Life after Achilles Rupture...

It's been a while, and while my leg is still skinny, barely a calf definition, I can now run 6 miles without my foot/achilles/leg feeling "weird".

With some timely fitness challenges at work, I've gotten back into shape (or perhaps I should say "lost" my "shape" (aka belly).

So, if you happen to come across this while feeling down after an Achilles rupture, keep your spirits up, you will recover and can become fully active again.

Twenty minutes on stationary bike

Went for a walk since the rain let up, then got the old stationary bike out and did twenty minutes, not too hard since this was the first time.

Able to limp around without crutches on the vacocast with the large heel, but it is still awkward.

Day 47: vacocast

Day 47, March 19, 2012: Vacocast Day 1

Vacocast arrived today. Just saw yesterday somebody say they order one with a spare cloth liner... I don't see a spare cloth liner available as a product on the website. Maybe should have called in the order.

So the first thing out of the box that this is more moving parts in terms of initial adjustment than the standard cam boot. You adjust the footbase in one of three positions for your foot size. You adjust the back support for calf size (these are harder to pull out although the youtube video makes it look easy). Then you adjust the flexion for whereever you are in your rehabilitation.

This is where it's a bit weird. According to my doctor my foot was supposed to be at 30 degrees plantarflexion. 2 inserts were prescribed for the original cam boot. I never really thought or understood exactly how this 30 degrees was measured so didn't really think about it, until now. I set the vacocast for 30 degrees (setting 3 on the vacocast), and immediately knew that this was way more than what my foot was at. I tried putting the vacocast on at this angle but it just seemed too much/impractical (toe pointing so much down) considering my foot basically felt flat in the original cam boot. Even at 20 degrees it seemed like too much. At this point I had other things to do so I put off exploring this issue until later.

Later, I retried putting the vacocast on with the 10 degree setting. In this case I was just testing out the adjustments, so I didn't have the large curved base on the vacocast but 10 degrees felt the same as the original cam boot.

That makes me wonder if I spent too much time at this angle, or what the effect is/will be.

In any case, I plan on showing the two to the physical therapist tomorrow, as well as trying to drop by the doctor's office (in the same building) to show and get advice on the flexion setting for where I am at today (I don't want to wait 2 more weeks to my next doctor appointment, and I certainly don't want to go to the vacocast 30 unless this has to do with adding full weight bearing, which I am currently not doing, just some partial weight bearing).

Right now there is no immediate comfort difference (just sitting with leg elevated in the vacocast) but this could be because I've gotten used to the original cam boot.

Day 39: Time to start exercising again.

Time to lose weight (again). I've been doing some exercise, but nothing regular and there's really no excuse for that considering I've had time on my hands.

Day 37

Day 37, March 9, 2012: First full day back at work, Vacocast ordered.

As mentioned, took Thursday off because Wednesday having been the first full day "upright" was just too much. But being back at work with the "team" was refreshing and really just want to get back to "normal" (again one of those things you'll have to cope with).

Friday went by ok, until the end of day when hanging out (our company has on site weekly happy hour) on crutches for a while, was definitely ready to go home and get the leg elevated at that point.

But even after only a couple of days with the boot, I just couldn't see myself being cooped up at the fixed position in this boot for weeks to come, so I caved and ordered a vacocast pro today.

As mentioned previously, when the cast came off I was given a prescription for physical therapy... after two weeks. Likely several Achilles bloggers, that just seems too slow. I at the very least want to start attempting to test my body to see if it can start sooner. It'll take a week for the vacocast to get here anyway, so we'll see.

Day 34 Cast off!

Day 35, Wednesday March 7, 2012: Cast Off!

My nice blue cast comes off... As mentioned I had been anticipating this day since I was "looking forward to the boot", the next concrete progression, etc.

Since other people blog about being anxious of the tool that is used to remove the/a cast (a small circular saw type device), don't worry. First the person removing the cast should explain that 1) it makes noise (well the vacuum attached makes the most noise) and 2) it doesn't cut skin... at best (worst?) it may be ticklish. I've had previous experience so the saw part was not an issue. The bit of apprehension was the manipulation of the leg and the final prying off the cast... I find I'm now very sensitive/apprehensive about it moving/the threat of it moving even if it's not actually hurting. It's a weird feeling.

The cast was removed and I got to take a picture of my ankle which I had neglected to do when the cast was put on (at that time my ankle was much more swollen despite keeping it elevated almost all the time). The ankle was less much less swollen than the last time I saw it, so that felt good, but it was still swollen and just seeing and not being able to move it was also kind of depressing. Despite knowing that no matter what it's a long road to recovery, it is difficult to be optimistic. I guess the main point is ok to be realistic, just don't get depressed/down. Chin up and all that!

Cast off, stitches out, boot...

So the my surgeon comes in to see the ankle for the first time since surgery and to remove the stitches.  Either I had gotten over my apprehension by trying to move my toes/foot while waiting for the doctor, or (some) doctors (and massasseurs!) somehow know how to hold/handle another persons body without making them apprehensive if not even making them more relaxed. So it was and she replaced the stitches with buttefly type bandages saying that when they fall off on their own then their job would be done by then.

I had emailed the office earlier about getting the Vacocast instead of the fixed cam boot but apparently she had not gotten the email since I only received a confirmation phone call later that evening. So at the time of prescribing the boot she had not gotten the information link to their website and was not familiar with it. So she gave me a prescription for a cam boot and physical therapy and told me the former was on the first floor and the latter on the fourth floor and said she'd see me in 4 weeks. (April 3, 2012).

So now need to go into a side rant on the boot and medical insurance. First off, I know, I am lucky to have medical insurance in the first place. This type of injury in the US for somebody without insurance can be financially devastating.

So I went downstairs to the "Orthotics Center" and they said they are not in my insurance's (Blue Shield) network. They said I'd likely be footing (sorry) the full bill if I get the boot from them, and provided two other places in the city (San Francisco) that were in the Blue Shield network... So there I am with my foot exposed (like I said above I was very apprehensive about any "threat" of movement so this made me very anxious and pissed, and they are telling me to go across town to get the boot. I don't know what the story is, why this "center" in the building wouldn't be in the Blue Shield network when the surgery clinic and physical therapy center are (they are all part of the same UCSF Medical Center as far I know but apparently somehow managed differently with respect to insurance coverage).

While I'm ranting, I'm also perplexed that the front door of the building has an automated door but the Orthotics center does not. Not only that but the staff weren't about to get up to help me (and others I saw) navigating their relatively heavy door (for somebody who is on crutches or other issues). They left it to passer by's or patients/friends of patients to help people with the door. Really? And this was also true of the Orthotics center I ended up at as well. They also had a large heavy door and the people at the front desk made no effort to assist people coming in and going out. Strange.

Anyway, just seems like it's something that you shouldn't have to worry about, go across town for. Can you tell I'm a Canadian?

So I went into work after this and ended up attending a meeting that went on for about an hour. With the foot being down all day for the first time in a long time, by the end I was very uncomfortable and just had to seek out a lounge/somewhere to get my foot elevated. Decided that it was probably too early to try and repeat that again the next day so stayed home. But went in the next day and managed to get in a full day with only really getting uncomfortable late in the day after standing up for a while on crutches (but those are supposed to be separate daily blog posts aren't they?-P).

Das boot:

The best thing about this is having the ability to remove it to wash/just let it all hang out. What a relief. Both my legs have atrophied. Very little if any real muscle tone in the left leg now!-( Amazing how fast this happens.

Day 21 - Day 33

Achilles Rupture catchup

Not surprisingly, didn't get into the habit of updating. Guess I need to access this on the iPhone.
(see http://support.google.com/blogger/bin/answer.py?hl=en&answer=41452)

Day 21, Wednesday February 22, 2012 - Day 33, Tuesday, March 05, 2012

Not too much to report in this period. This was mainly time spent waiting for cast to come off on Day 34, which I'll make a separate catch up post for.

Main issue during this time period was the difficulty with feeling bound to bed/keeping foot elevated. Although not "painful", the feeling is more "uncomfortable" to the point of just not being able to tolerate it knowing that fully elevating the leg provides relief. Still prevents sustained work in a sitting (or upright in general) position even if leg is elevated to waist level. Very frustrating.

This time was mainly spent in anticipation of the cast coming off and going to a boot...