I'm interrupting the regular Cottonwood programming to share my latest life update:

0/10 recommend injuring your achilles tendon!

But, alas, I did injure it and am currently recovering from surgery for an achilles tendon repair and calcaneus ostectomy (fancy terminology for a bone spur removal). I thought I would share a little bit about the journey in case it's interesting to you or you find yourself in a similar situation in the future!

 

How did you injure yourself?

Of course, this is the #1 question! I wish I had a good answer. I simply do not know! Some people have grandiose stories of athletic achilles injuries. If you know me well, though, you know that I was NOT injured because I was participating in a triathlon or anything crazy like that. All I know is that my heel started hurting badly almost a year ago. During that time period, I had been doing much more physical activity than normal preparing for our first market sale and community yard sale. Since I'm nearing middle age, I just figured that I was getting old and my feet hurt. ☺️  That may be part of it, but, as I found out, these injuries can happen over time with repetitive stress on the tendon. So, that's the best I can do with an answer.

 

Doctor Visits and Physical Therapy Process

After about six months of pain and a worsening limp, I decided it was time to make an appointment with a doctor. He was confident that I was dealing with tendonitis but performed an x-ray during the appointment to rule out any issues with the bones. He made note of a bone spur, commented on my inflammation, prescribed some steroids, referred me to physical therapy, and recommended an MRI if I did not achieve significant results with physical therapy.

I went to physical therapy 2-3 times a week for two months. I'm a believer in physical therapy, so I had high hopes starting my treatment plan. Those hopes were QUICKLY dashed after my first few appointments. I was in so much pain during therapy (insert a few tearful moments as well). The most difficult and painful part of the therapy was muscle scraping. I will spare you the details, but I still cringe thinking about the intense discomfort from the scraping. I am sure it has great benefits for many cases, but I was not helped much from it. The actual physical exercises over the two months were challenging. I could tell that my calf muscles were strengthening, and I did have some improvement with my tendon pain. Very little helped, though, with my inflammation/swelling. The therapist was impressed with my strength but was baffled by my swelling and continued complaints about pain. Toward the end of my treatment plan, she decided to try kinesiology tape (KT Tape) on my leg/heel. It was the most beneficial thing we tried; it provided some pain/swelling relief!

KT Tape Tutorial for Achilles Pain/Support

 

On my third visit to the doctor, I admitted that I felt a little bit better with therapy but was still concerned with the continued pain and inflammation. I asked, "Should I just toughen up and deal with it?" He responded by recommending an MRI to rule out tendon tearing before he just told me to toughen up. 😆  Seemed reasonable, huh? He also commented that I had significant start-up pain and a good bit of sensitivity when he examined my heel, so he wanted me to have the MRI to find out/rule out tendon complexities.

FYI: This process was becoming quite expensive even with good healthcare coverage!

 

MRI Test

I can now check "have an MRI" off of my list of things to dread. Since the MRI was of the foot, only 2/3 of my body was in the MRI machine, so I was extra thankful for that. (I may need to add "have my full body in an MRI machine" back to my dread list.)

Before the MRI, I changed into scrubs provided by the medical office. The scrubs were so much better than a typical hospital gown! Then, in the imaging room, I laid down, and the techs covered me with warm blankets, inserted ear plugs, and strapped my foot down in a weird looking box. I found a great video online that shows the process almost exactly as I experienced it. Nothing to dread, friends. I actually found it to be very cool!

 

 

I had MRI results available in MyChart within 3 hours of the test! I doubt that is typical, but I was very impressed. I was NOT impressed that the summary of findings was very clear that the achilles tendon was torn. Ugh!  Of course, my doctor was out of the office for an entire week, so I had to wait a while to chat with him about the results.

 

Surgery Decision

Since I knew ahead of time that the doctor would discuss an achilles tendon tear, I asked a friend to join me for the appointment. We were prepared with questions especially since we thought surgery would be discussed. During my follow-up appointment, we first talked with the physician assistant (PA) who verified that my pain and inflammation was explainable by the MRI results. He explained the tear and discussed the surgical option to repair the torn tendon.

When the PA left to collaborate with the doctor, I was overwhelmed. I was so glad to have a friend there to talk about what we had heard from the PA. My lingering question was "is the tear really bad enough to justify surgery?"

I wonder if the doctor overheard our discussions. When he joined us, he quickly said, "I could see the tear on the screen from across the room...This is a situation where 2+2=4." He spent a good bit of time explaining the surgical and recovery processes. He said the surgery itself was a 30-45 minute fix. There was not a lot of bleeding or pain associated with the procedure. He heavily emphasized the recovery process, though. I would be in a cast and would be non-weight bearing for 4 weeks. I would transition to a boot around week 4 and would begin physical therapy once I was in the boot. He warned that the foot/leg would be weak for 6-9 months. Full recovery could take up to one year. Whew. I was overwhelmed.

While I still had a few lingering doubts, I told them at the end of the appointment that I was ready to go ahead with the surgery. I had babied my foot for almost a year and had tried so many non-surgical alternatives in attempts to heal the injury. I had also spent so much money this year chasing the issue that it just made sense to hit my max out-of-pocket amount and just get it done! I jokingly asked them to schedule it quickly before I could back out of my decision. Surgery was scheduled before I left the office, and it was scheduled for the following week!

 

Surgery Day

My hospital arrival time was set for 6:20am. In any other circumstance, I would complain about an early morning, but, on this day, I was ready to get it over with! Once I checked in, the prep process began quickly.

  • I met my nurse and she asked a lot of preliminary questions like "when did you eat/drink last" and "do you have known allergies" and "who is here with you?" I also signed paperwork providing my approval for the surgery.

  • I then changed into a gown, had an IV inserted in my hand, and took some oral medications provided by the nurse.

  • I talked with the nurse about the nerve block process. I had mistakenly thought the nerve block would be done when I was under anesthesia, but she explained that it would be done while I was still awake. She did promise that she had special medicine that would make me comfortable, and that I probably would not remember it.

  • I met the anesthesiologist and answered all of his questions. I expressed my nervousness about the nerve block. He kindly explained how it would work and eased my mind a little bit about it.

  • My friend was allowed to visit me for a few minutes before my nerve block procedure. Honestly, she was probably only with me for 3 minutes before the anesthesiologist arrived!

  • The nurse helped me to roll on to my side and put medicine in my IV. The anesthesiologist then inserted a small needle guided by ultrasound in the back of my leg to administer the nerve block injection. I did think it was crazy that I felt something like electrical shocks in my leg during the injection process.  I *do* remember the whole experience, but I also remember it not being bad at all. The nurse's special medicine worked like a charm!

  • I waited for a while in the prep area before they wheeled me to the operating room.

  • Once in the operating room, many people appeared! I had not been in the room for a minute, though, before the anesthesiologist asked me again to share my name, birth date, and procedure. That's the last thing I remember!

  • The surgery took about an hour, but, all in all, I was in the operating room for about 1 hour and 45 minutes. 

When I woke up and started talking in the recovery room, I immediately said that my leg felt very heavy, that I had a headache, and that my throat hurt. Thanks to the nerve block, I could not feel anything in my leg, so no complaints there. I really struggled to wake up, though. I was so out of it!

Here's a random helpful hint if you find yourself having surgery of any kind on your leg/foot. Choose your hospital attire carefully! When you attempt to dress yourself after surgery, you will want something that is easy to pull on, especially if you have a large cast. You will not want to wear anything that is tight-fitting like leggings or skinny pants. I actually wore a knee-length pull-on skirt, and it was so easy to put on after the surgery. I think loose-fitting shorts would also be a great choice.

When it was time to leave the hospital, the nurse wheeled me to the car and helped me to transition into the front passenger seat. I do not remember being uncomfortable in the car, but I was still struggling with a headache and throat pains. I just wanted to get home! After about 10 minutes in the car, though, I was asking my friend to stop by Chick-fil-A for a milkshake. Best decision ever! It felt so good on my throat, and I think it helped my headache. That's the story I am telling myself anyways.

Once home from the hospital, I faced the first mobility challenge: the steps from the garage into the house! I used crutches from the car to the steps, and then I just decided to sit down and go up the steps on my behind. It was very easy to go up the steps, but I struggled to stand up! It would have been very helpful to have a chair or stool close to the door to hold on to while trying to get up. (In retrospect, I should have had familiarity with crutches and should have practiced going up and down the stairs with crutches before my surgery. It's not hard to do, but I just was not prepared before I came home from the hospital.)

By the time I was home and resting in the recliner, my headache was gone! My primary complaint was the sore throat caused by the breathing tube down my throat during surgery. My foot did not bother me much at all on Day 1 thanks to the nerve block.

I had a good appetite a few hours after returning home. My first meal was a bowl of chicken noodle soup. The discharge instructions recommended a light diet of soups, jellos, and clear liquids for 24 hours. (Not sure that the milkshake on the way home was a clear liquid, but who's going to tell on me?)

The most important thing that I started immediately at home was elevating my foot above the level of my heart. This was critical to control swelling (and subsequent pain). I actually preferred my foot high in the air. It was the most comfortable and least painful position, especially for the first days of recovery. This picture perfectly captures my view for the first full month of recovery. Recliner + Leg Elevation. (And, yes, that is a very large cast!)

 

Achilles Tendon Surgical Repair Recovery

The doctor shared that he thought I would be much better by Christmas (approximately 3 months), but also warned that the full recovery process for this surgery was 9-12 months. I will plan to write out another blog post with details about the full recovery process. Stay tuned!