13 Days Out

I had my first follow-up appointment this past Friday, and everything is looking really good so far! I’m hoping the news stays good throughout my recovery. I’m really glad I have the surgeon I have. Even though I inconvenienced him last week with my fall, he was still nice and joked about it with me by asking if I had any more “incidents” or if I managed to keep things quiet in the week that elapsed since then. I’m also grateful that he’s not one of those doctors who preaches about my being overweight and how it would be so much better for me and my foot to lose it. Despite being overweight, I have no problem zooming around the city on my bike, and I’m a lot faster than some of the other people I pass. The more I ride, the more in shape I become, so I appreciate not being nagged about it like some of the doctors I’ve seen in the past have done to me.

To get back on topic, I got to hear some more detail about my procedure. I knew what the surgeon was planning to do before I went in, of course, but my last appointment with him before surgery was in September, and the MRI was in July. He had told me in September that the exact plan depended on what things looked like when he got inside my foot and how much damage there was that didn’t necessarily show up on the scan. He ended up taking the Achilles tendon completely off my heel bone and cutting the damaged parts away, shaving down my bone, and then reattaching it with two small screws. I did not end up needing a tendon transfer, so that’s awesome. He also made an incision higher up and released the upper part of the tendon so it wouldn’t be so tight all the time. One of my coworkers told me before my surgery that she thought of me as bionic (because I work so hard), and that in turn I would heal fast. Well, with the screws I’m partially bionic now, but the only power it’s given me is the power to drop 50% of everything I touch.

During the appointment, I had the splint cut off and the stitches removed. I was a little anxious about the stitches coming out because I afraid it would hurt, but only two of the eleven caused discomfort. The incisions looked so gross with all the scabs and clotted blood, and there were still a few small raw spots that probably opened when the splint got pulled off (because it was sticking to my heel). They told me they were actually looking really nice for being ten days out, so as bad as they looked to me, to a trained eye, they’re doing just fine.

Incision 1 with no stitches.
Incision 2

After the stitches came out, they let me clean up the wounds a little bit, but a lot of the scabs didn’t want to come off, so I just left them. I didn’t want to open up more raw areas unnecessarily. I then got a fiberglass cast put on with my toes pointing down so everything could heal right. They had a lot of colors to pick from, so I went with a pretty baby blue. If I have to have it on for a month, I might as well have a color that looks nice.

My pretty blue cast

I go back for another follow-up in the middle of January, so hopefully things continue at a good pace. I asked if the tendon would be strong enough to play tennis on eventually, and was told that after it was properly healed, it should be fine. I haven’t been able to play tennis in over a year, and if I have to wait that long to play again, it’ll be worth it; I really miss it. There’s some new courts in a nearby town that I’d love to try out. The ones at the park down the street from me are full of chips and areas where the court is just stripped away. I also want to be ready for some bike events in the fall. I don’t know how possible it might be, but I’m going to give my rehab everything I’ve got when it starts. I’m ready to get back to the activities I enjoy without having pain slow me down.

Post Op Week 1

One week out from surgery and I’m doing well. I’ve had almost no pain since my surgery. The nerve blocks I was sent home with lasted me four and a half days. It was strange living with a numb foot for so many days, but much preferable to the pain I would have had otherwise. It was an odd sensation pulling the wires out of my leg because they went in there a good couple of inches, but it didn’t hurt. They slid out easily and it was a great feeling to get rid of all that tape covering most of my thigh. Any pain I have had has been more of a discomfort. I’ve come home from work with my foot feeling a whole lot worse than I’m feeling now, so I really have no reason to complain about it.

This isn’t even all of the wires I had to deal with. I had another one under my knee that can’t be seen.

The second day after my surgery, I woke up in the middle of the night needing the restroom. I was half asleep and trying to wrangle my crutches and I ended up losing my balance, stepping right on the surgical foot (which is supposed to be non weightbearing), and falling on that leg. It was a long night after that waiting for the doctor’s office to open to find out what they wanted me to do. I ended up having to go into the office so my surgeon could look at it and make sure I didn’t do any damage. Thankfully he said it looked fine and warned me not to make the mistake of using my crutches while I wasn’t fully awake.

Pretty much the rest of the week, I’ve just been laying around. I have to keep my foot elevated above my heart almost all the time. I’m only allowed to get up for 15 minutes each hour, and I’ve also had to ice an hour on and an hour off all day. Once my official follow-up appointment comes, I may get to have a little more leeway in being up and about; it’s all going to depend on what my surgeon says. I’m definitely ready to get out of the house for a while. It’s been a little lonely being cooped up and not being able to do much more than watch TV or read a book.

Living my life from the reclining chair. So exciting!

My biggest hope for this whole process is that I achieve a full recovery. My surgeon told me realistically that this surgery has about an 80% success rate, and a lot of that is going to be dependent on how well I follow all the rules and the physical therapy regimen. I’m keeping my hopes high!

Surgery Day

It’s been a week and a day since my surgery. All in all, it was a good experience. Not fun, of course, but a good experience. It was my first surgery, so I didn’t know what to expect, but I chose to have surgery at a hospital that specializes in orthopedics and that eased some of my fears.

The morning of surgery started at 4 am, and I had to be at the hospital by 5 am. I arrived as instructed, and no one was at the front desk. After waiting for ten minutes or so, I saw someone walking down the hall still dressed in their coat and carrying their bag. This woman ended up being the registration person, who was apparently running late. A few minutes later I got to go back into the registration room and get the admitting process started, but the patient system was down with some sort of technical issue. The lady called tech support and started getting a little irate with the person on the phone because now the waiting area was full of patients waiting to register for their procedures. Fifteen minutes later, she finally just had me sign some paper consent forms and I was on my way back to the pre-op area.

Pre-op was pretty standard fare from what I know from family members who have had surgery. Vital signs, weight, a few routine tests, and an IV line were all taken care of within my first half hour back there. I changed into a gown and I was hooked up to a bunch of monitors and had wires going everywhere. After that, it was a bunch of questions about my health and then a lot of waiting until about 7 am.

The anesthesiologist came in to talk to me about what to expect in the operating room and did a quick assessment. He then told me they offered nerve blocks for the procedure so my foot would be numb when I woke up. I agreed to the procedure, and then my room got really full of people. I wasn’t expecting to have five people suddenly surrounding my bed. They put my leg up on this platform and brought in an ultrasound machine. My nurse gave me something through my IV to help calm me down, and I felt drowsy for a split second, but I was too determined to watch what was going on to give in to sleep just then. The anesthesiologist gave me a shot to numb the back of my knee where he was inserting the nerve block catheter. It didn’t hurt but it burned a little. After that, I didn’t feel him slide the tubing into my leg, but it did feel like I got a cramp in my calf when he started injecting the medication. The same procedure was completed midway up my thigh, and again I didn’t feel anything. A lot of people must not be able to handle the procedure because all of the nurses called me a “tough lady” because I didn’t flinch at all.

While the anesthesiologist was finishing up the second block, my surgeon came in to make sure I didn’t have any last minute questions. I couldn’t think of any because I was preoccupied with what was going on with the nerve blocks (and feeling quite exposed in front of the good-looking anesthesiologist). My surgeon signed his initials on the leg he was operating on and then left. Just five minutes after that, I was being wheeled into the operating room.

The OR was freezing cold, and one of the nurses put a warm blanket over me once I moved over onto the table. I just laid there for maybe thirty seconds and the anesthesiologist asked if my fingers and toes were starting to tingle. I said no, and then someone put a mask over my face and told me to breathe. After three breaths, my memory is blank until I woke up in recovery.

It was strange waking up after surgery. I could hear my surroundings and people talking around me, but my body felt so heavy that I couldn’t even open up my eyes. I felt pretty nauseated, but I don’t remember if I threw up anything. I just remember a couple of strong waves of nausea and then I fell asleep again. I woke up to my nurse telling me that she’d let me wake up for fifteen more minutes and then she’d bring my family back. I was still really drowsy and kind of confused. I remember asking for a sip of water, and the nurse told me it took so long for me to wake up that the ice was gone. I didn’t really care at that point; my mouth was so dry that even warm water was fine. She just let me have a small sip because I was so nauseated and told me I have the “anesthesia curse” because I was so drowsy, and because even though they put a nausea patch behind my ear and pushed more medication to prevent nausea before my surgery, it didn’t seem to help. Now I know that for next time.

About two hours after my surgery I was allowed to be discharged to home. They sent me home with my nerve blocks still intact and a bag with a continuous infusion set to last me several days depending on how high I ran the dose. I also got sent home with a wedge pillow for elevating my leg and a cooler that holds ice water and connects to a special ankle wrap that fills up with that ice water to help keep the swelling down. I was told I could only get up 15 minutes each hour and the rest of the time my leg has to be elevated above the heart until my follow-up appointment.

One nice surprise I found with my discharge instructions was a card signed by all the nurses that took care of me and hand-written messages wishing me well. It certainly made me smile. I’m looking forward to getting the details of my procedure at my follow-up appointment; I was so out of it after surgery that my surgeon had to go into his next case and couldn’t talk to me. All I know is what he told my family, but I want to know more.

So, until then, I hope everyone has a good week!

Nerve Block Pumps
My nerve block “balls” that were filled with local anesthetic. It was amazing not to be in pain when I woke up.

Introductions Are In Order

bike lights
Riding at night is so much fun.

Cycling is my absolute favorite activity. That’s what I plan to focus a lot of this blog on, but for the next several months I want to chronicle my recovery from Achilles tendon surgery, both for myself and for anyone who can benefit from it. I hope to share tips that others in the same situation can use because I’m basically going in blind.

FSCN3349
My favorite place to ride past.

I’ve had insertional Achilles tendonosis for the past year and a half. It’s definitely been a drag. I’ve tried everything to treat this, but nothing’s worked. It’s been quite the journey to this point. I started seeing a podiatrist a little over a year ago, and from there I spent the months of November 2017-March 2018 in a combination of a walking boot, then a hard cast, then a boot again until it got worse, then a cast again and several weeks off work. The best thing the doctor I was seeing at the time did for me was finally having me try physical therapy. Until I started therapy, I was too sore to even want to try cycling, but after a couple of weeks, I was back on my bike again. I did therapy for 9 weeks, and while I improved 60-70%, the progress stalled and I was still in pain every day. It was also still a struggle to make it through a work day (I have a job where I’m on my feet all day). The therapist that I worked with recommended a different doctor to me after the podiatrist told me there was nothing more wrong with me and to come back as needed.

Switching doctors was the best move I could have made. I’ve been under the care of an orthopedic surgeon since June of this year, and it’s been a good experience. I appreciate that my surgeon didn’t rush me into surgery right away. He had me get an MRI done, which my first doctor didn’t deem necessary, and it revealed quite a lot of damage. He told me my tendon looks like it belongs to someone twice my age. With that information in mind, he told me I could try bracing again, but it would only have a 60% chance of working, or I could do surgery, which has an 80% chance of working. I wanted to avoid surgery as long as possible, so I tried the brace again, but it didn’t work and surgery was my only option left. So, after all this time, I have to do surgery after all. I know that it may not work, but I’ve been praying. If I put the time and effort into recovery and rehab, I feel certain it will be fine.

My surgery is set for December 11. My surgeon is going to take my Achilles tendon off my heel bone, clean up the damage, reattach it, and do a lengthening procedure. I won’t be able to put any weight on it at all for ten weeks, and then it’s going to be aggressive physical therapy after that. I don’t know when I can cycle again. The only thing I know for sure is that I won’t be doing 30+ mile rides for a long time. It’s going to be slow to get back into it. It’ll be even longer before I can play tennis again. I haven’t played tennis since my tendon first started hurting because I can’t even run thirty seconds without feeling pain. Cycling was my only option left for outdoor activities, and thankfully it’s something I’ve always loved. I’m hoping to challenge myself and do some shorter bike events, and a 5k at some point during 2019, but the soonest that’s likely to be is summer or fall.

I hope you will join me on this wild ride we call life. If you have any tips for me or any experiences you want to share, please do! I always love reading the comments on my blogs! I plan to update this at least once a week, so check back soon!

catcast
My cats loved it when I was in my cast earlier this year. Can’t say I felt the same way.