Yesterday, after a talk with my GP Michelle Reeves, I called local orthopedic surgeon Drake White to schedule a surgical repair of my ruptured Achilles tendon. I had visited his office the day before and was pleased by his attention to my questions and his candor. “Hrm, maybe we can do this tomorrow morning,” he said. “I already have three joint replacements scheduled for next week. Let me call the hospital and get back to you.” About fifteen minutes later, he called to say, “We’re on for 8:00 am.” He explained some preparations to me, and wished me a good night’s rest.
Not surprisingly, I had a little trouble sleeping. I woke up at 4:00. From that point on I dozed a little. I got out of bed, got dressed, and wished I could have coffee. Erin drove me to McDonough District Hospital at 6:45, and I went through the paperwork, signatures, surveys, etc. I forgot to tell the hospital about my wisdom teeth extraction, but other than that I think got my medical history right. My first surgery. (Can I hope it’s my last?) I marveled at the speed of the people in admitting: I mean, I’m fast with the ole computer, but the two people I spoke with flew through the screens in the hospital’s database system. Quite frankly, I just about flew through admitting, too. At one point, I had to wait about two minutes, but that was it.
Once I got into pre-op, I learned I’d be waiting there, because someone had come in for an emergency appendectomy and the OR wasn’t ready. I changed into the hospital gown and went through all the pre- and post-op info with “my” nurse. A different nurse put in an IV. All the members of the surgical team came through, introduced themselves, and expressed good wishes. (I realize now this was probably part of their “do the right thing to the right person” protocol.) Dr. White spent a few minutes with me making sure I was ready to do the procedure. I was. He then confirmed it was my left achilles which needed fixing, initialed my leg, and went to do rounds while we waited for the OR to clear.
Meanwhile, Dr. Shea Trost came in to begin the anesthesia. I enjoyed talking with him, since he was glad to explain what he was doing and why. (Yes, I am a geek, and I thank him for geeking out with me.) He introduced an anesthetic, then used ultrasound to find the sciatic nerve and perform a popliteal block, effectively cutting off any feeling in my leg during and shortly after surgery. (For sure. My leg is still numb as I write this, 16 hours later.) I watched SportsCenter for a little bit. Then the team came to wheel me into the OR, returning things to deliberate speed: without hurry, but with no wasted time, they positioned my gurney next to the operating table, moved supplies into position, etc, kidding with each other the whole time. Someone gave me a mask with anesthetic; I don’t remember who. I thought, “I wonder how long this will take.”
Next thing I knew, I was in recovery. I don’t remember exactly what order things happened, since I was pretty loopy, so this may be a bit loopy too. I got to have coffee and some crackers, and Dr. White came by to say everything went well. (His call to Erin at 9:45 shows the surgery took a little more than an hour.) It turns out I had a full rupture of the Achilles, not a 85-90% rupture like the ER doc thought. However, my plantaris stayed intact–saving me from a more invasive surgery–and there was little damage to the tendon sheath, which should make recovery go more smoothly. As Dr. White described it in my office visit, he made an incision about 6″ long, opened up the tendon sheath, trimmed all the frayed bits off my Achilles, stitched it back together, and closed me up with staples. From my understanding, there’s really only one way this is done; here’s a more technical explanation.
I called Erin around 10:00, and she walked over. Once I was feeling clear-headed enough to go, she went home to get the car. About 11:45, we headed home. I was still pretty loopy, so I wheelchaired it to the car out front. My good friend Rizwan Hamid came over to help Erin get me up the front steps okay. Not long after that, Chris Delany-Barmann stopped by. Turns out we are all White patients, so we talked about our respective medical problems a while. Erin made me some lunch–the turkey I was gonna fry the day my rupture happened. Yum. Since then I’ve been sitting in our big comfy chair with my foot up. That’ll be my MO for the next few days.
Unlike most foot or leg injuries, most Achilles tendon issues are casted with toes pointed down so the tendon doesn’t heal too long. This cast is heavy! It’s two thick pieces of fibreglass connected by cloth bands and wrapped in Ace bandages. This allows the cast to expand as I swell up, then contract as the swelling recedes. While accelerated rehabilitation protocols appeal to me, the risk of re-rupture does not. So my route will be more traditional: after two weeks, this cast comes off, my staples come out, and I go into a new cast, also toes down, for six more weeks. After that, Dr. White and I will see how things are going; physical therapy may start at that time, or we may wait longer. Many of my friends have wished me a swift recovery. I’d like that; getting around on crutches isn’t easy. And I’m glad for all the good wishes. But safe will trump swift. In some ways, what we did today is the easy part, and the real work will happen in PT.
I am very grateful to everyone who has offered to help my family and I deal with this. Thank you for the good wishes—on Facebook, email, this weblog.
Update 10/25: I got a note today from MDH Surgery, so now I know their names! Thanks to Debbie, Carol, and Kathy, in addition to Drs. White and Trost.