Yes, Virginia, there IS life after surgery!

Well, it's been a few months since I posted here - and the good news is that's because I've been so ACTIVE that I haven't had time!  I finished my physical therapy in March, and continued to stretch and walk and do some of the exercises I learned there at home.  (It's July now and I still do the stretching and walking part.) 

Here's the good part - and I will post a photo which pretty much says it all:

At the Eagle's Nest summit in Germany, June 2011

We just returned from two weeks in Europe, and we walked an average of 4 hours a day - up and down mountain trails, on rocks, on cobblestones, you name it.  Not only did my ankle hold up well - it actually felt BETTER the more walking I did.  Absolutely no swelling, and very little stiffness (though it does still feel stiff and slightly sore when I get up each morning). 

Nine months out, here's my status:

• The scar looks OK.  I mean, it's not pretty, but I wouldn't call it disfiguring.  It's obvious I've had surgery if you get to looking at it, but it's not something anyone would notice right away.
• My left ankle (the one with drama) is 1/2 inch thicker than my right ankle.  But since the thickness is around the back, it's not noticeable from the front.
• Due to this thickness, I have to be a little more careful about the style of shoes I wear.  For instance, those cute "Roman-style" sandals with the strappy ankle and back?  No way! But stilletos?  ABSOLUTELY!
• My left leg is still weaker than my right, but I see slight improvement as each month goes by.  The left calf muscle is nearly back to it's original size, but it simply isn't firmed up like the right side. I can really tell a difference when I squat down and then try to stand back up without using my arms.  I mean, I can do it - but it ain't pretty. 
• The worst thing about this whole ordeal is that I've gained about 15 pounds over the course of the year I've been dealing with this injury.  I expect to be able to walk this off, but considering that it's July in Texas, and the outside temps are over 100 every day, and start out in the muggy 80's even at 6 am - I'm probably going to put off that hot and heavy morning walk for a few more weeks.  I am confident though that I can get this weight back off.

One trick that seems to work well as I walk around - and something I did which really helped get me ready for all that vacation walking - is that instead of defaulting to that limp which seems to shorten each step (hard to explain, but it seems like my left foot's range of motion is inhibited), I make a conscious effort to push through each step from heel to toe on that foot.  Hope that makes sense.  I mean, my left foot WANTS to stiffen up and create a shortened step and consequent limp, but I make myself "roll" through the entire step - and this has really helped me overcome a noticeable limp.  Ask your physical therapist about this - don't just take my word for it.

Keep the faith!  Keep your physical therapy appointments!  And KEEP WALKING!

26. And you thought torture was against the Geneva Convention...

Take a look at what fun I've been having in physical therapy. Imagine that you have a large, bumpy, tender scar on the largest tendon in your body. Now - imagine someone forcefully scraping a stainless steel instrument the size of a butcher knife up and down that scar, with the sole purpose of "breaking down scar tissue." Good times...

http://www.youtube.com/watch?v=FDm4KUbbi9I

Welcome to the world of physical therapy - and the Graston Technique.

I'm slapping my jaws about it, but the reality is...I think it works.  It's a bit too early to tell for certain, but I think I can see some improvement after two of about ten sessions I'm scheduled for.

I started PT this past week and have been twice.  The first time was basically an evaluation.  Good news on that front - I'm healing very well.  In fact, my range of motion is EXCELLENT - so - that shows that all that gentle stretching I've been doing has paid off.  One less thing to worry about.

Apparently my marked limping is not due so much to the tendon as it is to my weakened calf and ankle muscles.  I can buy that.  I wore some form of a boot or a cast for nearly 8 months - that right there will weaken your leg significantly, even without surgery.

So - the great news is that the tendon itself is completely healed.  YAY!  Now - two problems still exist.

1.  The scar is very raised and bumpy, which is not good if I ever want to wear cute shoes again.  Which I do.  So - we've got to minimize that scar.  Even if it wasn't for cosmetic reasons, a scar that is swollen and uneven can cause undue stiffness, so it's gotta go.

2.  My entire left leg is very weak.  This creates balance issues, as well as all sorts of aches and pains that come with favoring my right leg.  So - gotta strengthen that leg up.

The leg strengthening thing is easy - though tiring.  Basically, it's just a lot of different exercises meant to strengthen my calf and ankle muscles.  They actually feel good and even after just two sessions, I can tell a difference.  Of course, I'm doing some of them at home as well.

That scar stuff?  DIFFERENT STORY.  The Graston Technique is, quite simply, very painful.  This is coming from a woman who had four kids without anesthesia!  When I say something is painful, I mean it.

It does make sense though.  If you've ever had therapeutic massage, you know that the therapist often uncovers sore knots in your muscles.  This is part of what is worked on in the Graston technique, and though it's tender and can be painful, you know it's doing some good.

The sucky part is when the therapist starts scraping, rubbing and bearing down on that Achilles tendon and scar.  OUCH OUCH OUCH OUCH OUCH OUCH OUCH.  She kept saying to me, "You doing ok?  I need you to talk to me.  You ok up there?"

Finally I gasped, "Stop.  Listen.  I can't carry on a conversation with you going to town on me like that."  She said, "I can stop, or ease up if you like."  I twisted around and looked at her and said, "Let me ask you something.  Will this be over sooner, in fewer sessions, if you just have at it and I suffer through it?"  "Yes," she said ruefully.  I sighed.  "Then tear the roof off the sucker.  I want to see light at the end of the tunnel!"

So off we went into Agony Land. 

THIS BETTER WORK!

25. January update - three months out from surgery!

Well, it's been awhile, so I figured I better update this blog and give out a little more sunshine and light for all you Achilles Tendon Injury Sufferers.

To summarize - things have gone very well for me.  October 15, 2010 was the surgery.  My cast was removed in just a few weeks and replaced with the biggest boot in the history of mankind - an instrument of torture that I grew to hate with every fiber of my being.

But right before Christmas, I was liberated from DAS BOOT, as we called it around my house.  At that point, my doctor told me that I was not to do ANY sort of exercising other than gentle stretching, and walking carefully in flat shoes, resting whenever I felt pain or had swelling (which I did through the first few weeks of January).

I've noticed a couple of things.  First of all, though the scar has healed nicely, my tendon is still significantly swollen, so wearing any sort of shoe that puts pressure on the back of the ankle is impossible.  I didn't realize that even most athletic shoes put a lot of pressure on that area.  So - I've invested in several pairs of clogs, which are fine in the American South - just throw on some cute woolly socks and you're stylin'.  I have also found that I can wear loose, soft boots - but no heels, and no shoes with any sort of stiff material around the back of the ankle.

I've also noticed that once I get up and walking, my ankle doesn't hurt much - but notice that word "much."  One dissappointing thing is that three months out of surgery, I still have constant, albeit dull, pain in that pesky tendon.

The biggest frustration for me right now though is that I still have a limp.  It's lessening, but still definitely there - and if you've ever walked for long with a limp (and I'm sure most of you have at this point!), you know that this eventually causes all sorts of other aches and pains - tricky knees, an ankle prone to twisting, and even a stiff back and neck.  So yes, I've got all that going on!

So where's the sweetness and light?  Here it is - I AM OUT OF A CAST, OUT OF A BOOT, AND WEARING TWO MATCHING SHOES AND WALKING.  Considering that some of these recovery times for this injury and surgery can drag on for up to a year, three months out I'm feeling pretty dang good about everything!  Next post - physical therapy, because that's what's now a big part of my final stretch of recovery.

24. WARNING WARNING WARNING - FRUSTRATION AHEAD!

I got to thinking about everything and I realized that in order to be completely honest about this whole venture, I should talk about what I am beginning to think is inevitable emotionally - frustration and even depression.

My surgery was four weeks ago, and I returned to work two weeks ago.  Objectively, I know that I am slowly but steadily healing, and that one day my life will be normal again.  At least, that's what I believe, and the odds are definitely in my favor.

But...I gotta warn you, disability is frustrating.  I am SO SICK AND TIRED OF THE CRUTCHES AND THE ROBOCOP BOOT.  I am tired of sitting on my flabby butt being inactive.  I am tired of not being able to clean my own house (and I'm a neat freak).  I am tired of everything being a struggle.  I'm tired of being bored.  I'm tired of my house.  I'm tired of not being able to shop without it being a major hassle.

I am tired of not being able to wear two shoes!

My leg and ankle are weak and pathetic.  My tendon is swollen to twice it's normal size.  On the bright side, the scar itself is not shocking or distracting - I think within a few months it will be nothing more than a small white line down the back of my ankle. 

But I think the hardest thing for me to deal with is the solicitude of others.  Now isn't that weird?  But I hate to be dependent on others.  I hate asking people to do things for me.  I hate, hate, hate being a burden!  When I'm at work, I hate worrying my customers, who are inevitably alarmed when they see the crutches or see me get up to help them.  Oh, how I hate the clumsy, painful limping along on crutches, and the sympathy that pours out of people!

There - there's my rant. 

I have to remind myself that I was in pain BEFORE the surgery - and things were getting worse, not better.  However, that's hard to remember at this particular point - when I am MORE disabled than I was before the surgery, and I have months to go before I am recovered enough to resume life as I knew it before.

This achilles tendon injury and surgery are exactly what I said they were - DRAMA, DRAMA, DRAMA!

One thing that has been very helpful is that I can track this same set of emotions on other blogs - and the vast majority of those bloggers eventually report excellent results - after many months of rehab.  And I have read as they hit this same wall I'm hitting now - and lived to tell about it.

If you're struggling with this, also - KEEP THE FAITH!

23. Gettin' jiggy wid it!

Well, well, well - good news and bad news.  The good news is that I can tell I am regaining strength in my ankle and calf, and I'm able to put weight on it without cringing - though at this point there's still so much swelling that I can't imagine ever putting that gimpy foot back into a regular shoe!

The other good news is that the incision is healing very well.  The top of my foot is still numbish and tingles if I stroke it - and it seems to be the type of thing that could very well be attributed to the tourniquet that was used in surgery, as Dr Langford said.  This could take months to correct itself - and may not ever be 100 percent fixed, but I can live with that.  But back to the incision - it's a nice, straight, pink scar - not too bumpy, but still definitely tender.  The achilles tendon itself remains quite swollen - roughly twice as thick as the one on the other foot.  UGH!

And all these years I've been a bit vain about my nicely tapered ankles.  Now I only have one nicely tapered ankle!

Every morning the swelling has receded, and every evening it's back in full force.  I have a feeling I'm going to be battling that swelling for months to come.

So the swelling and tingling are the icky news items, but one more good news item is that my ankle seems pretty mobile.  Overall, I'm definitely seeing improvement.  Not every day, but slowly over time.

Another thing that's improved is that I'm getting quite nimble on these crutches.  The key to crutches is to rest your weight on the HANDLES - NOT the pads under your arms.  If you rest on your armpits you will hurt all over.

One ominous sign when it comes to the length of recovery time - my doctor gave me a six months handicapped placard for my car - and I'm beginning to believe I'll need every day of that. 

I have a doctor's appt Wednesday - so I'll update this again then!

22. Twas brillig, and the slithy legs did gire and gimble in the wabe...

Oh, frabjous day, calloo, callay, I'm chortling in my joy!  I went to the doctor a couple of days ago and I am out of the plaster and gauze cast and into a boot, which allows me to (very gingerly) put a little weight down on my foot!  This is important for several reasons:

1.  It makes walking on crutches a LOT easier.

2.  I can get my leg wet.

3.  It will allow me to use the leg in a limited manner, which should decrease the atrophy of the leg muscles.

Yes, I said atrophy.  Take a gander at the difference in the size of my legs - in just two weeks!  Now - I realize that neither of my legs actually qualifies as "scrawny," but...there is a definite difference between the two:

So - as much as I've appreciated my knee scooter, I'm retiring it for now.  I've found that walking with crutches, while still maddening in it's own way, is not quite as scary when you can bear a bit of weight on the gimpy foot, and I can't help but think that using that leg will offset some of that scrawniness.

The rest of the good news is that my tendon is healing very well, better in fact than average.  This is VERY exciting to me because achilles tendon injuries and surgeries are notoriously bad at healing well, because blood flow to that area of the body is not good.  The fact that I'm healing so well so far has me thinking that my rehab will probably go well when I start physical therapy in a couple of weeks. 

When the doctor took off the plaster cast and unwrapped my leg, it looked AWFUL!  I will spare you images of the abomination of the desolation, and will just use mental imagery instead.  My leg was shriveled, wrinkled because of the gauze wrapping and muscle atrophy (sorry, but I'm used to firm, tight calves!), orange from the iodine wash they used during surgery, and (this was the WORST PART!), HAIRY. 

And then I got a look at the scar......

OK, I have to admit - I'm going for effect here.  Actually the scar itself isn't as bad as it looks - the black stuff is glue.  My totally cool doctor used glue rather than stitches or staples.  So in spite of the grody look of it, this scar is actually beautiful.

21. Warzone photo

Thank you, Dr. Langford, for following my expert instructions so well!  And thank you for sending me this photo - it's always nice to be validated.

OK, seriously, I feel that I was very blessed to be a patient of Dr. Langford.  He has a rock solid reputation in this area, excellent bedside manner, and - most importantly to me (though I admit this is not usually a high priority for most people) - he has a great sense of humor.

GO, DOC!