Another Ruptured Achilles!

I did it again! Almost exactly fifteen years after my previous Achilles surgery, I managed to rupture the Achilles on my other leg.

Once again it happened at squash, and in a very similar way. We were midway through our second game; I hit a return of serve, and then started moving back to the T. As soon I pushed off, I felt the now all too familiar pop at the bottom of my calf, and collapsed to the ground. There wasn’t much pain, but I immediately knew what was wrong.

I limped off the court, applied the club’s packet of frozen peas to the area, and phoned Sharon to come and fetch me. Unfortunately granny was back in South Africa, and so Sharon was on her own with the kids. This meant getting them out of the bath and into their pyjamas, ready for a visit to the emergency room.

After much deliberation, we opted to head to the San, despite it being private and likely costing more. We were hoping that it would be faster and, more importantly, thought it would be easier with the kids being only 5 minutes from our house.

Sadly we were wrong on the first account. After arriving at 7pm, I only got in to see a doctor at 11pm. He got me to lie down on my stomach with my feet hanging off the bed, and squeezed my calf. My foot didn’t move, and so he confirmed it was likely an Achilles rupture. He booked me in for an ultrasound the next day, referred me to a specialist orthopaedic surgeon, and then put me into a back-slab. He then asked me if I wanted to spend the night in hospital, or go home. I opted for the later, and so he gave me a pack of opioids, a $450 bill, and sent me home.

And then the problems started…

First thing on Wednesday morning I phoned radiology to check when they could see me. I was told that they were prioritising in-patients, and that they may not be able to see me, despite having been referred by the emergency room. This meant phoning around trying to find another radiology department with an opening. Thankfully, a few hours later, the San phoned me back to let me know they could squeeze me in.

In the meantime, I had booked an appointment with Dr Newman for Thursday. This meant having to beg the radiology department to prioritise my report so it would be ready prior to the appointment (reports generally take 48 hours to produce).

Sharon then drove me back to the San for my ultrasound, which was a less than pleasant experience. The sonographer who saw me was fantastic, but she struggled to get a good image as there was significant bleeding and swelling at the site. And so she scanned, and scanned, and scanned. And then she wiggled my foot (which hurt like hell), and scanned some more. And then she did it all again. Eventually, she headed out and found a doctor who repeated the whole process. An hour and much pain later, they decided I had a full rupture 13cm about my ankle, which is abnormally high.

That evening the problems continued. Dr Newman’s rooms phoned to say he had come down with Covid and would no longer be able to see me. They gave me another specialist’s name, but it was already 5pm, and so their rooms were closed.

The next morning I went about phoning doctors. Between Sharon and I we must have called at least 10. We even phoned friends who worked in the hospital and got referrals. But despite that all, we couldn’t find a doctor with a free spot to see me. By the end of day it had been 48 hours since I injured myself, and I didn’t have a doctor. I was frustrated, and was considering heading back to the ER in the hope that they would get me in with the oncall specialist. Time matters with Achilles ruptures!

Friday was much the same as Thursday. We phoned doctor after doctor, all to no avail. Eventually I got back in touch with Dr Newman, and made an appointment for the following week, hoping he’d have recovered from his Covid.

And then I sulked on the couch over the weekend.

Come Tuesday, 1 week after the injury, Sharon finally drove me to see Dr Newman. After taking off the back-slab (and making me even more happy by saying that Achilles’ ruptures should be set in a front-slab) he gave me one minor prod before clinically diagnosing me with a musculotendinous rupture of the Achilles.

In short, I had ripped the muscle off the tendon rather than rupturing the tendon itself. This turned out to be good news since it meant no surgery. Firstly, suturing muscle to tendon is difficult. And secondly, its not necessary. As it turns out, the reason they operate on Achille’s tendon ruptures is not to get them to heal faster, but rather to keep the tendon short. If the tendon has completely ruptured, and the ends have pulled apart, allowing it to heal naturally will result in a longer Achilles, which ruins your body’s biomechanics.

I was sent off to the physio to be fitted for a cam boot, set at 15 degrees. And then I was told to keep my foot raised for 4 weeks.

From the doctors we headed to the chemist where I bought a set of elbow crutches. I don’t know why people use axillary crutches (which the hospital had given me), but they are horrible. They suck on stairs, they hurt your arms, and they are incredibly immobile.

It took an entire week, but I was finally sorted. I’m not sure why finding a doctor is so difficult in Australia?! But it was certainly a different experience to South Africa, where I had already been operated on 48 hours later. Maybe South Africa is more efficient than we give it credit for.