Wednesday, 14 October 2009

Final consultation

Last Monday I had my final consultation with the consultant-I-have-still-yet-to-meet, although for the first time I saw someone I'd seen previously. He was very pleased with the leg, and told me to massage the tendon daily in order to reduce the internal scar tissue, which makes the tendon seem thicker (almost double the width) of my now weedy-seeming good tendon.

The previous Friday I had the penultimate physio session and this time was told to raise up on both heels and let myself down slowly on the injured heel, 3 x 15 daily. Difficult.

At the moment I have a virus, so have had little exercise for 5 days now.

In about 4 months time I'm going to build up slowly to dancing again, but I shall be very careful and will not attempt to do any Masai jumping again. I must remember I'm 48!

Monday, 14 September 2009

Week 12 - Walking (almost) Normally

My visit to the consultant (who I wasn't there, as predicted) went as expected, and I was advised that I could dispense with the Aircast boot and crutches. I was told that I'm half way to complete healing, which would make the process from injury to complete healing about 5 months.

One dark cloud was that on Thursday evening I noticed that my leg, and in particularl my ankle, had become very swollen.

On Friday I had a second visit to the Physio. A very different experience, in a different wing of the hospital. A small, pleasant waiting room, and a wait of no more than 5 minutes. The physio is a nice young Chinese man who is cheerful, encouraging and obviously knows his stuff. He got me to walk around the gym in bare feet so he could observe how I walked, then got me to do a lunge to see how far I could stretch the tendon in comparison with the uninjured foot. Then standing on tiptoes. My homework is to do 3 rounds of 15 tiptoes, a lunge, and to remember to consciously push off with the heel when walking. All of which is helping, and the limp seems to be disappearing quite quickly.

Re the swelling, the physio said that exercise will help prevent it, but if swollen, I need to lie down with my feet against a wall. He said that it should be higher than the head, although this is the first time I had been told that. So in the evening, whilst watching tv, I've been lying on the sofa with my left foot up against the wall. Quite comfortable really!

Apparently the swelling may come and go for up to another nine months, and I will be seeing the physio once or twice a month for the next six.

Tuesday, 8 September 2009

Week 11 - Crutches Away!

The leg has been feeling stronger each week since my last post. Last week I started doing workouts in bare feet, and can feel the tendon stretching. I don't push too far it of course and if there's any pain I stop immediately. I saw a physiotherapist for the first time(!) on Friday and I think he was surprised at my progress. He got me to walk in bare feet and could see how I was limping, which also exacerbated my flat-footedness. He laughed when I told him I had cycled to the appointment, wearing my surgical boot. He told me I could dispense with the boot so I have been walking without it and the crutches outside since then. I kept it on at a party on Saturday night though, as I knew I wouldn't be able to resist dancing. It was a great ice-breaker too and got me lots of attention!

I'm seeing (or more likely not seeing) the consultant today, hopefully for the last time, and I expect he will corroborate what the physio said. I have to wear the boot to the consultation though in case he thinks the physio has overstepped his authority :-)

I asked the physio what the hospital did with the aircast boot and crutches. They clean and reuse the crutches, but due to fears of cross-infection, you get to keep the boot - or it gets dumped. What a waste. Surely they could be sterilised and used again? Hospitals in poorer countries would be grateful of them too I'm sure. Maybe I'll try and find a charity that accepts them and ships them out.

Or maybe I'll keep and wear it at parties.

Sunday, 23 August 2009

Week 9 - Feet on the Ground

It's now just over 8 weeks since I ruptured my Achilles Tendon whilst dancing. As of last weekend I have decided to walk without the boot, i.e. in bare feet or shoes, when indoors. I can feel the tendon getting stronger and can do heel raises (but not on the injured leg only). I'm being very careful of course and I am limping/walking oddly but I feel that it's the right strategy, in order to build up the calf muscle and stretch the tendon slightly. Fortunately I don't have any stairs to negotiate, just a single step. I'm looking forward to giving back the crutches and boot, but I'm not seeing the consultant (if I ever get to meet him anyway, see below) and physio for the first time on September 1st.

On a different note, I hope the NHS cleans up and reuses the crutches/boot, or passes them on to a country that can't afford new ones. I'm going to ask them what they do with them when I next visit the hospital.

Sunday, 16 August 2009

Not Unicycling


As of yesterday, I can now bicycle again - Yay! I cycled the 3 miles through town to my mother's home and felt fine. Had to remember to put my right foot down instead of my left when stopping at junctions though, but even then it didn't really hurt. I even clumped round Lidl (supermarket) on the way back. So am feeling a lot more mobile, though I wouldn't want to walk too far outside without my crutches - it's too slow. However, for going to see friends/relatives it's a great solution. I couldn't afford another taxi anyway the last bus back is too early in the evening.

Friday, 14 August 2009

The Big Chill

On Sunday I went with my partner and two friends to The Big Chill Festival at Eastnor Castle near Ledbury. I had wanted to go this year in order to see Gong, now reformed with early 1970s guitar god Steve Hillage. The Big Chill Company had advertised in my magazine, Gloucestershire Connections, in return for two tickets. It was a long walk from the car park (I had chosen the wrong one for my partner to park in) to the festival.

No doubt my elusive consultant would have tut-tutted, but I earnt plaudits (and a flirtation from a half-naked stranger!) for getting up and dancing in the afternoon sunshine. Great fun. Gong were far out, and had the same cosmic humour they had in the early 1970s. The only blot on the (beautiful, complete with lake and, of course, castle) landscape was the mile-long walk, mostly uphill, in the dark, back to the car park at midnight.

All in all, I walked about 4 miles, but the leg felt fine the next day, albeit slightly more swollen than usual. The tendon is definitely getting stronger, and I can stretch my foot upwards the whole way now. I am also doing foot-raises each morning, using my foot whilst standing up to lift the weight of my leg. There's no way I can walk preoperly yet though. Another few weeks to go. Insallah.

Saturday, 8 August 2009

Physio Delay

I had a call from a physio admin at the hospital yesterday morning to book an appointment on the 17th, two weeks after having first supposed to have seen the physiotherapist. Would that be OK? Well no, actually. I'm self-employed and I need to be fully mobile a.s.a.p. given the economic situation.

So yesterday afternoon a young-sounding physio actually called me and explained a lot of things. He said that taking the non-surgical route adds a fortnight to the healing time, and that physio shouldn't really begin for another two weeks anyway. However, he said that at that stage all I would be told to do was move my foot up and down, bootless of course, which I have been doing for some weeks anyway. He said 'let pain be your guide' which seems eminently sensible. I didn't tell him I had just walked a mile from town on crutches and felt fine. We finished by saying that I would seem him in three weeks immediately after my next appointment with the consultant.

Wednesday, 5 August 2009

Getting Stronger

After two weeks wearing the boot, I had another appointment with the consultant, A Mr Brown. Yet again there was a long wait in the swine flu incubator - sorry, waiting room, this time one hour twenty minutes. The previous three times it was 'only' 45 minutes. As usual the room was stuffy, crowded and airless, with nothing provided for patients to put their feet up on, even though many of us need to keepo our leg elevated. Oh, and we were treated to ten minutes of screeching fire alarms. A nurse reassured us that everything was ok and I could just about hear her say something about workmen at the other end of the corridor and that we would be all right if we kept the fire doors shut(!).

Also as usual, Mr Brown didn't make an appearance. Maybe he doesn't actually exist. Presumably he's extremely busy. As was the physiotherapist, who I was due to see for the first time as well but he/she/they were apparently too ovewhelmed to see any more patients. Anyway, the guy who did see me felt my tendon and seemed confident that it was healing well. He said I could remove three of the wedges in the boot. Afterwards, I decided to walk the half a mile home rather than take another expensive taxi. It was great to have some fresh air (or as fresh as it gets on the Bath road anyway) and exercise.

I can now almost lift my foot nearly 90 degrees, and as of earlier this week I can now stand up in the shower. I can't walk yet and certainky can't lift myself up on my injured foot. But the tendon feels stronger all the time, so hopefully in 4 weeks time when I say goodbye to the boot I'll be walking normally again.

Sunday, 26 July 2009

Bed Without the Boot

In order to keep the foot in the pointed-down position whilst asleep, after removing the boot at night I wrap a scarf around my lower leg and foot, which I then secure using tape. I then pull a thick bandage sock (the same type as that given to me to wear with the boot) over it. I also make sure the over-sheet is fairly loose at the bottom of the bed, in order to allow the feet room to move around. I don't use just a duvet but a combination of sheet and duvet, as I hate getting wrapped up in them or having them slide off me when I sleep.

Natural remedies

Since week 1 I have been taking twice-daily doses of Ruta Graveolens (Rue)., a homeopathic treatment for tendon problems, and Celadrin. Hopefully (it's difficult to tell), these are supporting the body's natural healing function. The latter is pretty amazing when you think about it - that the two ends of the tendon are (hopefully) knitting themselves together is a bit of a miracle. But then the human body is just that.

Given The Boot

Last Tuesday I had my third outpatient visit to the local general hospital. After waiting for 45 minutes in the corridor (a swine-flu avoidance measure, since the waiting room is always packed with people) I was called in. The fibreglass cast I had been wearing for the previous two weeks was cut away to reveal my leg, which looked pretty much as it has always looked, except for some slight puffiness around the foot and some minor bruising on the side of the arch of the foot.

I was then given an aircast boot, fitted with 5 wedges in the heel to ensure the foot is positioned at 45 degrees. The boot comes in two parts, held together with velcros straps, and includes four inflatable cushions to provide compression and a snug fit.

The benefit of the boot over the cast is that I am able to walk (clump!) slowly around the house without crutches, and can thus carry stuff for the first time in several weeks. I can also remove the boot in bed and in the shower - although I still have to sit down on a chair in the shower with my foot sticking out, resting on a small camping stool.

Walking with the boot and crutches is now much less tiring, since my weight is now not exclusively supported on my good leg. Indeed earlier today I have just walked down to the local shops and bought a cake, something I couldn't have done a week ago.

The registrar (for some reason I have still yet to see the named consultant I have had appointments with) said that I need to come back after two weeks and have a couple of wedges removed and to start physiotherapy. When I asked how he knew whether the tendon was healing or not, he gently felt it and thought he could feel a 'gap' where he said it had joined, but I'm not sure I found that concincing. Maybe I'll ask for a scan next time. He also said that within 4-5 weeks I'll be walking without crutches and boot. I hope that's the case.

Monday, 13 July 2009

Surgery - or Not?

After reading about the pros and cons of surgery to bring the two ends of the ruptured tendon together, I opted for the 'conservative' approach, i.e. to let the tendon heal naturally. There were many factors in my decision, such as wishing to avoid infection, surgical complications, post-surgical pain (wimpy of me I know) and general anasthesia. The words of astrologer and herbalist Graeme Tobyn rang in my ears - 'never have surgery if you can avoid it'. This blog is going to record the progress towards healing, given that I have opted for the less common, conservative route.

How It Happened

On June 27th 2009 I organised a dance for invited friends. It was the first time I had danced since the autumn of 2006. In the middle of some particularly energetic Irish dancing, it 'snapped' with a bang loud enough for my friend James to hear it. I thought I had been kicked in the back of the leg and was surprised when I couldn't put any weight on it. I was helped outside to get some air as I was in shock, feeling faint and nauseous. After having it bandaged and ice-packed by a friend who knew the R.I.C.E. principle (Rest, Ice, Compression and Elevation), and having been given a cup of hot, sweet tea, I felt better and wasn't in any great pain. Later on my partner took me to the Accident & Emergency and a full rupture was diagnosed by a nurse who did The Thompson Test.

After a long period of waiting around in cubicles it was put into a full Equinas plaster cast, my knee bent at 45 degrees and the foot pointing down, ballerina style. Once it had set I was given a pair of crutches and told I could go home.