Day 44 - Boot Off

Had my post op with Dr. Y today. He was very pleased with my healing! He said that I have healed faster than most and that I have more muscle activity in my calf that he would have expected. I am supposed to start a few sessions of physical therapy in two weeks. He said I'm healing great and that this is a critical time for healing so he doesn't want me to rush into physical therapy but also wants me to go in two weeks so that I can really get the most of my healing at that time. I'm allowed to walk, although I walk with a slow limp, and can't take too large of a stride. I can use a treadmill to walk, gradually increasing speed and distance, and ride the bike with little resistance. Dr. Y said I likely won't feel comfortable enough to jog for another 2 months or so. He also reiterated that I am healing excellently and that he anticipates I will be playing whatever sport I want at whatever level I want. I just have a hard time believing that right now with how little strength I have in my lower leg. I'm also still very worried that the mental healing will take just as long if not longer than the physical healing. On the plus side, ramadan is finishing, september is here, and I am lighter than I've been in 6 years.

Day 35 - 1 month since surgery

It's been a month since my surgery. I have been doing great with my boot and abandoned both my crutches and knee scooter earlier this week. Since wednesday I have been just limping in the boot (minus one wedge that I removed last Sunday). My leg feels great although I'm pretty sure I can't bear any weight on the ball of my foot still. The surgical site is healing very nicely now that I have been more compliant with the boot and am not stretching/stressing the achilles. I removed the last wedge earlier today and it is slightly more painful to walk in the boot without the wedges. I did put a padded shoe insert under my foot and hope that will help give it a little extra support and help me transition to not using the boot. I was going to start more actively working out last week but have decided that I will stick to push ups, sit ups, and pull ups at home. Since I'm fasting and will be done on either the 29th or 30th and the boot should be off on the 29th, I've decided that I will start more strenuous workouts at that point in time. The good news so far I have continued to lose weight. I am the lightest I've been in about 6 years and if I continue to lose about 7 more pounds, I will be the lightest I've been since 1997! I know some of the weight is water weight and probably a little muscle mass but if I can maintain a strict workout regimen come September, I think I can achieve my goals.

So my goals are: 1) Be under 180 (currently 185 give or take 2 pounds on any given day) by early 2012. 2) Complete a sprint triathlon in Jan/Feb 2012. 3) play one more season of outdoor soccer in spring 2012. 4) Get back to my usual quick self by playing basketball, racquetball, and squash regularly.

Day 24 - Cast Off/Boot On

I had my three week post-op appointment this afternoon. I wasn't as lucky with getting seen right away but only had to wait 30 minutes before going back. When the nurse took me back she mentioned that she had me down for 8am. We were specifically told that there were no 8am appointments. It would have been ideal because I wouldn't have had to reschedule my own patients and drive 30 minutes there and back in the middle of the day. She did tell me that next time just show up in the morning no matter what time my appointment is the doctor would see me. On a side note, doctors and dentists offices are so different. I wasn't given any option of when I could schedule, was given no confirmation call, was not greeted on arrival, and was made to wait 30 minutes. In my offices (and most I believe), you are given scheduling options, receive a confirmation call 1 or 2 days prior to your appointment, are always greeted with a smile, and will never wait more than 10 minutes. If you do have to wait, I will personally come and apologize and notify you that I am running late and will also likely compensate you with a discount or account credit. Anyway, I'll stop ranting now.

The nurse cut off my cast and I was able to see the surgical site for the first time in three weeks. I could already notice that I had lost muscle in the calf. I was surprised to see how bruised my ankle still was and I had a little parasthesia around the actual repair site. Dr. Y came in and stated how pleased he was with the healing and did a few muscular tests and said that I was healing extremely well. He removed my sutures, cleaned me up a little and told me that I will need to be in my boot for 3 weeks. I asked my list of questions and he answered them all. He said that I can start bearing weight but he doesn't want me 'toeing off' yet. I will be removing one (three total) heel insert from my boot each week and he wants to see me in three weeks for another post op. The nurse put my boot on and instructed me on how to inflate and deflate the air cast. The good news is I can finally shower and scrub my leg. The bad news is that he wants me to sleep in this giant astronaut boot. After three weeks I was told that I can begin therapy with stretching all that stuff. I'm sure much to wifey's and Dr. Y's chagrin, I will have the boot off and stretching as much as I can.

Day 16

The weekend was great, very relaxing. We really couldn't go out and do much and so I'm getting a bit of cabin fever from not being able to go out and really enjoy myself. I keep telling myself that not bearing weight and immobilizing my foot really is the best way to heal. It's just hard sometimes when I want to just cut this stupid cast off and start stretching and moving my foot around. My post op appointment is in one week and I absolutely can't wait. My foot is feeling better and better each day. Today was the first day of Ramadan and everything went well, the days are long but it will only get better from here on out.

Day 13

Well I made it through a week of work. I'm 10 days post surgery and feel even better than a couple of days ago. I know I'm not supposed to be bearing weight but I limped around with the cast today and had no pain. It's a little tough because they have my foot angled awkwardly. My foot didn't even get tired towards the end of the day like it did earlier in the week. I cannot wait to get the cast off, I'm tempted to try and reschedule my appointment for a few days earlier and see if I can get Dr. Y to take my cast off. I did some pushups this morning and it felt good but my shoulders and chest are a little sore. It's amazing what only two weeks off will do for ones conditioning and strength. I hope to work out a little more this weekend and will try to get my appointment rescheduled early next week.

Day 11

So I have worked three full days now. I had to have wifey drop me off and pick me up because I'm still unsure as to how well I can drive. Monday wasn't bad but I had a bigger case/pt. in the afternoon and my foot felt like a balloon after sitting down for a while. I think the whole day just kind of caught up to me with that one patient. I had to excuse myself three or four times to take a minute break and prop my leg up. Mobility was no problem at all with the scooter but I am doing less (only sitting with patients), so it leaves more for Shari to do. Tuesday I thought would be better but it was the same with the foot getting tired and feeling swollen towards the end of the day. Sleeping is much easier now that I don't have to always keep it elevated. Showering with a trash bag on my foot is the norm as well. A patient did bring up an outstanding point yesterday. She was saying that she had a cast on her wrist and it was middle of the summer and when the doc took it off is stunk to high heaven! I never even thought about that until she mentioned it. I'm not looking forward to finding out that's for sure. Work was good today and I think I'm going to try and work the upper body a little tonight. I'm starting to become more and more worried about how I'll be mentally after all this is over and how I will get back into playing competitive sports. I'm afraid that if I try a little hard and I feel a little pull or pain and I'll freak out and just quit. I have sprained my ankles enough times to know that even if I rehab everything physically, mentally I'm not sure how long the rehab will take. I want to be able to run, jump, play soccer/basketball/racquetball/squash at a high level and hope that I can get back to it quickly and safely. One more day of work and then three off again.

Day 7

Well I think I might have overdone it a little today. I felt pretty good but tried to crutch around a little more. We went to go get dinner and just standing in line for 5 minutes really caused my leg to hurt. It seems like I'm okay if I'm laying down (obviously), even sitting is okay, kneeling is okay (which is good since I'll be on the knee scooter for a few weeks), but the act of standing really seems to cause the most pain. I think I will take it easy tomorrow in anticipation of a full week of work. I will try to start some upper body work next week. Pushups, sit ups, pull ups, plank work and some bands will hopefully be okay until I get the boot.

Day 6

So I haven't taken any pain pills in over a day. I now have a small pharmacy worth of Vicodin left over. I suppose I'll just save them for a rainy day. I have actually had a great few days off and caught up on some Redbox movie watching. I still can't get over how good I feel. I'm really not hurting, just greatly inconvenienced with this cast on. I have a three week post op appointment set when I believe Dr. Y will take my cast off and determine whether I need to be in the cast longer or if I can now move on to the boot. I actually talked to a friend who ruptured his achilles in April and he told me was in a cast for 6 weeks and a boot for 6. He is only just now running and working out. I think he limped around on it for a while before surgery so he could have done more damage prior to surgery. My next step is to come up with a set timeline for myself so that I can try to get back into shape as soon as possible.

Day 5

Woke up this morning extremely rested. My leg was still numb this morning so I slept like a baby all night. I also took a couple of 7.5/500 Vicodin because the doc told me to take it before anesthesia wears off. I slept great and had zero pain. I showered early as well. My leg wrapped in a trash bag as usual. I pretty much laid around and kept my leg elevated. I became a little concerned because my leg was still numb 20 hours later! It wasn't until about 22-23 hours that I was able to wiggle my toes and feel everything again. I have only taken one pain pill and must say that I feel pretty good. I'm going to take it easy the next few days and let me foot down on occasion so that I can get used to having down for work on Monday.

Day 4 - The Surgery

Today is surgery day but I'm going to work until noon in the Indiana office. This is also the first day I get to try out my handy dandy knee scooter. Work was busy but wheeling around on the scooter was fast and efficient. I did notice a lot of blood profusing to my lower leg so I had to keep it elevated when not with patients. I left work around 11:45 and immediately headed to the hospital. I registered and was taken back to pre-op in about 10 minutes. I changed and they took my vitals. I will go ahead and brag on the fact that my BP was 123/73 and my HR was 54. I love the fact that Dr. Y was asked to do an H&P and his was response was "it's fine". I had to wait a couple of hours for surgery but I kind of figured that would be the case since I didn't schedule early in the morning. I was told that it was a tendon to tendon repair so that I would heal a little faster than if it was tendon to bone or tendon to muscle. I surprisingly wasn't nervous at all and saw some familiar faces and friends at the hospital. The anesthesiologist was very nice and another anesthesiologist there with mine knew the pediatric dentist next door to my office that I am good friends with. They gave me my fentanyl and versed and I was extremely relaxed when they blocked my leg. I really don't remember anything after that except waking up and feeling very groggy. I was told the surgery went great and that my leg would be numb for 12-18 hours. My throat hurt and I felt fairly nauseous. I had a little coke and told the nurse I was ready to go home. I was only in recovery for about an hour. As I was waiting for the car, I felt pretty nauseous but it passed as soon as I got home. I was very tired so but I did eat a PB&J and some Ramen noodles before going to sleep. I slept excellent since my leg was numb and I didn't feel any pain. I am getting a little scared as to what I might feel once the anesthesia wears off. I can only sleep on my left side or stomach, so that's a bit of an inconvenience. So far so good!

Day 3

Got the first appointment of the morning at the orthopedists office. My doctor was great. Talked with me for at least 40 minutes. He actually saw my brother 3 years ago when he broke his collarbone in a not so glamorous sledding incident. On orthopedic surgery resident also told me that he is a very good surgeon and very conservative. I believe his group specializes in sports injuries and treats some of the UofL athletes. I can't remember if they did the basketball or football team. He explained the injury, talked about the literature out regarding pain management, post op healing time, risks, and long term results. He also mentioned that none of his repairs have ever reruptured, although I wonder if any surgeon admits to having one rerupture? We scheduled the surgery for Wednesday afternoon, a couple of days sooner than expected. Dr. Y wanted me to rest for 4 days so hopefully I will only be off work for one day! He did tell me that I will be in a very uncomfortable cast for 3-4 weeks, and then a boot for another 4 weeks. When I'm in the boot I can start putting weight on my foot and after the boot comes off I can start some therapy. He also told me to get a knee scooter for work. I think it will help me get around nicely. I left the office by 9:15 am and was informed that I needed to get an x-ray, MRI, and lab tests before my surgery tomorrow. I was sent to Jewish Northeast off Old Henry Rd. This hospital was super nice and had about 5 people working it seemed like and only about 3 patients. I registered, was taken to diagnostics to wait for my MRI and waited for at least a half an hour. A tech finally came and informed me that they were overbooked and I was actually supposed to go to Jewish South. I was extremely irritated because from what I could tell, I was the only person in the waiting room and nobody had gone in or out for at least 10 minutes! So off we head to Jewish South to get the MRI and blood test. It was not bad at all getting everything done and the blood test was super fast because wifey's cousin worked at Jewish South and helped speed the process up a little for us. I must say I'm starting to get a little nervous about this all. Even after playing every sport under the sun, this is the first major injury I have ever had. I've never been under anesthesia of any kind or certainly never had an injury that required anything more that some 'tussin, band-aids, and a lecture from mom. I worked until 7 tonight and will be working a half day tomorrow. I suppose keeping busy and not thinking about things will be good for me.

Day 2

Drove myself to work left footed again. Called the orthopedist and set up an appointment for tomorrow at 8am. I'm thrilled that I will be the first appointment, maybe I can actually talk to the doctor and ask him questions and be seen on time. I'm hoping that I can work all week and that I can have my surgery on Friday morning. I don't know how long I will be down but I really don't want to miss any work. Work wasn't too bad, wheeled myself around and crutched it when necessary. I tried to keep my foot elevated when I wasn't with a patient. I'm a little worried about Wednesday in the Indiana office because the drive is longer and the office is not set up as ideally as the Prospect office. I told my wife I wanted to do some pull ups and she scolded me so I guess I won't be working out until after the surgery.

Day 1 - The Injury

So yesterday I decided to play basketball. I have been working out 7 days a week for the last two months, dieting and feeling great. I had lost 12 pounds and was hopefully on my way to losing about 10 more. Mind you, I had been playing soccer, racquetball, lifting and doing my 'Insanity' workout for months now so it's not like my body wasn't used to this sort of stuff. There was a young guy playing ball who could jump out of the gym and he was killing our team on the boards. Being the overly competitive person that I am, I said that I would guard him and I'd keep him off the boards. I was easily 4 inches shorter, 12 years older, and he could out jump me by at least 8 inches. But for the next two games I kept him off the boards and we won both games. We just started the next game and the match ups were the same. We were up 6-2 when the shot went up. I blocked my guy out and we both jumped tipping the ball off to the right. I landed and starting to take a step to chase the ball and my man came down on the back of my leg near my ankle. I stumbled, got back up and took a step. I fell to the ground again. I still was closer to the ball and tried to get up and take a step towards the ball and again I fell straight down. Now I finally realized something was wrong. I instantly thought it was my ankle, having sprained my ankles no less than 20 times since high school. I had decent side to side mobility and nothing hurt. I could not put any weight on my toes or the ball of my foot. I could put a little on my heel as long as I didn't try to flex my foot at all. My brother had told me he has seen two people snap their Achilles on the squash court and I've always heard stories but I didn't really feel anything. I knew something was wrong when I felt the back of my left leg and everything felt fine. I reached to feel my right leg and where my Achilles tendon should be, there was nothing, it was soft and there was no taught band to be found. I sat down for a minute and nothing happened. No pain, but no improvement in the range of motion. I knew I had torn my Achilles. I hobbled to my car and drove home left footed. I knew my wife would be mad. We had been talking recently about the fact that I need to stop playing soccer with 20 somethings and I need to quit playing ball with college kids and not play so hard. But like any other active guy who has played sports at a high level, I refused to listen. Although I had stopped playing indoor soccer and was starting to pick up less physically confrontational sports. Although, I can't be mad at anyone, this was a complete freak accident. If I was playing squash, racquetball, running, or biking, I wouldn't have to worry about the contact or someone else stepping on me, I would only have to worry about my own limitations and over reaching/stretching/working. I arrived home, made it up the stairs with a little help, took a quick shower and then we headed to Jewish Hospital ER. I registered and was taken back in about 20 minutes. The ER doc was wonderful. He lives near my office and recognized the name and he calls my brother for OB/Gyn consults all the time. I can't help but think that it helps to let people know you are a doctor. I hate to abuse that privilege, but as my wife said, I earned it. Anyway, I hadn't taken anything yet for pain, and was still surprised that as long as I didn't flex my foot, it really didn't hurt. The ER doc felt it and said, 'yep, it's shredded, needs surgery, I can take an x-ray if you want but you know is gone, do you have an orthopedist'. He gave me the names of the group that does the UL basketball team and the group that does the UL football team. He splinted my ankle and wrapped it, gave me pain meds and told me to call the specialist in the morning for an appointment. I was very happy with my visit. I was seen quickly, treated well, and told exactly what I wanted to and needed to hear. The ER doc even called me an hour after I left to let me know that he talked to docs in both groups and that they would both be glad to see me. I spent the rest of the day at home with my leg propped up. I couldn't stop thinking about how little I'm going to be able to work out and how useless I'm going to be!