Nov 4 – Day 11 post Achilles operation first appointment. This was the day I was originally supposed to have my cast removed but I had it removed earlier in the week as I thought it was causing my calf pain. I have been in my boot have been zero weight bearing. To get around, I have been using my iWalk 2.0 but for the most part I stay at home hunkered on my couch with my leg elevated. I cleaned myself by submerging myself in my bathtub which is more like a soaker. I elevate my left foot and tie a garbage bag over it to ensure I do not get it wet. I continued to take both the morphine and the oxycodone. Good news is that I was getting sensation back to my foot and toes. I can actually feel them when I move.
The dr. appointment went smooth. It was a challenge to make my way to the doctor’s office but I just took my time. I initially thought that the stitches would melt away but apparently it had to be removed. Just a nip on one end and tweezers on the other end to pry out the sutures did the trick. It did hurt. Surprisingly, there were two total which had to be removed. I thought there were several but that was it. He then used surgical tape to seal the wound just in case.
Next, the doctor cleared me to begin physical therapy. He asked if I had a place in mind and that they had one right next door which I can try out. I honestly didn’t and it was convenient to be able to check out a place right next door so I went ahead and made an appointment. My first physical therapy session was going to be Nov. 14th. One month after the rupture and 20 days post op. Meanwhile, I continue to move my toes to encourage blood circulation and elevate my foot above my heart to minimize swelling.
It was on the Sunday after Achilles surgery when I started to feel pain in my calf. Initially, it didn’t bother me that much as I attributed to the re-engaging of my calf after the repair of my Achilles. However, the pain increased to the point where it bothered me when I rested and when I was on my crutches. I was also using my iWalk during this time to get around the house so I wasn’t sure if that had some contribution to it.
On Tuesday day 5 post operation, the pain became so immense that I decided to call the doctor the following day. I thought it was due to the cast being too tight around my calf. I called the doctor’s office on Wed. day 6 post operations. The nurse asked me how long has the pain been ongoing and I said 3-4 days. She expressed her displeasure that I didn’t call sooner. She relayed the info to the doctor and he wanted me to go see him right away! Normally, I wouldn’t mind going to see him but he was in his other office way out in Anaheim which was about 45 min away! I indicated that I wasn’t sure if I could get a ride that far out. He said he needed to ensure I didn’t have a blood clot and that I had to go to the ER right away.
This was totally unexpected. I didn’t want to incur another ER visit so I found a way and got a ride to Anaheim from a good friend. With just 15 min notice, I was on my way.
I arrived at the office and waited for about 20 min. While I was waiting, I had a conversation with another patient of Dr. J who had bone spur removed from his foot. That’s one interesting thing about orthopedic patients. You tend to feel this sort of camaraderie with others as the physical disability is so visible. I’ll share a bit more about this when physical therapy starts.
When it was decided I had to see a doctor for the pain, I knew the calf had to come off. Prior to this, I had penciled in the first doctor visit, which was another week away, to get the cast removed. I was a bit looking forward to this to see how the scar was and maybe get the cast removed early. I first answered a few questions with the same nurse who took my call then a cast technician came in to remove my cast using this Dremel like tool. There was so much padding that it kept coming out. The color of my foot was actually pretty good. Also surprisingly, no bad smell 🙂
The doctor came in and gingerly removed my foot from the cast. I wasn’t sure what to expect from my scar as this is the first time I had such an incision in any part of my body. At first glance, it looked like how I expected to look. The doctor said it looked really good. There were some slight dis-figuration along the actual suture but it was very straight and no discoloration or swelling.
He pressed on my calf in various areas and inspected it. He asked if I had any pain right behind my knee along my calf. I said no. The pain was more deep down in the main calf muscle. He was relieved and pretty sure it was not a blood clot but wanted me to get a Doppler ultrasound. We had trouble finding a place that could offer this with such short notice but I managed to find a friend whose neighboring radiology center had a unit and was able to fit me in. I never had a Doppler ultrasound but they basically use the sound of blood whooshing through my veins and blood vessels to see if there are any abnormality. The result was negative. What a relief! Another good news is that the doctor cleared me to wear my walking boot and didn’t have me go back in to get another cast.
The time has finally come for my Achilles surgery. I was so anxious to get the surgery done that I didn’t think much about the pain or have time to be scared. I suppose one can worry about issues and risks associated with surgery. I don’t remember the last time I was under general anesthesia. Maybe when I was in college for a colonoscopy. I digress. I just wanted to hurry and get the surgery done and start the recovery and get back on my feet.
The day started at 4:30am. We already dropped off the kids last night at the in laws who agreed to help drop off the kiddos at their schools. Hindsight, it was good the surgery was this early as I didn’t have to worry about any traffic or fasting throughout the day. It took about 45 min to arrive at the surgery center near LAX. We parked our car at the empty lot and got to the registration window a bit before and spent another 30-40 min doing paperwork. I was led into the prep room and gave my wife a kiss. She went to the car to take a nap lol.
In the prep room, I had to strip to my underwear and wear a patient gown. The one where only your front is covered. There were about 3 nurses who prepped me and 2 other patients in neighboring beds who were getting operated at the same time as well. IV was put in and several checks to ensure the right foot get operated. My ID band was to be worn on my wrist opposite of my injury. I was also asked to put an arrow using a washable marker where the injury was on my calf. Another nurse shaved my leg with a disposable razor without any soap. That didn’t go well at all. The nurses did a great job ensuring I was comfortable and chatted among themselves most of the time. The anesthesiologist came in to introduce himself. Asked about my surgery and if I had any allergies. He mentioned that he will put a mild dose of anesthesia into my IV and I should start getting sleepy soon. He explained the nerve block that will be put on my entire leg and that it should last up to 12-48 hours.
Shortly after I was wheeled into the surgical room. I took a quick glance and it was typical, sterile environment. Just a few seconds later, I blacked out.
Next thing I noticed I was in the recovery room with a huge cast on my left foot. I was extremely drowsy from the drugs and my head was spinning. It was just passed 10am and my surgery was a success. Just in time, I see my wife walk in. It was a bit of an odd feeling as I felt almost half asleep but can hear the other two patients in the room seem to have less side effects and ready to check out to go home. I took in some water and spent about 45 min in the recovery room. My bladder was also really full and had to get wheeled to the restroom. As I slowly recovered, the nurse tried to small talk asking about our kids and where we lived. She reminded us to make sure I take my pain meds.
Once I felt ok to be upright, I was wheeled to my car.
Truth be told, I was just getting used to life with just one leg. I was actually scheduled to play in a soccer game that Saturday with my cousin who just moved to the U.S. That was out of the question.
Part of me was glad that I got the adjustable Maxtrax ROM Air Walker walking boot. I didn’t care much about the air pump but it did feel much more secure instead of the soft / hard splint I got at the ER. I was always paranoid about getting that thing wet.
There wasn’t much I could do other than wait for surgery date to be confirmed. We didn’t get any confirmation of the surgery date / time so my wife and I decided to find another orthopedic surgeon. We went with a referral from a friend who was an oncologist. He knew a orthopedic surgeon from his days in medical school. Upon calling the referral, the office indicated that he only worked on shoulder issues and referred me to their ankle and foot specialist. I guess a referral’s referral was better than finding someone blind. Appointment with Dr. J in Pasadena was made for Tuesday.
I spent the weekend at home icing my foot several times a day while keeping it elevated. I pretty much planted myself on the end of the couch with 3 cushions from our backyard patio set. The cushions were much more flat than any pillows on our house and stacked well.
A new norm
With this injury, I had to revise my daily routine which was the most inconvenient part of this injury. First of all, I had to humble myself to accept help from others. This included help from friends, neighbors, relatives, and especially my wife. God bless her. I actually help out around the house a lot from doing chores, grocery shopping, picking up the kids, and even cooking. All this was out the door for the time being. My primary goal during week one was to keep my foot elevated and reduce the swelling – in other words, just sit.
With the iWalk 2.0, I was able to somewhat do more than being on traditional crutches. But I was still very limited. I am fortunate to be able to drive as my right foot is fine but I kept my activity level at a bare minimum. This weekend, I only went to church and that was it.
Taking a shower was also out of the question as I was not allowed to get my splint wet and it was not possible to maneuver myself in and out of the shower safely. I resulted to submerging myself in my bathtub with my injured leg outside the bath. It was very straining for my back and extremely difficult to get in and out the bathtub. Not much choice and I really wasn’t looking forward to doing this for months to come.
The appointment was early at 9:15am. It wasn’t the best time as my wife had to take the kids to school so it was the first time I drove myself since the injury. This wasn’t an issue as my injury is on my left foot and both of our cars are automatics. However, I won’t have the convenience of being dropped off the curb. It was also the first time I had to go at distance with the crutches. I actually had a handicap placard lent to me by a friend as I waited for mine to come from DMV so I thought I could at least park at the handicap spaces near the office. I arrived on time due to unusual traffic and to my dismay, all the handicap parking was taken. I guess it wasn’t that big of a surprise considering it was a relatively large medical office. I parked to the far end of the first floor parking. Hindsight, I should’ve went up another level and parked near the elevator. I gingerly made my way off the car and onto the crutches.
I struggled. I was out of breath and my armpit was tired from making my way from the parking lot to the medical building. As I entered the medical building, I realize the medical office was across the building! I then made my way for probably another 120-150 feet. Combine that with the parking, I probably traveled an industrial block on my crutches.
I signed into an office decked out with sports memorabilia such as signed jerseys and team photos of college and scattered professional sports players. Seems like this place had a high profile clientele. After about 20 min wait, I was called in by an intern probably from USC or UCLA. There were actually a number of interns staged in the back reviewing the patients for the day. I was asked basic questions about the injury, my current pain level, age, and general health questions. After about 10 min, the orthopedic doctor came in. He was a young Asian doctor who was probably the same age as myself. Maybe a bit more. Hard to tell with Asians. He was very emphatic and walked me through the available options. He was very honest about the conservative options to the most progressive treatment available at the moment. Conservative treatment was to not have surgery but set my foot at a steep angle so the tendon will fuse together. He said even for full ruptures, it can heal by itself although it will not be as strong. He also explained the most progressive option which was a new treatment where he opens a small incision to tie the tendons back together. However, it came with a comparatively high risk of nerve damage. The benefit would be a short recovery time. The most common treatment would be to make a large incision and tie the tendons back together. Without any pressure, he said he performs this operation the most and considers it very low risk with a high success rate. I agreed. I had to work with his surgery scheduler to see when I could be fit in. He led me to an in house x-ray room to ensure I didn’t have any structural damage. After x-rays, I was fitted into an adjustable Max Trax walking boot and off I went another city block back to my car.
Day 3 of my Achilles rupture was uneventful which I imagined. I just needed to get the result of the MRI and proceed to find an orthopedic surgeon which was in itself a challenge. I had never shopped for a surgeon before. The previous surgery I had was through a medical group where I was not afforded to select my surgeon. Everything worked out and it wasn’t a major surgery so I wasn’t too particularly concerned. This time it was different. I received a call from my chiropractor who notified me that I had a FULL rupture, not a partial tear. My mindset changed a bit. He reminded me that I am now a candidate for surgery. Whatever hope of conservative recovery option of non-surgery was likely off the table. I was planning on having surgery anyway but now the question is when. Most information I read regarding Achilles surgery indicated that the best time to have surgery was within 2 weeks. Below is not my MRI but this is similar to what I saw. I’m unable to extract my MRI without the proper software / device.
My chiropractor gave me a three names who he highly recommends and I went ahead and called them. Out of the 3, I was only able to reach the office of one of them located about 15 miles away. A bit further away than I would like but nonetheless I didn’t have much of a choice. They proceed to tell me that the next available appointment was the following Thursday. I dropped my chiropractor’s name and they fit me in the same Thursday. The first orthopedic appointment is booked.