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Sew Happy Together! (Achilles Tendon Rupture – Part 3)

Posted August 18, 2009 6:00 AM by ShakespeareTheEngineer

It was like sewing two mop heads together.

As I awoke from the anesthesia, my surgeon, the very talented Dr. William O'Connor, told me that he was admitting me for the night even though the procedure had been scheduled for day surgery. Under the influence of pain killers such as morphine, I was amenable to just about anything. But as so many CR4ers know, curiosity dies hard. I had questions. First, why was I staying in the hospital overnight?

Warning: The Following Contains Graphic Material

My ruptured Achilles tendon ranked alongside the worst orthopedic injuries that Dr. O'Connor had ever seen. The operation had involved entering my calf with surgical pliers and pulling one end of the Achilles down so that it could be sewn, fiber-by-fiber, back together. Dr. O'Connor likened the procedure to sewing two old-school mop heads back together, one strand at a time.

He expected me to be in a great deal of pain because it was a relatively traumatic surgery. With my leg immobilized, I felt okay - but I wasn't arguing. The pain did come, but mostly from swelling. Once the anti-inflammatory drug Tordol was added to my intravenous (IV) regimen, I was fairly comfortable but groggy. Some mild complications kept me in the hospital for three days.

Pointed in the Right Direction

When I was finally discharged, it was back to the splint with toes pointed all the way down. I also had strict instructions to keep my foot elevated, to keep all weight off it for six weeks, and to try really hard not be an idiot. My wife smiled knowingly, as I had struggled to follow these types of instructions four years ago when I had knee surgery. And I had paid the price then for my disobedience.

If I behaved now, I could drive as soon as I felt up to it (the injury was to my left leg) and return to work as long as I kept up with the most unenjoyable part of my recovery: twelve days of self-administered Lovenox injections in my abs. (Lovenox is an anti-blood clotting medication). I was told to expect bruising all over my abdominal muscles by the time I was done. I lucked out, though. The Lovenox injections were painful and burned, but there was no bruising.

Life on crutches was tough to get used to, but not as bad as many people have it after knee surgery. Fortunately, I could bend my knee to position my leg in a way that kept me comfortable. I spent several days in a recliner and then graduated to a pull-out sofa. And despite a trip over a curb that forced me to bring down most of my weight on my left leg (and sent the edges of my vision gray), I did as I was told. In two weeks time, it was my turn for suture removal. It was also my first look at the incision (via cell phone picture) and time to pick a color for my new fiberglass legging.

Up Next: Casting Call (Achilles Tendon Rupture – Part 4)

Related Readings (please note that hyperlinks will not work until future blogs are posted):

Part 1 - My Achilles Heel - Achilles Tendon Rupture
Part 2 - To Cut or Not To Cut? Not Even a Question!
Part 3 - Sew Happy Together
Part 4 - Casting Call
Part 5 - The Process of Getting a Handicapped Parking Permit
Part 6 - The Orthopedic Boot(y) Call
Part 7 - I'm Going to Rehab
Part 8 - Preparing for the Breast Cancer Run
Part 9 - Results from the Breast Cancer Run

Resources:

http://www.mayoclinic.com/print/achilles-tendon-rupture/DS00160/DSECTION=all&METHOD=print
http://en.wikipedia.org/wiki/Achilles_tendon
http://en.wikipedia.org/wiki/Orthotics
http://en.wikipedia.org/wiki/Achilles_tendon_rupture

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#1

Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 9:54 AM

All I can say is: ew.

I am convinced not to hurt myself like that ever.

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#2
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 10:00 AM

I ran into a guy at the track on Thursday who blew out both of his, one playing basketball and the other? Softball. Better be careful when sprinting out of the batter's box when you are playing for the GlobalSpec Shockers, there, Jaxy.

Next week will deliver an incision pic!!!

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#3
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 10:06 AM

>.< Don't tell me that!

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#4
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 10:12 AM

Just remember the warning signs/risk factors that I posted in segment #1:

Most often, an Achilles tendon rupture is the result of poor conditioning, a health condition, or inadequate support of the lower leg. In my case, I fit several of the caution areas, but realized this too late. As I reviewed the risk factors and evaluated my own case, I learned that rupture can stem from overuse, running on hills or hard surfaces, tight calf muscles, poor stretching habits, weak calf muscles, worn or poor-fitting shoes, and/or flat feet.

Part 1

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#5
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 11:38 AM

You know this is one of those injuries that gives me that "weird" feeling when thinking about it or imagining it happening to myself. I almost feel nauseous.

This morning, as I do twice a week rather than "normal" cardio I run sprints outdoors. Thankfully your injury never crosses my mind at that time. If it did I think I would stay indoors and opt for the elliptical instead all week.

But I do not have any of the warning signs you mention for a Achilles injury. The worst I have suffered sprinting is a slight hamstring pull, due in part to cold weather and not warming up sufficiently before sprinting.

Just the same I am fortunate not to have gone through what you have and hopefully I will never know the experience. I wish you a healthy and happy recovery.

Not sure if I want to see those pics you mentioned either.......

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#6
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 1:11 PM

I think warm-up and hydration is key. I have always had tight calves, and have prone to cramping in them. And while my stretching habits have improved, some days I just want to throw on the cleats and go play.

I will admit that after running and coaching track, the thought of one of them popping was nauseating. The pain hasn't been nearly as bad as advertised. Immobilization was the key. That ended 85% of my pain.

The pic isn't that gruesome. I took it with my cell phone, laying on the doctor's table, so the resolution is fairly poor. Maybe I should give it to Mello to fix up.

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#7
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 1:15 PM

Please don't give it to Mello! She will do too good of a job on it!

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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 1:19 PM

See...you don't want to look, but you know you will. Print it out next week and I will autograph it for you!

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#9
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 3:02 PM

I'd be happy to make your injury look more gruesome! ;^D

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#10

Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 3:48 PM

please don't post the pic! i get nauseous thinking about the incision. i know i will not look when he takes my stitches out.

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#11
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 5:30 PM

It really isn't gruesome at all. It is just a dark line. Unless Mello can spice it up, of course.

I was expecting to be totally sickened by it, but it was actually confidence building in that it didn't look like that big of a deal and that I could definitely get through it.

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#12
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 5:37 PM

that's good to know! i've seen achilles surgery scars before & they were gross! btw - i asked my doc to prescribe me valium & he did. so, i'm hoping that is helpful.

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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 5:49 PM

It did wonders for me. I was on Tordol while I was in the hospital and that was the best. All the pain was from cramping and inflammation.

Scar management is really important when you get your cast off. I also made fists with my toes once I was in my cast and flexed them up and down. Pretty soon I'll post a pic of my scar. It is long, but really thin and it looks better than any other one I have seen pictures of online.

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#14
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 5:56 PM

ok, i'll do that. i'm going to do everything i possibly can to recover completely.

i'm hoping the valium helps me sleep. that has been a total nightmare for me! my pain comes mainly when i crutch and when i elevate with my leg straight. i either have to be on my stomach or on when on my back, my leg needs to be turned to it's resting on the ankle bone instead of the incision.

if you say the scar is not bad, i believe you and will look. the scar i have from the ligament surgery sounds like your achilles scar...just a thin line.

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#15
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 6:04 PM

I was like that, too, for a while. The nurses commented that it was interesting how I slept on my side but I was just keeping pressure off the incision. Once I was in the cast, it was more protected and more comfortable.

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#16
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/18/2009 6:17 PM

that's good to know. i've been sleeping in the position i was operated on, but with my injured leg bent. not the most comfortable way to sleep, but it's really the only way for me. i've never been able to sleep on my back. i never thought i would say this, but i can't wait to get a cast!

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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/19/2009 7:23 AM

While I was happy to get rid of it when the time came, I was also excited to get the cast because it made my leg more stable and it felt more protected. I was much much more comfortable in the cast as compared to the splint and it allowed me to be able to get better sleep.

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#18
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/19/2009 8:43 AM

that's what i'm hoping for. right now, i'm so afraid i'll bump my leg.

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#19
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 10:16 AM

Scar management is really important when you get your cast off.

I have been told that Bio-Oil works really well at reducing even old scars. I think it should be available in the States.

(I can't use it - it actually makes my arthritis worse: no surprise there really - so far the anti-arthritis drugs I've taken make my arthritis worse! Apparently the next step is self-administered sub-cutaneous injections...for life. Oh joy! Still, I keep telling myself that diabetics do it, so I should stop being a wimp.)

Good luck to both of you in your recoveries (a bit late, just found the blog).

I've also heard other people say they've used various anti-aging or facial moisturisers that have helped reduce scar appearance. I've tried looking, but can't remember where and can't find the posts (not on CR4!).

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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 10:26 AM

ER,

Thanks for the head's up. I have really creaky joints (particularly my knees) and something that I found that helped lubricate them was a drink called Joint Juice. Its claims have not been verified by the FDA, but since it is not shellfish based and is mainly Glucosamine, Vitamin C and vegetables, I tolerated it pretty well. My only empirical data is that when drank it consistently, my knees hurt less (although I was also working out regularly, too). It might be worth checking out, if you haven't already. It isn't a panacea, but it would sure beat ab injections. I can speak from personal experience on that one!

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#23
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 10:52 AM

and is mainly Glucosamine, Vitamin C and vegetables,

Nooooo. I can't take glucosamine - I was recommended it when X-rays showed a small amount of arthritis in my hip. Within 10 days, all my joints seized up, painfully. Then the fun started - over the next nearly two years, the joints took it in turns to lock up, each lock lasting 2-3 days. Of course, by the time my GP appointment came round: pain gone, movement restored.

I did see a consultant physio about the even longer standing shoulder problem - on a good day. He got me to hold my arm out and he tapped my hand. I know he only tapped my hand, coz my hand didn't hurt. However the pain it caused in my shoulder sent me back a couple of paces, I cried out in pain and clutched my shoulder. When my brain caught up with all the reflex signals, I realised I was staring at him liked a whipped puppy! He just nodded and said now he knew I wasn't faking! Trouble was, physio etc didn't help and I still can't swim (or do more basic movements)

Eventually, a similar thing happened when I got an emergency appointment when the other shoulder locked. The GP caught hold of my wrist to extend my arm and I screamed! He referred me, I eventually got re-referred to Rheumotology, where I'm told I have rheumatism (but not blood markers). I react badly to all the drugs so far and can't take painkillers or NSAIDs. Life's a peach. I just want to get back to swimming and kayaking

Thanks for trying though: maybe this will help someone else - I'm just blessed with a very odd constitution!!

I have to say though, Vitamin C and lots of green vegetables do help. Chocolate makes it more painful...

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#24
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 11:01 AM

Holy cow, that sounds rough. I will keep my eyes and ears open. Since you are already on the trail of dietary solutions and problems, I will pay particular homeopathic remedies that I come across that are glucosamine free.

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#21
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 10:29 AM

that's good to know! thanks for the info. good luck with your shots!

shakespeare - all morning, i've been getting this shooting pain in my leg, i think where the incision is. it's like a nerve pain, almost like when you have a root canal. did that ever happen to you?

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#22
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 10:41 AM

Just a little at the incision site. Are you tweaking it or twisting at all?

I did have some bad shooting pain, I described them as lightning strikes, but it was mostly on the outside edge of my foot, which is where I also had the majority of numbness. I think it may have been my body dealing with the lack of sensation and the swelling.

They passed with time (and became both less intense and frequent in about 1-2 weeks). How long is it before your follow up?

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#25
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 11:43 AM

yes, just at the incision site. i was just laying on the couch, with my 1 year old niece sitting on me. she's tiny. all of a sudden, it felt like lightening strikes (good description, btw) up my leg. since the surgery, that was the first time i felt that sort of pain.

my follow up is on Tuesday, which is when i get the hard cast.

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#26
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 11:46 AM

I would assume it is the same phenomenon. Mine came out of nowhere, usually when I was laying down. I am no doctor, but I would assume that unless they get unbearable or come with some other symptoms like expanding numbness, headaches, or fever, you are just going through the same process that I did.

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#27
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 11:51 AM

ok, good to know. i was just worried that i popped a stitch. thank you again for all the responses to me. you have no idea how helpful you have been! i really appreciate it. :)

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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 11:56 AM

No problem. That is one of the reasons that CR4 and GlobalSpec was interested in my writing this series. This is a common injury and there will be those that come after us that will also be looking for guidance.

Just a warning that I will be on vacation next week, so if I am not answering questions, it doesn't mean that I am ignoring them. I will answer anything that I can once I get back on 8/31.

Hopefully, so other CR4ers will be able to pick up some slack for me as I know I am not the only one who has been through this, here.

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#29
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 12:24 PM

thanks for letting me know! i hope you have a great vacation! going anywhere fun?

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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 12:31 PM

North Carolina's Outer Banks. It should be interesting. Today is my first day off of crutches.

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#31
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 12:35 PM

congrats about crutches! i hear the outer banks is great. i think the waves are pretty good down there this time of year (not that you'll be doing much surfing just yet;)). have fun and be careful walking on the beach. that was always tough on my ankle after the last surgery.

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#32
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 12:37 PM

Thanks. I most certainly will. I have ZERO desire to go through this ever again.

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#33
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Re: Sew Happy Together! (Achilles Tendon Rupture – Part 3)

08/20/2009 1:04 PM

tell me about it!

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