Swelling is down, still trying to keep the foot elevated as much as I can.

As I said before, it’s difficult to elevate the foot without putting pressure on the heel. When I am at my desk, my foot is propped up with a pillow on top of the table. I have to sit a bit sideways to make sure the foot isn’t resting on the heel. Bad posture.

I’ve started to hop around a bit more to go to the bathroom, eat, etc. I wonder how bad that is for the recovery.

Called American Express to dispute the charge by www.mdnationwide.org. I’ve called them several times, and they don’t answer or return phone calls. American Express decided to just credit me back my $19.95 They are not going to dispute the claim with mdnationwide either, which I found surprising. So they are just going to eat the $19.95.. hmm.

It’s actually difficult to keep the ankle elevated at all times. Every time I get up to go use the bathroom, I feel the blood rushing down to the foot and it feels like it’s going to explode.

I’ve been reading that it’s not good to put direct pressure on the incision wound, which is what happens when you lie on your back and elevate your ankle. This article from the American Journal of Orthopedics recommends that you lie on your stomach or on your side while elevating the cast. The important part is not putting any pressure on the stitched area. It’s tricky to do, but not impossible.

Back is being stressed from being bed-ridden, I need to find ways to elevate my foot without damaging my back as well.

Accidental twitches of the toe during sleep that strains the achilles heel is quite painful. I am wide awake after that, the pain lingers for some time. One hell of an alarm clock. Hopefully it’s not doing any permanent damage.

I slept fitfully last night because of my throbbing, swelling ankle. The color of my toes are fine, and they are not swollen so I am hoping that this is to be expected. I am waiting to get a confirmation of this from the physician’s assistant.

The foot is slowly starting to swell up. I spent a good part of yesterday at the desk with my leg raised, but not raised above the level of my heart. I later found out that this was a big no no. I have been good about elevating my ankle from then on.

I also accidentally put weight on my injured ankle while moving around in the kitchen, as well as the accidental twitches of the foot which results in a slight strain on my achilles tendon. I’ve been reading that the first 2-3 weeks is a crucial time for proper healing of the incision as well as the repaired tendon. I’ve decided to stay in bed as much as possible.

I regret that the surgeon didn’t put me in a CAM Walker (boot) instead of the cast. The cast is lighter, but the toes are more exposed so there is a more of a chance for me to strain the achilles tendon. Also, I can’t exactly adjust the cast to take account for the swelling. I am starting to feel more pressure in the cast and it makes me wonder at what point I need to go see the physician.

For the pain, I am taking a generic for Lortab 7.5 500mg one in the morning and one at night. Right after the surgery, I was taking two at a time, but the pain has subsided and I prefer to not be over-medicated. I was also told that pain-killers can cause constipation, and I don’t need that either.

The pain isn’t nearly as bad as I was expecting it to be. I’ll see the surgeon for a follow up in 10 to 14 days. And then a new cast and another follow up 2 weeks later. If all goes well, I should be going into a walking boot, and I should be able to put a bit of weight on my left leg.

So, I’ll be on crutches for 4 weeks. Rehab will start in 6-8 weeks. I should be recovered enough to walk normally in 2-3 months.

The orthopedic surgeon said that about 95% recovery is possible after a year with good, consistent physical therapy sessions. I should be back on the basketball court by then, hopefully.

My girlfriend drove me to the hospital. Surgery day! Waited for hours and finally was called back into the pre-op area. I changed into a gown and spoke with the anesthesiologist, in his mid 40’s.

He asked me how I hurt myself, and I told him. His face brightend up and asked me to play the guessing game:

“Guess how many college 3’s I made in a row?” I said 7, and he said 19. I was impressed.

“Guess how many NBA 3’s I made in a row?” I said 10, and it’s 11

“Guess how many freethrows I made in a row?” I said 30, and it’s 62

I initially considered making ridiculously high guesses, but I thought better of it considering he seemed like a nice guy and he was going to be putting me to sleep.

My favorite player? Didn’t really want to think and didn’t care.. I said Kobe or Lebron. His favorite, Nash.

Well, he put me under real good, and the last thing I remember before the surgery is being rolled into the operating room.

After the surgery, I regained consciousness surprisingly refreshed.. then I got dizzy and nauseous. It was miserable, but my girlfriend came by to pick me up from work and took good care of me.

I now have a new cast, and my leg hurts a lot more than before. Luckily I am drugged up so it’s not so bad. So a follow-up visit in 10-14 days, and probably another one a couple of weeks after that.

She took me home, and I slept and slept. I got up at 9pm and I felt better. My food intake of the day consisted of cranberry juice, cookies, hot chocolate and a bananna. I hope I lose some weight through all of this.

Let’s see how it is tomorrow.

Looks like there is a chance that I’ll have the surgery tomorrow morning. Doctor’s assistant called and said that they might be able to squeeze me in tomorrow for the surgery. He’s a foot and ankle surgical specialist so I am hoping that I am in good hands. No food/drink past midnight, and I’ll get a call early tomorrow morning.

Talked to a friend in the medical profession. He told me to make sure that the surgeon is board certified. I looked up the surgeon’s credentials through Google. Yep, looks like he is board certified, and he is a clinical assistant professor.

It all seems like such a crap shoot. I wonder if there is a better way to select a surgeon. I am able to do more extensive research on buying a television set than selecting a surgeon who will operate on me. I’ve visited a few physician review sites, and either they are pay sites or they are free sites with nothing more than the doctors’ office addresses.

Reading other’s reviews about physician review sites, it looks like http://www.mdnationwide.org might be worth trying. It costs $19.95, and they’ll compile a report for you within the hour. The website is rather cluttered, but it had some basic useful tips on finding a quality surgeon.

Disturbingly, this error popped up after I submitted my credit card information:

Luckily, I still received via e-mail the username/password to login to view the report. Nope, no report yet. I’ll check back in an hour and see if there is a report available. Otherwise, I am going to have to call my credit card company and make sure that my CC wasn’t charged. If it turns out to be a bust, I’ll try http://www.healthgrades.com. They charge $30, but has a better looking website. However, someone’s review from last year claims that MDNationwide compiles a better report. Yep, more research required to find the best Doctor review site, pay or no pay.

Getting around in the crutch is quite uncomfortable. I am thinking of buying the Hope Crutch. It costs $118 for my height.

I also found this:

Maybe I am nuts for considering the iWALKFree, but I think this might be a better alternative than the traditional crutches.. I’ve read some customer reviews, and overall, it looks like a good alternative to crutches. I’ve watched the company’s videos, and people can move around pretty well with it. It does look a bit goofy with the foot sticking straight out back, but it might be better than not being able to use your hands with traditional crutches.

I am not sure about going out in public with it, but it looks like it’ll work well for moving about around the house. For about $330, it might be worth it. I like the idea of the hands-free crutch, but I don’t like their implementation. I think it can be improved, even if it might cost a little more.

If there are any other alternatives, please let me know.

Total Achilles Tendon Rupture is what I suffered on Friday night, and I thought this blog “from injury to recovery” might help someone else who might have the misfortune of going through the same experience.

I’ll post all that I learn through this ordeal. Hey, I am going to be immobile for quite some time, so this is a better alternative to sitting in front of the TV. I got the idea to do this from Coops: http://cybermanachillesheel.blogspot.com/

He has written pretty extensively of his Achilles Tendon rupture experience and recovery (with some pretty graphic pictures that makes me cringe). It’s helped me a lot in that I can somewhat anticipate what it’ll be like for me for the next several months. It’s good for my mental preparation. So here it goes:

Day 1

Friday evening, I drove over to the gym to play some pickup basketball for a few hours. About three games into the night, I ruptured (fully tore) my left achilles tendon. Surprisingly, the pain wasn’t as excruciating as I had envisioned for an achilles tendon tear. I felt the dull, numbing sensation of the after-effects of an ankle sprain, but no initial sharp floor-slapping pain that accompanies a severe sprain. There was a definite “pop” that felt like an explosion that reverbrated all the way to my calf muscle.. which makes complete sense. It’s like a rubber band snapping, and the thought of that still makes me grimace.

After the pop, my left foot was out of commission for good, and I barely managed to limp to the sideline. The gravity of the situation hasn’t set in completely, and I sat there dumbfounded, watching my team win possibly my last game of pickup basketball. Until the injury, I had played aggressive and well, and I felt good that I left the game on a positive note.

Sitting there in the gym, I felt around for the achilles tendon on the back of my left foot. Yep it wasn’t there. Did a quick check on my right foot for comparison.. yep it’s there and the difference was obvious. So then I knew that it was a pretty grim situation, and I limped back to the car to drive home.

Driving wasn’t a problem as my right foot was healthy, and I drive an automatic. I thought about driving directly to a hospital, but I didn’t know which hospital to go to. So as I was driving home, I called my girlfriend who was home and asked her to look up what to do and find out which hospital to go to. I wished that I had done a little bit of research beforehand about the best hospitals in the area.. well now I know.

Reminder: Always know which hospital has the best care near where you live.

I got home and limped into the house. Changed into comfortable clothing and grabbed a book as I knew that it’ll take hours in the Emergency room to see a doctor. It didn’t help that it was a Friday night. I also called a friend who is now a doctor and got his advice on the matter. He basically said: expect to be there for several hours, that I’ll see an orthopedic surgeon at some point for a diagnosis and schedule a surgery (most likely), make sure to call the insurance company.

Reminder: Call the insurance company before being admitted into the Emergency Room. Otherwise, the insurance company might screw you real good.

So my girlfriend and I drove to the closest hospital that my GPS receiver found, and I hopped out of the car, into the emergency room. The waiting room was not empty, but definitely not busy. I stood around for 20 minutes and finally someone appeared at the check-in counter. I filled out a couple of forms with spelling errors and redundant questions. That really didn’t give me the best first impression of the place.

I also called my insurance company, and since it wasn’t during the normal business hour, the automated message advised me to leave a message with my information if I were going into the emergency room. I kept thinking to myself.. “hmm, what if no one gets this message or they accidentally delete it? Are they going to send me a bill for thousands of dollars? How am I going to prove that I actually called?“

A nurse brought me back in to check my blood pressure and asked a few questions. Afterwards, back in the waiting room for several hours.. I managed to scavenge a wheel chair in the waiting room.

After a couple of residents poked and prodded my leg, I had several x-rays (to see if there were any bone chips from the injury). The hospital didn’t run MRI machine in the middle of the night, and the doctors said that it was pretty obvious that it was a full tear.

The Orthopedic surgical resident said I had two options:

1. Cast for 6-8 weeks and my tendon will eventually heal on its own.

2. Cast for a few days until they can schedule me for surgery. Shorter recovery time by about a week, and will have stronger tendon than letting it heal on its own.

Surgery was the best option for me since I am young/healthy enough to fully recover from the surgery, and people who have their achilles tendon surgically repaired are less likely to have another rupture.

The surgery will be followed by 4-6 weeks of recovery time.. and then there will be physical therapy for the next several months.

I had to sign a waiver form that pretty much said that it’s not the hospital’s fault if something goes wrong during the surgery. If some complications arise, then they “do not resuscitate”. And of course, there could be bacterial infection and that I could die from that. My mind kept racing back and forth between the MRSA infection reports that I occasionally read about in the local news and Grant Hill’s near-death experience from the infection that he contracted during his ankle surgery. I guess I can’t fret too much about things that are beyond my control.

Looking back, I should have read over the waiver form more carefully, and I should have gotten a copy, but it’s probably pretty standard document… or so I hope.

Well, they did the pre-operative blood work, EKG, and took a chest x-ray. The doctor said that someone will call me in a few days to schedule a time for the surgery.

The residents put me in a cast, and made sure that it wasn’t too tight. I could wiggle my toes, they were not cold or turned blue/black, and they were not numb. They also got me a pair of crutches and showed me how to walk with them. It was my first time using the crutches, and it started to irritate around the armpit area. I wasn’t allowed to put any weight on my left foot, and it felt awkward walking with the crutches. I then realized that getting around was going to be really difficult, and I was going to be limited in what I can do quite a bit more than I had anticipated.

Going up and down stairs is going to be annoying, but doable. Going up and down stairs while carrying anything is going to be very, very difficult.

We talked to one of the residents, and she said that this hospital is one of the better ones in the area. It was a relief to hear that. Also, we overheard others in the waiting room that this was a good hospital so I felt somewhat relieved to be there.

I got dressed, and we left the hospital around 5am. It was a relief to have my girlfriend at my side. She is a trooper! Earlier, I had also called all my friends and family to let them know what was going on. They were very supportive, and they googled for information on the injury on my behalf while I was waiting without internet access.

Overall, the emergency room experience was positive. Doctors were helpful and most nurses were friendly enough. There were a few things that led me to believe that some of the nurses didn’t care much for the patients in the waiting room. I guess you get calloused after seeing sick (and sometimes nasty) people all the time. I still feel that it’s wrong to treat people like chopped-liver when they are at their most vulnerable state.

But what can you do? In the end, only you will care most about your health. I just have to do my best to learn the ways to get the best care, and I’ll leave what I cannot control up to fate, God, or randomness. Maybe they all amount to the same thing in the end.