5/7 - Das Boot!

So it's been a while since I've written about the actual recovery.  As I mentioned in the last post, I made it through the long days of having a cast and not being able to do much.  It is astonishing how quickly we can adapt to new circumstances, as within a week or so I was able to get my scooter up and down the stairs on my own, and take care of everything in the house (with the exceptions of changing light bulbs and carrying my laundry basket)  :)

Nevertheless, I was very excited for my appointment last Friday to get the cast removed and progress to the next stage of recovery.  And I have very good news to report, which is that the recovery continues to go faster than expected, with no setbacks or problems of any kind!!!!  Here are the details.

During the appointment, first the Cast Technician had to remove the existing fiberglass cast.  Since it has hardened since being applied, the only way to remove the cast is to break it apart, which these days is done with an electric  saw.  Pretty cool, right?  He let me know that I'd feel a little pressure and a tickling sensation from the vibration of the saw.  I asked if he minded my taking a video of the process, and since he was OK with that plan, here's what it looked and sounded like.

Once the cast was off, my surgeon Dr. Jensen took a look and was very happy with the lack of swelling and the overall coloration of the scar.  He then ran a variety of quick strength and flexibility tests, and they were surprised to see that I had regained more flexibility in the ankle (both up and down) than expected.  And while essentially most of the muscle in my right calf is gone, the reflexes there were working perfectly as well.

So while I was supposed to have another week or two of dealing without being able to put any weight on my leg, they decided to progress me directly to a walking boot and said I can start testing the flexibility and putting some pressure on it immediately.  I also got a prescription to start physical therapy, which is supposed to run twice a week for 4-6 weeks as needed.

First up, the boot!  It's pretty light, has a ton of Velcro straps, a raised heel and lots of padding.  It takes about 90 seconds to get on and strapped in properly.  And the best part is that I can take it off whenever I want: to sleep, to shower, or whenever I'm just sitting around and will be for an extended period.  My surgeon actually wants it off at least a few times during the day so I can stretch my ankle and leg.  Here are two pics of what it looks like by itself and when I have it on.

When I got home, in addition to taking a shower and actually cleaning my right leg and foot for the first time in 6 weeks, I also took a picture of the scar.  For those that saw teh last picture a few posts ago, you'll see the great improvement based on how it looks now.

In the 8 days since this appointment, I've already noticed even more improvement.  I can stand with both feet on the ground (with the boot on) with no pain, and can even take a couple of quick hobbling steps.  I can "walk" with the crutches and my right foot touching the ground, and even get up and down the stairs pushing off on my right leg and not needing to hop anymore.  All positive steps (literally).

The only unfortunate thing is that I haven't been able to actually start physical therapy yet.  I contacted the recommended provider last Monday, but then went back on the road for a meeting in Dallas.  And unfortunately found out on Wednesday that they were an "out of network" provider for my insurance anyway.  So I found a new PT place on Friday, and I have my initial evaluation with them this coming Tuesday.  Hopefully I'll be able to get 2-3 sessions in with them after the evaluation before I have to hit the road again for Atlanta on May 17. 

That's about it for now.  I expect a lot of stuff to happen about two weeks from now.  I should be completely free of crutches by then, and the scooter will get returned around May 24.   I think I'll be cleared to start exercising more normally (swimming,stationary bike), and will even hopefully be cleared to try driving by Memorial Day and my vacation in NY.  More updates as I have them!

4/25-29 - On the Road Again

It's been two weeks since I've written a post, but that's mainly because there hasn't been much to say.   I've been in the strange waiting period where the leg is healing, but until I get the cast off and start physical therapy nothing much changes from day to day.  There's essentially no pain, and I've gotten very accustomed to the changes that stem from living with limited mobility.

The only major news of note was that after a month off, I had to head back out on the road for work this week...  Generally speaking I probably travel somewhere three weeks a month for work,  so to have done none of that for 4-5 weeks is a big deal.  Everyone at work has been very understanding, and I probably could have waited even longer if I wanted to.  But the reality is that this is what I do, and while I knew it wouldn't be a fun week, I needed to get back out there and know that I was earning my keep.

Unfortunately, I chose a hell of a week.  I wound up traveling somewhere i the neighborhood of 7,000 miles:
 - On Monday from San Francisco to San Diego
 - On Tuesday from San Diego to Edmonton (through Seattle)
 - On Wednesday from edmonton to Dallas (through San Francisco)
 - On Friday Dallas back home

So what did I learn?  Well,  primarily that when you're injured and traveling, people are very nice to you!  From wheelchair escorts to flight attendants, cab drivers, bell hops, my colleagues, and even complete strangers, I encountered nothing but people willing to help me get where I needed to be (with one unfortunate  exception).  Some of the highlights included:

• The lovely woman sitting next to me from San Diego to Edmonton who offered to switch seats so I could sit in the aisle and stretch my leg
• The staff at the United Red Carpet Club at SFO who arranged an extra wheelchair escort to take me through the food court (and even carried my tray) so I could have dinner in between flights to Dallas
• The United staff in Edmonton who walked over to Starbucks and got a drink for me 
• The woman at the ticket counter in Dallas who checked my bag for free
• My cab driver in Edmonton who went out of his way to find an open drive-through after midnight so I could have a bite to eat on the way to my hotel
• My driver back at home who brought my suitcase up to my apartment and then drove me to my medical appointment for no extra cost
• The bellhop in Dallas who got me ice, bottled water, and even offered to bring a sandwich up to my room when I checked in at 1:30 AM (yes, I got there very late) so I wouldn't have to go back down to the lobby on crutches more than once
• All my colleagues throughout the trip who picked me up, drove me around, carried my bags, and made my life as easy as possible - Thanks EVERYONE!

There are some downsides to traveling while injured too.  For example:

• While you go to the front of every security line when you're in a wheelchair, that also means you have to get the full manual pat down from security at every airport.  It takes forever, as they have to test not only your body, but the cast and the chair too
• If you have a long layover, you can't really spend any time wandering/shopping.  Your escort will take you from gate to gate, and stop at a Starbucks or the restroom, but once you get to the new gate you're pretty much stuck there until the next plane boards
• Customs agents find it very odd to see someone who can't walk traveling alone :)
• You spend a fortune in tips

Thankfully, while I will be traveling a few more times before I'm off the crutches for good, the rest of my trips should be much simpler.   Next week it's back to Dallas for a couple of days.    The week of the 16th I'll be headed to Atlanta for a night, and the week of the 23rd a quick trip out and back to Houston.  Then I'm on vacation for a bit in New York over Memorial Day.  Maybe someday I'll get to travel in my own time zone again....

More tomorrow about the actual recovery, as I am now officially cast-free!

4/7-11 - An Ode To Clint Eastwood

It's been a very, very busy week, with all sorts of stuff going on (injury, work, sports, personal, travel, etc.)  So to encapsulate I give you The Good, The Bad and The Ugly.

THE GOOD
The best part of the last few days was my first post-operation appointment with the surgeon. He removed the cast to take a look at how things were going.  And the proclamation was that everything is healing as well or better than he hoped!  Perhaps I should have started with THE GREAT!   In any event, there was less swelling and blood than he expected, and all the nerves, reflexes and the re-sewn tendon itself are all behaving properly.  Hurdle # 1 not just passed, but leaped.

So the next step is a fiberglass cast that I'll have for 23 days.  It's much lighter and more streamlined than the plaster cast, which is great.  Easier to sleep and get comfortable sitting for long periods. Should make traveling better too.  I see the surgeon again on April 29th to switch from this cast to a boot, and then we start the long process of physical therapy, which includes teaching my new tendon how to stand, swim, work a stationary bike, walk, and drive, most likely in that order.  For the time being, here are a few pictures of me getting fitted with the new splint.

4 steps to putting on the fiberglass splint

To get the splint on, first the tech covers the wound with standard first aid bandages (top left).  Next he rolls a cotton tube over the leg, and folds down the top and bottom (top right).  The cotton helps keep the cast from itching, and makes it as comfortable as possible.  Next he takes two rolls of fiberglass, dips them in warm water and rolls them on top of the cotton tube, much like fitting a tennis racket with a new grip.  When he's done, the fiberglass starts to harden (and gets quite warm).  During the hardening process, he holds the foot steady to make sure it's pointing as straight as possible (bottom left).  After a few minutes the fiberglass is hardened and stable, and you have the finished product (bottom right).

Other good stuff... There were a number of other positive things that happened last week.  In no particular order:

• I had a great performance review, and even got a nice raise!  Now I can pay my medical bills...
• The Rangers made it as gut-wrenching as possible, but did squeak into the playoffs when Carolina lost the last game of the season.  First time in many years the Rangers and Knicks will both be playing post-season games at Madison Square Garden.
• I'm taking a week off in late May to see my family, attend my 25th High School Reunion, and a summer-camp reunion in the Berkshires of MA
• While I won't be doing the charity work I'd hoped, it looks like I'll get to go to Nepal (and Hong Kong) in November for pure vacation instead

THE BAD
Not everything can be positive I guess.  Unfortunately I broke up with the woman I've been dating for the last few months.  :(    I really like her (and hope the feeling was mutual) but in the end there were just too many obstacles and differences between us to make it work.  We decided that moving on was the best thing for both of us.  No drama, just sadness.

Other minor hiccups for the week:

• I managed to get my new pretty fiberglass cast wet yesterday.  Apparently water got into my cast protector in the shower.  Only the very top and bottom got damp, and they dried quickly, so I didn't get a new one put on, but will have to be more careful.  Or just not shower!
• The Mets have started the new season 4-6 and blown a number of late leads.  This was to be expected, but still hurts to watch.
• Schedules at work are about to get CRAZY!  Starting next Wed, I have at least one major presentation every day for 9 straight work days.  And I've booked my first post-injury trip.  Might as well dive back into the deep end, so from April 25-29 I'll be going from San Francisco -> San Diego -> Edmonton -> Dallas (stopping in SF) -> back home again.  Nothing like crossing the continent from North to South twice in one week, right?

THE UGLY
Thankfully, there's only one thing that qualifies in this category.  Before I got the new splint on, I had my surgeon take a picture of my new scar.  The photo below was taken right after the plaster cast came off, and right before the surgeon removed the stitches.  Personally I think it's kind of cool, what do you all think?

My new scar, right before the stitches were removed!

4/5/11 - On Pain and Pleasure

I had a terrible day yesterday.  I'd already been dealing with low energy for a few days, and I wonder if that's a result of being indoors and stationary for more than I'm used to.  But then last night around 7:00 I started to get a headache, and over the next hour it got worse and worse.  My head was hot and the rest of me was shivering, and by 8:30 or so I was covered in sweat and pretty miserable.  I took some ibuprofen and tried to do everything I could to just fall asleep, which finally happened around 10 or so.  I woke up about 4 this morning and felt all better, so I don't know what was going on yesterday...

But it definitely got me thinking about PAIN, and all the different kinds of pain we endure. I remember when I was really sick two summers ago, it was the first time in my life that I had to deal with any serious, long-lasting pain.  When my pneumonia turned into something worse, I went through 2-3 weeks of absolute misery.  It hurt to take every breath, coughing was a nightmare, and in the worst two days before I got serious medical help, it sometimes took me 10 minutes to shift positions in bed because everything hurt so much.

By the time I finally had my surgery, I had been sick for about 5 and 1/2 weeks.  And I (and everyone around me) learned something very interesting.  Apparently I have a surprisingly high tolerance for pain.   Who knew?  My surgery was very invasive, (they had to puncture, drain and deflate my left lung amongst other things) and the doctors and nurses were all shocked at how little pain medication I took in the days immediately following.  That continued when I cam home from the hospital.  I can't say that I took none of the painkillers I had, but it was a much smaller amount than anyone expected.  Some of that was because I was just happy to not be sick anymore, but I also just didn't feel like I needed them.

I recall thinking then, and still do now, that I had at least gained some appreciation for what people who deal with chronic pain must be feeling.   And I hoped that I would never experience something like that again.  So here I am two years later, injured instead of sick, but dealing with it again.   The pain in this case doesn't compare to before, but it's still real.  My leg hurts when I wake up in the morning, or whenever it's been in one place for too long.  And because I can't use my right leg, now other places hurt.  The sides of my chest hurt from the crutches, my hip hurts if I use the scooter too much, and my left foot hurts whenever I stand for too long on the crutches.  And then came whatever happened to me yesterday, and everything was magnified.

And yet with all of that, I've had a number of people comment to me that I seem to be awfully upbeat (or at least not as down as they were expecting).  I decided as I recovered from the pneumonia and surgery to just not let things bother me.  Life's too short and there's too much to be happy about in the world to get dragged down by the little stuff.  And while that's easy to say, it's not always so easy to do, but I've found that it works for me - at least so far.  I can't say that I'm happy to be dealing with this injury, but I know that it's temporary, and that it could have been worse.  And if I work my ass off during the recovery, I should be stronger and in better shape when I'm done than when it happened. 

Back to the title of this post, pain often comes hand-in-hand with pleasure, and I had another example of that just yesterday before my head started to hurt.  By the way, if you HATE sports, I'd recommend you stop reading this post now.  :)

For anyone that's a sports fan (except for football addicts) the 6 weeks from the beginning of April to the middle of May is arguably the best time of the year.  The NBA and NHL are wrapping up their regular seasons, and playoffs start in two weeks.  The Masters is this weekend; the Kentucky Derby next month.  The NASCAR season is in full swing.  March Madness ended yesterday (Congrats Huskies!).  And most importantly, baseball is back.

LET'S GO METS!  LET'S GO METS!  LET'S GO METS!  LET'S GO METS!

Sorry, got a little distracted there.  So yesterday I was watching the Rangers play the Bruins on National TV from Madison Square Garden.  There are 3 games left in the NHL season, and the Rangers are clinging to the last playoff spot in the East.  Most hockey experts believe they can be a team to be reckoned with if they get into the playoffs, but they have to get in first.  They hold their own destiny, but losing any of their last three games takes that control away from them.  And just like the Mets of '07 and '08, last year the Rangers held their own destiny to the final day of the season, when they lost (in a shootout) and finished one point out of the playoffs.



In any event, once that sense of despair set in, something quite astonishing happened.  The Rangers got a lucky bounce on a rebound and scored to make it 3-1.  And right near the end of the period the same guy (go Vinny!) scored again so we went to the third period trailing 3-2.

The announcers, who were neutral, started the third by talking about how Boston is a team that doesn't give up leads.  They've outscored their opponents by 40 goals in the third period this year, and only lost 5 games all year in which they had even a 1-goal lead at any point.  So with their work cut out for them the Rangers dug in ... but as the minutes ticked away (20 ... 18 ... 15 .... 12 ... 8 .... 5) hope seemed to as well.  When Brandon Dubinsky scored off an unbelievable pass from Ryan Callahan with less than 4 minutes remaining to tie the game, the crowd went wild, and I was happier than I've been since the injury happened.  When Michael Sauer scored about 50 seconds later, I started to tear up.  And by the time Derek Stepan scored an empty-net goal to seal the 5-3 win I was crying outright.

A last note on the game before I wrap up.  As a hockey or sports fan, in case you're curious about just how amazing that comeback was, try on this stat.  The Rangers and Bruins are two of the NHL's "Original Six" teams, which means they've been playing each other since 1942.  In the multiple hundreds of games they've played against each other since then, this is the first time the Rangers have EVER won a game against Boston after being down 3-0.  Craziness...

Anyway, back the main topic.  It's astonishing how quickly you can go from pain to pleasure and back again.  In the span of an hour yesterday I went from being dejected about the Rangers playoff chances, to ecstatic about the comeback to laid out with a monster headache.  Whether that's the emotions of a simple hockey game, or surgery to fix weeks of agony, the two will always be tied together. 

More to come....

And a quick postscript about the game.  It turns out that the heart and soul of the Rangers, Ryan Callahan, fractured his ankle while blocking a shot late in the game to protect the rangers new-found lead.  He's out indefinitely, and will probably miss the entire playoffs.  Pleasure to pain for him and the team too....

3/31/11 - Scooting Outside and Taking a Shower

The 31st was Day 3 after the surgery, and Day 9 since the injury.  I spent the first part of the day catching up on a week's worth of email from work and cleaning up a bit around the house, and then decided it was time to take a shower.  There are a number of complications around showering with this type of injury:

• You can't stand up - so you need to either take a bath or shower sitting down
• You can't get the splint/cast wet
• It's a challenge to step over the edge of the tub to get into the shower

So to overcome these obstacles, I've had to invest in a couple of new tools.  First is a device that goes over the cast to protect it from getting wet.  Alternatively called a DryCast, ShowerBeauty, or even a shower condom (gross, I know), this is a latex or nylon sleeve that covers the entire limb.  There is an expandable opening that you out your foot through, and once the whole leg is inside, there is a very cool elastic band that seals against your skin to prevent water from getting inside.  These things are secure enough to go swimming in!  Here are a few pics of what the sleeve looks like hanging loose and with my leg and cast inside.

Cast Protector hanging on the towel rod and over my injured leg

Of course, once it's on you have even less traction than before on the injured leg, so you have to be extra careful on the slippery surfaces in the tub/shower.  Once the cast protector is on, the next challenge is getting into the shower and sitting down.  We designed a process that seems to work well, and will undoubtedly become less clunky over time. 

1. First I load the basket of the knee scooter with my bath towel, a beach towel, and the clothes I plan to change into after the shower
2. Next I wheel the scooter into the bathroom and place it up against the side of the shower next to the handles and faucet.
3. I open the sliding glass door, swing my good leg into the shower, and shimmy my butt from the scooter onto the shower bench (see pic below)
4. I swing my injured leg from the scooter into the shower, and lay my foot (well my heel) on the ledge in the very front corner of the shower against the door to keep it elevated.
5. While sitting on the shower bench and with the door still open, I take the beach towel and lay it across the seat of the scooter to prevent it from getting wet.  I take my clean clothes out of the basket and lay them on top of the beach towel. I leave my bath towel in the basket.  
6. I close the glass door, then turn on the faucet for the tub and let it run until the water reaches the right temperature.  Then I left the lever to start the shower and I'm good to go
   
   Showering while sitting down is another odd experience that I guess I'll get used to.  The shower bench is the perfect width so that I have enough room to maneuver around a little, but it's also stable enough so I know it won't slip and slide.  When I want to shampoo my hair or wash my back I can turn around and kneel on the bench (just like I do on the scooter).  When I'm done I take the towel from the basket and dry off as much as possible in the shower before reversing the process and getting out.  I get dressed while sitting on the scooter with my leg extended onto either the toilet or a little step stool that I also just bought as well.  What fun! 

Shower Bench inside my shower

The rest of the day was busier than expected thanks to a few friendly visits.  My wonderful friend Marnie came by with her son Josh after she got off work, and helped me run a few errands.   Marnie (with her fiance Jason) has been a tremendous help the last few weeks - she's the person who picked me up from the gym when I first experienced the injury and took me to the ER.  Now more than ever I'm looking forward to attending their wedding next month.

In the evening Chris came by again as he was in the neighborhood for a business dinner.  We went out to get some frozen yogurt at Juicy Berry.  Juicy Berry - Delicious!  And then sat down and played a few hands of cards while enjoying a late night caffeine boost at the 'Bucks.  This was also a great test of the scooter, as I used it outside for the first time. We put the scooter in the trunk, and then once we arrived I used it instead of crutches the rest of the time.  It worked wonders in the parking lot and both stores.  I got a couple of odd looks, but it's clearly also a conversation starter, as I had two different people comment how they wished they would have had one while recovering from a leg injury at some point in the past.

The next morning meant going back to work, so we headed home and I tried to get a good night's sleep!  More later....

3/29/11 - 3/30/11

The first two days after surgery have been a study in patience and education.  The first half of Tuesday saw Chris, my mother and aunt running errands and getting everything in my apartment ready for me to fend for myself.  Chris made omelets for breakfast and then made a Starbucks run, my aunt picked up library books, and my mother did a few loads of laundry.  We made sure the shower bench was set up and ready for use (more on that next post), replaced a few lightbulbs, changed the sheets on the bed, and made sure that everything I needed was within easy reach.

It's a very odd experience to be waited on in your own home when you live alone, but at the same time I can't say how much I really appreciated all the support. I know I'll have to get used to asking my friends and neighbors for help over the next few months to do things that I previously wouldn't ever have even given a second thought, and that will be a tough transition.  Everybody left around 3 on Tuesday - Chris headed home to his family, and my family up to San Francisco for a few days.

So the patience I mentioned is all about learning to cope with the limitations imposed by the injury, and forcing myself not to push too hard, or as my surgeon put it: "Don't be a hero!".  The education is getting used to a new way of doing things.  Chief among those, and perhaps the most important part of the post-surgery setup was renting and learning to use a knee scooter.  This incredible little doohickey allows someone with a lower leg injury to cruise around on any flat surface without needing crutches.  You kneel down with the injured leg on the pad, and use the healthy leg to propel yourself along.  In the second picture you can see the hand brakes that work just like a bicycle.  And in the first picture, in the background out the door and down on the street you can just make out my car - which I sadly won't be able to drive for way too long.  :(

In case it's hard to picture just how the scooter works, I had Chris take a quick video with my phone.  And I've got to say that while at first I found it to be really awkward and a little embarrassing, that was very quickly replaced by the relief of not having to use crutches to get around my own apartment.  I'll eventually be able to take the scooter outside too, as it works perfectly well on sidewalks - so I'll be able to get myself to Starbucks, the convenience store, Quiznos and the library - essentially anything within a couple minutes and without needing to cross a major road.

There's other things I've had to learn, or relearn, as well.  Getting used to sleeping on my back with my leg elevated is one (I'm usually a side sleeper) and trying to find comfortable ways to do everything from sit at my desk, to showering, to cooking are all others.  I'll cover those in more detail over the coming days and weeks.

3/28/11 - Surgery Day

Michael's Recovery Blog Day 1

So I've decided to create a blog to document my recovery from a ruptured Achilles tendon.  I suffered the injury on Tuesday, March 29 while playing volleyball at the Sunnyvale Community Center.  The next day I got the official diagnosis from my Orthopedic Surgeon/Podiatrist, and we scheduled surgery for the following week. 

I spent the next couple of days researching the injury, surgery and recovery and planning as best as possible for what my life will be like for the next few months.  That included everything from ordering a shower bench, renting a knee scooter, creating a grocery delivery account on Safeway.com, fulfilling prescriptions, arranging for travel to and from the surgical center and more.  I'll detail all of those things in more detail in days to come.  The blog starts on March 29th, the day of the surgery.


Enjoy!




I had my Achilles tendon repair surgery on Monday afternoon.  The surgery lasted about 90 minutes, and afterward my surgeon (Dr. Jensen) said everything went as well as could have hoped.  I woke up with  a new fiberglass splint on my leg, which will stay there until I have my first post-surgical appointment and get the stitches removed on April 6.

It's not much to look at, but here's a glimpse of the splint:

Monday night was a bit of a blur.    Lots of painkillers and a few memory blank spots for me.  My mother and aunt were visiting from New York, and my great friend Chris volunteered to pick me up after the surgery and spend the night making sure I was doing OK and not suffering any complications.    We had a yummy dinner from The Bay Fish and Chips (Yelp - The Bay Fish and Chips) and then my friend Whitney stopped by to say hi.  Finally made it into bed right after midnight, and just in time for the post-surgical pain to really kick in.  Ouch...