Wednesday, 16 July 2014

Am I behind the 8 Ball?

I've been thinking, as you do when you are in this predicament.  I am now 5 weeks post op and not due to see my specialist until week 7. I'm starting to think he is is a figment of my imagination as it's been so long. All I have is a piece of paper with the protocol my Dr is following. No signs of any physio or exercises aside from wiggle my toes and exercising the quad.
After reading so many positive stories of people weight bearing at this point, I am now concerned how slow this is going. AM I BEHIND THE 8 BALL ?
I am at the point where I'm struggling with the idea that I am still 7 weeks away from wearing shoes and driving again. Frustrated is an understatement. Mildly pissed is another understatement. You feeling where this is going?  So I started reading up and watched some youtube videos and decided to take out one of my wedges to get me closer to the goal. Ouch! Swelling and a sore heel for a few days but I'm good as gold now. So happy with that first attempt of moving this along. Once the swelling went down and the pain was mild I decided to see what my foot was capable of.  I have been petrified to say the least about re-rupturing it but where's that going to get me... stressed so I'm over that buzz now and concentrating on 'How strong is my ankle/leg'. Granted I am not going to win a race against a snail to date but man can I hop!  I have managed to move my ankle up and down without any pain and some control, I can place it flat on the scales and bear some weight. So next on the plan was started bearing some more weight on it while in my boot.
I started using the knee scooter around the house and then branched out to the mall two days in a row and ended up with a really sore knee cap so had to go back to crutches all the time. They suck! I think I will have a burning ceremony at the end of all this (ok I won't the hospital will bill me for them but the thought is there).  I attempted to walk on my boot, felt pretty flat after that, looked worse than a waddling duck but each day I have improved. I am now cooking dinner without the crutches and feel like I am making some progress. Made an appointment with a physio who I have been too in the past. Hoping to get some rehab happening before my appointment in 10 days. Keep you posted :)

Tuesday, 24 June 2014

Is it only 2 weeks post surgery. Really???

What an interesting two weeks it has been. Emotional train wreck one minute, sobbing like a teenager who just broke up with her boyfriend of one week the next ! I feel pregnant again about 8 months to be precise, the time when your back hurts, your feet swell, you have to roll a few times to get the momentum to roll out of bed, eating almost everything , thinking about what you will eat next, feeling like it's never going to end, sleeping sometimes mid conversation, and of course the dreaded mood swings (clearly this can not be pointed out when I'm in one).
First few days I am sore and feeling very robocop-ish, my husband and kids are doing a great job trying to keep the house sorted. I'm incredibly tired and keep my leg elevated as much as possible. The mighty All Blacks play their first test against England and the ANZ Netball Semi's are on so I'm enjoying the Foxtel in my room and meals delivered on a tray like the hospital. I am having more pills than my grandma and thankful the pain goes away quickly. Aside from the Panadol, I have Oxycodone, Inza an anti inflamm and 1 jab of Clex-aid each night to prevent blood clots. I'm weak in the tummy and jabbing the little needle still makes me hold my breath and look away. Pathetic I know. My tummy is bruised and look much like a pin cushion after one week of those. The incision site burns most of the time.
Monday arrives and the kids go to school, hubby goes to work and thankfully my friend calls in to help, you certainly are thankful for friends and family at this point.  My Dad picks up my knee scooter and wow I'm a new woman. Scooting round is a godsend , I am able to get a few simple chores done. A few loads of washing, making dinner and checking up on homework. While I know how much rest everyone has recommended it's unrealistic for me and I soon work out whats ok and whats too much. Any throbbing or strong pain means get to bed, burning where the incision is means this is the last thing you can do for a few hours, and on my scooter or crutches for more than 2 hours means rest & elevate. So about day 5 I stopped with the Oxy and started with panadol and nurofen every 4-6 hours. Pain was moderate but manageable and started to ease off.
By day 8 I was getting pain in my calf like I had stretched it. It was throbbing but I couldn't locate the pain other than in my calf. I had been too active probably and thought that it was related to that, after dinner it would get worse and a few nights I was waking up to take pain killers. I am amazed how tired I can get , my body is obviously working hard to compensate for my leg. Time to add some good food to my diet and some vitamins. My achilles on my good leg is becoming sore and my back is killing me. Being this immobile is hard, my head is still coming to terms with it. A few more days and my Mum arrives from New Zealand and I really can't wait to see her. Something about having your Mum around when you're sick (or injured). Before she arrives I have my post op appointment with the surgeon.
The surgeon was running an  hour late so the waiting room was like AA for ATR patients. It went something like this "Hi I'm Alan, I am 6 weeks post op ..... " we discussed first shower out of boot, modes of transport ( I was the only one who hired a scooter) two of us were just newbies and the other 4 were able to advise us on the things that helped or hindered them. It was the best 1 hour I've spent in a waiting room. Got to see my incredibly busy Doc and he opened up the boot, removed the dressing, snipped a few stitches and asked a few questions. He said my achilles had coiled up which was news to me, that my scar looked good. I am now allowed to partial weight bear with crutches as tolerated. He asked me to describe the calf pain and wrote a referral to have an ultrasound to see if it was a blood clot.  Really I thought, could this get any worse!
So following day I went to the ultrasound appointment. A lady morphing Cruella De Vil meet me and told my husband there wasn't enough room for him. Once in the room she asks me to get down to my underwear and that I wasn't going to like this. I am feeling like I'm going to despise this woman. Yep I did. She didn't leave the room or offer a gown, she made me feel like shit asking me why I thought I had a blood clot and that it's unlikely. I explained that I would rather be rugged up at home than going through the pain I was in and that my surgeon sent me. She had to squeeze my calf 20 times, it hurt like hell. Sure enough there was a DVT, a blood clot in my vein. She then told me to go straight to my doctors.
My lovely GP who knows us well called me to discuss it. "Young Kylie you are in the wars, what are we going to do with you" she said calmly. I was relieved to be dealing with her. We made an appointment and was told to double up on my injection that night. I am now on Xarelto (rivaroxaban) twice a day. She said I will be on medication for 6 months. Bummer but it could be worse. I guess thats why they say there are more complications with surgery.
Two weeks down and it really feels like months. I have a few down moments with the kids and not making to one of their special activities or just hanging with them, I am missing not watching their sport. So decided I would take the wheelchair, my Dad and all the kids for a morning of rugby as my husband was working. Both boys had big games. It was so good to be amongst it again, cheering and yahooing on the side line. Caught up with lots of the rugby Mums who didn't know I was injured 4 weeks earlier let alone the surgery and wondered why I wasn't at the games, however the Dads were cracking jokes about my Husbands new line of work and were all up to date with camboot and my progress. It was hardcase. 3 hours later I could feel the swelling and called it a day. Could barely keep my eyes open on the drive home , that was harder on the body than I thought. So home for a rest with my leg up and I was feeling pretty good about my outing.  Only 8 - 10 weeks to go ... NO WORRIES

Sunday, 15 June 2014

D- Day

Packed my overnight bag, some reading, charged the ipad in the morning. Patiently waited for my husband to come back and pick me up for my 11:45am Check-In. I was almost excited, hungry from fasting but excited. My Mum called from NZ wishing me luck and upset she wasn't here. Pulled up to the hospital which I hadn't been to before, crutched my way in to the "concierge". For a brief minute I thought we were checking in to a hotel for the night. Lovely place but they checked me in too late and theatre was ready while I was in the foyer, my Doctor was losing his shit. 
 So the fastest pre admission in history and I was ready to roll with my boot on one leg and my compression sock on the other one. Doc barely spoke to me, the anaesthetists were great as was my nurse but my doc he started freaking me out with all his stress. Because I had been told to come in later he was going to have to cancel the last on the list. Just as I was about to have the gas I thought I hope he does a good job he's so angry...Next thing I know I'm trying to convince the male nurse with an english accent next to me that I feel great and would love a cup of tea. He didn't oblige but chatted with me as I came in and out of dream land. Went back to the ward where my husband was waiting and felt pretty good. Had a cuppa and was ready to eat my arm off after that. Dinner was impressive I'm sure it was the fact that I hadn't eaten all day but I wasn't complaining. I had the IV left in but got rid of the oxygen up my nose not long after dinner. Was feeling quite sore but wide awake, must have been the drugs. I saw about 6 nurses over the next few hours but was really wanting for someone to tell me about my surgery, finally the night shift nurse who started at midnight looked up my notes and found out why I couldn't feel my toes and why my leg was really swollen. I had been given a block like the dentist so I got my leg up high for the rest of the night and she opened up my boot to reduce the swelling. So after some uncomfortable hours I was finally able to sleep. I enjoyed the rest from the organised chaos at home and knew I was in better hands in the hospital, just for one night though. Morning came and I was offered a bed pan, a commode or if I felt safe to go to the toilet.... Hmmm tough choice! Pass me the crutches please. Physio came by and made sure I was able to use my crutches safely and showed me a few exercises to keep some strength in my quad, the good leg was getting worked out every time I moved. The surgeon popped in briefly, thankfully a lot calmer than the day before. He was happy with how the surgery went and gave me the low down on going home. Daily injections to stop blood clotting... I'm a bit soft but knew I'd have to toughen up and jab my tummy as the family are all gifted with weak stomachs. Non weight bearing, pain relief as I needed it, rest up and he was gone. Took all of 4 minutes. By lunchtime I was able to go home. Still flying high on the pain relief I was feeling good about going home.

Thursday, 12 June 2014

My Rehab Protocol

0-2 weeks - Camboot, non weight bearing
2-4 weeks - Camboot with 6cm heel lift (can remove for showering but wear while sleeping)
4-6 weeks - Protected weight bearing as tolerated
                  - Active plantar flexion and dorsiflexion to neutral
                  - Non weight bearing fitness/ Hydrotherapy
6-8 weeks  - Remove heel lifts (one per week)
                 - Weight bearing as tolerated
                 - Dorsiflexion stretching slowly to 90 degree angle
                 - Incision mobilization if required
                 - Fitness / cardio exercises to include weight bearing as tolerated
10-12 weeks - Wean off boot
                 - Return to crutches as necessary and gradually wean off
                 - Continue to progress range of motion, strength, proprioception
12 weeks - off boot, into shoes
6 months - Sport specific training can commence

Wednesday, 11 June 2014

The surgery

This is what happens while I'm knocked out. If this makes you squirm then I advise never to google "achilles tendon surgery images" Made me weak in my one good leg.

To go under the knife or not that is the question

12 days after the event I am scheduled to see the trauma clinic doctor to have the cast removed and get a boot put on. My lifelong friend drove me, hooked me up with coffee and a bite to eat while we waited 3 hours to see someone. I was having boot envy as people were coming out with cool looking casts and funky boots. Doctor took a look assigned me with a boot with the most incompetent dude in the joint. He struggled with the mechanics of the boot and was rough as guts. 

The freedom of being able to scratch is something we take for granted, as soon as the cast was off I went to town. damn it was good, my swollen ugly as looking leg was looking pretty scary though. I could have braided that shit! Once Mr Incompetent got the boot on he said " now try it out" What the hell buddy I'm not able to walk on it. Pleased to get out of there and organise my ultrasound and specialist appointment with someone who knew what was going on with my recovery. 

So managed to get ultrasound done and appointment booked for the morning. I was feeling unsure about the chances of my tendon having a good shot at healing while in the cast as it wasn't positioned properly. My new Doctor advised that my gap was 2cm long and thought the process had been compromised. He explained the gap I currently had would make it difficult to be able to take off, run, jump and my re-rupture rate was 20% compared to 2-4%. However the complications of surgery were also a big consideration. 

While I'm not going to play for the country I'm still active and love my sport with my children. Hemi is also a runner so not being able to chase him wasn't an option. Therefore surgery was booked two days later. 

I relished in the fact that I couldn't do too much more damage and had a little boot off time at night and loved the showering without the cast. I wasn't worried about going under, just wanted to give myself the best chance at having a normal operating leg again. Bring on Friday ...

Friday, 6 June 2014

Autism and achilles ruptures don't mix

The day after the event poses a few issues for our family. Our youngest Hemi who turns four later in this crazy week has struggled with my injury. Hemi has Autism. Change is very difficult for children with Autism and Hemi is no exception. I am the only one who drives him to kindy and therapy so clearly that's out of the question for a while. His Dad dropped him off and my Dad picked him up. 
I could hear the screaming before they hit the driveway, quickly I hopped off the bed and grabbed my crutches... He was in a full on meltdown. As I unlocked the door there he lay screaming, hitting as my Dad tried to protect his head from the concrete. I felt helpless. My Dad tried to explain what happened and I could see the heart break in his eyes as he told me. Hemi saw Pa's truck and normally he would love a ride with him but not from school. He started saying "Mommy's car" over and over then hit Dad several times as he tried to get him into his carseat with the help of his teacher aide, he tried with all his might to break the windows in the truck. 10 minutes in a car with Hemi in meltdown mode is stressful for everyone and Pa got to see something he had never experienced with him before. I would normally restrain my boy, squeeze him tight and make the room dark until he calmed down but I couldn't even pick him up. There's not much you can do but let him ride it out, once he's over it he's back to his cheeky self. 45 minutes later he was back. 
Saturday is sports central in our family so hubby took the boys to rugby and our girl went to netball. Hemi showed his frustration again as I couldn't play and run around with him so while making our lunch he pulled every item of clothing out of my drawers, squirted out my make up, emptied my typically overloaded woman's handbag on the floor. He showed me what he couldn't tell me "This sucks" I agreed. 
Fortunately he has come to terms with my lack of mobility and worked out who can do what for him in the family and most of all who can drive. Such a smart little guy! 
Meanwhile my cast had to get re-plastered as the first one wasn't in a plantar flexion position (toes pointing down) my foot was almost at a 90 degree angle and was very painful. I also managed to slip off my crutches on my way home from the children's emergency as my eldest son was stung by a bee and had an anaphylactic reaction. I got a big knock to my head and cut my head open, bruised up my knee, knocked my sore leg. A few days of headaches and memory loss I went to my GP to be told I had concussion. 
What a bloody week !