FEET, FAIL ME NOT. « Soccer Talkers

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FEET, FAIL ME NOT.

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Started 5 months ago by ADMIN
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ADMIN

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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

The average pro athlete is younger upon injury than the average rec player. EVERY pro athlete is fitter than ANY rec athlete. And YES, I would have to believe that access to top notch medical care, physio, nutrition would be readily available to the pros and not necessarily the rest of us.

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

Posted 5 months ago | # |
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The main reason a pro recovers from an injury much faster then us non-athletes is because of the conditioning of the muscles in the injured are pre- and post operation. If you are in average physical condition when you blow out your knee it would take you longer to recover then if you were an athlete whose world revolves around training. This also comes in to play after the surgery.
The average Joe does not have the time or the resources to receive the reconditioning that a pro athlete might receive. I don’t know how many average Joes can afford a personal therapist, and a trainer 5 to 6 times a week for 5 to 6 months. Even with work benefits at $2000.00 for the year, you are not even going to afford 1 month worth of training that these guys get.
When I blew my knee I was lucky that there were still physico clinics that OHIP covered. Even then I was limited to 3 1-hour sessions a week for 12 weeks. After that it was up to my extended heathcare benifets and me to cover the coast. Thanks to Mike Harris, this is no longer available. ( That was for all you Liberal Hates)

Posted 5 months ago | # |
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I would agree with you, EBIND. Also, elite athletes likely have better muscular and skeletal dispositions at birth, which is part of the reason they got to elite status.

We've all known those lucky few who have had try-outs with the big clubs overseas and have maybe even made the 3rd division B team. One thing they'll always remark on is the difference in fitness.

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Part 6

The day of the surgery arrived. I was asked to be there 2 hours prior, so I arrived at the hospital around 7:30am. Thankfully, this was the opening day of the Olympics so there was plenty to read in the waiting room. Who was going to light the flame seemed to be the big debate in the Toronto Star.

Some lady was getting a scolding for forgetting her health card when they called me. A bunch of questions were asked, all of which I had answered before. Back to the waiting room. Another call. Another nurse. Same questions. This time I was given two gowns to change into and bag for all my belongings. They marked the bag with my name and also marked the crutches I had brought with me. Back to another waiting room, where everyone else was “gowned”. Another call. Another nurse and then came the same questions AGAIN. One significant difference this time. She asked, “Do you use an M-PAP and a C-PAP?” I paused trying to digest what she had asked. I was thinking about saying, “I’m not here for any kind of PAP thing, lady. Wrong gender” when she continued, “For your sleep apnea? M-PAP or C-PAP? It says here you have sleep apnea.” She showed me the chart with my name on it and under, "Conditions", someone had scrawled, “Sleep Apnea”. I revealed that I did not have sleep apnea and silently wondered what other errors were on my chart. Maybe I was being admitted for rotator cuff surgery? A colonoscopy? A vasectomy? Who knows? It also amazed my how the same set of questions could get asked 5 times by 5 different people and still an error occurred.

Instead of being brought back to the waiting room, I was brought to a large room with a bunch of beds and directed to mine. A nurse came by and started my IV. Saline and antibiotics (I think). I still had 40 minutes before my 9:30 surgery, so I got back into my Star. I caught snippets of other convos at other beds. One guy was having his knee replaced, a few older gents were having cataract surgery, the girl across from me had nasal polyps. 9:30 came and went. So did 9:45, 10:00, and 10:15. I was now nearly through my second bag of IV. I asked the nurse if Dr. Alexander was running late. She responded that she didn’t know, but it was unlike him to be late.

A few minutes later, the anesthesiologist, Dr. Singh came by. After some questions about my medical history, he explained to me that I would be given a sedative to relax me, a nerve block from my knee down that would give me relief from pain for 16 hours, and a “spinal” that would allow them to do the surgery. I was surprised that I would not be "put under” for this surgery, but have since learned that there are numerous advantages to spinals over generals; namely cost, less blood loss, and your airway is not compromised. There was one BIG disadvantage, which I will get into later. Anyway, I was not keen on being “put under” and was generally pleased that I’d be somewhat lucid for the surgery.

A few minutes later, Dr. Alexander came by. Same pleasant bedside manner as the first meeting. He introduced me to Dr. Flores from Niagara Falls (I think) who would be observing/learning the FHL transfer/Achilles turndown procedure. I was comforted by the fact that my surgeon would be teaching the procedure to another. In my world, that meant (i) he must be pretty good and (ii) he would be less likely to screw up with one of his peers there watching. I asked a few additional questions. Dr. Alexander initialed my left ankle with a Sharpie and indicated that he’d see me in a few minutes.

The O/R nurse, Rupinder came to fetch me and I began my gurney journey down to O/R.
Drs. Alexander and Flores greeted me at the O/R door. I was wheeled in and nervously glanced around looking for the drill. I didn’t see it, so they must keep those things well-hidden. LOL!!! Dr. Alexander introduced me to the other members of the surgical team and announced to all what surgical procedure would be carried out.

Dr. Singh instructed me to move to the narrow operating table beside me and lay prone (face down) with my feet dangling over the end. He asked me to get comfortable. I turned my head to the right and then to the left and got settled. I noticed a monitor about a metre away with an image of a pair of feet on it. Could this be a training aid or could it really be….I wiggled my toes….YUP, the feet on the monitor were mine. “Um, guys…am I supposed to be seeing this?” I asked. “That’s entirely up to you.” came the reply, “If you’re squeamish, just close your eyes and go to sleep.” Nah, this was going to be cool. I was the kid who volunteered to dissect the cat in Grade 13 biology. Everyone else did the frog or the fetal pig.

After that things happened very quickly and efficiently. I don’t recall the nerve block being administered in my knee or the spinal, so I guess the sedative was working. I do remember my legs (both of them) being swabbed with a reddish solution (iodine?) and the cutting starting. To my surprise, there was very little blood. I remember in my research reading that a tourniquet would be applied to the thigh to greatly reduce blood flow, but I don’t recall this in my procedure. Then came my questions.

“What’s that yellow stuff?”
“Fatty tissue.” was the reply. [I wonder if the reply would be the same if I were a female??]
“Is that the tendon sheath?”
“Yes, I’m just cutting through it now.” came the answer.

I recalled Dr. Alexander commenting on how badly damaged the tendon was and that’s it. After that, the sedative must have kicked in because I don’t recall anything and must have dozed off. I’ve concluded that the doctors figured by my questions that I was a “talker” and likely upped the dosage on the sedative; otherwise we all would have missed the Opening Ceremonies later that night. LOL!!!!

[more later]

Posted 5 months ago | # |
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Part 7

The rolling of the gurney back to the recovery room must have jarred me from my light slumber. By the time I was wheeled into the room, I was wide awake. Apart from being senseless from the waist down, I was feeling pretty good.

It occurred to me that the cataract guys were back recovering as was the girl with the nasal polyps, so although it felt like 15 minutes had gone by, I knew that it must have been longer. My wife confirmed that it was now after 1:00pm, so the surgery must have been around 2.5 hours. Dr. Alexander had told her in the waiting room that everything had gone well and the tear in my Achilles was 7cm long.

I recall the nurse bringing me a cracker and some apple juice, which I quickly quaffed (bad idea). Shortly thereafter, feeling began to return to my lower extremities. Recall that because the surgery was delayed, I had a extra bag of IV in my system, plus any IV during and post-op, plus the apple juice. I had the overwhelming, painful sense that I had to "go", but nothing was working yet. I guess this is the big disadvantage of spinals.

When I could no longer stand it, two nurses got me up on to a wheelchair and brought me to the washroom, all the time warning that it was "too early" and I would NOT be able to "go". They were right. ~~~Curses!!!~~~

As it turned out, all I needed was a little inspiration. Someone mentioned the word, "catheter" and that helped tremendously. :)

The nurse warned that the nerve block on my left leg would likely last until the wee hours of the morning and after that, there would be "discomfort". She started me on my course of painkillers. Oxycodone (aka: Percocet, Percs, hillbilly heroin, Tylenol 7, fixer, goodies, four doors). My apologies to any addicts reading this, but I can't see how you can get hooked on this stuff. I just got sleepy, had a ringing in my ears, and I think I even drooled. I was asleep in 15 minutes.

It was approaching 6pm and I guess the nurses figured they had had enough me because the rushing started. They got me dressed, gave me my prescription, some deep breathing instructions to prevent blood clots, my follow-up appointment, and some other written instructions. While my wife went to get the car, I asked the nurse if someone was going to show me how to use the crutches. I knew it wasn't rocket science, but since I had never used a set before, I figured it was a fair question. "Oh, we don't do crutch watch here", she barked. "We'll give you some literature" (they never did). Wow, it wasn't like I asked her to make me a sandwich. I guess her shift was ending and she wanted to get home for the Opening Ceremonies. Fair enough as I had that on my mind too.

LESSON #7: WILLIAM OSLER HOSPITAL DOES NOT DO "CRUTCH WATCH".

Soon I was home, feet up, parked in front of the television. My left leg from the knee down was still completely senseless. I got my first good look at the leg. A big back-slab plaster cast had been applied. My foot was flexed with the toes fixed pointing down somewhat.

It surprised how close the experts from the Star had come to guessing who would light the Olympic flame.

Let the Games begin.

[more later]

Posted 5 months ago | # |
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Part 8

The first obstacle presented itself. How the hell does one go up and down the stairs on crutches? In the end, I figured it would be best to have a set of crutches for the main floor and another set for upstairs and scale the stairs on my butt, thereby eliminating the need for crutches on the stairs. I thought that was clever until I figured out 2 weeks later just how easy it was to do the stairs on crutches. It’s like riding a bike. You can’t read instructions on it or have someone explain it; you just have to try it.

The nurse had one thing right. That nerve block that completely numbed my left leg from the knee down wore off in the wee hours of the morning. The “discomfort” she warned me about woke me from my sleep. It was maybe a 6 (on a scale of 1 – 10), but figuring it would only get worse, I threw back 2 Percs. I was asleep again in 15 minutes.

I took 1 more Perc the next morning and went cold turkey after that. Don’t bother PMing me asking to have or buy the remaining 97 tablets. I already returned them to the pharmacy, but I did have offers. Sad.

My post-surgery instructions were to lay in bed for at least 3 days with my foot elevated to reduce swelling and do my deep-breathing exercises to prevent blood clots. Apart from the regular washroom breaks, this is pretty much how it went for 3 days. Thank God for CTV’s extensive Olympic coverage. LOL. I’m glad we do well at it, but how did curling become an Olympic sport? Doesn’t curling exist just to justify beer drinking? Sorta like Oktoberfest? I’m sure bowling, billiards, and darts can’t be that far off.

LESSON #8: THERE’S A FLEDGLING MOVEMENT AFOOT TO GET BARREL JUMPING INTO THE WINTER OLYMPICS. I WOULD SIGN THAT PETITION IN A HEARTBEAT. “GASTON LAPIERRE…GOLD MEDAL, CANADAAAA!!!!!”

I returned to work on Tuesday, 4 days after the surgery.

[more later]

Posted 4 months ago | # |
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Part 9

Driving to work on Tuesday made my leg ache. This was the first time I had my foot down for any length of time since the surgery. By the time I got to work, my toes were purple and very swollen.

I am fortunate that I have an office job that allows me to keep my foot up. With Achilles surgery, there is no weight bearing for 6 - 8 weeks, so had I been a mailman or a mechanic or say a lumberjack, I would have been off work for a great deal of time. This is why some after surgery can do nothing more than lay in bed for 6 weeks.

Elevating my foot brought instant relief. I could still feel some discomfort around the sutures (which I was to learn later were actually staples), but this was relieved somewhat by resting my elevated leg on the side of the calf rather than the back of the calf.

My co-workers were great. Appreciating that I had an obvious mobility issue, most brought me my mail, water, lunch. I figure I'll be owing them big time down the road.

I decided to try out the big toe. If you've been following this blog, recall that my FHL tendon was "harvested" to save my Achilles. This meant I would not be able to flex my big toe down. I wiggled it. No problem. I tried to point it up. A little stiff, but I could point it straight up. I tried to curl it down. I got it to neutral and that was it. There were be no more picking up quarters on the beach as the functional ability to curl my toe down under my foot was gone.

I am grateful that this has been one of the mildest winters in recent memory. Getting around on crutches is hazardous at the best of times. I imagine attempting the task in a foot of snow and ice with the wind howling around would be downright foolish.

Showering would be another foolish task. I tried it once. Cast wrapped in a garbage bag trying to balance on one good leg on a wet, soapy, slippery ceramic floor would certainly have qualified me for a Darwin Award had I broken my neck. I doubt I would have won, but top 3 finish for sure. Own the Podium! So baths it was. I hate baths. Do you really feel clean after a bath? I don't. I just feel as though the dirt on me has been relocated.

I had 10 days until my post-surgical follow up appointment. I fell into a weekday routine of going to work, spending my days with my foot up working in front of a computer, coming home and spending my free time helping the kids with their homework and watching the Olympics. Weekends were spent sleeping in, watching movies/Olympics/emailing on the laptop. A real slug's life.

LESSON #9: WHAT DO 100% OF ALL LOTTERY JACKPOT WINNERS DO? GAIN WEIGHT. IT'S A FACT. GOOGLE IT.

Same is likely true of those on crutches who are unable to bear any weight on a leg. It's hard to burn calories laying on a couch flipping channels between NBC (Brian Williams) and CTV (um...Brian Williams!!!). I read, however, that those on crutches for any length of time can look forward to toning their arms and shoulders. So I got that goin' for me. LOL!!!!

[more later]

Posted 4 months ago | # |
EBIND

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Weight gain after surgery. You better believe it. I was not a small guy to begin with when I blew out my knee. I went 210 lbs to 276lbs in a mater of 3 months. Mind you I was also working in construction at the time of my injury. It took 2 years to get back into shape (some what). Your new lesion should be change in diet. Most patients gain 10% to 15% of their body weight after a surgery that deems them immobile for more then 6 weeks.

In my case I had just gotten engaged so I had an Italian mother who waited on my hand and foot. A Girl friend that would always bring over something for a snack aka McDonald's. A future mother-in law that insisted on having me over for diner 3 times a week. (that is 2 diners in one night 3 times a week for 3 months ). I was also on some sort of steroid for the first 6 weeks. Steroids + limited mobility = FAT. 66 Lbs. In 3 months.

An you top that one Admin..

Posted 4 months ago | # |
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Whoa...that's unreal weight gain. You increased your weight by 30% in 3 months. Or about 5 lbs/week. That's some serious chowing down. LOL!!!! Hope you got back to where you want to be.

Posted 4 months ago | # |
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Part 10

My follow-up appointment was scheduled for Wednesday, February 24th, 12 days after my surgery.

I parked at the usual place when I go to the hospital, between entrance A and B. Big mistake. On crutches, it was a good 15 minute jaunt from there to the fracture clinic. Oh well, I'll know next time.

Still, I made it to the registration desk 5 minutes prior to my scheduled 8am appointment. This was the morning of the big Canada vs. Russia Quarter Final hockey game so I tucked into the Star figuring I'd be awhile. To my surprise, I was called almost immediately.

LESSON #10: GO FOR THE 8AM APPOINTMENTS AT THE FRACTURE CLINIC. YOU MIGHT AVOID THE 3 HOUR WAIT.

A nurse led me to my room and began to cut away my back-slab plaster cast. I understood that I would be fitted with a new full cast that day. I was given the advice by some others who'd gone through this that a good idea is to rub some moisturizing lotion on your skin between casts to prevent the skin from drying out. I told the nurse that I had brought some lotion with me that I intended to use. She paused, grinned and blurted, "Ya, no problem". Still grinning minutes later and assuming that this lotion thing had amused her, I had to ask,
"I'm gonna be the joke-of-the-day in the lunchroom, aren't I?"
"No", she laughed, "It's just that guys typically don't think about that."
Ya, I'm sure I went on to be the joke-of-the-day. LOL!!!

No matter. I was excited to see my leg back in the flesh. The front (shin) was in surprisingly good shape. Looked fine. The back, however, was a different story. The gash was from the base of my heel to mid-calf and the wound had been stapled every 5 mm's or so. The nurse introduced me to the nursing student, Sean who was going to remove the staples. Did his name tag really say, "Nursing Student"? Yes, it did. Why me? A nursing STUDENT to remove staples? Really?

As Sean washed my leg with warm water, I struck up a nervous convo with him.

"So Sean, ever done this before?"
"Ya, this is all they let me do here."
"Oh really, so you do this often?"
"Ya, all the time."

This put my mind at ease. I figured he must be good at it if he was to "go-to guy" on the staple team. Thankfully, I was right.

Around this time, Dr Alexander walked in. He mentioned that the surgery had gone well and that I was in for a "long rehab." I sorta figured as much from my research, but he probably gets those who haven't researched at all asking if they can play again that weekend once the staples are removed and therefore preempts that question with the "long rehab" line.

While talking to Dr. Alexander, I lost track of how many staples Sean had removed. But he was up around 40 by the time he was through. He swabbed my wound with something (alcohol, I'd guess) and began to apply a non-adhesive dressing when I asked,
"What about the other staples?"
"What other staples?", he replied.
"Are there not more by my big toe?", I asked.
I was unwilling/unable to bend my leg or foot in a way that would allow me to get a look at the second surgical site (where the FHL tendon was removed), but I assumed it was there somewhere.
"No", replied Sean, "You're done."
I thought, "What? Was I misled?"
I was told that my FHL tendon would have to be removed to fix the Achilles.
My mind raced thinking, "Maybe when Dr. Alexander opened up my calf, it wasn't as bad as he thought and he was able to quickly suture it together? But I couldn't flex my big toe. Something doesn't add up."
I applied my lotion ;-) while Sean finished applying the dressing and led me to another room where others were having casts removed and applied. The technician Jim introduced himself and told me that I would be having a fibreglass cast applied. Fibreglass casts are much lighter and stronger than their plaster counterparts, but there is one drawback...

"There will be a nominal charge for this", Jim said, "and the bill will be sent to your home."

I still haven't received the bill, but have since learned the nominal charge is $80.

Jim asked me to pick which colour I wanted. There were about 10 different styles/colours to choose from: black, orange, a white one with green frogs, but I quickly settled on the red one. This was afterall the day of the big hockey game, so I figured I'd go as patriotic as possible. These fibreglass casts go on wet and it actaully looked kinda "wine" coloured as Jim was applying it (sorta Portugal home, circa: 1998). This wouldn't do. Noticing the look of consternation on my face, Jim offered, "Don't worry, it will dry red!" Whew!!!

The angle they chose to set my foot at was 75 degrees, with the goal being 90 degrees (the foot perpendicular to the leg). A follow-up appointment was made for March 10th. As much as I tried, I struck out on the 8am slot (all booked up). We'll see how the 10am one goes.

I saw Dr. Alexander on my way out and got in my question.

"Dr. Alexander, I noticed there was no defect on the side of my foot."
"Why would there be?", he asked.
"Oh, I thought you had to remove my FHL tendon?"
"That's totally old-school", he laughed, "We removed everything through the back of your foot."

He went on to explain that there are only 3 centres in North America that use this approach and it's relatively new. This would likely explain why I never found anything on the web regarding this mode of surgery. The benefits are obvious. One surgical site instead of 2 which, therefore cuts (excuse the pun) in half the chance of infection, nerve damage, mobidity, etc..

With the cast now dry, solid, and Team Canada red, I made the long journey back to the exit.

[more later]

Posted 4 months ago | # |
EBIND

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DID you not read the part about a Italian Mother. She stayed home for the first 3 weeks just to make sure her son was eating.( I was the KING).Three months later i was also the KONG. Pasta anyone.

Posted 4 months ago | # |
woooooo

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"These fibreglass casts go on wet and it actaully looked kinda "wine" coloured as Jim was applying it (sorta Portugal home, circa: 1998). This wouldn't do. Noticing the look of consternation on my face, Jim offered, "Don't worry, it will dry red!" Whew!!!"

EH! You would of been lucky to have that wine colour!! lol

Posted 4 months ago | # |
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"EH! You would of been lucky to have that wine colour!! lol "

Well, it certainly hasn't been lucky for the golden generation, has it? X-D

Posted 4 months ago | # |
4Rest

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Did Dr Alexander decorate his hallway through his letterbox?

Posted 4 months ago | # |
hookminor

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It appears that, aside from the football skills, Admin has something else in common with Beckham.
However, somehow, Beckham doesn't have to wait for his surgery as long as Admin did.
I wonder is the hospital he'll have his surgery in is one of the three that pulls the FHL tendon through the back of the foot. They only do that for elite athletes, I think!!

Posted 4 months ago | # |
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Ruptured Achilles'...it's not just for weekend warriors, anymore. LOL!!!

God's speed, Mr. Beckham.

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PART 11

I had my first real scare when one of the crutches slid out from under me after slipping on a piece of paper on the floor. The human brain is a great thing, but nothing's gonna stop those automatic reactions and when my crutch slipped, the immediate reaction was to plant my left foot. I think on a scale of 1 - 10, the pain was probably a 42. It was one of those sharp, aching, throbbing, burning, shooting, stabbing pains you get when you PLANT YOUR EFFIN' FOOT AFTER HAVING YOUR ACHILLES' RE-ATTACHED. The kids were within earshot, but that didn't stop the stream of profanity from leaving my mouth (another one of those automatic reactions, I'd guess). I didn't move for awhile hoping the pain would subside (it did) and hoping the kids hadn't heard my Richard Pryor imitation (still not sure about that).

LESSON #11: IF YOU'RE GONNA BE HOBBLING AROUND ON CRUTCHES, MAKE SURE YOUR HOME IS CLUTTER-FREE.

I struck out on my idea of parking closer to the fracture clinic for my second follow-up appointment when all the lots were full. So, again I parked between entrance A and B and prepared for the 15 minute crutch jaunt down to the clinic. There was much less arm fatigue this time, so I guessed I was getting the hang of it.

My appointment was scheduled for 10:45am and upon check in, I was informed that Dr. Alexander was running 90 minutes behind, which would easily turn into 135 minutes behind by the time I saw him. I settled into the Star. Brewer alum', Peter C. (who works at the hospital) paid me a surprise visit in the waiting area. He has been reading this blog and gave me some advice on the stair climbing ("good go to heaven"). Thanx Pete. Makes sense now.

I was finally called for my 10:45am appointment around 1pm. I sat in the examination room for another 30 minutes. As it turned out, it was someone's birthday and there was a big cake and celebration going on. The gang at the fracture clinic seem like a tight knit group who really enjoy their work and that's nice to see. The technician, Tony cut away my fibreglass cast. I was horrified to see my atrophied limb. I have chicken legs to begin with, but now my left was definitely Angus Young-like. Hard to believe how quickly it withered away. I would be willing to bet the girth of my calf is no bigger than that of my forearm.

Dr. Alexander came to see me. Strangely, I was expecting him to be horrified too (he was not) even though he likely sees these limbs tens-of-times a day. I began to ask him about my episode when the crutch slipped, but he stopped me in mid-sentence and basically assured me that there would be no damage as long as I had the cast on. I assumed from his answer that these kinds of slips happen all the time and I'm not the only clutsy crutch-walker out there. He moved my foot all around and checked the tension in my new Achilles' system. Pleased that I was able to get my foot to neutral (90 degrees), he instructed Tony to fit me with an aircast. My instructions were to continue the non-weight bearing for another two weeks, but to try and use my foot more and more each day.

Tony fitted me with an aircast. If you've never seen one of these suckers, the inventors obviously "borrowed" the design from a Stormtrooper costume.

My aircast:

The great thing about the aircast is that you can take it off to:
1) do your stretches,
2) shower,
3) scare your kids by showing them the gash on your leg.

I was given some very basic daily stretches to do and a follow-up appointment in two weeks time and was sent on my way.

That evening, I had my first shower in a month.

[more later]

Posted 4 months ago | # |
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hookminor wrote:
"I wonder is the hospital he'll have his surgery in is one of the three that pulls the FHL tendon through the back of the foot. They only do that for elite athletes, I think!!"

Since Beckham had his surgery right away he would not need the FHL transfer. The fact that his surgery took a mere 50 minutes would confirm this.

Posted 4 months ago | # |
EBIND

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I think they knew what they were doing with David. After all they flew him to FInland for the surgery. I bet he got to look at some ass while he was there.

Posted 4 months ago | # |
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PART 12

Going into my 6th week on crutches, I made a few observations:

1) A few nights ago, I woke in the middle of the night needing to go to the washroom (ya, I'm getting to that age now). I crutched it over to the "john" still in my sleepy stupor and I noticed my heart was racing. What was this all about? Had I been dreaming? No, don't think so. I was just that out of shape. It's a sad reality that you can spend much of your adult life rising before the sun 3 or 4 times a week, jogging a few miles to maintain a certain level of fitness only to have it quickly evaporate when you're laid up with an injury for a few months. But I guess, to paraphrase Cher, "If fitness came in a bottle, everyone would have it."

2) To alleviate the boredom, I've resorted to stunt crutching (or is it crutch stunting?). I think this is my mind sub-consciously telling my limbs to GET MOVING. I can balance on the crutches now with both legs off the ground, do air splits, and even managed to hold a pike position for a few seconds. I told my wife of my intention to have her "time" me on the stairs this weekend. She just gave me "the look". She'll likely have no part of this, but I think my son who shares my zeal for competition can be easily talked into it. Like I said...boredom.

3) I managed to get out to a few matches at the Soccer Centre and Fairgrounds this week. Not being that mobile, I figure I've had a legitimate reason for foregoing much of the action over the last 5 weeks, but I think there's more to it than that. When you know you can't play and likely won't be able to for several months, watching becomes much more difficult or even unbearable. I remember when I was a kid reading that when Bobby Orr was forced to retire (still hard to believe he was only 31), he couldn't even watch a game or read a sports column for months. No, I'm not comparing myself or my injury to Bobby Orr('s), just an observation. Most of you watch matches knowing that you'll be getting your "fix" soon. I cannot.

I took my first tentative steps sans cruthces this morning. After a deep breath, I managed 3 steps (2 with bad leg, 1 with good leg) across the bathroom floor and then exhaled. The bad foot was still in the walking cast, so it was secure. The was no pain in the Achilles' area, but just about everywhere else. My foot immediately ached and I could feel and hear the joints that haven't been stressed in over a month. I could also feel the discomfort in my knee and hip. These joints have been on cruise control for some time now, so I guess this can be expected.

The simple exercises that I've been doing (ankle pumps, ankle circles) have proved stubbornly difficult and I think this is due to the fact that there is still moderate swelling in the ankle. To reduce the swelling, I've resorted to a couple doses of Advil/day and elevating my foot for longer periods during the day. I'm hoping the exercises will be easier once the swelling has been reduced and I can get the next hurdle soon.

[more later]

Posted 4 months ago | # |
Ajaxfc

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hmm beckhem got same injury too

Posted 4 months ago | # |
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PART 13

In a very short period of time, the walking without the crutches has grown exponentially. I am now up to walking around without crutches most of the time with the goal being to the shed the crutches altogether in another couple of days.

Again, the problem hasn't really been the Achilles' area, but my sacroiliitis. I've had flare-ups with it over the last 10 years. When it gets really bad, I can't walk and even sneezing or coughing will bring on immediate pain to the area. The first time I had it, I was on Advil every couple of hours. My doctor sent my to a rheumatologist who prescribed Voltaren (Diclofenac), which I consider to be a wonder drug since it cleared up the inflammation in a couple of days. I guess not using the joint in 6 weeks and then trying to walk on it brought on the sacroiliitis.

David Beckham's torn Achilles' has brought some much needed attention to the ailment. If you've seen the video, you can see how easily these tears can occur. No one is around Becks, he's hardly even moving, and when it tears you can see him look behind to see who kicked him (a typical reaction). We also hear that he will (likely) miss the Finals and will be out of the game for 6 months. That's interesting because I've had no fewer than 6 clowns tell me that when they tore their Achilles', they just "wrapped in in a tensor and were back playing in 2 weeks". Ya...ok! Listen, we all like to commiserate about wounds/injuries, as evidenced by this blog, but let's keep the fairy tales and embellishments out of it.

I had my 3rd follow-up appointment with Dr. Alexander at the fracture clinic yesterday. He manipulated the ankle and pronounced the progress as "excellent". I have been given the go-ahead to:
1) lose the crutches
2) gradually ween myself out of the air cast
3) begin "agressive" physiotherapy with "no restrictions".

[more later]

Posted 4 months ago | # |
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Good to hear it went well Admin..."your sacroiliitis"?? should i ask?

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Your sacroiliac is where the base of your spine (sacrum) meets your pelvis at the ilium.

Made popular only because of the 1989 hit by Maestro Fresh Wes, "Let You Backbone Slide" when he declared, "So many suckers on my sacroiliac. It's like a rap-sack, backpack, wic-wic-whack, give me some slack jack."

I have a previous arthritic condition that causes swelling here. Strangely enough, the more active I am, the less it bothers me, so it's no surprise that the recent period of inactivity has brought on the condition.

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PART 14

~~~WARNING: GRAPHIC IMAGE BELOW ~~~

I've been off the crutches for a week now. I had an episode of sacroiliitis that required me to resort to a walking cane for a day, but other than that, I've been walking unassisted just in my aircast. It's great to once again have full use of my arms while walking. I can actually carry my breakfast to the table instead of eating it standing up. Whoppee!!!

I had my first physio appointment yesterday. I forgot to ask for permission to use the name of the clinic and the practitioner in this blog, so I'll leave it generic for now. A big mistake I made with my initial physio was simply choosing a place that was close to work so I could nip over at lunch for treatment. This time, I was much smarter and sought opinions from others. I would like to thank referee Neil W. for his recommendation. The clinic I am going to is top notch and the therapist is excellent. You get the feeling that he could talk for hours about Achilles' tendons and ailments, but not in a boring way; rather an interesting, did-you-know fashion.

I explained to him how the rupture was originally misdiagnosed. He is also a teacher/instructor for physiotherapy and stated that he would be disappointed if one of his students (let alone a registered therapist) missed this diagnosis based on the symptoms that were present at the time. The "biggie" is not be able to rise to your tip-toes. That alone should have been enough to indicate that there was a major problem. I mentioned that I had figured at the time that there was very little pain and concluded from that that there was no tear. According to him, this is actually counterintuitive. There is no pain because there is a complete rupture meaning there's a gap between the two torn ends of the tendon. Partial tears are actually more painful because the ends are still attached and are being painfully stretched likely every time you move your leg.

LESSON #12: WITH AN ACHILLES' TEAR, THE LESS PAIN, THE MORE SEVERE THE INJURY LIKELY IS.

The actual physio treatment consisted of:

1) ice around the swollen ankle/heel

2) manual manipulation of the joint to reduce the swelling

3) Electronic Muscular Stimulation. Kinda eerie to feel my calf actually flex for the first time in a long time

4) Gentle stretching

5) Some kinda of pressure cast that would inflate with air to help force out the swelling.

I was told that my strength and flexibility would likely return, but the mass never does. I guess I'll need to buy a guitar, don a school boy's uniform, and learn the duck walk vis-a-vis Angus Young because it would seem that the chicklen leg is here to stay:

Going forward, the plan is to continue with the physio 3 times/week with some short term goals/recommendations being:

1) Stretching. With my aircast off, roll a soccer ball back-and-forth under my foot to gently stretch the area. What a cruel thing to do to a guy who can't play. I'm gonna switch it to a basketball instead. LOL!!

2) Pool exercises at the next physio appointment.

3) Cardio will start after the next physio appointment. It will be the stationary bike. If whoever invented that stationary bike wanted it to seem less boring, they should have pick a name slightly more exciting than "stationary". YAWN!

4) I was told to lose the aircast whenever I am sitting or sleeping and should only be using it now for walking. This will help get the ankle joint moving again and reduce the swelling.

5) So that gravity could do it's thing, the therapist recommended elevating the foot of the mattress 4 inches. Up until now, I had been sleeping with my foot on a pillow, but it didn't surprise me that the pillow was not under my foot when I woke up the next day. With the mattress elevated, it does not matter how restless your sleep is, your ankle will be above your hip, thereby allowing gravity to aid in the reduction of swelling. I was surprised how well this had worked with the swelling noticeably reduced this morning when I woke up.

I obtained a copy of my operative report which I've included below. I find it fascinating. Upon reading, there are (at least) 2 things I got wrong about my surgery:

1) The actual surgery ("tourniquet time") was only 70 minutes, not the 2+ hours I had originally thought.

2) I had read that the FHL tendon would be fastened to the heel bone by drilling clean through the heel and then looping the FHL through the hole. It was actually anchored into the heel bone with a screw.

DATE OF OR: 12/02/10
SURGEON: Pradeep Alexander, MD, FRCSC
ASSISTANT SURGEON: Dr. Luis Flores
ANESTHETIST: Dr. Ashley Singh
ANESTHETIC: Popliteal Fossa Block with a Spinal
PRE-OPERATIVE DIAGNOSIS: Massive Chronic Achilles Tendon Tear, Left
POST-OPERATIVE DIAGNOSIS: Massive Chronic Achilles Tendon Tear, Left
OPERATION PERFORMED: Complex Repair of Achilles Tendon Involving Excision of 6cm Segment with Achilles Turndown with Repair of Defect and FHL Tendon Transfer

PROCEDURE: The patient had the anesthetic as listed above. The time out procedure was used to confirm the appropriate site. He was given preoperative antibiotics. He was laid prone on the operating table. A tourniquet was applied to the left thigh. Total tourniquet time was 70 minutes for the case. The leg was prepped and draped in the usual fashion. I also prepped and draped the right leg to determine the proper amount of tension. With the foot prepped and draped, a 30 cm was incision was made over the distal aspect of the Achilles tendon. Skin fat was split in line with the incision. The peritenon was opened and preserved. There was extensive mass of tear. The defect was measured to be about 6 cm in size. The had been scar tissue filling the defect. I excised the scar tissue between the defect. At this point, I then carried incision through the posterior fascia and was able to identify the FHL tendon. The tib post neurovascular bundle was identified and protected during the course of the incision and was not injured during the procedure. Traction was applied to the FHL muscle belly. The FHL was then cut around the talus. I then used a fiber loop suture and size the tendon to be a size 7 mm in diamter. A wire from the Arthrex bio tenodesis screw was drilled into the posterior aspect of the calcaneus. We then reemed with a 7.5 mm [bit].
His bone was of extremely excellent quality. I had to drill twice in order to achieve appropriate depth. It was reemed down to about 28 mm in depth. I then applied the 7.5 peak tenodesis screw with 23 mm of length. I was able to insert the tendon with excellent tension. I compared the tension to the other side and was able to achieve the
normal resting tension. I then harvested the turndown from the middle third Achilles tendon. This was done in central one-third of the tendon. I was able to take 6 cm of tendon and turn this down to repair the distal Achilles stump. The split in the Achilles tendon proximally was closed with 2-0 Fiberwire. Fiberwire was used to reattach the tendon distally. I then sewed the FHL muscle belly to the turndown with 2-0 Fiberwire. The wound was was with saline solution. I was able to close the peritenon with #1 Vicryl. Then, 2-0 Vicryl was used to close the skin with 3-0 Nylon horizontal mattress type fashion. The wound was dressed with Jelonet, 4 x 8, ABD, a below-knee backslab was applied with the foot in plantar flexion. The patient was extubated and returned to Recovery Room in stable condition. All counts were correct.
AUTHENTICATED

How many of you can say you have "bone of extremely excellent quality"? Not too many, I'd bet. LOL!!! I'm getting a T-shirt made up. ;-)

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Posted 4 months ago | # |

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