system is after surgery. She explained that there are many meridians of energy flow that travel through the area that I and then surgeon messed up. I was extremely sensitive to some simple treatments and am hoping that she is helping me move along in my recovery quickly, at least when I don't cause my recovery to go backwards.  

Reviewing my Nova knee walker

I am starting to feel better and cut my pain med consumption down considerably. Having my body function more normally and my head clear up has let me see some hints of the length of the recovery process. Time has been moving really slowly so far and I have exhausted everything I want to watch on hulu and almost everything on netflix. The process will be more clear next week when I find out how much work I can do on my injured leg.

Thinking about other people and their injuries has put my injury in perspective. One of my students broke his leg and had to have surgery this weekend - we'll be having dueling crutches or walkers next time we meet. A friend broke his leg skiing two years ago and has had complications that are still causing problems. If this goes smoothly, I'll be putting weight on it in two weeks after injury. And so far the pain hasn't been as bad as I expected.

Now I would like to review my knee walker. It is a rental unit and has obviously seen some miles but wear and tear only applies to a couple of the issues. It seems to be a Nova four wheel model. A few of its components are "stolen" from bicycles but obviously this wasn't built with the best of bicycle technology in mind. While I am being critical of it, it has made a big difference in my independence but it could be much better...

• First, the unit is very heavy. I mainly know this from watching Teresa carry it. I'm guessing the tubing is steel. This seems unnecessary as it only needs to support half a person. It is rated for 300lb people and maybe safety standards suggest some high level of overengineering. One would imagine an aluminum frame could be built for a similar cost that would cut the weight in half. There are other unnecessary additions such are both a seatpost collar and a bolt that goes through holes in the post. And the seat post looks like it is made out of a barbell type of material. The wheels are solid plastic which would likely be heavier than inflatable tires.
• Second, its handling and steering are weird. At any sort of speed it gets unstable. That would be forgivable if it had a tight turning radius that made it be too responsive, but its turning radius varies depending on which way you turn and is fairly minimal to the left. Neither direction seems to turn very quickly and I often end up lifting the front wheels off the ground to turn it - not exactly a safety feature.
• Third, the brakes are crap. The design is stupid, using brake pads on the rear wheels themselves. I think this is how they stop cable cars and the first bicycles. In my used unit, the brake actually only stops a single tire. Fortunately, the solid tires have no grip on carpet or wood floors, so this doesn't cause any instability. And if you don't have all your weight on the unit, the wheel locks up but it doesn't stop either. The brake lever looks like it came from a huffy from 1990 and has a hand lever that is large enough for big foot. As a safety feature, it does have a reflector on the handle, so if a car is approaching from the right, they might no run me over in my living room.
• Fourth, the solid tires are awful. As I noted, the handling and braking are poor probably due to the tires and the weight isn't helped either by them. I have to imagine there are inflatable tires out there that don't mar floors. The big thing this would provide is some ability to handle transitions between surfaces. I am not looking for a full suspension knee walker, but something that could role over a transition between rooms and grip a little along the way would be nice.
• Fifth, the grips are very thin. I don't plan on putting tons of miles on this, but the grips are extremely thin and provide no real cushioning and little grip. Again, bike grips have improved dramatically in relation to this in recent years and the worn out grips on this unit could be easily replaced.

Despite all my issues, the unit actually works just fine and the knee cushions so far seem to be the best part of the unit. It provides good stability as long as it is used cautiously. For the first time since my injury, I was writing on this blog to procrastinate doing some real work, which I am off to do now. Before, I was doing it because it was all I felt like I could do. With better weather coming soon, I'll be taking the knee walker out for a proper field test and might see some brilliance in the design, although I doubt it.

Recovery Days 3-4

I am happy to report that I am starting to feel better. The pain levels have dropped and I slept through the night last night without additional pain medication for the first time. I might even work a little bit before I want to nap today.

Yesterday had three bits of excitement - leaving the basement, showering, and visiting the acupuncturist. Later on in the recovery, this will seem pretty minor, but getting back to doing regular things and getting more mobile was exciting. Teresa went all out and bought us a safety show chair with a back on it. She thinks it is a good investment since we will start to need one more often now that we are getting older. The combination of my first activity for a few days and the treatment left me really tired yesterday afternoon. But resting combined with my best night sleep after surgery has sent me forward this morning feeling quite good.   

So another week of being careful not to damage the repaired area while I hopefully continue to feel better every day. The acupuncturist warned me that I may get a bit grumpy in the next week or two as my system tries to process the toxins from the surgery out of my system and I have to adjust to not having fun like I am used to. In the past few years, I've discovered that exercising is extremely important for my general health and feeling of well-being. For the short term, I need to obtain that without exercising.

I am quite happy to be feeling like I've turned a corner on the healing and now can start thinking about getting back to more of a normal mode of operation.

Recovery Day 2

Last night I finally started to feel some real pain. Not unexpected but not enjoyable either. I also got some deep sleep but my balance at 4 am was poor and I had to put some weight on my leg to avoid falling. I don't think I did any damage but the adrenaline spike kept me awake for a while last night.

Teresa often jokes about my habit of kicking in my sleep, especially after I watch soccer. This morning, even though I didn't watch the US-Guadalupe soccer game last night, I kicked with my injured leg in my sleep. What a wonderful way to wake up!


Buster has been extremely gentle around me and my injured leg. He is a border collie/ blue heeler mix and has tons of energy but seems to know that I am not 100% and is being very careful not to make it worse. 

I am beginning to see some direct impacts of the surgery on work, skipping a conference call on Thursday and having some work go stagnant because I am not able to function yet. I was optimistic yesterday about being able to get up to campus at the end of the week but now am thinking it might be the end of next week.

I see the acupuncturist on Thursday and maybe that will help me turn a corner on this and start to feel some heeling instead of feeling like I am mainly trying to avoid tearing my stitches.

Recovery Day 1

My surgery went well yesterday. The surgeon said that while it was ruptured, it wasn't as much of a mess as he usually sees and that it was an "easy" repair. Teresa joked later (not to the doctor) about asking for a discount on the surgery because it was easier than normal. My pain levels have been minimal but I didn't sleep well last night. I discovered sleeping on my stomach halfway through the night and that made it much nicer.

I chose to have a spinal anesthetic which created a few new experiences. The slow loss of feeling to lower extremities while they were positioning me was unusual. And then regaining feeling and the happiness that things were working again. While my gentleman's vegetables were still numb, I got an itch in that area that I couldn't seem to scratch. Eventually the feeling returned, but I've had some psycho-somatic itchiness from that experience. They did give me versed during the surgery so I don't remember any of it and am happy about that. I woke up and once the feeling returned, I felt good almost immediately. I am also taking a little aspirin to help to prevent blod clots that they observed as a rare complication here - not sure if that is related to living at higher elevation or not. I will also be starting to work with my acupuncturist this week to try to speed the recovery process.

I left the surgery in a splint which I have to wear for two weeks. Then onto a dynamic splint (the day before my birthday) and some weight bearing for the following two weeks. By four weeks, I will be in a walking boot and by eight I should be walking without support.

I have enjoyed all the emails, FB posts, phone calls and comments here supporting me in the recovery. It seems like a little thing to do that, but it is appreciated.

Waiting for surgery...

I am in the holding period waiting for surgery on Monday afternoon. I tried to do a little more on Friday wearing my walking boot, watering our raised gardens and making quite a few trips up and down the stairs. I now have grown a bit of a cankle and am seeing the rainbow of colors from yellow to black showing up below the injury. Teresa got me out of the house today and it was really enjoyable even though it wasn't a big adventure. We went to the museum of the rockies, saw the frog exhibit, and then did a little shopping, trying to anticipate post-surgery needs and wants. Mainly it was nice to get out of the house and spend time with her before I become really dependent on her next week. Being able to chat with some of the neighbors and friends we ran into while we were out was also nice.

Some of the ramifications of getting injured that you don't think about are the impacts on other people. We were going to remodel our kitchen at the end of June, but have moved that project to August at the earliest. My students aren't getting much attention as well as some of my other research projects that are just sitting still. I also see the impacts for Teresa because I have been her main exercise partner and she is having to take time off work next week to take care of me. She has signed up for some fun local mountain bike clinics and hopefully will link up with some (new) friends that are at her level for some further adventures this summer. It will be a bit of a role reversal for her to come back and tell me about her adventures in the next couple of months. And Buster (our dog) is getting lots of love but not as much exercise as normal.

We've been discussing how to modify my diet since my calorie consumption is going to drop. Probably the easiest thing to drop is beer, but I am reluctant on that one. I think I am more interested in smaller portions than that...

Post #2

I found reading blog posts (http://www.achillestendonblog.com/) about other peoples experiences with achilles tendon ruptures both scary and reassuring. The ortho appointment was interesting. It was a full rupture. I "failed" the Thompson's test and he noted that there is a gap in the tendon with possibly a few fibers still connecting it. The gap in it is really noticeable now. He thinks I will be a good candidate for a full recovery. I left the office with a walking boot and don't need crutches until after the surgery.

I have to admit that the exact dates for the different steps in the process flew by me in the conversations, but for the moment I just get to keep it comfortable and avoid further injury. He wants fibrin (?) to fill in the heads of the tendon so he can perform what is supposed to be a 20 minute surgery. Basically, he will stitch the two ends of the tendon back together and that will be it. The incision should only be an inch or two. Surgery will be sometime early next week. A couple of weeks and I get to start working it out again lightly. He thinks I should be walking by the Joint Statistical Meetings the first week in August.

I am feeling more positive about this today than yesterday. I know it will be a long process, but I will be more active sooner than I had expected. It was nice to get the splint off my leg and be able to do some icing again as my ankle was a bit swollen and starting to turn black and blue. I do love my garage sale polarcare 300 for icing - so much better and safer than ice or ice packs.

I have been fascinated that there are people looking at my blog. I have my work website and I know it gets some traffic but never know how much or who is looking  at it. If I knew how many people were looking at it, I would probably spend more time making it look nice.

I think I am finally getting an interest in working again. This week has mostly been lost for work and I hate that my recreation has cut into my work this much. I pride myself on keeping the two separate and using my recreation time to benefit my work. Usually I do this by either sorting out problems while doing fun stuff or having more energy when I am at work because of doing the fun stuff. In recent years, I have definitely recognized that if you are not healthy, you can only be productive for a short amount of time. Taking time to be healthy increases productivity, at least for me, except this week.  

First blog post...

I had never really been interested in creating my own blog, but I ruptured my achilles tendon on Monday, June 6 playing ultimate frisbee and facing months until I am back to normal has motivated my interest in having an additional outlet and distraction. I was recently tenured and promoted to associate professor of statistics at Montana State University and the change in pace and obligations also has encouraged me to consider this additional outlet.

First to the injury... I have been slowly easing back into playing ultimate and getting more fit this spring. The last few years have seen me playing ultimate sporadically compared to 1992-2004 where I played competitively at Luther College and the University of Wyoming. In those years, I played at least half a dozen tournaments a year, playing on college, open and coed teams. I was the player/captain/coach for both Luther and UW. Before that I played soccer competitively up until a back injury during training camp at Luther College in Fall 1992. All of that ultimate and then the tenure process took a bit of toll on my body, mainly my knees and my fitness levels. And I am now almost 37. So getting back to a fitness level where I can play ultimate, possibly competitively, has been a challenge this spring.

I had a good ski season, feeling stronger than I had in years. Then I started running a little as temperatures warmed a little, until I strained my left calf muscle about 2 months ago and had to take a couple of weeks off. Then I made it to a few pre-Bozofest practices and it wasn't pretty. But I didn't have any major injuries through that and started to feel my fitness improve. Then I started mixing in elliptical training and a few bike rides and really felt like I was turning a corner.

That brings me to monday. It was the first night of summer league. I did a nice warm up, stretched a bit, and then we started playing. It was the first time that my knee and all my muscles felt good. Fitness was still a little low on long points and my throwing was conservative or inaccurate on my one huck. I played around 4 or 5 points but was surprised with how good I felt (not great, but not as bad as I expected).

Then on a turnover near our endzone, I took off on a cut to lose my defender. It felt like someone stepped on my heel as I took off, holding it down as I tried to run. I had the oddest combination of tingling and numbness in the middle of my lower leg. It only hurt when I tried to walk off the field and was extremely weak. I later discovered that no one was near me when I was cutting. I think I knew I had hurt my achilles, but wanted to think it was a muscle strain/tear.

Thursday I go to the orthopedic surgeon and probably will have surgery to re-attach the tendon. I had seen discussions of 6-8 weeks for recovery but that is likely how long I will be in a boot or cast. Mayo clinic suggests 4-6 months for the complete recovery process. That takes me from August to between October and December. I hope to try to chronicle my recovery process here as well as taking time to discuss life as a statistics faculty member. Life always involves a balance between work and play, and it looks like my play time is over for the summer.