Over A Year On…

Well it’s been a long while since I last posted on this blog, but thought I would give a quick update for those that still visit. It’s over a year now since I first snapped my Achilles, and all I can say to people who are reading and are at the early stages of their injury – it does get better!

I’m still visiting my physiotherapist approximately once a month as I’m still building up my calf muscle to full strength. She’s been great throughout, and whilst there have been a couple of setbacks along the way, overall I’m happy with the rate of my recovery. I knew it would be around 18 months if not longer before I played football again, and I still think it will be. I can run again now, and am using an app called ‘Run 10k’ (there are lots around) to build my stamina back up and to improve my calf strength, as well as training towards a 10k over 13 weeks – a distance I would never have ran before my injury.

At the moment on a weights machine I can push my body weight through my injured leg, but need to be able to do about twice my body weight before the physio will sign me off. Running is really helping me feel normal again though, and varying the speeds is helping me to get some of the spring back in my leg too. Other physio activities I still do include hopping, skipping (embarrassing), cycling and walking. It may seem like it’s been a long time, but since coming out of the boot 10 months ago I’ve been determined to do it the right way, and the right way for me was to take it slowly. The achilles itself doesn’t hurt at all, apart from being tighter and thicker than the other one, but that’s always going to be the case and it’s not really noticeable to the naked eye. Scars are starting to fade too and they again can’t really be noticed.

I feel like this time next year I’ll be able to play football again, and for those of you that have read my earlier comments, I was a bit more sceptical about ever playing again.

Since I last posted I have also got married – she said yes – and on Monday I start a new job covering my boss’ maternity leave, which I’m looking forward to. So 2013 is definitely looking better than 2012, and I’m looking forward to a delayed honeymoon in September too!

21 Weeks Post-Op – Getting There

Many apologies for not posting for ages – being back at work and able to walk again has meant I’ve been pretty busy!

I’m now 21 weeks post-op, and the physio seems to be going pretty well. I’m seeing her every one or two weeks dependent on dates available, and the key exercises I’ve been doing whilst there include:

Calf and heel raises, including on one leg, wearing weights jacket and reaching as high as possible on the wall
Same as above on the edge of a step to stretch out achilles
Walking on tiptoes
Light jogging on trampoline
Exercise bike and cross trainer

Outside of the hospital gym, I’ve been walking a lot and seem to pretty much walk without a limp most of the time, and have finally got round to using my new bike a few times too. I’ve also been swimming a few times which is good all-round cardio exercise. I’ve done the same exercises as above at home nearly every day, with one or two exceptions when I’ve been having a particularly painful day. After the first couple of gym sessions, I couldn’t do much the next day as it hurt so much. I thought it’s probably good to feel a bit of pain as it means things are starting to work again.

The physio said that things are going well and that I’m slightly ahead of schedule. It’s just a long process of building my calf muscle back up to full strength and gradually stretching out the achilles too.

I’ve been back at work since 9th July, and they’ve been good in allowing me time off to see the physio, and with patience when it takes me ages to get to meetings! I can walk to the hospital from where I work so that’s a plus point. The first couple of weeks were hard work after 13 weeks off, and whilst still wearing the aircast boot I was a little slow getting around. It was good to be back and now I have adapted back to the routine things are going well again.

Since I last posted, I’ve also been on my stag do! I’m not getting married until March next year, but I wanted to go to Kendal Calling which is held in July, so we had to go a little early. I had a great time (20 of us went all together), although it was probably a little too soon after my injury in some ways. I had to sit down and watch bands a lot of the time, and getting around muddy fields in an aircast boot is pretty difficult. The toilets were pretty disgusting too, as is standard for UK festivals, and camping was occasionally grim! Everyone was really good to me and looked after me, and overall I had a really good laugh – anything beats sitting around at home. We saw James, Maximo Park, DJ Yoda, Tribes, Shed Seven, Feeder, We Are Scientists, Dodgy, and Inspiral Carpets amongst others, so there was a bit of a 90’s vibe going on.

Yesterday I came back from another festival, Bestival, which was brilliant. This one was much bigger than Kendal, and I went with the girlfriend this time. We booked a B&B (she doesn’t do camping) and stopped for a couple of extra nights before the festival to turn it into a bit of a holiday after missing out earlier in the year on our trip to Devon. The weather was ace and we managed to get on the beach most mornings before heading over to the festival. We saw loads of bands including De La Soul, Sister Sledge, Roots Manuva, Alabama Shakes, Greg Wilson, Michael Kiwanuka, Sigur Ros, The XX, Earth Wind & Fire, Ben Howard, Two Door Cinema Club, New Order and the one and only Little Stevie Wonder! He has the best voice I’ve ever heard, even at the age of 62, and his set was peerless. This one included lots of walking, so hopefully the physio will say I’ve reaped the benefits of this when I next go on Thursday and won’t worry too much about the beers I’ve had…

12 Weeks Post-Op – Hey Ho Let’s Go

Well I had my 12-week post-op appointment yesterday with the consultant and then later on with the physio.

The consultant was a bit of a waste of time and I was in there for about 20 seconds – he basically said “are you walking yet?” – and when I said you haven’t told me to, he said “OK I’ll see you in another month”. When I asked if I can walk (with or without boot), go back to work, drive etc, he just said ask the physio all of those questions…

My physio, I’m happy to say, is very good. I don’t know whether I’m allowed to name her, but I’m not slagging her off so her name is Tammy! When I got to the physio gym, I took the boot off and she said “Right, let’s see you walk.” I didn’t know whether to do this with or without crutches, so I tried without. I carried one of the crutches in my left hand (I’ve ruptured my left Achilles) just in case I needed to push my weight on to something. I managed to not use the crutch, and whilst I was walking very gingerly it was a strange sensation but a very good one. I felt like a baby learning to walk again, albeit a big fat hairy bearded baby. Having walked up and down the gym a couple of times (very slowly), Tammy showed me some exercises to be doing over the next couple of weeks before my next visit:

Exercises

1. With something at approx. waist height to put my hands on to bear a slight bit of weight (such as a kitchen worktop, table or a window sill), put both feet flat on the floor and then lift my right foot off the floor bearing all weight on my left leg with my foot flat. Repeat 3 sets of 15 reps at least once a day. This is the more difficult one as my body’s centre of balance has shifted to my right side, so balancing on my left leg is difficult and obviously I’m wary having not stood on it for 3 months too. I couldn’t do it for more than a couple of seconds – it makes you a bit dizzy actually!

2. Again with something at waist height to catch weight, with both feet flat on the floor and straight, push up onto toes bearing equal weight across both legs. Repeat 3 sets of 15 reps once a day. This one doesn’t feel as strenuous but this is to try and learn to balance weight evenly across both legs again and it’s difficult to judge at first.

3. Continue to use theraband (this is what the big green rubber band thing I had is called apparently) to push against, with leg straight and with knee bent whilst sitting down. Similar amounts of reps to above. This will help flex and strengthen calf.

 

Aside from individual exercises, she said the best thing to do is just walk around and get used to that again, which will obviously strengthen calf again too. Having walked around a bit yesterday in trainers (no boot), it was very strange, pretty stiff in my ankle and foot as can be expected. I’ve decided to put the boot back on this morning as it was hurting too much to walk around the house without and is much better with it. I’ve made sure to wear a trainer on my other foot to allow for the height difference too. I’m going to buy some decent quality walking boots with a bit of a heel, which I was planning to do anyway. Never before have I realised how bad for you pumps are! I seem to be struggling to bend my knee when I’m walking for some reason, but this is probably due to being cautious at the moment and hopefully that will come over next week or so.

The physio also said that swimming is a good exercise to strengthen the leg and get back some general fitness (as someone had commented on one of my previous posts) – and I agree and look forward to going on Sunday morning. I asked about cycling but she said it’s probably best to leave that for a couple of weeks. I have a road bike and she said the roads are a bit too uneven to risk it (anyone who lives in the UK or has been here will know this, and with the amount of rain we’ve had over the last couple of months potholes are worse than usual). Next time I go to see the physio, on 23rd July, she said I can go on the exercise bike then and see how it goes.

In addition to exercise, rest is of course still important, so I should continue to keep it elevated for at least some of the day to reduce swelling and can apply ice if I need to as well.

 

Back to work

She said she’s happy for me to go to back to work now too, which I’ve never been so happy to hear in my life. It’s been a long 12 weeks. She said not to walk the 15-minute walk to the train station and back, and that I should get a lift for this part of the journey for at least a couple of weeks. My brother, who works at the same place, has agreed to pick me up and take me home from the train station each day, so that’s cool. Once I get to work it’s only a short journey to my office. She said to make sure I wear shoes with a bit of a heel, which all of my work shoes have so that’s fine too. I will probably take a crutch with me for the first week or so too, which I’ve still been carrying around a bit whilst I get used to the sensation of walking again. It still feels very strange but it’s only been a day so far… so I look forward to returning to work on Monday.

 

Driving

I also asked if I could start driving again. She made me push my foot down against her hand (to test if I had enough power to press the clutch down if I need to make an emergency stop), and she said it seems like it would be fine, but to only make short journeys and test myself out – again not doing too much too soon. I don’t drive nearly as much as I used to now anyway now that I get the train to work, but it’s still something I’m looking forward to getting back to.

 

The main thing to come out of this part of the process for me is how hard it is to shift your body’s centre of balance back to the centre of your body when standing. I’ve become so reliant on my right side over 3 months that it’s really difficult to stand on my left leg! This will come back with the exercises though over time. The pain of walking is mainly in the stiffness of my ankle and my heel – the Achilles itself doesn’t hurt that much although it is still healing. She said that the length of my Achilles is pretty perfect so doesn’t need stretching anymore, and my ankle range is very good too. It looks like it’s only a couple of degrees out from my good foot.

Whilst there I also asked about my stag do, which is coming up in 3 weeks. We’re not getting married until next March, but I wanted to go to this particular festival so 21 of us will be going up to Kendal on 26th July. Tammy said definitely take and wear the boot, and I think it’s fair to say I won’t be jumping around to any bands! At least it will minimise the abuse I’m subjected to, a small positive to come out of the whole thing…

10 Weeks – Euro Mania

I’m 10 weeks post operation now, and not much has changed since the last update I posted. I’m still not too mobile, although have just been for a bit of a walk around the block where I live just to get used to the sensation of being upright and walking a little. Still in the aircast boot, now with two of three wedges removed, and obviously still on crutches too. I haven’t felt much pain at all from removing either of the wedges, it’s been a pretty easy transition each time, but I haven’t put anywhere near full weight on the foot – it’s still supposed to be at around 20% until I return to the hospital in two weeks time. I don’t know if they will take away the boot and the crutches at that point – I feel like I’ve sort of forgotten how to walk now after 3 months without putting my foot on the floor properly.

I’ve been watching quite a bit of football during the Euro’s, and so far it’s been a pretty good tournament. The one good thing to come out of my injury is I’m always home from work by bang on 5pm when the games kick off! England have been OK, I’m a big Roy Hodgson fan so hope we do well. I think reaching the quarter finals is a good start to his international managerial career anyway, and we’ve got some good young players coming through (Welbeck, Oxlade-Chamberlain, Wilshere, Cleverley, Jones, Smalling) so the future looks bright to me. It has all been said before of course.

Away from football, my student nurse girlfriend has now finished for the summer so has been looking after me well for the last week or so (as well as for the last 11 weeks). We’ve got some wedding planning to do which we might get around to doing at the weekend, but I say that most weekends and it never happens. Smells like the fajitas she’s cooking are nearly ready, so I better go…

8 Weeks Post-Operation

Haven’t posted for a while due to a bit of a lack of progress, but here’s my most recent thoughts!

Saw the doctor on Thursday (7th June) which he admitted was a bit of an unnecessary appointment but they wanted to just check I was doing OK. I was in the consultation room for less than a minute, and he told me to make another appointment for 4 weeks time when I should be able to begin full weight bearing.

On Friday 8th, I had my first appointment with the physio in the hospital gym. I have one of the senior physios from UHB which I’m happy about, and her husband also ruptured his Achilles a couple of months ago so she understands the injury from both sides – the medical and the personal. I was hoping for more from this appointment, but she said there’s not much I can do physio wise until I can bear more weight in 4 weeks time. She gave me a large rubber band type thing that I can put under my foot and push down to start to strengthen my ankle and get some movement back. I find the circular motion of my ankle the hardest exercise to do, but over the past 2 weeks there’s definitely been some improvement. I can now put my foot on the floor a lot more in the boot, and have taken out the first of the 3 wedges. I’m going to take another one out next week, and another the following week so by the time I return to hospital I’ll have had all of the wedges out for 2 weeks. Both the physio and the doctor said it’s going slowly because the stitches need to heal properly post-operation and until 12 weeks it’s not worth doing anything strenuous for fear of doing more damage than good. The physio said that it’s easy to stretch out the Achilles, but it can’t be tightened again once I’ve stretched it, so there’s no point in doing too much too soon. They’re still saying 20% weight bearing for next few weeks but in all reality I’m probably doing more than that as it’s difficult to judge. I think this is their way of just saying don’t stand on it.

I’ve certainly noticed an expanding waistline now too! I haven’t changed my diet much since I stopped exercising 2 months ago, and it wasn’t brilliant to start with although we do try to cook balanced meals. I’m probably eating a bit less but not much. I feel a bit more mobile with the boot and have managed to have a couple of showers in between all of the baths I’ve been having, standing on one leg. Stairs are still pretty difficult to negotiate when out and about. I’m doing some work from home which helps to make the time pass. Today I might go for a short walk around the block, on my crtuches and in the boot, just to get out and get used to moving again. Living in a second floor flat makes going out a bit more of a chore than it should be, but I need to make sure I don’t just sit around for the next month and get used to walking again.

A Tip Of The Hat

This guy has some good (and humorous) tips on things that are useful whilst you have an Achilles injury:

http://meandmyachilles.wordpress.com/2011/05/09/top-tips/

Bootylicious

I had my 6-week appointment at the hospital today (6 weeks since I had it operated on). I’m on schedule and have moved from a cast to an aircast boot. Looking at my leg today it has definitely shrunk in terms of muscle, but it will be fine to put back on when I get more active again. I was expecting a bit more progress than I got at this stage, but the prognosis from the consultant is to be very cautious.

I had the cast removed and asked the doctor if I’d be OK to return to work now I have this boot. He said no, I needed to stay off for the next 6 weeks whilst I’m still recovering, but I asked him to add to the sicknote that I can work from home on a laptop, so that is what I’ll be doing from next week. He said that mobility wise I’m not going to be able to get to and from work, and get around whilst I’m there. On a positive note he said the stitches are healing/have healed well, and then the plaster technician fitted the boot with 3 wedges initially, removing one every two weeks. In terms of partial weight bearing, which I can now do, the doctor said that I can put 10-15% weight on my foot when I’m up and it’s in the boot – but I have no idea how much this is in real terms so I’ll see how I get on over the next few days.

I then went to see the physiotherapist for the first time – this is where I thought there would be more to do. But she said at this stage post-operation it is still very sensitive and risk of re-rupture is very high if I try to do too much – and she kept pushing the point that I must take it easy. She told me to wiggle my toes daily and bring them forwards and backwards (but not too much), curl my toes inwards and outwards, and slowly bring my ankle up and down too so that it doesn’t stiffen up. This needs to be in very short motions and doesn’t feel like much, but I’m going to do what I’m told as I REALLY don’t want to mess it up.

I can have it out of the boot if I’m sitting down with my foot up, which is nice to let some air get to it and not have the heavy weight on my leg (the boot is heavier than all of the casts I’ve had!). I’m not sure what they said about showering – I think I can shower it now but I’m going to call them tomorrow to check. I would need to sit down in the shower – would be interested to hear what everyone else has been doing. I don’t have a shower over the bath, we’ve got a separate shower. I’ve had a bath every day for 7 weeks with my foot in a black bag, and it’s getting a bit tedious now to be honest. As you can see from the photos above, my foot is pretty dry after 7 weeks in a cast. That’s going to take some cleaning!

The other photo is of my Robocop boot – the little blue pump is what you can use to inflate/deflate the boot to make it fit more/less tightly as you wish. From early experience, I don’t think I’m going to have it inflated too much. The doctor said that every time I move I must have the boot again – and similar to the physiotherapist, he was very forceful with this point. If I fall on it, game over.

It feels like a lifetime so far but the doctor pointed out that in the scheme of things, I’m halfway through what is a 12-week rehabilitation, with physio carrying on after that for some time probably.

I have another appointment in two weeks with the doctor to have a wedge removed from the boot and wounds checked, and another appointment the day after with the physios in the hospital gym. I’m hoping the physio will be stepped up quite a bit at that point, but they seem to be taking it particularly cautiously at the moment. I’m just going to do what I’m told as I don’t want to make it worse. The physio said to just look at it as a series of steps and don’t look beyond the next appointment, and it will make things a lot easier.

4 Weeks Post-Operation

Went back to the hospital today for my 4-week post op appointment. Had to wait around for a good 2 and a half hours before I eventually got seen, and it took about 10 minutes to remove the old cast, move my foot up to ‘plantar grade’ (pretty much as far as it will go) and put the new cast on. Again, it hurt, but probably not as much as last time as it was half way there already. My leg is definitely starting to waste away now, I’ve not seen it as thin since I was about 11 years old, and my foot is very dry and a bit horrible by the looks of it.

I go back on 24th May now for my next appointment (the 28th, in 2 weeks time when I should be going, was full). That’s when I’ll get the air cast boot hopefully, and can start bearing some weight on my foot which will be nice. I should be able to have a shower then too – YES! I’ve had a bath every day for 5 weeks, and it’s a bloody pain! Don’t think I’ll be able to drive with the boot and will still need to use crutches for the 6 weeks that I have it, but hopefully will be able to rely on the sticks less as time goes on.

2 Weeks Post-Operation

I had my first post-op appointment with the hospital yesterday, to have the wounds checked and my cast removed. It took a while at the hospital as they were running around an hour late. It was a relief to get the heavy plaster cast taken off that’s for sure!

The nurse checked the wounds and said she’d never seen a scar like mine before (which at first is a bit of a worry when you hear!). My operation was done using percutaneous surgery, where several small incisions (in my case three) are made horizontally,  as opposed to one long cut vertically down the length of the Achilles. Having read up a bit on this before the op, I believe that the smaller incisions mean that the wounds will heal better and are less likely to get infected, but there is more chance of nerve damage doing this type of surgery than if it was done using open surgery. Some scientists believe that re-rupture rates are higher in those who have percutaneous operations, but newer studies tend to suggest it’s similar whichever operation you have.

It turned out that the surgeon has been doing it that way for 2 years but the nurse had never noticed – hmmm.

I thought that a semi-equinus cast would mean a shorter one than the current full-length cast (up to my knee), but it actually means that my foot should be pointed halfway between pointing at the floor (as it was after surgery) and at 90 degrees to my shin. You probably already knew that, but I didn’t! So it’s still a cast up to the knee.

The nurse pushed my foot up to between 75° and 80° to put a new lighter cast on, and that hurt as the Achilles was being stretched for the first time since surgery. I went a bit pale apparently! I’d suggest taking some painkillers before you go to the hospital if you can – I haven’t taken any for over a week. I have to go back again in another 2 weeks when it will be moved to 90°, and then 2 weeks after that it will be swapped for a plastic boot which I will have for 6 weeks.

It’s been a long 3 weeks so far I have to say, and the hard work will really start when I have to start physio in 4 weeks time.

Time The Greatest Healer!

I haven’t posted for a few days, mainly because I’ve had nothing to post about. I’ve been watching quite a bit of TV (which for anyone who knows me isn’t what I usually get up to – I don’t actually know what I do usually).

A good friend of mine, Mick, has borrowed me a lot of DVDs as my film knowledge isn’t what it should be for someone who worked in a cinema for 5 years, and he’s a geek with nigh on 500 DVDs in his ever expanding collection. I’ve watched 10 films in the last 2 and a half days, which is some going I reckon! The best one so far has been ‘Annie Hall’ (Woody Allen) which I am pretty ashamed I haven’t seen before, but then I hadn’t seen ‘Back to the Future’ until a couple of years ago – that’s the level of film knowledge we’re talking. The strangest one I’ve seen so far was also a Woody Allen film called ‘Sleeper’, and I’ve also taken in ‘Raging Bull’, ‘Wild at Heart’, ‘Hugo’ and ‘Rear Window’ amongst others.

‘Rear Window’ is a Hitchcock film about a guy with a broken leg (in a cast up to his waist and beyond!) who thinks he has seen a murder from his Manhattan apartment window. I’m far from NYC, but it made me chuckle anyway. It’s worth watching if you have a couple of hours – which if you’re reading this you must have!

Plans for the rest of the week include more films (and some football tonight), a relaxed weekend ready for my next hospital appointment on Monday to change the cast and check the wounds. On that subject, I had another letter from the hospital today from my original consultant (that I saw on the day after I did my Achilles) inviting me for my ultrasound scan on Friday May 4th. This would have been 4 weeks after, and so my operation wouldn’t have been until about 6 weeks post accident. Another example of the hospital not talking to each other, even within the same department. I think I’ll stick with the consultant who did my op… and this is how long it would have taken to get a scan had I not chased it – by then the whole thing would have been a mess.

Right, I’m thinking ‘Midnight Cowboy’…

Famous Achilles Injuries

I’ve been reading up on famous people who have ruptured their Achilles, and it makes for quite a good list of both sporting and non-sporting A-listers. Here are some of them, with a separate list of footballers due to my better knowledge of the game…

 

Non-sporting

George Clooney

Brad Pitt (ironically whilst playing the part of Achilles in the film Troy)

Al Gore (trivially the same initials and surname as me, Mr A A Gore!)

Dwayne Johnson/The Rock (apparently an actor/wrestler)

Missy Elliott (rapper/producer)

Judi Dench

Russell Crowe

 

Sporting

Boris Becker (ex-Wimbledon champion)

Kelly Holmes (2 Olympic golds in Athens 2004 & BBC Sports Personality of the Year)

Darren Campbell (British former 100m and 200m sprinter)

Lewis Moody (England rugby player)

Simon Katich (Australian cricketer)

Mark Lewis-Francis (Team GB sprinter)

Alistair Brownlee (British triathlete and one of Britain’s best gold medal hopes in 2012)

Tiger Woods has also suffered with Achilles tendonitis, a sometimes precursor to a rupture, on a number of occasions.

Footballers

David Beckham (you know who he is)

John Barnes (ex-Liverpool winger)

Yakubu (Blackburn striker)

Steven Taylor (Newcastle defender, ruptured his Achilles earlier this season: http://www.bbc.co.uk/sport/0/football/16116940)

Curtis Davies (Birmingham City centre-half)

Jermaine Jenas (Tottenham midfielder, was on loan at Aston Villa and suffered injury in his first start)

Valeri Bojinov (ex-Manchester City striker now playing in Serie A, who had also previously suffered a knee ligament injury – quite an unlucky player)

Willy Sagnol (ex-France full-back who had to retire following his injury, suffering nerve damage during the surgery – glad I didn’t know this before my op!)

Fabio Aurelio (Liverpool defender)

 

I’m sure there are many more too. Some of these celebs and sports stars were admittedly older than me when they got their injury, but it’s good to know that it can happen to proper athletes as well as to amateurs, and it’s not just as a result of my poor fitness!

There are some devilishly handsome men in there too, so I’m in good company. The ratio of ruptures of men to women is somewhere between 5:1 and 20:1 depending on where you read. I haven’t read into this enough to know why, but maybe it’s due to men generally being heavier and therefore putting more pressure on the Achilles when pushing through? Not sure, this is just me speculating. In the case of David Beckham, I imagine his rupture was due to the way in which he takes a freekick or corner – planting his left foot next to the ball quite heavily before whipping it with his right foot, for 20 years plus, must have had an adverse effect.

Image credit: http://houstonrunningblog.blogspot.co.uk/2010/04/what-soccer-star-david-beckhams.html

Keep Right On To The End Of The Road

This is my nice new blue cast that I had changed today in about 2 minutes – good work UHB! Don’t need to go back now until 30th April…

Get In Touch

It’s good to see that people have been reading this blog – makes it even more worthwhile.

If anyone wants to get in touch to chat further or to ask any questions, you can comment on the posts or alternatively get in touch with me on Twitter:

www.twitter.com/adamgore

Back at the hospital tomorrow for a cast change, so if there’s any news I will update again tomorrow. I’ve just had my 2-week hospital appointment through too to check the wounds and check my progress, that’s scheduled for 30th April. I’ve noticed a few visits to the site from Norway, so welcome to you guys from there! I’ve always had an affinity with your country despite never having been, as there is a good-sized Norwegian supporters club for my football team, Birmingham City. I’d be interested to hear of your own progress – is there a national healthcare system similar to the UK in Norway? I’ve also noticed some visits from the US – again, I’d be interested to hear about your own progress and how fast things are moving.

See It As A Fresh Start

Today has been an OK day. The pain from Friday’s operation is starting to wear off, although I’m feeling quite a bit of cramp in my calf due to the cast being restrictive on movement, for obvious reasons. Hopefully this will start to wear off when I get a shorter cast in 10 days time. I’ve been trying to move my toes as much as possible to keep the blood flowing. I have sore hands from using crutches but had a good tip from a guy in the hospital who saw I was struggling – pick up some weightlifting gloves and it will save your hands, as well as help you to have better grip on the crutches. They’re only cheap and could save 3 months of pain!

It’s been a day where I’ve been in a positive frame of mind actually. I’m starting to see it as a fresh start in exercise terms and a chance to try out things that I haven’t spent much time on in the past, and to experience new sports. All of the rehabilitation articles that I’ve been reading suggest cycling is a good form of exercise during rehab as it doesn’t put much strain on the tendons, so I’m looking forward to that part of it. It’s easy to get stuck into a routine, in exercise and in life in general, and sometimes to break from that routine will help to freshen your mind and think about new and different things. There are definitely better ways to do this than rupture your achilles, but once it’s happened you might as well use it in this way! Like I said in yesterday’s post, I think the majority of the battle with this injury is in your head – the physical aspects take care of themselves for the first couple of weeks certainly, and it’s amazing how good the body is at healing itself after surgery.

I’ve been reading today about exercise during the stages in which you’re in a cast and boot, and this article on achillesblog.com was quite useful:

http://achillesblog.com/tomtom/exercise/

At the same time, it’s important to let the body recover from surgery for at least the first 2-4 weeks, and eat the right things to encourage the natural healing process along. The obvious things like fruit, veg and plenty of water to keep hydrated. Having said that, I have just eaten quite a lot of Maoams…

Things To Look Forward To

It’s Monday morning now and I had the operation on Friday morning, so 3 days have passed.

The nerve blocker started to wear off on Saturday morning, and the painkillers were definitely needed at that point! I’m trying to keep it elevated as much as possible – it’s frustrating for anyone who doesn’t like sitting around doing nothing and isn’t used to doing that, but if it makes my recovery better then I will keep doing it. This particular cast needs re-enforcing at the end of the week, it’s very heavy but I’d rather everything was kept in place so it’s an inconvenience worth bearing.

In other news, had an email at work this morning to say my Cyclescheme voucher had arrived for my new bike. I ordered it a few days before the rupture, and was looking forward to riding to work over the summer as an added fitness boost. It might have to wait a few months before it makes its debut now (probably just in time for winter), but this is the one I went for on the recommendation of a friend:

http://www.evanscycles.com/products/specialized/sirrus-2012-hybrid-bike-ec030741

I’ll have to see if they can deliver it, but it’s something to look forward to anyway. Other than that, over the next week I’m going to try to relax (there must be a significant mental aspect to the body’s recovery in my opinion) and I need to design my own wedding stationery too. My girlfriend and I are getting married next March, so that’s the main end goal – to be walking and fit for our first dance. In the more immediate future, I’m having an early stag do at a festival called Kendal Calling at the end of July – so that’s around 13 weeks away, another date to work towards. It’s important to try and give yourself goals and things to look forward to, and to try to remain as positive as possible. There will always be people worse off, so I’m trying to see it as a fresh start and looking at other sports that I will be able to play when I’m recovered. I might not play football again, but I’m looking forward to cycling more and think I’ll enjoy it.

The Scan and the Op

Missed updating for a couple of days as I’ve been busy at the hospital, but the good news is I’ve now had the operation.

On Thursday I went back to the fracture clinic, and later on that day had the ultrasound scan which confirmed a 90% tear of just over an inch, which confirmed the need for an operation as the tendons wouldn’t be able to reattach themselves that far apart. I rang the fracture clinic and they confirmed that I was on the list for an operation for the next day. The staff from Ambulatory Care, which is where you go pre and post operation, called me later on in the evening to let me know what I needed to do.

On Friday 13th (!) I went in at 7.30am and was told I was on the rolling list, which meant it could be anytime that day that I have my operation, or it could get delayed, cancelled or moved if an emergency came in. Luckily, at 8.20am they were ready for me so I got changed and went down to the anaesthetic room. I won’t go into too much detail for those that are squeamish, but they knocked me out with general anaesthetic, and also put a nerve blocker on my leg (similar to an epidural) that meant I wouldn’t feel so much pain when I woke up. As I type the nerve blocker still hasn’t worn off, so later today I expect to be in a lot more pain than I currently am! I’d never been under general anaesthetic before so I was nervous, but it was only a few minutes before I was out.

The operation took around 2 hours, and I came out of the anaesthetic as I was being wheeled back to the recovery room. The consultant who performed the operation came and told me that the operation went very well, and the nurse gave me a quick pain relief tablet. He said that I’ll only have 3 small scars and that they’ll hardly be seen. The staff at UHB throughout the whole day were excellent, from the nurses on the ward, to the doctor, consultant and theatre staff – with the possible exception of the anaesthetist who was a bit of a butcher and hurt my hand a bit!

I was back on the ward for 11am, and was told I should be able to go home by 2pm. It was a bit later than that by the time the physio had been and checked I could use my crutches properly, but in and out within 8/9 hours seemed a good deal after being told there might be a chance I’d have to stay overnight originally.

I’ve been told I’ve now got to go back and have the plaster changed next week to reenforce the back slab that’s currently on it (it’s a very thick one to protect the stitches etc), and then go back the following week to have the plaster changed again and wounds checked. The risks after the operation are blood clots and the potential development of DVT, so it’s important to keep your leg elevated as much as possible. I’ll be in a cast and not be able to bear any weight on the leg for 6 weeks, followed by 6 weeks in a plastic boot at differing angles to start to strengthen the Achilles. After that there will be quite a bit of physio to build up strength in the Achilles and in the leg muscles, which will have pretty much wasted away in 12 weeks time! After the op I feel like I’m starting the road to recovery, which feels much better after the horrible couple of days thinking I was going to have to wait weeks just for a scan.

The Waiting Game

That brings us to today – Wednesday 11th April, the day I decided to start this blog.

Today has been the worst day so far – Tuesday was painful, and with keeping my leg elevated there is a build-up of blood that rushes down to my ankle and my foot every time I stand up on my crutches, which hurts. I’ve been taking Ibuprofen to kill some of the pain, which seems to work OK. Today, Wednesday, this pain has been exacerbated a bit further, and the boredom of daytime TV and Facebook has kicked in! I’ve had lots of well wishes from family and friends which is great, and just about keeping me going at the moment.

The reason today has been particularly bad is the ultrasound news. My partner works for the hospital and so went to ask how long I can expect to have to wait for an ultrasound scan. Having read about people’s experiences online I assumed this would be a couple of days, with most people having surgery within a couple of weeks. She was told there is currently a 6-week wait for scans!

This obviously led to a lot of stress, for both of us, so I decided to give the hospital a call. After ringing for 3 hours, to a variety of different numbers and being put through to various different people (all in the wrong departments, or in most cases ringing out/dead lines), I eventually got through to the nursing station at the fracture clinic where I was on Monday. The nurse who answered was very helpful and reassuring, and as soon as I mentioned the scan waiting list she said that for an achilles injury, scans should be within 48-72 hours. This was such a relief after thinking all day that it was going to be 8 weeks before an operation, by which point the tendons will be a right mess. I left my details and as I write am awaiting a call back to say when my ultrasound scan will be. After this I’m hoping that they will operate within a week or two, so that I can start the long road to recovery and physio. If I hadn’t have been able to get through to this nurse today, who knows where my record would have gone and how long I’d have been left to wait. Here’s hoping…

Monday morning – Fracture Clinic

When at A&E they made me a morning appointment for the fracture clinic, also at University Hospital Birmingham. I was finding it difficult to use the crutches at this stage, having never used them before, and at 14 stone my right leg was struggling with the burden of supporting my whole body weight!

When I arrived at the fracture clinic I was seen pretty quickly, and was again impressed with the doctor’s personable nature. He asked me a few questions about smoking, steroids and various other things that may affect my recovery, and then performed the same test that was done at A&E to check the injury.

He said there were two options – surgical and non-surgical. With the non-surgical route, he said there was a greater risk of re-rupture at a later date, but with the surgical route there was the obvious threat of infection through surgery. The blood supply in the area of the achilles isn’t too great, so post-operation infections can occur. He said that for someone who is quite active (I play quite a bit of football and also do 2 spin classes a week most weeks) it is likely that the surgical route would be best, as there is less risk of re-rupturing. Before this decision is made, an ultrasound needed to be done to determine the length of the rupture. The doctor said that for tears of less than 10mm, the non-surgical route is standard.

He sent me away and said the hospital would be in touch with regards an ultrasound, and to book an appointment back at the fracture clinic for one week later to look at the results and choose the best route.

The immediate aftermath

Straight from the pitch, I went to A&E at University Hospital Birmingham, and was seen within an hour by a good doctor. I told him what had happened and what I thought I’d done, and after a couple of tests he confirmed that I had ruptured my achilles tendon. I had an x-ray, put in a temporary plaster and was sent away with crutches. All in all, I was there for about 1 1/2 hours, and apart from the miserable service at reception I was mildly happy with the treatment so far.

It didn’t feel that painful at this stage as the natural adrenaline was keeping me going, and I didn’t take any painkillers at all on the Sunday evening. It was tough to sleep because of the adrenaline and the shock of the injury too.

Why?

On Sunday 8th April, at approximately 6.50pm, I felt like somebody had either shot me in the back of my left ankle, or thrown a hockey ball at me, whilst playing 6-a-side football. I turned around and there was no-one or nothing there. After a few seconds I realised I’d ruptured my achilles tendon. There’s a lot of online discussions around achilles ruptures, so I thought I’d blog mine from a UK perspective, including thoughts, treatment and recovery, partly as a way to keep myself sane but also to help anyone in the future who may get the same injury to get through their rehabilitation.