Patience Revisited....

2011_1023_patience

http://myachillesrupture.com - Some time has passed since my last post. Life has been busy. As you know, there's good busy and bad busy. Fortunately, I've been good busy. ;) I hope life is treating you well these days.

I continue to have weekly conversations with several of you and it's obvious that as people progress through this injury that the ways of seeing the world are being shifted. Accept it and don't resist it or you will face greater challenges as you continue down this road. At some point, you do need to take charge on this journey. A dangerous mindset to get trapped in is the "Injured and Invisible" situation and you want to be really sure that you are staying positive and systematic in your healing and rehabilitation protocols so that you may minimize the tidal wave of negative thoughts you don't want to allow to destroy you. Essentially, you want to revisit Patience if it seems to have left you; it's not impossible to get back on track.  

Feel free to leave a comment, email or connect in other ways I have setup. An open dialogue is critical when dealing with an Achilles Tendon Rupture injury; trust me, I know this all too well. ;)

**photo, courtesy of Vitó**

This happened to me 2 yrs ago....

http://myachillesrupture.com - May 2nd, 2009 was the date in which my life would be changed. Allow me to take you back to the scene of the incident; basketball was the activity of choice during that evening. I was running up and down in full court action for about 90min. No complaints, no hints of soreness, nothing to prepare me for what was about to happen.....I was driving through the lane to the hoop from the top left of the key. After about 4-5 aggressive steps to the basket.....BOOM! Imagine the sound of snapping your fingers and multiply that sound by 10. The guy covering me even looked at me and said, "Oh, that's not good!" I knew something was not right because I lost all of the tension in the back of my left leg, from the area under the back of my knee down to my heel bone. I never took another step on that left leg for fear of making  a bad situation worse. This was NOT a tweaked ankle or cramp in my calf muscle! I know enough about human anatomy and sports injuries to determine it was a ruptured Achilles Tendon. I hopped over to the bench and clutched by left calf muscle and it was like jello; this was bad. Guys were telling me to "walk it off" and get back out there to help my team. Instead, I hopped off the bench, out of the gym and into my car. I was going to drive home.

My mind was racing as I attempted to gather myself prior to driving home; fortunately, I was not driving a manual transmission because I would not have been able to drive myself home. My thoughts turned to my family....My wife and I had a new baby and a three year old child. I was very active with my children and I knew this injury meant immobilization would be incredibly important if I expected to make a reasonable recovery. Not good. I immediately went from concerned to very sad and disgusted with myself for what happened. I thought about work. A fortunate reality I had was that my employment situation was not dependent upon physical labor. As long as I had an Internet connection and a phone, I could still be productive. Whew!! Back to the family. How would my wife deal with this? She was laser focused on our new baby and we had an active 3yo who always wants to play as 3yo are entitled to do. ;)  I stared at my phone prior to starting my car to decide how I would tell my wife what happened to me; that time felt like an eternity. I chickened out and couldn't do it.....I dialed her up and said, "I'm on my way. I hurt my ankle, could you get the ice pack ready for me?" She said, Ok, and I started up the car and started driving....

The drive home was filled with more thoughts and "what ifs" and "whys". I've always been a person who took fitness seriously. I warmed up. I stretched. Sure, I was in my early 30's and certainly not in the best shape of my life, but I was above Weekend Warrior status and could hang in a 2-3 hour full court session of ball. I consciously consume healthy food and at least a gallon of water per day. These types of things happen to other people, not someone who puts forth the effort for preventative maintenance like I do, right? Wrong. So.......I get home. Fortunately, our garage is connected to our house. I was able to pry myself from the driver's seat and hop out of the vehicle and up the two steps from the garage floor to our kitchen floor. One small issue though....our 3yo was sleeping and my wife was putting the new baby to sleep. I needed some help getting to a chair or the couch. Sure, I could hop over there, but I also needed to get my foot elevated and the ice pack on it....soon! Oddly, the Achilles area was not painful, but did feel somewhat disconnected....because it literally was! Well, I decided that I did not want to wake up the kids, therefore, I decided to sit on the ground and slide myself (backwards, of course due to better leverage....) to the couch to then elevate my foot. At this point, I hadn't taken off my sock yet to look at the ankle area. My wife comes into the room and says, "What happened to you?" I said, "My Achilles Tendon is ruptured; feel my calf." I have a very calm wife and I'm glad she stayed that way. I took my sock off and the swelling and bruising had already begun. Uh oh....It was a Saturday night. "Of course, I can wait until Monday to see the doctor," is what I said to my wife. She wasn't having it....She said, "You're going to the ER...NOW!" I said, "I'm not bleeding. I have no broken bones." I know this is my Achilles. How about Urgent Care?" She told me they would tell me to go to the ER. Being the skeptic that I am, she called 2 Urgent Care clinics in our area and both said I needed to visit the ER and I did.

My wife offered to drive me to the ER, but again, our kids were sleeping and being they were so young, we decided that I could drive to the ER myself and my wife would remain at home. No problem. So, I drove to the ER. It's about 20min away from our house and yet another fortunate event took place...I was able to be seen within 20min of arriving at the ER. Are you kidding me?! No, it actually happened that way. We've all heard (or have even lived...) the horror stories of 4-6hr waits in the ER and how they won't see you unless you walk in with your arm in your lap. Thank God I had no significant waiting while there to see the doctor. At this point I was much more calm as I began to mentally accept what had happened to me. I was in a wheelchair and after registering, I was wheeled back into an examination room. The doctor came out within 5min of me sitting on the hospital bed. I was asked a series of questions about my overall health, past injuries and what I was doing that caused this. Then, I was asked to lay down on my stomach and hang my feet off the edge of the bed. It was time for the Thompson Test and I passed; my suspicions were confirmed, I was officially diagnosed with a complete rupture of my left Achilles Tendon. I was told surgery would be the an option to consider and I was put into a partial cast/heavy layers of wrap and given crutches (my best friends for the next 8wks) and sent on my way. I was able to carefully position myself into my vehicle and I drove home. 

I called my wife on the way home to tell her the diagnosis and that I would be seeing the surgeon on Monday and likely have surgery sometime during the week. Scary. I had never been cut open before. I don't have a fear of needles, blood or hospitals, but I was just very fortunate that I was able to make it into my 30's with no surgical procedures with being as active in sporting activities as I had been for my entire life. Fast forward to Monday and my appointment with the surgeon. My wife was able to come with me and we just took this new experience as best we could; I was glad she was there. Having a strong support system in tact when you go through an injury, surgery and recovery like this is probably the most important detail to have in place if you can influence that. Sidebar comment: Injury or other traumatic experiences tend to present themselves without warning; be sure you don't take the quality of your relationships for granted. Had my wife, mother, grandmother, in-laws and even a very select group of friends not been so selfless with me, I would have been an absolute wreck. The mental component of this injury is VERY significant. Back to the surgeon visit.....So, I had about a dozen questions for this doctor, but he setup the consultation as a very systematic approach and I had most of my questions answered before I even asked them. This guy was great. He made me feel very comfortable and that was yet ANOTHER relief as I was going through the early stages of this injury. If you cannot tell at this point, much of what happened to me was outside of my control and I although I could control my reaction to these situations, it certainly made things a bit more convenient as they happened to be laid out. In other words, your mindset is crucial  from the beginning and throughout the duration of the recovery process. Some things you can control and others you cannot. I do subscribe to the fact that you can control YOUR reaction to certain situations though.....

I still found it to be odd that I wasn't having pain in my Achilles region. Of course, I was sure to keep the elevation level of my ankle above the level of my heart, but you can be sure that a few times when my leg was down that the swelling and pooling of blood in the affected area was quite painful. The surgeon mentioned that was normal and not to be worried. He said the surgery might ramp up the pain sensitivity for the first few days post-op. I had surgery two days later and the next chapter of my life would begin.....

The surgery happened without a hitch. I was given a few different meds for pain, to prevent infection (near the incision area) and was told to take a baby aspirin to keep my blood a bit thin to reduce the chances of a blood clot. I ended up taking the pain meds for about 3days after surgery. The pain was not unbearable and I am not a person who looks to cure ailments with medicine; I'd much rather be preventative and/or even homeopathic to some degree than immediately reaching for the western medicine solution of medication. I will admit that taking some of the pain meds took the edge off just a bit. I was in the heavy cotton and cloth wrapping  for one week and then I had a follow-up appointment with the surgeon's office for installation of the cast. The surgeon wanted to be sure that I was healing properly and that my incision area and stitches looked ok prior to removing them. Being the true Detroit Lions fan that I am, I went with Honolulu Blue as my cast color. ;) The cast went on with no issues and the elevation of the ankle area above the level of my heart continued..........for 6 weeks! Sidebar comment: You may have noticed that I intentionally mention "above the level of my heart" and this is very deliberate because it is THAT important! To truly reduce the pooling of blood to your extremities, you want to ensure you are not giving gravity a hand by keeping the injured area below the level of your heart. Blood clots are serious and impacting your blood circulation in a negative will slow down your healing and no one needs that.  

Fast forward to cast removal day. Of course there were many things that took place within the previous six weeks, but I'll spare you....I will say that the mental component of this injury was very prominent during that six weeks and having the positive reinforcement of my family and friends support structure was really important for me. So, the surgeon checked me out and made me lie on my stomach and pressed by left foot away from his body and told me to push back. THAT WAS SCARY!!! I thought I was going to re-rupture my Achilles and he knew that would be my reaction. Under my breath, I told that guy every name in the book. LOL! He was happy with my healing and wrote me a prescription for 2.5 mos of physical therapy. I was excited! I was really looking forward to physical therapy since it was progress and I really enjoy working out anyway, so I saw this as just formal exercise with a "trainer" and part of the journey I was on. Of course, I was also given a prescription for the ROBOCOP boot; again, progress! ;) I was still using my crutches at this point and for the next 3-4 weeks into therapy. After being immobile in a cast for 6 weeks, you can imagine that swelling was still something I had to manage as I was early into PT. I had a great experience in PT. I realize that not everyone's health care situation affords them that luxury and I definitely did not take any day for granted. Other than my family/friends support, the next important influence on my healing and recovery was my therapist. The guy was incredible! If you happen to be in the South Eastern MI area, I'd pass his name along to you in a heartbeat! Ironically, he graduated from the same University as I did for undergrad with his PT degree; instant street cred! ;) I learned a ton about patience and perseverance while going through PT. I had to have an extra month of PT because the surgeon was not completely comfortable with my walking 2.5mos in, therefore, he graciously wrought me a new script to extend it one month. That was ok with me because I knew it was helping and I could sense the progress and that is always a good morale booster in situations like this. My last day of PT was tough because I wanted to really continue the focused rehab and the extra motivating forces of my primary PT as well as the other PTs in the clinic. I was very much grateful for the care and the experience and I still carry the lessons I learned there 2yrs out from the injury. If you're fortunate enough to have a memorable PT experience, then I think you will really identify with what I'm saying here.

Fast forward 5mos and you get to the point in which I decided it was time to share my experience through this site. My reasoning for wanting to create a website was that since I had PLENTY of new found free time as I was healing prior to entering PT, I could not find any resource that I felt I could identify  with. Sure, there are technical accounts of Achilles Tendon rupture injuries, but I was not in the mood to read a case study or a medical journal. I wanted someone to share their honest opinion, both good and bad when it came to this injury. I'm certainly not here to say that my experience is the only way someone can go through this injury, but if I can (and I have...) connect with at least one person who takes the time to read this, watch a video, follow me on Twitter or connect on Vimeo, Posterous or even Facebook, then the effort to keep this site alive is WELL WORTH it. I can honestly say that for every person I connect with and speak to on a weekly basis, it still makes me smile that the Internet has allowed this form of community building and interpersonal support structure. I appreciate each one of you, seriously. Thank you.

I could share so much more that has happened to me in the last two years, but that's another conversation for another time. As always, if you have any questions about this injury, my experience, a useful mindset to possess as you go through this or anything else you are curious about, talk to me or at least talk to someone.....it's important to continue feeling connected to humanity....Trust me. ;)

Ways of seeing the World

Mar_tom_scar

 http://myachillesrupture.com - It can be an odd reality when you sustain an injury that impacts your mobility and literally causes you to sllllloooowwww down. An Achilles Tendon rupture is definitely an injury that is far from "mainstream" and much more common to be seen by an obsessed sports fan than the average citizen. I really wish I had a quarter for every time I had to explain this injury as well as anatomy 101. LOL! I mean, c'mon....Achilles Tendon. Check. Rupture. Check. Put the two together and it should not need any supporting detail, right? Wrong. Oh well, I don't have an issue explaining it to anyone, but it does lend itself to more of the idea of how this particular injury can possess such a mental component in the sense of how isolated one can feel because many people literally do not understand this injury and pass it off as a "hurt ankle" and we know this to definitely *NOT* be true.

There is something that I find myself doing that has somewhat of a mental component to it and the picture used in this post signifies that. It has to do with how I see the world now. I was picking some items from my vegetable garden recently and noticed an interesting patter on this tomato that made it pretty unique. The light bulb went off above my head and I immediately said to myself that the similarity to my Achilles Tendon rupture scar was pretty striking! Maybe I'm odd for thinking this way, but unique tomatoes are not the ONLY trigger for me. Haha! Every sports play I watch causes me to zero in and study the footwork even more now that I have sustained this injury. I watch my kids playing and focus on their heel/lower calf muscle region. Obsess, much? Why, yes. Thanks for noticing. Hahaha.

The main idea I'd like to leave you with is that you WILL see the world differently after sustaining an Achilles Tendon rupture. Is this a bad thing? I don't think so. It opens up the possibilities to many things you may not have considered before. New appreciation for family and friends. New ways of communicating. Not taking mobility for granted. Being more sensitive to those who lack mobility. New hobbies. More focus. More purpose. And even seeing tomatoes in a different light. :) These are just a few things I have definitely found to be true in my own life. As with anything I mention, your mileage may vary. :) It's all about making sweet lemonade from the lemons even if you've never tried...   

Forum


http://myachillesrupture.com - Wanted to show you some added functionality to the website that I believe will lead to more cross-discussion and community building for anyone who's ruptured their Achilles Tendon, family members, caregivers and anyone who cares to understand this very non-mainstream injury and the mental toughness needed to return to mobility and the longterm goal of physical performance.

Mobilegs

Mobilegs

http://myachillesrupture.com - I know that crutches have been in use throughout various societies for thousands of years, but outside of evolving from wood to aluminum, don't you think it's time for a major overhaul of this ubiquitous piece of medical equipment utilized everyday for leg injuries? Enter Mobilegs into the list of options. This product has an impressive set of offerings: soft underarm saddles, curved legs, adjustability from 4' 9" to 6' 4", the ability to handle weight up to 300lbs., soft handgrips with ergonomic features like a natural wrist angle, and a high-traction rocker foot.

After rupturing my Achilles Tendon (May 2nd, 2009), I was on crutches less than 3hrs later and had my ER-issued aluminum crutches near my side for the next 3mos (surgery, cast and several weeks in to physical therapy). We were best friends, but it wasn't always a good relationship. :) It's not rocket science to adjust the hand positioning on traditional crutches. The main issue for me was the occasional times in which much of my weight was on my underarm/arm pit region. I have a strong enough upper body (many people given crutches may not...) to support myself adequately on crutches, but again, there are times when you may want to lean onto the crutches and it's just not the most comfortable position for very long.

  Random facts I like about the product:

  • Manufactured in Minneapolis, MN USA
  • Sustainably conceived and manufactured
  • Competitively priced
  • Aesthetically pleasing 

I'm not so sure the average person thinks about injuring themselves in order to rush into the use of a mobility aid like the Mobilegs, but it's good to know innovation is taking place to bring options to the masses that can lighten the load of an already heavy situation. :)

It's a Game of Adjustments...

Mar_post_adjustments

http://myachillesrupture.com - No matter where you find yourself on the path to healing and physical performance following an Achilles Tendon rupture injury, each of us can embrace and apply the idea of adjustments on our quest. What do I mean by this? Well, let's assume you have been given the clearance by your surgeon to begin a program of formal physical therapy or some sort of deliberate range of motion and exercise protocol. You will undoubtedly find yourself being pretty robotic for the first few weeks. Part of this is reversing the effect of muscle atrophy and the "forgetfulness" of your muscle memory. Part of this is fear. Embrace the fear. Accept the fear. Don't let the fear block your ultimate goal though. Now that you've safely corralled your fear and have realized that your muscle memory *WILL* get back on track, channel your thinking and energy into a systematic plan of increasing your range of motion while paying attention to what your body is telling you. It's essential to not possess the exact mindset you utilized prior to your injury because it will not be compatible with your current physical state. It takes time and you would want to be more cautious than careless since inducing some sort of setback would not be a wise thing to do. Patience (for many of us...) is a difficult characteristic to express when things are going well, but even more of a challenge during times of injury, healing and physical rehabilitation.

Let's talk about adjustments. Inevitably, you will arrive at a plateau in your respective movements. Whether you are doing VERY EARLY range of motion movements or a prescribed set of "active" stretches, the lesson I'd like to leave you with is the idea that you CAN slightly tweak a movement for some added benefits. I was reminded of this when I went for a walk earlier this evening at a local park. I was walking around a blacktop track and would alternate on the track and off the track on the very uneven grass terrain. This track was in the middle of a park with plenty of trees and far from level surfaces and THAT is the type of thing that can positively impact your muscle memory and allow for gains to be made. You don't want to remain on a plateau for too long. The body gains no useful benefit from this prolonged action and you may even be setting yourself up for injury because you are not allowing your dynamic musculoskeletal system to be challenged in a reasonable manner. The key to this is to listen to your body and ensure you have an understanding as well as a consistent ability to perform the baseline movements within your physical therapy protocol. Next, attempt to make a minor adjustment within the movement(s) and the idea of making a note (as in, use a hardcopy/analog notebook or your cell phone) of these adjustments so you can keep a running tally of this to determine the benefits seen or the possibility of making other minor adjustments. It's essential that you be systematic if you intend on yielding benefits that go beyond the default.

Keep in mind that there is no specific "rule" for introducing adjustments into your protocol. I simply wanted to present the idea because I think it's worthwhile, I believe in it, have done it and was given the assurance from my surgeon and physical therapist that fine adjustments do provide benefit to the body and mind-body connection.

If you have any questions or need for me to clarify anything I've written in this post, feel free to leave a comment or connect with me in any of the other ways that I have setup.

**photo, courtesy of Sami Taipale**