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Here we go again… We got this.


Here is a recap of how it has gone so far
It should be noted- I did a lot of research on the subject. I had previously tried PRP as well as low shockwave therapy. Both did help reduce the pain initially but I could tell I was quickly on my way back to a lot of pain. I had a structural issue in my heels that needed to be removed in my case. I am the type of person that when I know what needs to happen to get the true result, I like to just do it. In my case I felt in my core this was the ultimate decision for me to make to actually give me the best chance at a full recovery and life.
Things that went into my choice
-        Non-surgical vs. surgical. Addressed above.

-        Was I ok with the outcome if it “worked” but I wasn’t able to run like I had before? Yes. I was and remain hopeful it will be my choice to return to normal triathlon activity. However just like I talk to my athletes who want to set a big PR, sometimes you have to be willing to take risks. Yes, they can be calculated but you need to back yourself at some point. If you don’t, who will? I knew I wasn’t happy with how I felt now. Something needed to change.

-        What was the technique I felt the most comfortable with? I chose a technique that used something called a speed bridge. http://www.arthrex.com/foot-ankle/achilles-speedbridge. I chose this because I was told it was knotless, I was told it was strong enough that I could put weight on it in 2 weeks, and the procedure made sense to me.

-        Who. This was a big one for me. I have use Dr. Paul Bishop for all my foot issues and continue to do so. He made my orthotics. They are the best orthotics I have ever had for running hands down. He fixed my forefoot issue which used to derail me. He diagnosed the issue I am dealing with now. He is amazing. He and I have become very good friends over the past couple years and I initially chose him to do my surgery.

After further discussion, he had recommended I speak to another surgeon he trusts implicitly. We thought due to our friendship it may make sense for me to have a different surgeon. I sometimes think about how honorable that was. The mark of a person who REALLY knows their stuff in my opinion, is the ability to practice humility. He obviously puts his patients first.

Even though he told me to consider someone else I was very reluctant to change from someone I have been having so much success and trust in. At the end of the day, Tanya and I decided to take him up on his offer to get us in with Dr.Vora.

Dr. Vora is equally as amazing. He cut right to the chase. He told me exactly what he thought I needed. He said I could mess around with PRP, and shockwave, as well as other non-surgical things but it would just be something that he would do to satisfy my curiosities. He said based on the structures in my Achilles and the extent of the Haglund’s deformity on my heels I will ultimately need surgery.

-        What was the expected outcome? He of course could not guarantee any outcome, but he was 99.99% sure I would have very close to 100% recovery. He said he had done hundreds of my procedures with great results and one athlete had just done a 100-mile trail run after. Each case is different though he warned and until he got inside to see the actually situation needed me to know nothing is a guarantee.

-        Grafting. VERY IMPORTANT – In my opinion, this was one of the most important choices. A lot of people I spoke to said they would use my FHL (the tendon that helps connect the big toe). To ME, it didn’t pass the smell test for returning to running at a high level again. While I have no qualifications to say what is best, like training I need to have confidence in the plan I choose.  What I really liked about Dr. Vora, and was one of the things that pushed me over the top with him; he said he has done so many of these and could almost promise he would not need a graft of any kind. His confidence in this was huge to me. Had he needed one, he recommended the FHL, but we agreed to use something else. (HE WAS ABLE TO DO THE REPAIRS ON BOTH SIDES WITHOUT A GRAFT)

-        My biggest advice – Once you decide, stay off google. It’s insane what you find on there. I found people saying terrible things, it freaked me out. I found DOCTORS asking other doctors how to treat is because they never had…. WTF??? So it goes back to: do your research, google, ask friends, interview doctors, whatever. Once decided, STOP. Trust the process. It’s like walking around an expo asking everyone else how they trained for the event and when their last long run was. You’re never going to get an answer that makes you feel affirmed. Trust your coach and your process.

-        Timeline.No doctor would do both at once. Understandably. Most suggested a 4-month spread. I convinced Dr. Vora to let me schedule my second one 6 weeks out. He agreed to let me schedule it if I would promise to cancel it if I had any doubts at all.

-        The second biggest choice, which I am lucky to have secured is PT. It can be as important as the surgeon. Gina Pongetti, and her team Taylor Millican and Lindsey Rose at Achieve are amazing. Literally every tool at their disposal I could need. Dry needling, Garston, ART, Alter G, etc.  Rob Duncan helps me with the PT exercises and Garrett Krug coming up with awesome ways to keep me fit even from week 2.

Dr. Ginsberg at Ginsberg Chiropractic in Geneva has helped my hips, neck and back stand up to the constant beating my body has taken from the crutches, and having the boot on. This is a huge point as a lot of people have back trouble for months after walking in such an uneven boot. It can be 2+ inches higher then then other leg with it on. Have a plan for this!
-         
RECAP

Left Achilles first. Last week of March 2016.

Week 1 – lots of laying around and pain meds. All non-weight bearing. A lot of swelling and discomfort however the pain was quite manageable with the meds. The worst is having to rely on others. Not because I am someone who won’t ask for help, but I appreciate they have their own stuff going on.

Week 2- Still non weight bearing. Still a lot of swelling when I wasn’t elevated. I was able to use my personal trainer, start PT and get Chiropractic care. At the end of this time I was able to get my stiches out which helped a lot. I was told to let the holes close then I could swim!

Week 3- At the end of this time I was able to get my stiches out which helped a lot. I was told to let the holes close then I could swim! A day after the stiches came out, I got a small infection starting in the lower part of my incision. Taya caught it immediately. She got me on some antibiotics to clear it up but it delayed my being able to swim till the end of the week. I was also told to start to walk in the boot (with a lot of heel lifts). It was very painful at first. I wasn’t sure how I was going to be able to do it at first and took my crutches with me a lot of places.

Week 4- What is becoming a reoccurring theme is things I can’t wrap my head around start to become possible pretty soon after. Walking in the two heel lifts at day 20 was almost impossible. After a few days, I could do it. Now I was down to 1!  I was able to start swimming in week 4 and I was SOOOOO out of shape. If I’m honest I was pretty discouraged with the times I was seeing. I started to ride the bike in the boot. Just on the trainer. This is good but I can only tolerate an hour before my ass hurts so bad (I can’t stand so I just sit there and push about 150 watts which means a lot of time on the saddle)

Week 5- I was able to take out my final wedge. I was able to feel more normal and do thigs like stand up without the boot and even shuffle around the house a touch barefoot. I wasn’t using the foot at all. Just was able to sustain some weight on it enough to slide to bathroom in the middle of the night etc. I started out the week not sure how my repaired foot was going to be able to sustain me when the other couldn’t, but I just had to trust that it would when the time came.

Week 6 – I got to take off the boot! This was huge because the last 4 days in the boot I was starting to get a lot of pain in my plantar fascia – A lot. It still hurts today. It’s the hardest thing about using my repaired foot actually. I got the boot off on Monday
Tuesday was Right foot surgery time.

Dr. Paul Bishop will be doing my post op follow up care. 






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