text: Lots to share over the last few months. My last post described some really difficult pain I have experienced as well as an unwillingness by the doctors to help figure it out. Well, i have answers now. After pushing the envelope by going to the Hospital’s Ombudsmen dept, I finally got the surgeon’s attention and the PA removed from my case. It led to a referral to a pain mgmt doc and a neurologist for an EMG.
  The outcome is that the anesthesiologist damaged a nerve when administering the nerve block just below my knee right before my surgery. Fortunately, it didn’t totally sever the nerve, so it should regenerate over the course of a year. The damage has caused ongoing electricity like pain in my foot and toes, lack of feeling in my calf and top of foot and dramatically impaired movement in my toes and foot from an active perspective (near paralysis for 6 weeks). My PT was instrumental in identifying the issues as I had not progressed in active ROM in that length of time. So, reading some of the comeback stories on here was difficult as i had been held back by the complication and lack of doctor attention.
  At this stage, i’m on a drug called Neurontin to treat the neuropathy which is helping manage the pain very well. It does have side effects which aren’t too bad though. I also started thinking about what else I could do to help- so I shifted to certain foods (plant based and more natural diet) and away from others (alcohol and my typical grease fare) to try to supplement the body’s efforts to heal. I’ve also found a freedom in the actual diagnosis so i can let go of the uncertainty and daily pain and move toward a positive attitude and convincing myself of an eventual full healing (mind over matter!).
  All of these things in combination have me in a much better place. My last month, in fact has seen a dramatic turnaround in my PT. I have now begun being able to engage my toes again partially and my foot is now actively at neutral ROM. I have lost my cane now and am able to walk without a limp. I still get significant swelling in the ankle each day, but my progress the last 5 weeks has been huge.
  So, hopefully my story can be a source of info for some.
  Posted in Post-Surgery | 2 Comments »
  11 weeks Post-Op: Pain, Shoes and Doctors disinterest
  Posted by terencemc on May 6, 2014
  Well, it’s been an interesting few weeks. I’ve made quite a bit of progress in PT yet my pain in the foot persists and what I wouldn’t give for a 7 hour night of sleep!
  First off, I should report I’m now done with crutches, just lost my boot yesterday. So, i’m in two shoes, the left (recovering) one with a wedge in it. This is great and exciting as I feel like i have much more freedom now, even if i have a substantial limp.
  Also, on the positive front, my Achilles feels great. My passive ROM is beyond neutral and it feels more and more normal each week.
  On the downside, since late March (5-6 weeks now), I’ve persistently experienced burning, stinging, "shocks", numbness and other pain in the foot. In recent weeks, it seems, although unconfirmed, it seems to be hindering my ability to progress with my Active ROM. So, I can’t "pull" my foot any closer to neutral than I was 3 weeks ago. I’m also, for the last week, experiencing a gimby big toe on that foot. By that i mean I can pull 4 of the toes up, but that one i can’t control. It just flops there. So, my walking is odd in that I feel the foot flopping on the ground with each step.
  My PT is concerned and referred me back to my surgeon, who has no interest in seeing me as he is just saying "nothing happened during surgery to cause this." So, he’s pretty much washing his hands of it. I’m sort of at a loss with where to go next. my PT is saying it’s "beyond the scope of what should be normal now" and that I should be seen, but who should I see if not my surgeon?? it feels like nerve pain, but seems so obviously connected to my surgery/injury recovery. So, that part is rather frustrating these days as I fight through.
  Posted in Post-Surgery | Tagged: limp, nerve, pain, twoshoes | 7 Comments »
  44 days, but who’s counting?
  Posted by terencemc on March 25, 2014
  Today is 44 days since the injury.. 34 since surgery. Here’s where I am..
  I am in my Vacocast boot and, as of last week, "50% weight bearing". So, I can put no more than half my body weight on the leg. I’m finding getting anywhere near there ridiculous given they still have my foot pointed downward in this boot and I’m at least 3-4 inches different in the injured leg due to the boot height. I am FINALLY going back for a second PT appt. Two weeks ago was my first and i’ve been doing a series of 8 stretches each day including plantar flexion, ankle/foot inversion/eversion, ankle plantar/dorsiflexion, straight leg raises, hamstring stretching, hip abduction, straight leg raises, and long arc quad…. my hamstring hurts from the stretching so i scale that back and the stretches of the foot are about 4 times a day so it causes pretty regular discomfort.
  Throughout the day, I’m still regularly feeling the blood flooding into my foot which causes it to swell against the boot. So, I tend to take the boot off alot during the day and elevating. i wore compression socks a couple days and that helped mitigate that somewhat.
  Today’s PT will undoubtedly involve measuring the ROM at this point I find that I have increased this a bit, but still feel a firm pulling of the repaired tendon and also a pulling in the bottom of my foot up below my toes. That’s a weird feeling. My blister issues from last week are resolving (thankfully). As for my surgical incision, that is healing pretty well. I am down to three band-aids over the remaining scabbed parts of the cut. I can see I’ll have a good scar, but that’s fine if this holds together long term. Based on the timeline from last session, i should be about two weeks away from full weight bearing….
  One note about the Vacocast.. I do like it better than the aircast they originally gave me for many reasons… However, the phys therapist is clearly flustered with the lack of knowledge about it and I feel like it kind of gets in the way as he doesn’t know what to make of it, so he’s getting hyper conservative (or did last week). Let’s see if that changes at all today.
  Mentally, I’m extremely frustrated. I own my own business and I had to miss a conference in NYC this week due to my lack of confidence being on my feet for 2 straight days schmoozing in an exhibit hall. Also, missing out on countless things with my kids, not being able to walk my dogs, etc is all adding up for me right now… I’m in a place where it feels like this is lasting an eternity. As my grandmother always said, "this too shall pass". i know i know…
  Posted in Uncategorized | 2 Comments »
  PT and PWB
  Posted by terencemc on March 19, 2014
  I feel like my doctors are much more patient than I am. Nevertheless, I am finally on "PWB" as of this Monday and for me that means up to 50% of my body weight on the injured leg but keeping my crutches. I also am faithfully doing my at-home stretches as per my Physical therapist.
  Here’s what i’m learning.
  When I do my foot stretches to move my foot back toward flat, I feel all kinds of things happening in my leg and foot. Pins and needles in my foot, muscle pain in my calf (finally it’s re-engaging!) and other niceties.
  My goals in PT are very gradual. For instance, I need to do my stretches to get me 1 degree closer to flat each day. That means 3 weeks of PT will get me to flat foot from 20 degrees PF (1 week in now).
  The pain isn’t over yet. Neither is the need for elevation.
  My next PT appointment is Wednesday next week. Hoping the progress I’m making continues.
  Posted in Post-Surgery | Tagged: goals, plantar flexion, PT, PWB, stretches | 3 Comments »
  Cast off, Boot on
  Posted by terencemc on March 6, 2014
  Had my first post-op appointment a few days ago and it was pretty great getting the cast cut off. It was my first look at the incision site and it was also the day to get the stitches out.
  The cut looks pretty well healed. It was funny though because it literally looked like a 6 inch zipper on my leg. But, the stitches didn’t pull at all in my 2 weeks post op and everything seems good. I shared with the doctor my pain experiences from the previous two weeks and was comforted to know that everything i went through was normal and not an indicator of anything else being wrong.
  I also decided to bite the bullet and buy the VacoCast. The medical team was pretty interested to see that as they had never heard of it. I have to say it’s a lot lighter than the AirCast and has the added benefit of not smelling awful after removing each day. I don’t start PT until Wednesday next week, so I am still NWB until then. At that point, I’ll better evaluate whether the ROM features are truly great. Just not at that stage yet.
  As I shower now with a bare leg, I am pretty shocked to see just how far gone the calf AND the quad muscles have become. I expected the calf, but the quad was a surprise. It made me realize just how far I have to go in PT. I’m also painfully aware of how weak my upper body is as I am pretty worn out after a few minutes on the crutches (stairs crush me).
  On the plus side, I’m on my second day without any meds. I have some discomfort yesterday after being out for a couple of hours. But, I’m really anxious to start my exercises and get myself closer to losing these crutches!
  Posted in Uncategorized | 4 Comments »
  5 days Post-Op…
  Posted by terencemc on February 24, 2014
  I had surgery 5 days ago. All in all, I think it went well except a few hiccups. The surgeon told me that the tendon was more damaged than they thought so they ended up reaching "higher up" in my leg to "pull down" healthy tendon to re-attach. Sounded worse than it was I gather as the surgeon was extremely pleased with the surgery overall. Said he believes I’ll be good in the long run.
  For those who haven’t been through the surgery, I was given general anesthesia and was offered, and accepted, a nerve block in the leg, which I best compared to the epidurals my wife received during a few of my kids’ deliveries. As it was explained, this block would really help manage the pain below my knee. Unfortunately, the block seemed to only work around my ankle and my foot. So, when i woke up after surgery, i was greeted with some pretty intense pain near the incision and followed that up with a double dose of percocet every 4 hours for a few days. the 2nd and 3rd days post surgery were clearly the worst though as the pain made it tough to sleep and the meds made it tough to stay awake. now, i’m 5th day after surgery and I’m weaning off of my narcotics but still feeling lingering pain. It almost feels more like bone bruising pain though- around my ankle, foot and then some burning around the incision that comes and goes.
  All in all, I’m anxious to get out of this cast, which is still a week away. I’m looking into the Vacocast instead of the walking boot. I had a humorous conversation with my doctor before surgery that i wanted to share. Prior to surgery, the doctor came in and asked his "any more questions before surgery", and I asked if he had ever heard of vacocast and if it woudl be ok if i switched to that instead of the ridiculously uncomfortable boot they had given me. He said he never had, but would connect me with "Megan" who could help with that. Turns out Megan is the sales rep for DJO global, the maker of the cast they gave me. Predictably, she discouraged the switch and told the nurses they had never heard anyone complain about the discomfort, heaviness of the boot before. NEVER! ha- I got a kick out of that. The reality is though the doc doesn’t really care which I use and the hospital has a deal with DJO so I’m not sure what I expected there. I guess this purchase and learning to use it is really on me.
  Can anyone who has used the Vacocast before (or currently) describe if it’s easy or hard to "learn"? i’ve seen the videos, but without knowing the pieces it comes with and having them in hand, it seemed not-so straightforward.
  Thanks all!
  Posted in Post-Surgery | Tagged: boot, cast, medicine, recovery, surgery, vacocast | 7 Comments »
  Basketball Blues…
  Posted by terencemc on February 17, 2014
  Hi All,
  Found this network of blogs and already finding it immensely helpful. Here’s my story’s start…
  I recently started expanding my exercise from weights and light cardio at the gym to pickup basketball with other 30 somethings a few days a week. I was a hoops player in high school and still love playing. On Sunday Night Feb 9th, i was about 90 mins in to my pickup games. We’d play 2 games, then sit for 1-2. It was a nice rotation. I was pushing for one more game and I now regret not packing up and leaving sooner. I took a pass on the right wing and just shifted quickly to drive to the hoop. With my right leg leading, I was pushing off my back leg and felt the POP and immediately dropped to the floor. The pain was awful and I couldn’t feel my foot. A buddy helped me to the side where i elevated, iced and tightened my shoe laces. After 15 mins, i knew something bad had happened. I was off to the ER.
  XRays came back clear and the doctor made his way in, felt my left leg from my heel to the calf, then immediately stopped and told me he had bad news- the Achilles ruptured. He emphasized he wasn’t an Ortho specialist, but had seen this before plenty of times. Mine was fully ruptured and I’d need surgery. The next day, i was in the Cleveland Clinic nearby and i had two doctors examine me. They were both Orthopedic specialists, one focused on non surgical treatment and the other a surgeon. They both agreed that given my fitness level, my age (37) and my overall health, it was best for my long-term recovery to get surgery and then proceed with PT and the usual process from there.
  That doctor appt was 7 days ago. My surgery is in 2 days. I’m getting slightly better on my crutches with my boot. But, still can’t put any weight on the foot. I now own a shower chair, crutches, plenty of surgical socks and a massive boot. Huge change overnight. I went from really down a few days ago about how long a road there is ahead of me to feeling pretty optimistic and goal-oriented today. It’s been a rough week for my wife who now has the responsibility for all 4 kids and 2 dogs in our multi-level home. She’s overwhelmed and afraid. I’m trying to find a way to help share my current optimism, but it’s not working yet. I think once the surgery clears, that’ll be a big weight off her shoulders.
  One thing I find myself doing is setting milestone goals for my recovery. Walking without crutches by 3 months, light jogging by 6 months, things like that. My wife and I disagree on the utility of this. I feel like i need to do this to keep myself going. My wife is understandably concerned i’ll push too hard too soon and experience a bad setback.
  I’d be interested to hear from you all on what the upside/downside is for goal setting like i am doing. Is this a potential for disappointment or do you think it’ll be an aid in my mental state and physical recovery in the months ahead?