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   I added this section so I could blog about my injury, surgery and subsequent rehab'/physio.

   I would encourage others to do the same regarding their injuries so that we can all learn.

   PART 1

   On Nov 29, which just happens to be my Birthday, I suffered a complete rupture of my left Achilles tendon while playing. The build-up to the rupture was unremarkable, but typical with these injuries. I was moving backwards with the play coming towards me. The play quickly changed directions, so I lunged forward springing off with my left foot. I heard a sickening "pop" sound (the kind you can mimic by placing your finger in your mouth, sealing with your lips, and quickly withdrawing). As I was falling, I recall my toes flexed forward (plantar flexion). I was carried off the field and helped to my car, but remarkably, there was very little pain.

   Within 30 hours of the injury, I had seen both my family doctor and a physiotherapist. I was surprised, but relieved when both of them concluded that it was not a ruptured Achilles, but something minor. "I think you strained your soleus", said the physio. "What about that 'pop'?", I asked. "Maybe that was your ankle cracking", came the reply. The doctor had me move my foot and toes all around and because I could do this with relative ease and very little pain, concluded that it could not be a ruptured Achilles.

   LESSON #1: LISTEN TO YOUR BODY, NOT YOUR DOCTORS.

   I've since learned that there are numerous muscles and tendons responsible for moving your foot. Your Achilles is what allows you to spring off with power. The fact that I could move my foot up and down and all around should not have ruled out a ruptured Achilles. With a ruptured Achilles, you have no functional ability to roll onto your toes. It's not like it's painful to do, IT SIMPLY CANNOT BE DONE. Your brain tells your foot to do it, but it cannot. The only thing I can compare it to would be waking up with your arm asleep. You cannot raise your arm until that feeling returns to it. If I had "strained my soleus" or say sprained my ankle, I would still be able to roll onto my toes, albeit painful. It's too bad that neither the doctor or the physio correctly diagnosed the problem because...

   LESSON #2: A RUPTURED ACHILLES IS A MEDICAL EMERGENCY.

   Not because you are going to die from it, but the chances of easily fixing it with less complications and subsequent morbidity are better in the first 2 or 3 days after the rupture. And once 2 or 3 weeks passes, a simple reattachment with sutures is no longer possible as the torn ends drift further apart and begin to scar.

   [more later]

   "So we beat on, boats against the current, still striving for 90 perfect minutes..."

   Posted 5 months ago | # |
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   Ajaxfc
   

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   Get well I have seen ppl get back to playing in 360 days or so , after 6-8 months of physio tharepy etc after the origional surgery and initial phase

   Good to learn about , how important is to consult with doctor ASAP ... I never knew you need to act so quickly on that injury , as with some knee injuries some teammates were told to let the swelling go down first before

   Posted 5 months ago | # |
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   PART 2

   I continued to hobble around for the month of December trusting, but somewhat skeptical of the doctor's and physio's diagnoses. At physio, I continued a 3 times/week regimen of ultrasound, EMS, and the painful lymphatic drainage. At home, I continued to ice the calf and ankle most evenings while elevating the foot. Most of the bruising and swelling had subsided 3 weeks after the injury.

   Exactly 1 month after the injury, I had an ultasound of the ankle. I don't know about you, but when I see an ultrasound image, you might as well be showing me a picture of Mars at night because I can't make out anything. The technician, however, murmured something about the tendon "hanging on by a strand of fibre". Hours later, I mentioned this to the physio at my appointment. He told me to stop everything I was doing and get back to the doctor ASAP.

   Early in the New Year, I was back at the family doctor. When I advised her what the ultrasound technician had told me, she looked puzzled because according to her, the ultrasound report simply indicated that there was too much swelling (edema) to see anything making a clear diagnosis impossible. She scheduled me for an MRI and set up an appointment with an Ortho Specialist. One thing I never "get" in this province is why doctors wait until things are dire before scheduling the MRI's. I know there's a long waiting list, but would it not make sense to schedule the MRI on Day 1 and then cancel it if it was not needed? That way, if it was needed, the long wait would be reduced since it was already scheduled on Day 1.

   The doctor also advised me to call the Ortho (Dr. Paitich) and get on his cancellation list ASAP. I called the same day and was advised that he was booking into June, but luckily, there was a cancellation for Feb 8th.

   My fortune changed that Saturday when I bumped into Dr. Sanjeev Goel while at my son's soccer match at the Soccer Centre. Sanj' has played in BAS since its inception. He noticed my limp. I told him what had happened. He agreed with my suspicions and told me to come see him the following Monday.

   LESSON #3: SECOND (OR THIRD) OPINIONS CAN'T HURT.

   [more later]

   Posted 5 months ago | # |
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   Ajaxfc
   

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   PAY PER VIEW I mean pay per visit ... if you know what I mean

   The more visits you make to doctor , the more CASH is made ^_^ ...

   That is why I am very direct with doctors I need the proper diagnosis , in 1 visit , think about the strin it must put on health care system as a whole

   You have to visit the doctor 10 times before they tell you go take Advils and Tynol

   I am noticing alot of medical clinics engage in such practices -

   A good doctor can diagose your situation in few minutes or worse you get xrays done , and you get a perfect feedback in 1-2 days, this is why they go to school for 10 years

   One dude twisted his knee he was told his knee will have to get operated 10,000+ who know what knee surgery cost , he visisted aother doctor for second opinion and doctor said rest and ice it , and surely enough 20-30 days of rest and his swelling was gone and he was doing ok in 3-4 months time

   Posted 5 months ago | # |
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   PART 3

   I planned to be prepared when I went to see Sanj', so I visited ratemds.com
   http://www.ratemds.com/social/?q=node%2F28882&sid=58

   to find some recommended Othro Specialists in this area.

   LESSON #4: ratemds.com IS A GREAT SITE WITH COMMENTS ON EVERY DOCTOR IN THE PROVINCE.

   I found 3 docs' with very good ratings. Curiously enough, Dr. Paitich, who my family doctor had recommended, was NOT one of them.

   Sanj' recommended only 1 doctor, Dr. Alexander. I was pleased because he was first on my list, as well. An appointment was scheduled at the fracture clinic at William Osler within 10 days. Not wanting to be a further burden on the medical system, I cancelled my Feb 8th appointment with Dr. Paitich.

   The fracture clinic is a dead zone where you can expect to spend half a day or more when you have an appointment. Any time you see signs warning, "EMERGENCIES MAY AFFECT THE TIME OF YOUR APPOINTMENT", you know you might be in for a substantial wait.

   In preparation for the appointment, I was asked to bring a CD of my ultrasound from December. Huh? Not that this was beneath me, but certainly at this juncture on the "information superhighway", we've reached the point where something like this could be easily emailed? At any rate, I went to Georgetown to pick up the CD. "That'll be $10, please." Ah, now the rationale became crystal clear. Let's make our system less efficient over $10. Got it.

   Dr. Alexander saw me within 2 hours hours of my scheduled appointment, so the wait wasn't as bad as I figured it would be. I told him how the incident happened. He took one look and my left leg, gestured with his thumb and forefinger that the gap was "this big", showing about 4 inches. I doubt he even looked at my $10 CD. "You can tell just by looking?", I asked. "And you can't?", came his reply. I took a look and he was right. There was a noticeable "deficit" where the Achilles had once been. A gap where the skin simply sunk in rather than laying taut over the Achilles. I asked him why the family doctor wouldn't have noticed this and he replied that the area was probably too swollen at the time. I'll give them that one.

   He explained to me because so much time had elapsed that the best chance for repair would be a procedure called FHL Transfer/Achilles Turndown and scheduled it for the following Friday. He warned of the risks (infection, nerve damage, blood clots, dysfuntion) and had me sign the mandatory waiver.

   He answered all my initial questions and had a pleasant demeanour. I asked how common the procedure was and he told me that there were 6 others needing this repair that had been to see him so far that day.

   He wrote down the procedure on a piece of paper, so that I could research it online while waiting for the surgery.

   [more later]

   Posted 5 months ago | # |
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   EBIND
   

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   I went through he same B.S. when i tore my ACL. My family doctor and an otho doctor were convinced it was cartilage damage. I bumped into a friend who was in Med school. He came over to the house to take a look at the knee. 10 minutes in he stated that it is more then likely the acl as he had no problem separating the joint. Sure enough he recommended a different otho surgeon. I was in the surgeon’s office in 3 days and under the knife for a complete repair of the ACL, some tightening of the MCL and PCL in about a week. Funny no cartilage damage.

   As for rateyourmd.ca, I have been on the sight. I think it is very hit or miss. Some times people have unreachable expectations of their doctors.

   Posted 5 months ago | # |
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   4Rest
   

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   When I was 17 (November '77), I turned my ankle. Initially I thought it was a bad sprain, but the hospital was on the way home, and it was hurting so much I went in and had it looked at.

   The older doctor that saw me concluded it was a a very nasty sprain, that I should go home, elevate, ice and come back in three days when the swelling had gone down. Waste of time coming here I thought, as that was I was going to do anyway.

   As I was getting dressed (why do they make you strip and put on the gown even when the injury is nowhere near your torso?), the other doctor, a young Australian intern, came back and asked if I would consider a second opinion.

   Naturally I was interested, he told me he thought that my ligaments had snapped, and if this was correct, then I needed surgery within a few days.

   He arranged for a visit with a specialist for the following morning, the specialist had no hesitation in confirming that my ligaments had indeed snapped and surgery was scheduled for the following morning.

   I was in hospital for two days, thigh to toe in plaster for six weeks, and managed to return to playing for the last three games of the season in May.

   To this day I thank that young Australian intern for intervening - if he had not, I don't even want to think about how it would have ended.

   Posted 5 months ago | # |
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   I went through he same B.S. when i tore my ACL. My family doctor and an otho doctor were convinced it was cartilage damage. I bumped into a friend who was in Med school. He came over to the house to take a look at the knee. 10 minutes in he stated that it is more then likely the acl as he had no problem separating the joint. Sure enough he recommended a different otho surgeon. I was in the surgeon’s office in 3 days and under the knife for a complete repair of the ACL, some tightening of the MCL and PCL in about a week. Funny no cartilage damage.
   As for rateyourmd.ca, I have been on the sight. I think it is very hit or miss. Some times people have unreachable expectations of their doctors.

   Not sure about rateyourmd.ca, but this site:
   http://www.ratemds.com/social/?q=node%2F28882&sid=58

   is very comprehensive. I've been unable to enter a doctor that ISN'T rated. The dentist I had in public school who retired 20 years ago is in there. LOL!!! Not sure how to make links "clickable" on here, but just cut 'n' paste it into your browser.

   I agree that some have expectations of their doctors that hard to meet, but I don't. My doctor quickly concluded that my Achilles must be intact because I could easily move my foot all around. I would expect any doctor with their strong understanding of anatomy to know this to be false. I don't want this to sound like I'm faulting anyone; at the end of the day we are all responsible for our own health and well being, but I would have preferred not to be led down the garden path.

   Posted 5 months ago | # |
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   EBIND
   

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   Hey Admin, Fault your doctor. Your well-being is in his hands. At the end of the day if you did not bump into another Doctor that you knew, you would still be limping around. Your doctor needs to know their boundaries and then advise you on whom to see.

   Posted 5 months ago | # |
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    Dislocated my shoulder during a game a few months back. Went to emergency and the doctors had me sitting in emergency for hours on end in the worst pain imaginable. Finally they brought me into a room where it seemed they may finally pop the shoulder back into place...not so much, I waited another couple hours where they provided me with morphine to ease the pain, which in my opinion was a waste of money when it takes a couple of seconds to pop the shoulder back into place...they finally transferred me to another even smaller room where I waited another couple hours...this whole time with my bone popping out of my shoulder where the pain got worse by the minute (the morphine did not help with the pain)...finally after hours and hours of waiting a doctor came in and performed the 20 second prodedure of putting my shoulder back into place...they never did a scan prior to this, which i was told they would do and was the reason i was waiitng so long...they did an X-ray after the fact evetn though this was clearly not a broken bone...finally had an scan a few weeks later and was told to do physio for 8-12 weeks a couple times a week...they tell me now the shoulder is OK, even though it has very little flexibilty and does not feel the same at all...I dont think i can trust the medical system any more since this incident and from Admins story, it all sounds fairly bleek.

    Posted 5 months ago | # |
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    wooooo, I've often wondered about separated shoulders. Does the extreme pain subside as soon as the shoulder is popped back in?

    I am hopeful that my story will have a happy ending.

    Posted 5 months ago | # |
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    woooooo
    

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    The pain went away almost immediately after it was put back into place.

    Posted 5 months ago | # |
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    4Rest
    

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    my shoulder pops occasionally - legacy of my fast bowling playing cricket = the last few occasions when I've been running the line.

    It's a strange pain, hurts like hell, like you've been burnt, but it quickly subsides.

    It doesn't hurt as such once it's back in, but it's very tender and you really don't want to wave your arms about too much for a day or two

    Posted 5 months ago | # |
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    PART 4

    By the time I had left the fracture clinic, an appointment for an MRI had already been scheduled for me for 2 days later. I guess it's comforting to know that when a medical professional figures that you real, real need an MRI, you can get one post-haste. Since the surgery was only 10 days away, the MRI was scheduled without delay.

    I began to research the proposed surgery online: FHL Transfer/Achilles Turndown.

    LESSON #5: ONLINE RESEARCH IS RECOMMENDED, BUT BE PREPARED AS SOME OF WHAT YOUR LEARN MAY BE CAUSE FOR CONCERN.

    The FHL tendon is the one responsible for flexing your big toe down. In my procedure, this tendon would be removed, or as the online description put it, "harvested" (doctors like to use farm terms) and "grafted" (another farm term) to my dysfunctional Achilles.

    How is this accomplished? If you asked any 8 year-old, they'd probably have it figured out. An incision is made on the big toe side of your foot exposing the FHL tendon. A long incision is made on the back of your leg, mid-calf down to your heel. The end of the Achilles that is attached to your calf is identified. Any scar tissue is removed ("debrided"). The FHL tendon is removed via the incision in the side of your foot. A 5mm hole is drilled through your heel bone ("calcaneus"). The FHL is threaded through the hole, looped around and then sutured to itself. So now you have one end of your FHL tendon secured to your heel bone with the other end free and one end of your torn Achilles tendon attached to your calf with the other end free. The free end of your FHL tendon and free end of your Achilles tendon are then sutured together taking care to keep the tension in the repaired leg the same as the tension in the good leg. Suture (or staple) up the incisions. Cast the leg from the the knee down to the toes with the foot flexed in a downward position to allow the tendons to "knit" and see you in 6 - 8 weeks. Of course, all of this is done while you're asleep, so no sweat, right? Or so I thought (more on that later).

    I must admit it can be quite disconcerting while researching when you see an image of some poor guy with his foot dissected and in the same image, you can see a drill in the background. The same looking drill that I have in my basement that I used to hang the blinds in the living room. A drill in the O/R is cause for concern. ;-)

    What about the poor big toe? You're correct if you've figured out that a big toe without an FHL tendon is dysfunctional. In the grand scheme of things, being able to have a functional Achilles-calf complex is much more important than being able to pick up a pencil with your toes, so the big toe becomes the sacrificial lamb in this procedure. A dysfuntional big toe is something the doctors would refer to as "not clinically significant". I guess ballet dancers with ruptured Achilles tendons are not candidates for an FHL transfer.

    [more later]

    Posted 5 months ago | # |
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    EBIND
    

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    Just on a side note. Was the option to harvest the tendon from a cadaver not available? I know they will do a cadaver harvest for an ACL if you are ok with receiving a dead persons tissue.

    Posted 5 months ago | # |
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    Just on a side note. Was the option to harvest the tendon from a cadaver not available? I know they will do a cadaver harvest for an ACL if you are ok with receiving a dead persons tissue.

    I wasn't given the cadaver option. While researching, I didn't come across any cadaver options for Achilles repairs. Maybe it isn't a viable option.

    Posted 5 months ago | # |
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    RDS
    

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    I've seen you play.If you were a horse you would have been put down
    right after the injury occurred.Maybe they should have done that to you
    and then we would have had your cadaver available to harvest for the good players.LOL

    Posted 5 months ago | # |
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    Ajaxfc
    

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    what is a cadaver ?

    Posted 5 months ago | # |
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    what is a cadaver ?

    AjaxFC, a cadaver is what RDS sees every time he looks in the mirror.

    Posted 5 months ago | # |
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    RDS
    

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    No, no, Admin.I see a wanker.Do you know 8 out of every 10 men
    admit to self stimulation,the other 2 lie about it!

    Posted 5 months ago | # |
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    PART 5

    With the surgery 1 week away, I went through the usual discourse.

    1) MRI. Surgeon requested this to confirm the size of the gap that needed to be fixed. I never found out the results.

    2) Pre-op visit to family doctor. The usual blood pressure check, medical history stuff. I waited for her to ask why the doctor performing the surgery was not the doctor she referred me to (Dr. Paitich). She did not. I have co-workers whose doctors remember where their patients went on vacation 3 years ago and all the other minutiae. My doctor is certainly not one of those. She asked me what the surgery was for. ??? Not that I'm looking for a new best friend in a doctor, but the recollection of some pressing medical details would be nice. I guess in today's world, even this is asking too much.

    3) Pre-op blood work at the hospital. The only thing remarkable here was the actual visit to the hospital campus. If you never been to the William Osler hospital campus and you need to go, DON'T park by the wrong entrance. You might have a 30 minute walk through the building to get to where you need to be. I was running late and was rushing through the halls and was actually passing people along the way. It had been over 2 months since the injury and realized then that I was learning to cope with my limp. Running was absolutely impossible, but walking fast could be accomplished. The pain in the trauma region was gone, but when you have to walk flat-footed all day, your heal will begin to ache. I had a gel insert in my shoe that helped alot with this heel pain.

    During my research, I read, "Post surgery, about 50-60% of recovery is gained within the first 6 months; however it may be 15-18 months before for maximal improvement is achieved."

    LESSON #6: ACHILLES RUPTURE REPAIRS REQUIRE A LENGTHY REHABILITATION.

    You can break your leg in 2 places and be playing 2 months later (although I wouldn't recommend it). Not so with surgical repairs of the Achilles. It would likely be a year until I could push off with my left foot with power. This is likely why many athletes (weekend or otherwise) "call it quits" after an Achilles rupture. Isiah Thomas comes to mind.

    [more later]

    Posted 5 months ago | # |
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    RDS
    

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    Look on the bright side.It will be quite a lengthy rehabilitation but
    thats better than what happened to the original Achilles.He died as a
    result of his injury!

    Posted 5 months ago | # |
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    Ajaxfc
    

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    Well it is 365 days by 6 month time you can walk normally , or even play but most ppl they wait another 6-7 months (knowing how good the medical system is) to be positively sure, and I have seen them run and 'miskick' the ball with that same injured foot good as ever, and I knew ok all is well

    But the first 3-4 months are something to get used to

    Posted 5 months ago | # |
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    GamedayDreamrz
    

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    On the same note....I had a player this session played two minutes of the first game and re-injured his knee which he had waited 2 years after surgery. To date he still isnt moving on it 100%. It wasnt even a challenge that caused the injury again. He simply recieved the ball and turned with it, heard his knee pop and that wasa it.

    Posted 5 months ago | # |
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    Ajaxfc
    

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    I question sometimes the idea that , do professional players get better service then us mortals gets

    Cuz I hear professional players blowing their knees left and right breaking legs , in half and doctors seem to fix them up but when every I see a non pro player gets injured I hear he is never back to his old glory days ...

    Is it becuse the pro players just get better health care ?

    For me a doctor that cannnot communicate to me as a person on a personal level is worth nothing -

    I don't know ... but if Ronaldo (the chubby one) can recover , from 3-4 serious injuries still eat like pig and play I am sure technically every one should be able to play again

    Posted 5 months ago | # |

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